Moderated Mediational Model of Emergent Sex Differences in Adolescent Depression

描述（由申请人提供）：四分之一的女孩，相比之下，八分之一的男孩，很可能在她完成青春期时被诊断为重度抑郁症。究竟是什么导致了这些令人不安的性别差异是几十年来激烈研究和辩论的中心，迄今为止几乎没有得出明确的答案。最近出现了对反应风格理论的支持，认为性别在沉思中的差异，或者对抑郁症的症状和原因的坚持倾向，可以解释这些性别差异的很大一部分（Nolen-Hoeksema，1994）。然而，反刍导致这种性别差异的机制仍然未知。本研究提出了一个新的适度中介模型，在童年中期和青春期早期的反刍，以帮助解释青春期抑郁症患病率的性别差异。我们的应用程序探讨女性性别认同如何可能调解性别和反刍之间的关系，以及反刍如何可能反过来调解抑郁症状的联系。此外，我们将研究年龄和青春期发育的影响如何调节这一模型。我们假设，这种中介模型将解释为什么性抑郁症的联系只在青春期变得明显，而不是在童年。在模型中加入这样一个适度的成分将有助于解释为什么青春期前的女孩和男孩有相似的抑郁率，但女孩更容易在以后发展抑郁症状。我们将在学年的三个时间点（大约间隔3个月）对450名学生，他们的父母和他们的老师进行问卷调查。我们将使用潜变量结构方程模型（SEM）来检验我们的中介假设和多组SEM来检验我们的适度假设。通过推进我们对抑郁症状中出现的性别差异的理解，我们将有助于了解男性和女性抑郁症的病因。这些知识将使临床医生能够针对高危青少年进行预防和干预计划，并将有助于将资源分配给最需要的人。该项目与儿科转化研究和治疗开发部对青少年抑郁症性别差异研究的优先权很好地吻合。

DESCRIPTION (provided by applicant): One in four girls, compared to one in eight boys, is likely to warrant a diagnosis of Major Depressive Disorder by the time she finishes adolescence. What exactly causes these disturbing sex differences is at the center of decades of intense research and debate, yielding few definitive answers thus far. Recent support has emerged for Response Style Theory, positing that gender differences in rumination, or the tendency to perseverate about symptoms and causes of one's depression, may explain a large part of the these sex differences (Nolen-Hoeksema, 1994). The mechanisms by which rumination causes this gender disparity, however, are still unknown. This study proposes to test a new moderated mediational model of rumination in middle childhood and early adolescence to help explain the sex differences in prevalence rates of depression during adolescence. Our application examines how female gender identification may mediate the relation between sex and rumination, and how rumination may in turn mediate the link to depressive symptoms. Furthermore, we will look at how this model is moderated by the effects of age and pubertal development. We hypothesize that this mediational model will explain why the sex-depression link only becomes evident during adolescence, but not in childhood. Adding such a moderational component to the model will help explain why pre-pubertal girls and boys have similar rates of depression, but girls become more likely to develop depressive symptoms later on. We will administer questionnaires to 450 students, their parents, and their teachers in grades 4, 6 and 8 at three time points during the school year (approximately 3 months apart). We will use latent variable structural equation modeling (SEM) to test our mediational hypotheses and multi-group SEM to test our moderational hypotheses. By advancing our understanding of the emergent gender difference in depressive symptoms, we will contribute to knowledge about the etiology of depression for both males and females. This knowledge will enable clinicians to target high-risk youth for prevention and intervention programs and will facilitate the distribution of resources to those who need them most. This project dovetails nicely with the priority given to research on gender differences in adolescent depression by the Division of Pediatric Translational Research and Treatment Development.