The one-year prevalence of Major Depressive Disorder in adolescents is thought to be as high as 8%, and yet few depressed adolescents receive specialty mental health services. Relationships among depressed adolescents and important adults in their lives significantly influence the expression and course of the depression, including mental health service use, but no studies have provided an in-depth description of these relationships. The purpose of this study is to describe common interaction patterns of adolescents who are depressed and important adults in their lives, with special attention given to interactions that influence the trajectory of the depression and service use. Data are drawn from a grounded theory study of the adolescent depression. Open-ended interviews were conducted with 52 community-dwelling young adults between the ages of 18 and 21 who experienced depressive symptoms as adolescents, four of their parents, and eight professionals who work with depressed youth. Participants were asked about their experiences with, or responses to, adolescent depression. For this study, narrative data regarding adolescent/adult relationships were examined. Constant comparison methods were used to develop a theoretical framework. All participants discussed how both adolescents and important adults ignore, hide or minimize the adolescents’ distress by acting “as if” things are fine; that is, they create a façade of normality. The concept of the façade is the central construct in the framework, which is comprised of the following elements: (a) three common interaction patterns (maintaining the façade, poking holes in the façade, breaking down the façade), (b) several adult and adolescent actions that constitute each pattern, and (c) two adult and adolescent strategies frequently used to carry out each action. The framework, which could be used by clinicians to identify patterns that facilitate or hinder recovery from adolescent depression, will be presented.
Research was funded by the Ohio Department of Mental Health, Grant. No. 02.1179
Session #1212 - Adolscent Issues in the Community
The 29th Annual MNRS Research Conference (April 1-4, 2005)