INTERPERSONAL CONTEXT OF ADOLESCENT DEPRESSION

尽管最近人们普遍认为儿童抑郁症是一种有效的、潜在的使人衰弱的临床现象，但关于儿童抑郁症的病因、意义和预后能力仍存在争议。提出的研究的主要目的是确定在障碍的早期过程中抑郁症的前因和后遗症。一个特别的重点放在理解抑郁症的上升在青春期，特别是在女孩。指导研究的模型认为，以父母抑郁和终生家庭破裂为形式的家庭功能障碍促进了人际关系的不适应观念和无效应对的发展，从而产生了抑郁的脆弱性。据推测，压力环境，包括规范性发展转变的谈判，会激活这种脆弱性，导致过渡时期的抑郁。由于个人特点以及青春期独特挑战的经历，女孩被认为对这些过程最敏感。最后，抑郁症预计会导致进一步的社会心理破坏，这增加了青春期持续或复发的可能性。该多元模型将采用前瞻性、多信息、多方法设计进行检验。从社区样本中选择抑郁儿童、外化儿童和比较儿童的亚组，在两年半的时间内进行随访，以探索抑郁症早期发病和复发的社会认知、情感、人际关系和环境过程。最终，可以预期，从这些研究中获得的知识可以为基于经验的干预计划的创建提供信息，这些计划旨在治疗儿童期发病的抑郁症。

Despite recent widespread recognition of child depression as a valid and potentially debilitating clinical phenomenon, controversy remains as to the etiology, significance, and prognostic power of depression in childhood. The primary goal of the proposed research is to identify the antecedents and sequelae of depression during the early course of disorder. A particular focus is placed on understanding the rise in depression during adolescence, especially in girls. The model guiding the research posits that family dysfunction in the form of parental depression and lifetime family disruptions fosters the development of maladaptive conceptions of interpersonal relationships and ineffective coping, which create a vulnerability to depression. Stressful circumstances, including the negotiation of normative developmental transitions, are hypothesized to activate this vulnerability, leading to depression during transition periods. Girls are expected to be most sensitive to these processes due to personal characteristics as well as the experience of unique challenges during adolescence. Finally, depression is expected to induce further psychosocial disruption, which increases the likelihood of persistence or recurrence of disorder across adolescence. This proposed multivariate model will be examined using a prospective, multi-informant, multi-method design. Subgroups of depressed, externalizing, and comparison children selected from a community sample will be followed over a period of 2 1/2 years to explore the social-cognitive, affective, interpersonal, and contextual processes underlying onset and recurrence of depression during the early course of disorder. Ultimately, it is anticipated that knowledge from such research can inform the creation of empirically based intervention programs designed to treat childhood-onset depression.