Literature Review

Depression in adolescents is a common occurrence in the society. This is because; during adolescence, teenagers undergo numerous changes that may be confusing. These changes are both physical and hormonal, and they alter the manner in which an individual makes decisions.  Many adolescents end up making poor life choices based on their hormones and the implications of these decisions are experienced later on in their lives. For example, some girls end up pregnant during their adolescence because of the increased hormonal levels.

This later on results to depression. Boys, on the other hand, may indulge in drugs and sexual activities at this period. This antisocial behavior interferes with the teenagers’ education, health as well as bringing pain to the families involved. Parents are therefore, advised to take their teenagers to regular counseling to avoid depression and where it has already occurred, to prevent the recurrence. Various scholars have over the years taken the time to research the cause and the development of depression in adolescents. This paper will focus on three articles written by different authors in an attempt to explain the cause and development of adolescence depression.

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Beardslee (2009) in his article associates depression in children to having depressed parents. He claims that parents who are depressed end up bringing up children with issues. This means that intervention strategies target teens living in houses with depressed parents. In the research, William alongside other practitioners arbitrated within troubled families. This intervention was especially effective when children were entering adolescence. This age was considered the age with the highest risk for the onset of depression.  William and his team selected a family-based approach to prevention by reducing risk factors. This was aimed at enhancing self-protective factors for early adolescents by increasing positive interactions between the adolescents and the parents. To achieve this, they sought to increase the understanding of each member of the family.

The team came up with preventive approaches that were designed to give information about mood disorders to parents. This knowledge was aimed to equip parents with the skills they need to understand their children. This was also aimed at enhancing dialogue between the parents and children to allow effective communication. The hypothesis of the research was that when parents participate in preventive programs, the parents would change. This change would be based on child-related attitudes and behavior in reference to depression and its impact on the family. In addition to this, they hypothesized that the parental change would result in children gaining more self-understanding as well as in children’s depressive symptomatology.

The method used to conduct this research was through a large-scale efficiency trial of two preventive intervention programs that were manual based. These programs were designed and used in public health facilities. The target population was relatively healthy children aged 8-15 and whose parents suffered from mood disorders. 88.5% of the sample population including 121 children took part in the exercise through the fourth assessment points. These families were assigned randomly to a clinician intervention or a lecturer. However, both interventions were clearly specified in manuals. The lecture condition involved holding two group meetings with no children present. The clinician-facilitated condition was made up of 6to 11 sessions. These included family meetings as well as separate meetings with children and parents. Here, parents took the initiative in the discussions where they opened up about their illness also the positive measures and steps they could take to promote a healthy parent-child relationship. Refresher meetings were also conducted at 6-9 month intervals. In both interventions, psychoeducational materials on facts about mood disorders were availed. Parents were encouraged to help their children understand their mood disorder. The children will not feel guilty about the parents’ mood swings.

These interventions made follow up observations on their subjects approximately 1 year and 2.5 years post intervention. The results of these experiments were measured in terms of a child’s symptomatology and understanding. Several predictor variables were also analyzed using repeated measures analysis with estimating equations. From the outcomes, it was determined that parents in both cases improved significantly. Parents in the clinician facilitated program, however, displayed more improvement than those in the lecturer program. The mean improvement was 9.8 and 6.63 respectively. Nonetheless, children in both programs showed significant improvement. Female children showed more improvement than the male children.  However, a child’s understanding of the illness was directly proportional to the parents change. However, having group meetings in the place of individual meetings did not have a significant impact in the change of the parent.

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In conclusion, the results revealed that these programs did not have long-standing, positive effects. However, both interventions have significant benefits. Family change emerged as an important variable in the research. This is because; a parent’s perception of the illness and the manner in which they handle issues influenced how the children adopted to their parent’s illness. These interventions, thus, promoted resilience related traits in children at risk.

The second article is contained in the journal of “Prevention of Depression in At-Risk Adolescents” by Garber & David (2009) among other authors. According to this article, adolescents of depressed parents were more prone to developing depressive disorders. Despite the fact, that tests conducted on a small scale prove that depression risks can be reduced. However, this is yet to be replicated on a large-scale population with varying settings. The study was, therefore, aimed at determining the impact of cognitive behavior (CB) prevention in comparison with the care given to patients on the onset of depression. The study was conducted on a sample population of 316 adolescents selected from 4 cities across the US. The adolescents were offspring of parents with depressive disorders from August 2003 to February 2006. These adolescents had either a history of depression or a current sub diagnostic depression. Assessments were carried out at baseline at an 8 week and 6 month interval. The adolescents were assigned to the CB prevention interventions.

These interventions were held in 6 months intervals where 90 minute group sessions were held. The result of this study revealed that the rate and hazard ratio of incident depressive episodes were less for adolescents in the CB prevention program compared to those in usual care (21.4% vs. 32.7%; HR, 0.63; 95% confidence interval [CI], 0.40-0.98). Adolescents in the CB prevention program also displayed more improvement than those in usual care (coefficient, − 1.1; z=−2.2; P=.03). For adolescents under a current parental depression at baseline with moderated intervention effects the results are (HR, 5.98; 95% CI, 2.29-15.58; P=.001). However, for adolescents whose parents or guardians were not depressed at baseline, the CB program proved to be most effective than while using usual care (11.7% vs. 40.5%; HR, 0.24; 95% CI, 0.11-0.50). In adolescents with a parent currently depressed, the CB prevention program was less effective compared to the usual care in preventing incident depression (31.2% vs. 24.3%; HR, 1.43; 95% CI, 0.76-2.67). In conclusion, the CB incident prevention program had a significant impact on the self reported depressed adolescents; however, its effect was not evident in adolescents who were from homes with currently depressed parents.

The third article describes depression is a common condition in adolescent especially those whose parents are depressed. Depression is preventable; however, this is dependent on the cost and the benefit of the prevention program. The objective of the research was to examine the cost-effectiveness of the preventive mechanisms put in place. These mechanisms are aimed at preventing depression in adolescents especially from families with depressed parents. The team carried out a cost-effectiveness analysis of a controlled trial that had been carried out randomly. This trial was conducted in a health maintenance organization where adolescents aged 13-18 years at a risk of depression were invited to participate.  The program involved 49 teens placed under usual care and 45 placed under cognitive therapy preventive program. The clinical outcomes of the study were converted into depression free days and quality adjusted life years. The family costs, costs of services received, organization’s maintenance costs and clinical outcomes, were combined in a cost-effective analysis.

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This was done whilst comparing outcome of the usual care with the intervention a year after the trial was begun. The results of this were estimated at $1632 in average cost of the intervention. The indirect and total direct costs increased by $610 in the case of the intervention group. However, statistically, these figures are insignificant. This reflected the possibility of a cost off set. The estimated incremental cost for every free day in the base case analysis was (−$13 to $52) this represented a 95% confidence level or $9,275 per quality-adjusted life-year (−$12 148 to $45 641) at the same confidence level. In conclusion, the study revealed that the cost an individual  incurs in order to prevent depression is comparable to the cost of treating the depression; therefore, the brief prevention programs meant to reduce the risk of depression in high-risk children is more costly compared to the usual care (Lynch & Hornbrook, 2005).

According to the three articles, it is clear that adolescents are high-risk people who are likely to get depression. This situation is heightened if the parents or guardians of the adolescents have suffered or are suffering from depression.  The authors of the articles attribute depression in adolescents to their parents. Parents with a history of depression are likely to affect their adolescent children.  However, after studies were conducted, it was proved that depression can be prevented in high-risk adolescents hence reducing the possibility of getting sick. Therefore, the claim that mental intervention for adolescents with depression will prevent recurrence of depression is true. However, these preventive interventions methods are costly.

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