Determinants of Depressive Symptoms in Adolescents : The Role of Sexual Harassment and Implications for Preventive Interventions

• Main Author: Zetterström Dahlqvist, Heléne
• Format: Doctoral or Postdoctoral Thesis
• Language: English
• Published: Mittuniversitetet, Avdelningen för hälsovetenskap 2016
• Subjects: Depressive symptoms; Adolescence; School; Public Health; Sexual harassment; Personal relative affluence; Gender theory; Ecosocial theory; Cognitive-behavioral; Preventive interventions; Global Health; Social Medicine and Epidemiology; Folkhälsovetenskap; global hälsa; socialmedicin och epidemiologi; Northern Sweden
• Online Access: http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-27565

Background: Depression is considered the worldwide leading cause of illness and disability in young people and an urgent public health issue. Within the field of public health it is of interest to deepen the understanding of determinants of depressive symptoms (DS) that are possible to address on a political or an organizational level. Also, it is of great importance to find methods to prevent depression in adolescents. To address these issues, the present thesis had two Aims: I) To study determinants of DS in adolescents, and II) to, by means of a non-randomized pragmatic trial evaluation, investigate the effectiveness a cognitive-behavioral intervention (DISA) in a real-world setting in relation to determinants of DS in adolescent girls. This was addressed by asking a) Which determinants on individual, psychosocial and structural levels are associated with DS in adolescents? (Paper I); b) What are the directional pathways between sexual harassment (SH) and DS? (Paper II); c) Which features characterize students who were assigned to a cognitive-behavioral intervention regarding levels of DS, psychosocial aspects and socioeconomic status of the respondents as well as of schools? (Paper III); d) Does DISA have an effect on DS in girls aged 14-16? (Paper IV); and e) Are there differences between the DISA participants and non-participants in the effects of psychosocial and structural determinants on DS? (Paper IV). Method: Data was collected in January 2010, 2011, and 2012, by means of a self-administered, electronic questionnaire in school. Students aged 14-16 in all nine public and one independent high school in a municipality in northern Sweden participated in the study (~1,000-1,200 students depending on the wave). All studies had DS as the single outcome variable. Individual level determinants were self-esteem and self-efficacy. Psychosocial determinants were parental/peer/teacher support; school demands; sexual harassment; and bullying. Structural determinants were family material affluence; parental foreign ...