Week 8: Epidemiology of Depression Flashcards
Lifetime Prevalence
1% of preschool aged children (3 to 5 years of age)
2% of elementary school aged children (5 to 12 years of age)
11% of adolescents (13 to 18 years of age)
Prevalence increases across adolescence
So gets more prevalent with age
Ethnicity differences
NCS A
Lifetime prevalence of mood disorders, which includes major depression, dysthymia, and bipolar disorder
Hispanic youth more likely than White youth to meet diagnostic criteria
for a mood disorder
White youth more likely than both Hispanic youth and Black youth to have received treatment for a mood disorder
Who gets treatment? Maybe health??
Sex differences
Gender differences
NCS A
Lifetime prevalence of major depressive disorder/ dysthymia in adolescence
Female: 15.9%
Male: 7.7
The course of this is important. At 11 and under, depression is rare but equal across sex
At 15 2:1 girls to boys
Equal after menopause
Explaining the Gender Gap
Basics
A lot of research has been done to try and understand why adolescent girls (and women) are so much more likely to experience depression
Important to note that no one variable explains the difference
Explaining the Gender Gap
Help seeking
(1) Girls are more likely to seek help
NCS A: No gender difference in use of services for depression (no difference in those seeking help)
Gender difference is found in community samples
-You would not see a gender gap here if it was not in the population but in seeking behavior
you do see a difference in community samples therefore differences in help seeking behaviour DOES NOT explain the difference
Explaining the Gender Gap
Biological factors
(2) Biological factors
Onset of elevated rates of depression in girls coincides with puberty
More mature pubertal status is linked to depression in girls, but not boys, and is a stronger predictor than age
Early onset puberty is a risk factor for depression
Puberty may sensitize girls to stress (hormonal changes may make girls sensitive to stress)
Explaining the Gender Gap
Stress
(3a) Stress
Puberty may create stressors for girls
Changes in physical appearance and sex role identification
- Attracts sexual interest fro older people
- Stressor, especially if puberty is young
In general:
- Robust link between stress and depression
- Girls/women far more likely to be sexually assaulted
- Women are more likely to live in lower SES conditions
Puberty could (2 things)
(1) Sensitize girls to stress biologically
(2) Create stress via added attention etc.
Explaining the Gender Gap
Interpersonal Stress
(3b) Interpersonal Stress
Conflict with friends, rejection by peers
Girls are more likely to generate interpersonal stress than are boys
Stronger association between interpersonal stress and depression for girls than for boys
Girls are more invested in interpersonal relationships (research has shown)
Explaining the Gender Gap
Cognition
(4) Cognition
Depression is associated with attributions about stressful events that are likely to amplify negative affect
e.g. This is all my fault, things will never get better
(stable attribution)
This cognitive bias appears comparable across girls and boys
This appears to be equal in both sexes (NOT THE REASON)
Explaining the Gender Gap
Coping
(5) Coping
Girls (and women) are more likely to cope by ruminating, either alone or with a
friend. Never moving to a problem solving state.
Thinking about a problem constantly, but never moving to active problem solving
In the context of depression: Why do I feel like this? Why is this happening to me?
What’s going to happen to me? I’ll never get better. I’ll never feel good again.
This is so unfair.
Summary
What 3 things explain sex differences in depression?
Major depressive disorder is rare in preschoolers and children
Becomes increasingly prevalent during adolescence, particularly for
girls
Difference in prevalence of depression between females and males may be due to differences in stress exposure, stress reactivity, and coping strategies
