A Correlation Study on Life Events and Depressive Symptoms among Adolescents Studying at Selected Schools in Mysore

 

Mr.Paramesha¹, Mrs. Buvaneswari. R. K.², Prof. Sheela Williams³, Mr. Vinay Kumar. G¹, Mrs. Saraswathi. K.N.⁴

¹Assistant Lecturer, JSS College of Nursing, Mysore

²Assistant Professor cum HOD of Mental Health Nursing JSS College of Nursing Mysore

³Principal cum Professor and HOD, JSS College of Nursing, Mysore

⁴Assistant Professor, Mental Health Nursing, JSS College of Nursing, Mysore

 

ABSTRACT:

Background: Depressed patients have significantly greater number of life events prior to the onset of their illness. Rates of depression have increased over the past five decades, with younger age of onset. Many adolescents suffer from brief periods of depression when they are faced with an upsetting event or disappointment.

Aim: The aim of the present study was to assess and correlate life events and depressive symptoms among adolescents studying at selected schools in Mysore.

Methodology: Descriptive and Correlation survey design was used. Using non probability convenience sampling technique, total 100 adolescents were selected. Tool used to collect the data consisted of three part: Proforma for selected personal variables (10 items), Modified Adolescent Life Events Questionnaire (46 items) and Modified Center for Epidemiological Studies Depression Scale for Children (20 items).

Results: Collected data was analyzed using descriptive and inferential statistics. Results revealed that, 91 adolescent’s life events score was between 0-23 suggestive of less life events and 09 adolescents suggestive of high life events with the score range 24-46. Present study findings shows that 50 adolescents have no depressive symptom, 40 adolescents have mild depressive symptom and 10 adolescents have suggestive of major depressive symptom. The calculated correlation coefficient ‘r’ value r ₍₁₀₀₎ = 0.886 between life events and depression found to be significant at 0.05 level. Chi square was computed to find the association with selected personal variables and was not significant at 0.05 level except for gender, class of study and occupation of father.

Conclusion: This study has revealed that adolescents life events was positively correlated with depressive symptoms among adolescents.

 

 

 

INTRODUCTION:

Depression is a disorder of major public health importance, in terms of its prevalence and the suffering, dysfunction, morbidity, and economic burden. It is estimated that by the year 2020, if current trends for demographic and epidemiological transition continue, the burden of depression will increase to 5.7% of the total burden of disease and it would be the second leading cause of disability-adjusted life years (DALYs). In view of the morbidity, depression as a disorder has always been a focus of attention of researchers in the world¹.

 

Major depression affects 3 to 5 percent of children and adolescents. Depression negatively impacts growth and development, school performance, and peer or family relationships and may lead to suicide. Biomedical and psychosocial risk factors include a family history of depression, female sex, childhood abuse or neglect, stressful life events, and chronic illness¹.

 

Depression has a significant impact on adolescent development and well being. Adolescent depression can adversely affect school and work performance, impair peer and family relationships, and exacerbate the severity of other health conditions such as asthma and obesity. Depressive episodes often persist, recur, or continue into adulthood. Youth who have had a Major Depressive Episode (MDE) in the past year are at greater risk for suicide and are more likely than other youth to initiate alcohol and other drug use, experience concurrent substance use disorders, and smoke daily².  Negative patterns of thinking and maladaptive information processing, termed cognitive vulnerabilities, have been shown to contribute to the development of depressive symptoms in adolescents who activate these vulnerabilities in response to negative life events. Life events are best conceptualized along a continuum with some negative events being more important than others (e.g., parental divorce, poor academic performance). Researchers from diverse theoretical orientations have proposed that certain personal factors (i.e., age, gender, and ethnicity) serve as vulnerability factors to the development of depressive symptoms³.

 

Depressed teens often fail in school, become isolated from friends and family, and may fall in to alcohol or drug abuse. Teenage girls who suffer from depression may develop anorexia nervosa, a life threatening eating disorder. Suicide often resulting from depression is the cause of all adolescent deaths. Depressed people of all ages tend to become socially isolated⁴.

 

NEED FOR THE STUDY:

Adolescence is a transition period from childhood to adulthood and is characterized by a spurt in physical, endocrinal, emotional, and mental growth, with a change from complete dependence to relative independence. The health of adolescent girls influences not only their own health, but also the health of the future population. Almost a quarter of India's population comprises of below 20 years⁵.

 

Currently available epidemiological data suggest a worldwide prevalence of child and adolescent mental disorders of approximately 20%. Of this 20% it is recognized that from 4 to 6% of children and adolescents are in need of a clinical intervention for an observed significant mental disorder. World Health Report-2001, report that half of all lifetime cases of mental disorders start by age 14 ⁶.

 

Depression in children and adolescents is associated with an increased risk of suicidal behaviours. The consequences of untreated depression can be increased incidence of depression in adulthood, involvement in the criminal justice system, or in some cases, suicide. Adolescent suicide is now responsible for more deaths in youths aged 15 to19 than cancer Suicide is the third leading cause of death among young people ages 15 to 24. Even more shocking, it is the sixth leading cause of death among children ages 5-14 ⁷.

 

Nurses work in a wide range of settings that provide care for the adolescent population. In the area of adolescent depression, nurses are uniquely positioned to implement primary prevention strategies that encourage positive cognitions and resiliency in schools, communities, and clinical settings. As opposed to other disciplines serving the adolescent population, the discipline of nursing has a holistic approach that encompasses health promotion and disease prevention. Nurses working with adolescents are in a position to identify adolescents who are at risk for the development of depressive symptoms by understanding the mechanisms through which depressive symptoms develop. Hence, the investigator interested to find the relationship between the life events and depressive symptoms among adolescents.

 

OBJECTIVES:

The objectives of the study are:

1       To assess the life events experienced by the adolescents studying in selected schools.

2       To assess the depressive symptoms among the adolescents.

3       To determine the relationships between life events and depressive symptoms among adolescents.

4       To find the association of life events and depressive symptoms among adolescents with their selected personal variables.

 

HYPOTHESES:

The following hypotheses are formulated for the study, and will be tested at 0.05 level of significance.

H1:	There will be a significant relationship between life events and depressive symptoms among adolescents.
H2:	There will be significant association between life events and depressive symptoms among adolescents with their selected personal variables.

 

METHODOLOGY:

Research Approach / Design:

Descriptive correlative approach was adopted for the study.

 

Study Variables:

Life events and depressive symptoms.

 

Selected Personal Variables:

age, gender, religion, class of study, type of family, educational status of parents, parents’ occupation, family income, birth order and number of siblings.

 

Setting of the Study:

The study was conducted in selected schools in Mysore.

 

Population:

Population comprises of adolescents studying at schools in Mysore.

 

Sample and Sample Size:

Adolescents aged between 13-16 years, studying at selected schools in Mysore. In the present study, one hundred (100) samples were selected.

 

Sampling Technique:

Non-probability convenience sampling was used to select the samples for the study.

 

SAMPLING CRITERIA:

Inclusion Criteria:

1.      Both boys and girls in the age group of 13-16 years, who are studying at selected schools in Mysore.

2.      Adolescents who are willing to participate in the study.

 

Exclusion Criteria:

1.      Adolescents who are absent during the period of data collection.

2.      Adolescents who are already receiving treatment for any type of mental illness.

 

RESULTS:

SECTION I: Description of selected personal variables of Adolescents Frequency and percentage distribution of adolescents according to their selected personal variables

 

Sample characteristics	F	%
Age in years
13 14 15	45 52 3	45 52 3
Gender
Male	64	64
Female	36	36
Religion
Hindu Muslim Christian	72 11 17	72 11 17
Class of study
8th  Standard 9th  Standard	50 50	50 50
Type of family
Nuclear	81	81
Joint	19	19
Educational status of parents
Father SSLC and below	5	5
Diploma and PUC	31	31
Graduate	49	49
Postgraduate	15	15
Mother SSLC and below	4	4
Diploma and PUC	44	44
Graduate	45	45
Postgraduate	7	7
Parents occupation
Father
Professionals	20	20
Business	48	48
Others	32	32
Mother
Homemaker	77	77
Professionals	10	10
Others	13	13
Family monthly income (in rupees)
10,000 and Below	8	8
10,001-30,000	67	67
30,001-60,000	18	18
60,001 and Above	7	7
Birth order
1st  Child	50	50
2nd Child 3rd Child	44 6	44 6
Number of siblings
Nil	27	27
1	61	61
2	12	12

 

SECTION II: Description of life event and depressive symptom score among adolescents.

 

A.       Frequency and percentage distribution of level of life events among adolescents.

The obtained life events scores of adolescents were further divided into different levels. The frequency and percentage of different levels were computed and presented in table-2

 

TABLE –1 Frequency and percentage distribution of level life events among adolescents. n=100

 

The data presented in the table 3 shows that the 91 adolescent’s were experiencing less life events with the score range 0-23 and 01 adolescents were experiencing high life events with the score range 24-46.

 

B.       Frequency and percentage distribution of level of depressive scores among adolescents.

The obtained depressive symptom scores of adolescents were further divided into different levels. The frequency and percentage of different levels were computed and presented in table-3.

 

TABLE – 2:Frequency and percentage distribution of level of depressive symptoms among adolescents. n=100

 

The data presented in the Table 3 shows that 50 adolescents were having no depressive symptom, 40 adolescents had mild depressive symptom and 10 adolescents had major depressive symptom.

 

C.       Description of depressive symptom score and life events scores of adolescents.

The life events and depressive symptom scores obtained by the subjects were tabulated to a master sheet and the total scores obtained for each were tabulated. Mean median, standard deviation, and range of life events and depressive symptom score were computed. The findings are presented in the Table -3.

 

TABLE – 3: Mean, Median, Standard Deviation, and range of life events and depressive symptom score among adolescents n=100

Variables	Mean	Median	S.D	Range
Life events	13.05	12	±7.27	02- 33
Depressive symptoms	16.03	15.5	±8.82	01 – 48

 

The data presented in the Table 4 shows that the mean life events score of adolescents was 13.05 with Standard deviation of ±7.271 median of 12 and a range of 02-33 as against possible range of 0-46.The data presented also shows that the mean depressive symptoms score of adolescents was 16.03 with Standard deviation of ±8.826, median of 15.5 and a range of 1-48 as against possible range of 0-60.

 

D. Description of life events scores of adolescents in different domains.

The life events scores obtained by the subjects were tabulated to a master sheet and the scores obtained for each domain were tabulated. Mean median, standard deviation, and range of life events scores were computed. The findings are presented in the Table 4.

 

Table – 4 :Mean, Standard Deviation, and range of life events scores in different domains  n=100

 

The data presented in the Table 4  shows that the life events scores of adolescents in each domains in which family and parents domain shows highest  mean score of 6.21 with  Standard deviation of ±4.83 and a range of 0-18 as against possible range of 0-23 followed by mean score of friends and social activities domain 3.98  with  Standard deviation of ±2.58 and a range of 0-12 as against possible range of 0-13 and school and classes domain mean score of 2.88 with  Standard deviation of ±1.98 and a range of 0-8 as against possible range of 0-10.

 

SECTION III:

Correlation of life events and depressive symptoms among adolescents:

To find out the significant relation between life events and depressive symptom scores among adolescents, Karl Pearson’s Correlation Coefficient was computed .To test the statistical significant relationship the following null hypothesis was stated.

 

H₀₁  :

There will be no significant relationship between life events and depressive symptoms scores among adolescents.

 

Table – 6 Correlation coefficient of life events and depressive symptoms scores among adolescents. n=100

Variables	Mean Score	Correlation Coefficient ‘r’
Life Events	13.05	0.88*
Depressive Symptoms	16.03

r ₍₉₈₎ = 0.195 * Significant  p < 0.05

 

Table 6 shows the correlation between life events scores and depressive symptom scores among adolescents .To find-out relationship  Karl Pearson’s Coefficient correlation was computed and calculated  ‘r’ value, r ₍₁₀₀₎ = 0. 88 shows that there was a significant correlation between life events and depressive symptoms. Hence, the null hypothesis H₀₁ was not supported and research hypothesis was supported. It is inferred that there was a significant relationship between life events and depressive symptoms scores among adolescents.

 

SECTION IV:

The association between life events and depressive symptoms among adolescents with their selected personal variables.

 

A. Chi-square values of life events of adolescents with their selected personal variables

To find out the association between the life events  among adolescents with their selected personal variables, age, gender, religion, class of study, type of family, educational status of parents, occupation, family monthly income, birth order and number of siblings, the following null hypothesis was stated.

 

H₀₂  :

There will be no significant association between life events and depressive symptoms among adolescents with their selected personal variables. Chi Square was computed to find the association.

 

The study was found obtained chi- square values of life events scores of adolescents were significant for class of study, occupation of father and not significant with other selected personal variables at 0.05 levels. Therefore, the null hypothesis H₀₂ is supported and the research hypothesis is partially supported.

 

IMPLICATIONS:

The findings of the study revealed that there is a correlation between life events and depressive symptom among adolescents. Nurses can play a vital role in counselling the adolescents. Nurses can also provide education and counselling services to their parents to enhance the positive mental health among the adolescents. As the nursing practice is based on thorough theoretical basis, these implications can be used to educate the parents in community primary settings for promotion of positive mental health. In order to reduce the various psychosocial stress experienced by adolescent, there is need to incorporate non pharmacological approaches like yoga, meditation, relaxation, peer group counselling .

 

LIMITATIONS:

·        The sample size was limited only to one hundred adolescents. Hence, the study findings cannot be generalized to large population.

·        The study is focused on only selected schools in Mysore.

 

RECOMMENDATIONS:

1.      A large scale study can be conducted to generalize the findings.

2.      A comparative study can be conducted regarding life events and depressive symptoms among adolescent girls and boys.

3.      A descriptive survey can be conducted to find out prevalence of depression among adolescents.

4.      A comparative study can be conducted between adolescents of rural and urban areas.

5.      An experimental study can be conducted on effectiveness of counseling program for adolescents with depressive symptoms.

 

CONCLUSION:

The findings of the study revealed that, the computed and calculated correlation coefficient between life events and depressive symptom found to be significant at 0.05 level. Hence, it can be concluded that, there was statistically significant positive correlation between life events scores and depressive symptom scores among adolescents. Hence it was concluded that adolescent depression is linked with their life events. Nurses work in hospital and community assume many roles, as a concerned parent, teacher or friend in helping adolescents. In the area of adolescent depression, nurses are uniquely positioned to implement primary prevention strategies that encourage positive cognitions and resiliency in schools, communities, and clinical settings.

 

REFERENCES:

1.      Grover S, Dutt A, Avasthi A. An overview of Indian research in depression. Indian Journal of Psychiatry 2010: 52:178-88.

2.      Lewinsohn, P., Joiner, T., and Rohde. P; Evaluation of cognitive diathesis-stress mode in predicting major depressive disorder in adolescents. Journal of Abnormal Psychology 2000: 110,203-15.

3.      Cara Suzanne Calloway. Cognitive Vulnerabilities, Negative life events, and Depressive Symptoms in young adolescents. May, 2010 [cited 2011 Dec 11]. Available from: graduate school of Vanderbilt university, Available from :http://etd.library.vanderbilt.edu/available/etd-03312010 151456

4.      Depression treatment remedies- help yourself to overcome and cure depression [Internet] 2009 Jul; [cited 2011 Jun 23].Available from http://www.happymoods.info/school-depression.

5.      Anil K Agarwal, Anju Agarwal. A Study of Dysmenorrhea During Menstruation in Adolescent Girls. Indian Journal of Community Medicine [Internet]. 2010 Jan; [cited 2012,Dec 17].Available from http://www.teenscreen.org

6.      Dorothy Stubbe. Practical Guides in Psychiatry: Child and adolescents Psychiatry. Lippincott Williams and Wilkins, Philadlphia. 2007:1: 106-7.

7.      Gail W Stuart. Principles and practice of Psychiatric nursing. 9th Ed.17.Noida: Mosby publishers. 2009

 

 

Received on 10.03.2015           Modified on 21.03.2015

Accepted on 11.04.2015           © A&V Publication all right reserved