Hammen_2009 - CURRENT DIRECTIONS IN PSYCHOLOGICAL S CIENCE...

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Adolescent Depression Stressful Interpersonal Contexts and Risk for Recurrence Constance Hammen University of California, Los Angeles ABSTRACT— High rates of diagnosable depression in ado- lescence, especially among young women, present chal- lenging clinical and research issues. Depression not only portends current maladjustment but may also signal risk for recurrent or chronic depression and its associated im- pairment. Because depression is most often a response to stressful events and circumstances, it is important to understand the stress context itself. Individuals with de- pression histories are known to contribute to the occur- rence of interpersonal and other stressors at a high rate, and for young women particularly, the occurrence of in- terpersonal stressors and conditions in turn predicts re- currences of depression, in a vicious cycle. Interpersonal dysfunction in early adolescence predicts the likelihood of continuing maladaptive functioning in peer, family, ro- mantic, and parenting roles. The transmission of depres- sion from one generation to the next involves not only heritable factors but also the likelihood that depressed youth become caught in life contexts of marital and par- enting discord that portend dysfunction for their offspring and continuing depression for themselves. KEYWORDS— adolescent; depression; stress; gender differ- ences; stress generation Adolescent depression is a captivating topic for several reasons. Rates of youth depression are the highest of all psychological disorders in this age group; the disorder affects millions of youngsters and their families. Depression is impairing and is associated with many problems, such as school difficulties and dropout, unwanted pregnancies, health problems, drug and al- cohol abuse and smoking, intimate partner violence, and prob- lematic peer and family relationships, as well as anxiety, eating, and disruptive-behavior disorders. Tragically, it can also be fatal due to its association with suicide. In addition to the challenges of its immediate clinical and social consequences, researchers are intrigued by the emergence of gender differences in rates of depression in adolescence, matching the 2:1 ratios of female to male depression observed in adulthood. There is an enormous literature on adolescent depression that covers clinical and treatment findings, sociodemographic issues, and etiological perspectives. The focus of work reported in the current article is on the role of stress, and especially interper- sonal stress. The developmental task for adolescents is the creation of their individual identities and initiation of the roles that affect the rest of their lives. However, for many depressed adolescents, perhaps especially girls, the lives they create are dysfunctional and entrapping and may portend a vicious cycle of recurring depression and stress. The work that I highlight is unique in its focus on the context of the lives of youth and the mutual influence between stress and depression, the focus on
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