Understanding depression in children
Professor Esteban Cardemil's research
Depression is a serious disorder that affects about 1 in 5 Americans at some time in their lives, and research indicates that low-income individuals suffer higher rates of depression than their wealthier counterparts. Given that many racial and ethnic minorities in the United States are more likely to be living in poverty than Caucasians, and that they are significantly less likely to utilize formal mental health services, low-income minorities are particularly at-risk for the development of depression and other mental health problems. Therefore, research that develops novel mental health services that are more accessible and relevant to the lives of low-income and racial and ethnic minorities may yield important benefits to increasingly large portions of the population.
Alleviating and preventing depression in low-income minority children
Psychology professor Esteban Cardemil is particularly interested in understanding the development of depression in low-income and racial/ethnic minority populations, and in developing innovative ways to either prevent or treat depression in these populations. In 2002 Cardemil published the results of a study designed to evaluate the efficacy of a cognitive-behavioral depression prevention program with low-income Latino and African American 5th and 6th grade children. The results from this experiment were intriguing: the prevention program was clearly beneficial for the Latino children, although it seemed to provide little benefit to the African-American children.
The prevention program had already been shown to be effective for suburban, Caucasian middle-school children. For the new study, Cardemil and his colleagues made several revisions to make it more culturally appropriate to low-income minority children. The program was designed to alleviate and prevent depression by teaching children:
- about the links between thoughts and emotions
- how to generate a list of possible explanations for negative events in their lives and how to use evidence to determine the most likely explanation
- ways to handle conflict, set goals, and problem solve social situations
Methodology
Cardemil and his research team administered the revised prevention program to African American and Latino students at two low-income middle schools in Philadelphia. The students who participated in the research study were randomized into two experimental conditions. Approximately half of the students received the intervention program, while the other half served as a control population. Participation was voluntary, and parents were told their children would be attending a program designed to help children better handle difficult situations at home and in school. No mention was made of depression.
The research began by having each child complete a series of questionnaires designed to
- Diagnose any existing depression
- Determine the child's tendency to make internal, stable and global explanations for negative and positive events (attributional style)
- Assess the occurrence and prevalence of negative thoughts and attributions (negative automatic thoughts)
- Assess the degree to which the child feels hopeless about the future
- Assess the child's self-esteem in a number of different areas (perceived self-confidence)
The prevention program was then administered over a 12-week period during the school year. The students who were in the program attended weekly 90-minute group sessions in groups of 10. Each session had a variety of activities (e.g., role play, skits, homework assignments) that were designed to teach the children about the various topics. Immediately after the program's completion, the children filled out the above questionnaires a second time, and again at three months and six months.
Results
Cardemil hypothesized that children who participated in the prevention program would experience
- a decrease in depressive symptoms,
- a decrease in negative automatic thoughts and hopeless thoughts
- an improvement in explanatory style and self-esteem
And the hypotheses were generally supported for the Latino children who participated in the prevention program, as they reported fewer depressive symptoms, fewer negative automatic and hopeless thoughts, and improved self-esteem as compared to the control children. These effects were present up to six months after the end of the program.
In contrast, while the African-American children who participated in the prevention program reported fewer depressive symptoms over the course of the six months, their scores were not statistically different from those African American children in the control group.
Directions for further research
Findings from this study have spurred Cardemil to investigate two different research directions, both of which are taking place here at Clark University. In response to the study's results with the African American children, he is conducting a project to better understand how children from low-income, urban environments develop and express depression and its associated symptoms. Many undergraduates have been involved in this line of research. The second area of research attempts to build on the success of the prevention program with Latino children. Specifically, Cardemil has developed and is currently evaluating a novel depression prevention programs for low-income Latina mothers.
Top