Impact of neighborhood characteristics on depressive symptoms among adolescents in the United States

项目摘要/摘要 青少年抑郁症是美国的一个主要问题。据估计， 在12至17岁的人群中，抑郁症的患病率为12.5%，即2015.5年中有300万人患有抑郁症 严重的公共卫生问题，因为患有抑郁症的青少年患精神疾病的风险增加 与没有抑郁的青少年相比，精神障碍、自杀和药物滥用。很少有研究发现 调查了社区在抑郁方面的作用，特别是在青少年中。为了解决这一差距，这 对具有代表性的美国青少年样本的二次数据分析研究建议：(1)确定 美国青少年集体效能感与抑郁症状的关系 青少年在基线水平，(2)检验青少年的调节作用--感知的集体效能和 邻里结构劣势与父母集体效能感的关系 美国青少年中抑郁症状的水平，分别在基线和(3)估计变化 抑郁症状与邻里结构劣势关系的轨迹研究 在基线、一年后和八年后的美国青少年中。中心假设是 社区结构劣势和集体效能会影响抑郁症状 这在一定程度上解释了美国青少年抑郁症发病率的上升。拟议的研究将 使用国家青少年到成人健康纵向研究(Add Health)8年的数据，a 一项由美国7-12年级青少年组成的纵向研究。总样本量为24,210人， 代表不同种族/族裔群体的青少年及其父母。将使用多层建模来 确定邻里结构劣势和集体效能对抑郁症状的影响。 拟议研究的结果将有助于识别社区特征， 在美国青少年中影响抑郁症状和随后的抑郁症发病率。 邻里结构劣势和集体效能的组成部分将作为 制定结构性和其他干预战略，如社区一级干预，目的是 减少或防止抑郁。最终，解决邻里结构上的弊端并加以改善 集体效能可能有助于减少抑郁症状，提高心理健康利用率 减少青少年的心理健康负担，从而减轻青少年日益沉重的心理健康负担。

Project Summary/Abstract Depression among adolescents is a major concern in the United States (U.S.). It is estimated that the prevalence of depression among those 12 to 17 years old was 12.5% or 3 million in 2015.5 This represents a serious public health issue as adolescents who are depressed have an increased risk of comorbid psychiatric disorders, suicide, and substance abuse compared to adolescents who are not depressed. Few studies have examined the role of neighborhoods on depression, especially among adolescents. To address this gap, this secondary data analysis study of a representative sample of U.S. adolescents proposes to (1) determine the association between adolescent-perceived collective efficacy and depressive symptoms among U.S. adolescents at baseline, (2) examine the moderating role of adolescent-perceived collective efficacy and parental-perceived collective efficacy on the association between neighborhood structural disadvantage and levels of depressive symptoms among U.S. adolescents at baseline, separately, and (3) estimate the change trajectories in the relationship between depressive symptoms and in neighborhood structural disadvantage among U.S. adolescents at baseline, one year later, and eight years later. The central hypothesis is that neighborhood structural disadvantage and collective efficacy will affect depressive symptoms among adolescents, partially explaining the increase in depression among U.S. adolescents. The proposed study will use 8 years of data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a longitudinal study comprised of U.S. adolescents in grades 7–12. The total sample size is 24,210 with adolescents and their parents representing various racial/ethnic groups. Multilevel modeling will be used to determine the effect of neighborhood structural disadvantage and collective efficacy on depressive symptoms. The findings from the proposed study would help in the identification of neighborhood characteristics that impact depressive symptoms and subsequently depression incidence among adolescents in the U.S. Components of neighborhood structural disadvantage and collective efficacy would serve as targets for the development of structural and other intervention strategies such as community-level interventions, aimed at reducing or preventing depression. Ultimately, addressing neighborhood structural disadvantage and improving collective efficacy may help to reduce depressive symptoms and increase mental health utilization among adolescents, thereby reducing the growing mental health burden among youth.