Abstract
The influence of gender and other individual and context characteristics on the prevalence and severity of depressive symptoms among Jordanian adolescents remains unclear. The aims of the current study were to: (a) characterize depressive symptoms profiles for Jordanian adolescents; and (b) examine gender differences in the type, severity, and correlates of depressive symptoms. Cross-sectional data were collected from 2,349 Jordanian adolescents ages 12 to 17 using a nationally representative school survey. The Beck Depression Inventory-II was used to assess the presence and severity of depressive symptoms. Female adolescents had significantly higher mean depression scores (17.9 [SD = 11.6], 95% confidence interval [CI] [17.3, 18.5]) than their male counterparts (13.8 [SD = 10.2], 95% CI [13.2, 14.5]). Approximately 41% of girls and 26% of boys reported scores indicating moderate to severe depression. Sex differences and socially constructed gender differences need to be adequately considered in the planning and delivery of mental health care for adolescent depression. If the risk for depression is gender-specific, prevention strategies cannot be gender-neutral. [Journal of Psychosocial Nursing and Mental Health Services, 56(2), 44–55.]
- Abela J.R., Stolow D., Mineka S., Yao S., Zhu X.Z., Hankin B.L. (2011). Cognitive vulnerability to depressive symptoms in adolescents in urban and rural Hunan, China: A multiwave longitudinal study. Journal of Abnormal Psychology, 120, 765–778.
10.1037/a0025295 Crossref Medline, Google Scholar - Al-Balhan E.M. (2006). The Children's Depression Inventory as a reliable measure for post-Iraqi invasion Kuwaiti youth. Social Behavior and Personality, 34, 351–366.
10.2224/sbp.2006.34.4.351 Crossref, Google Scholar - Al-Musawi N.M. (2001). Psychometric properties of the Beck Depression Inventory-II with university students in Bahrain. Journal of Personality Assessment, 77, 568–579.
10.1207/S15327752JPA7703_13 Crossref Medline, Google Scholar - American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. Crossref, Google Scholar
- Angold A., Costello E.J. (2006). Puberty and depression. Child and Adolescent Psychiatric Clinics of North America, 15, 919–937.
10.1016/j.chc.2006.05.013 Crossref Medline, Google Scholar - Beck A.T., Steer R.A., Brown G.K. (1996). Manual for Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation. Google Scholar
- Benarous X., Hassler C., Falissard B., Consoli A., Cohen D. (2015). Do girls with depressive symptoms exhibit more physical aggression than boys? A cross sectional study in a national adolescent sample. Child and Adolescent Psychiatry and Mental Health, 9, 41.
10.1186/s13034-015-0064-5 Crossref Medline, Google Scholar - Bhatia S.K., Bhatia S.C. (2007). Childhood and adolescent depression. American Family Physician, 100, 73–80. Google Scholar
- Buttigieg J.P., Shortt A.L., Slaviero T.M., Hutchinson D., Kremer P., Toumbourou J.W. (2015). A longitudinal evaluation of the Resilient Families randomized trial to prevent early adolescent depressive symptoms. Journal of Adolescence, 44, 204–213.
10.1016/j.adolescence.2015.07.014 Crossref Medline, Google Scholar - Centers for Disease Control and Prevention (2010). Web-based Injury Statistics Query and Reporting System (WISQARS). Retrieved from https://www.cdc.gov/injury/wisqars/index.html Google Scholar
- Cook M.N., Peterson J., Sheldon C. (2009). Adolescent depression: An update and guide to clinical decision making. Psychiatry (Edgmont), 6(9), 17–31. Medline, Google Scholar
- Courser M.W., Shamblen S.R., Lavrakas P.J., Collins D., Ditterline P. (2009). The impact of active consent procedures on nonresponse and nonresponse error in youth survey data: Evidence from a new experiment. Evaluation Review, 33, 370–395.
10.1177/0193841X09337228 Crossref Medline, Google Scholar - Cyranowski J.M., Frank E., Young E., Shear M.K. (2000). Adolescent onset of the gender difference in lifetime rates of major depression: A theoretical model. Archives of General Psychiatry, 57, 21–27.
10.1001/archpsyc.57.1.21 Crossref Medline, Google Scholar - Dardas L.A., Bailey D.E., Simmons L.A. (2016). Adolescent depression in the Arab region: A systematic literature review. Issues in Mental Health Nursing, 37, 569–585.
10.1080/01612840.2016.1177760 Crossref Medline, Google Scholar - Dardas L.A., Silva S., Noonan D., Simmons L.A. (2016). A pilot study of depression, stigma, and attitudes towards seeking professional psychological help among Arab adolescents. International Journal of Adolescent Medicine and Health. Advance online publication.
10.1515/ijamh-2016-0070 Crossref Medline, Google Scholar - Dardas L.A., Silva S., Noonan D., Simmons L.A. (2017). Studying depression among Arab adolescents: Methodological considerations, challenges, and lessons learned from Jordan. Stigma and Health. Advance online publication.
10.1037/sah0000101 Crossref, Google Scholar - Dardas L.A., Silva S., Smoski M., Noonan D., Simmons L.A. (2017). Personal and perceived depression stigma among Arab adolescents: Associations with depression severity and personal characteristics. Archives of Psychiatric Nursing, 31, 499–506.
10.1016/j.apnu.2017.06.005 Crossref Medline, Google Scholar - Dardas L.A., Simmons L.A. (2015). The stigma of mental illness in Arab families: A concept analysis. Journal of Psychiatric and Mental Health Nursing, 22, 668–679.
10.1111/jpm.12237 Crossref Medline, Google Scholar - Duong M.T., Cruz R.A., King K.M., Violette H.D., McCarty C.A. (2016). Twelve-month outcomes of a randomized trial of the positive thoughts and action program for depression among early adolescents. Prevention Science, 17, 295–305.
10.1007/s11121-015-0615-2 Crossref Medline, Google Scholar - Egger H.L., Angold A. (2006). Common emotional and behavioral disorders in preschool children: Presentation, nosology, and epidemiology. Journal of Child Psychology and Psychiatry and Allied Disciplines, 47, 313–337.
10.1111/j.1469-7610.2006.01618.x Crossref Medline, Google Scholar - Essau C.A., Conradt J., Petermann F. (2000). Frequency, comorbidity, and psychosocial impairment of depressive disorders in adolescents. Journal of Adolescent Research, 15, 470–481.
10.1177/0743558400154003 Crossref, Google Scholar - Essau C.A., Lewinsohn P.M., Seeley J.R., Sasagawa S. (2010). Gender differences in the developmental course of depression. Journal of Affective Disorders, 127, 185–190.
10.1016/j.jad.2010.05.016 Crossref Medline, Google Scholar - Fombonne E., Wostear G., Cooper V., Harrington R., Rutter M. (2001). The Maudsley long-term follow-up of child and adolescent depression. 1. Psychiatric outcomes in adulthood. British Journal of Psychiatry, 179, 210–217.
10.1192/bjp.179.3.210 Crossref Medline, Google Scholar - Gearing R.E., Schwalbe C.S., MacKenzie M.J., Brewer K.B., Ibrahim R.W., Olimat H.S., Al-Krenawi A. (2013). Adaptation and translation of mental health interventions in Middle Eastern Arabic countries: A systematic review of barriers to and strategies for effective treatment implementation. International Journal of Social Psychiatry, 59, 671–681.
10.1177/0020764012452349 Crossref Medline, Google Scholar - Gould M.S., Greenberg T., Velting D.M., Shaffer D. (2003). Youth suicide risk and preventive interventions: A review of the past 10 years. Journal of the American Academy of Child & Adolescent Psychiatry, 42, 386–405.
10.1097/01.CHI.0000046821.95464.CF Crossref Medline, Google Scholar - Hale W.W., van der Valk I., Akse J., Meeus W. (2008). The interplay of early adolescents' depressive symptoms, aggression and perceived parental rejection: A four-year community study. Journal of Youth and Adolescence, 37, 928–940.
10.1007/s10964-008-9280-0 Crossref, Google Scholar - Hankin B.L., Mermelstein R., Roesch L. (2007). Sex differences in adolescent depression: Stress exposure and reactivity models. Child Development, 78, 279–295.
10.1111/j.1467-8624.2007.00997.x Crossref Medline, Google Scholar - Harkness K.L., Alavi N., Monroe S.M., Slavich G.M., Gotlib I.H., Bagby R.M. (2010). Gender differences in life events prior to onset of major depressive disorder: The moderating effect of age. Journal of Abnormal Psychology, 119, 791–803.
10.1037/a0020629 Crossref Medline, Google Scholar - Hermens M.L., Oud M., Sinnema H., Nauta M.H., Stikkelbroek Y., van Duin D., Wensing M. (2015). The multidisciplinary depression guideline for children and adolescents: An implementation study. European Child & Adolescent Psychiatry, 24, 1207–1218.
10.1007/s00787-014-0670-4 Crossref Medline, Google Scholar - Horowitz J.L., Garber J. (2006). The prevention of depressive symptoms in children and adolescents: A meta-analytic review. Journal of Consulting and Clinical Psychology, 74, 401–415.
10.1037/0022-006X.74.3.401 Crossref Medline, Google Scholar - Hyde J.S., Mezulis A.H., Abramson L.Y. (2008). The ABCs of depression: Integrating affective, biological, and cognitive models to explain the emergence of the gender difference in depression. Psychological Review, 115, 291–313.
10.1037/0033-295X.115.2.291 Crossref Medline, Google Scholar - Kessler R.C., Avenevoli S., Costello E.J., Georgiades K., Green J.G., Gruber M.J., Merikangas K.R. (2012). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry, 69, 372–380.
10.1001/archgenpsychiatry.2011.160 Crossref Medline, Google Scholar - Kraemer H.C., Wilson G.T., Fairburn C.G., Agras W.S. (2002). Mediators and moderators of treatment effects in randomized clinical trials. Archives of General Psychiatry, 59, 877–883.
10.1001/archpsyc.59.10.877 Crossref Medline, Google Scholar - Larsson B., Melin L. (1990). Depressive symptoms in Swedish adolescents. Journal of Abnormal Child Psychology, 18, 91–103.
10.1007/BF00919458 Crossref Medline, Google Scholar - Lopez A.D., Mathers C.D., Ezzati M., Jamison D.T., Murray C.J.L. (2006). Global burden of disease and risk factors. New York, NY: Oxford University Press.
10.1596/978-0-8213-6262-4 Crossref, Google Scholar - Lorant V., Croux C., Weich S., Deliège D., Mackenbach J., Ansseau M. (2007). Depression and socio-economic risk factors: 7-year longitudinal population study. British Journal of Psychiatry, 190, 293–298.
10.1192/bjp.bp.105.020040 Crossref Medline, Google Scholar - Merry S.N., Hetrick S.E., Cox G.R., Brudevold-Iversen T., Bir J.J., McDowell H. (2011). Psychological and educational interventions for preventing depression in children and adolescents. Cochrane Database of Systematic Reviews, 7, CD003380.
10.1002/14651858.CD003380.pub3 Crossref, Google Scholar - (Eds.). (1994). Reducing risks for mental disorders: Frontiers for preventive research. Washington, DC: The National Academies Press. Google Scholar
- National Research Council. (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Washington, DC: The National Academies Press. Google Scholar
- Okasha A., Karam E., Okasha T. (2012). Mental health services in the Arab world. World Psychiatry, 11, 52–54.
10.1016/j.wpsyc.2012.01.008 Crossref Medline, Google Scholar - Olsson G., von Knorring A.-L. (1997). Depression among Swedish adolescents measured by the self-rating scale Center for Epidemiology Studies-Depression Child (CES-DC). European Child & Adolescent Psychiatry, 6, 81–87. Medline, Google Scholar
- Salokangas R.K., Vaahtera K., Pacriev S., Sohlman B., Lehtinen V. (2002). Gender differences in depressive symptoms: An artefact caused by measurement instruments?Journal of Affective Disorders, 68, 215–220.
10.1016/S0165-0327(00)00315-3 Crossref Medline, Google Scholar - Siever L.J. (2008). Neurobiology of aggression and violence. American Journal of Psychiatry, 165, 429–442.
10.1176/appi.ajp.2008.07111774 Crossref Medline, Google Scholar - Soares C.N., Zitek B. (2008). Reproductive hormone sensitivity and risk for depression across the female life cycle: A continuum of vulnerability?Journal of Psychiatry and Neuroscience, 33, 331–343. Medline, Google Scholar
- Spence S.H., Sheffield J.K., Donovan C.L. (2003). Preventing adolescent depression: An evaluation of the problem solving for life program. Journal of Consulting and Clinical Psychology, 71, 3–13.
10.1037/0022-006X.71.1.3 Crossref Medline, Google Scholar - Sund A.M., Larsson B., Wichstrom L. (2001). Depressive symptoms among young Norwegian adolescents as measured by The Mood and Feelings Questionnaire (MFQ). European Child & Adolescent Psychiatry, 10, 222–229.
10.1007/s007870170011 Crossref Medline, Google Scholar - Thapar A., Collishaw S., Pine D.S., Thapar A.K. (2012). Depression in adolescence. Lancet, 379, 1056–1067.
10.1016/S0140-6736(11)60871-4 Crossref Medline, Google Scholar - World Health Organization. (2002). Integrating gender perspectives in the work of WHO. Retrieved from http://apps.who.int/iris/bitstream/10665/67649/1/a78322.pdf Google Scholar
- World Health Organization. (2005). Child and adolescent mental health policies and plans. Retrieved from http://www.who.int/mental_health/policy/services/essentialpackage1v11/en Google Scholar
- World Health Organization. (2011). WHO-AIMS report of mental health system in Jordan. Retrieved from https://www.ecoi.net/file_upload/1788_1308390842_mh-aims-report-jordan-jan-2011-en.pdf Google Scholar
