Preadolescent Precursors to Depression in Girls

描述(由申请人提供)：当女孩进入青春期后期时，有五分之一的机会经历严重的抑郁发作。这是男性抑郁症患病率的两倍，是女性最常见和最致残的疾病。然而，在确定抑郁症的前兆方面几乎没有什么努力，因此，现有的旨在预防这一重大公共卫生问题的计划寥寥无几。在目前的模型中，青春期抑郁的出现被概念化为心理挑战、生理变化(即青春期)和青春期特有的社会需求的组合。相比之下，这项拟议的研究是基于这样一个前提，即青少年抑郁的根源至少部分存在于青春期前。我们有一个独特的机会，通过利用正在进行的一项基于社区的年轻女孩研究--匹兹堡女孩研究(PGS)--来解决女孩抑郁发展中的问题。 在这项拟议的研究中，我们将检验这一假设，即在青春期前的一些心理相关因素中存在可测量的、有意义的差异，这些相关因素是后来抑郁的先兆。这些问题包括过度的同理心和遵从性，以及情绪调节的困难。这种相关性没有被纳入传统的精神病理学模型，但有间接证据支持它们在女孩抑郁发展中的作用。此外，我们将测试关于照料环境类型和学校经历的假设，这些假设与女孩青春期前的特征相互作用，以增加日后抑郁的可能性。这些假设将在一项对240名从PGS中确定的女孩的纵向研究中得到验证，其中一半的女孩已经表现出较高的亚临床抑郁症得分。这些女孩和她们的母亲将在8岁、10岁和12岁时接受实验室评估，并将在8岁至12岁期间每年接受涵盖抑郁和焦虑障碍的半结构化访谈。

DESCRIPTION (provided by applicant): By the time girls reach late adolescence there is a 1 in 5 chance of their experiencing a major depressive episode. This is twice the rate of depression in males, and represents the most common and disabling disorder for women. There has been very little effort at identifying precursors to depression, however, and as a result, there are few existing programs aimed at preventing this major public health problem. In current models the emergence of depression at adolescence is conceptualized as resulting from a combination of psychological challenges, biological changes (i.e., puberty) and social demands that are specific to adolescence. In contrast, the proposed study is based on the premise that the roots of adolescent depression lie at least partly in the preadolescent period. We have a unique opportunity to address issues in the development of depression in girls by taking advantage of an ongoing community-based study of young girls, the Pittsburgh Girls Study (PGS). In the proposed study, we will test the hypothesis that there are measurable, meaningful differences in a number of psychological correlates during preadolescence that serve as precursors to later depression. These include excessive levels of empathy and compliance, and difficulty with emotion regulation. Such correlates have not been incorporated into traditional models of psychopathology, but indirect evidence exists to support their role in the development of depression in girls. In addition, we will test hypotheses about types of caregiving environments and school experiences that interact with preadolescent characteristics of girls to increase the likelihood of later depression. These hypotheses will be tested in a longitudinal study of 240 girls identified from the PGS, half of whom already demonstrate elevated, but sub-clinical depression scores. The girls and their mothers will be observed in laboratory assessments at ages 8, 10, and 12, and will be administered semi-structured interviews covering depressive and anxiety disorders annually from ages 8 to 12.