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交叉身份与青少年抑郁:过去十年中抑郁情绪和快感缺失的模式。

Intersecting identities and adolescent depression: Patterns of depressed mood and anhedonia in the past decade.

机构信息

The Department of Psychology, The University of Illinois Urbana-Champaign, 603 E. Daniel Street, Champaign, IL 61820, United States of America.

The Department of Psychology, The University of Illinois Urbana-Champaign, 603 E. Daniel Street, Champaign, IL 61820, United States of America.

出版信息

J Affect Disord. 2022 Dec 15;319:518-525. doi: 10.1016/j.jad.2022.09.088. Epub 2022 Sep 23.

Abstract

BACKGROUND

Research suggests adolescent depression is increasing and certain adolescents may be uniquely vulnerable. However, limited conceptualizations of identity and time, as well as the reliance on unitary conceptualizations of depression, inhibits a nuanced perspective on these trends. In response, we examined how adolescent depressive symptoms, depressed mood, and anhedonia, vary across intersecting identities over time.

METHODS

Secondary data analysis on the National Survey on Drug Use and Health between 2009 and 2017 was conducted. In total 145,499 nationally representative adolescents (ages 12-17) completed a diagnostic assessment for depression. Lifetime and past year reports of depressive symptoms, depressed mood, and anhedonia were treated as separate variables. A novel, mixed-level model in which participants were nested within identity (defined by one's age, gender, race/ethnicity, poverty level) and time was used to test our aims.

RESULTS

Overall, the relation between depression outcomes and identity did not vary over time (p > .01). Further, identity's impact on depression was approximately ten-fold that of temporal effects. Multiracial, late adolescent, female adolescents were at particular risk. Findings concerning depressed mood and anhedonia were similar across analyses.

LIMITATIONS

All facets of identity (e.g., sexual identity) were not included in the model and a unidimensional measure of poverty may have underestimated its depressogenic influence.

CONCLUSION

Adolescent depression outcomes are mostly consistent across criterial symptom subtypes and time, but vary as a function of identity. Prevention protocols that highlight mechanisms of risk tethered to social identity, and include salient experiences of females, late adolescents, and multiracial youth in particular, need to be prioritized in mental health initiatives.

摘要

背景

研究表明,青少年抑郁的发病率正在上升,某些青少年可能特别容易受到影响。然而,对身份和时间的概念理解有限,以及对抑郁的单一概念理解的依赖,阻碍了对这些趋势的细致观察。有鉴于此,我们研究了青少年抑郁症状、抑郁情绪和快感缺失如何随时间在交叉身份中变化。

方法

对 2009 年至 2017 年期间进行的全国药物使用和健康调查进行二次数据分析。共有 145499 名具有全国代表性的青少年(12-17 岁)完成了抑郁症的诊断评估。将终生和过去一年的抑郁症状、抑郁情绪和快感缺失报告视为单独的变量。采用一种新颖的混合水平模型,参与者按身份(由年龄、性别、种族/族裔、贫困水平定义)和时间嵌套,以检验我们的目的。

结果

总体而言,抑郁结果与身份之间的关系在时间上没有变化(p>.01)。此外,身份对抑郁的影响大约是时间效应的十倍。多种族、青少年后期、女性青少年的风险特别高。关于抑郁情绪和快感缺失的研究结果在分析中相似。

局限性

模型中未包括所有身份方面(例如,性身份),并且贫困的单维衡量可能低估了其致郁影响。

结论

青少年抑郁结果在很大程度上与标准症状亚型和时间一致,但因身份而异。预防方案应强调与社会身份相关的风险机制,并特别关注女性、青少年后期和多种族青年的相关经历,这需要在精神健康计划中优先考虑。

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