Wojcieszak Zuzanna K, Mennies Rebekah J, Klein Daniel N, Seeley John R, Olino Thomas M
Department of Psychology, Temple University, 1701 N. 13th St., Philadelphia, PA, 19122, USA.
Department of Psychology, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY, 11794, USA.
Res Child Adolesc Psychopathol. 2021 Jul;49(7):963-973. doi: 10.1007/s10802-021-00791-3. Epub 2021 Feb 20.
There are few studies on the predictors of long-term course of major depressive disorder (MDD) with an onset in childhood and adolescence. Studies have relied on variable-centered methods, utilizing psychosocial and clinical characteristics to predict depression outcomes. However, fewer studies have used person-centered approaches that rely on profiles of functioning to predict course and outcomes of depression. This study examined the long-term course and outcome of early onset depression as a function of profiles of psychosocial and clinical characteristics in adolescence. Participants from the Oregon Adolescent Depression Project with a history of MDD by study entry (M = 16.29 years) and who had follow-up assessments at age 30 were included (n = 215). Psychosocial and clinical constructs, including domains of internalizing problems, externalizing problems, correlates of internalizing problems, adolescent stress, and social support, were assessed in adolescence. Latent profile analyses found a 3-class solution with Low Negative Cognitive Style (LNCS; 27.9%); Internalizing and High Negative Cognitive Style (INT/HNCS; 53.9%); and Internalizing and High Negative Cognitive Style plus Poor Interpersonal Functioning and High Stress (INT/HNCS+ ; 18.1%). Overall, classes differed in depression morbidity, such that the INT/HNCS+ class had the greatest depression morbidity across follow-up assessments. Social adjustment differed between all classes, with the INT/HNCS+ class showing the worst functioning, the LNCS class showing the best functioning, and the INT/HNCS class falling in the middle. Patterns of clinical and psychosocial functioning were differentially associated with long-term depression and social adjustment among youth with depression.
关于儿童期和青少年期起病的重度抑郁症（MDD）长期病程的预测因素的研究较少。以往研究依赖以变量为中心的方法，利用心理社会和临床特征来预测抑郁结局。然而，较少有研究采用以个体为中心的方法，即依靠功能概况来预测抑郁症的病程和结局。本研究考察了青少年期心理社会和临床特征概况对早发性抑郁症长期病程和结局的影响。纳入了俄勒冈青少年抑郁症项目中在研究开始时患有MDD病史（平均年龄M = 16.29岁）且在30岁时进行了随访评估的参与者（n = 215）。在青少年期评估了心理社会和临床构念，包括内化问题、外化问题、内化问题的相关因素、青少年压力和社会支持等领域。潜在剖面分析发现了一个三类解决方案，分别为低消极认知风格（LNCS；27.9%）；内化与高消极认知风格（INT/HNCS；53.9%）；以及内化与高消极认知风格加人际功能差和高压力（INT/HNCS+；18.1%）。总体而言，不同类别在抑郁发病率上存在差异，在整个随访评估中，INT/HNCS+类别抑郁发病率最高。所有类别之间的社会适应情况不同，INT/HNCS+类别功能最差，LNCS类别功能最好，INT/HNCS类别居中。在患有抑郁症的青少年中，临床和心理社会功能模式与长期抑郁和社会适应存在不同程度的关联。
