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Identifying ways to predict which individuals may experience a major depression in the transition period from adolescence to adulthood can have a significant impact on interpersonal and occupational development and overall quality of life.
A study in the American Journal of Psychiatry gathered data from a community-based group using multiple informants (participants and mothers) and evaluated seven major time points - ages 5, 6, 9, 15, 18, 21, and 26. The goal was to identify childhood and adolescent predictors (up to age 15) of major depression experienced between ages 18 and 26. Delineating the predictors of major depression in this transition to adulthood has direct application to prevention and intervention efforts designed to forestall depression in this high-risk period. This study identified childhood and adolescent familial and behavioral-emotional factors predicting depression during this critical developmental stage.
In the family domain, risk factors included having a depressed parent or sibling was significantly related to experiencing depression in the transition period, having a sibling with a substance use disorder by age 15 and having a sibling who attempted suicide were also significantly associated with depression. Interestingly, being born into a large family and/or to older parents was a significant risk factor. Self-reports of family violence and low family cohesion were also significant markers. Significant behavioral-emotional characteristics included both participant- and mother-rated internalizing problems at age 15. Self-reports of anxious-depressed behavior at ages 9 and 15 proved to be significant indicators, as were self-reports of depressive symptoms in midadolescence.
While there are some limitations to this study, it is a good beginning and points to a need for additional evaluation and assessment with the primary goal of prevention and early intervention. The authors conclude that "major depression occurring in the transition to adulthood has the potential of resulting in chronicity and impaired functioning later in adult life. It is therefore important to identify, treat, and monitor youth who express anxiety and depressive symptoms in adolescence." These findings suggest clear markers apparent in childhood and adolescence, that present an opportunity for those who work with and treat this population. The identification of these predictors provides an ideal moment to break the cycle of psychopathology.
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