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Theses Doctoral

Adolescent Depression and Suicidality in the USA: A Look at YRBS Profiles and Health Risk Behaviors as Predictors in the Past 10 Years

Cheng, Bryan

Depressed mood is one of the most common of all psychiatric symptoms occurring in children and adolescents. Population studies suggest a point prevalence of between 10 to 15% of children and adolescents having symptoms of depression. Further, depressed adolescents are also significantly more apt to demonstrate suicidal ideation accompanied by a concomitant sense of helplessness and hopelessness. The overall aim of the study was to identify and characterize profiles of depression and suicidal behavior within the adolescents of the USA in the past 10 years. This study utilized epidemiological, cross-sectional, data from the Youth Risk Behavior Surveillance System (YRBSS), a biennial census that monitors six types of health-risk behaviors that contribute to the leading causes of death and disability among youth. Latent classes of the indicators were generated utilizing latent class regression modeling. Predictors were then regressed on class membership in a multinomial logistic regression simultaneously to assess significance. Finally, a juxtaposition of the profiles and significant predictors followed to allow for observation of differences in number of profiles and other qualities (i.e., proportions of sample in each class, etc.) as well as to visualize and note “carryover” predictors across the past 10 years. Findings revealed a relatively stable pattern of profiles and predictors over the years with the exception of 2015. In the analysis of demographic variables, membership of the “low- risk non-depressed” class was consistently or more frequently associated with being male, older, not of an ethnic minority, and non-ethnically bi-or multiracial, across all time points. Three clusters of behaviors and factors emerged as significant predictors of depressed mood and suicidality. The first cluster consisted of typical adolescent risk behaviors that includes delinquent behaviors (i.e., fight, weapon carrying, or use of over-the-counter drugs), smoking, alcohol use, as well as consensual (non-violent) sexual activity. The second cluster of predictors that was significant consisted of experiences of traumatic events such as bullying, sexual assault, and intimate partner violence. Finally, a third cluster that showed significance consisted of self destructive behavior such as the use of illicit or hard drugs and maladaptive dieting, restricting or purging behavior. Several protective factors such as having sufficient physical activity and getting at least 8 hours of sleep daily also emerged as significant. Limitations to the YRBS and this study were discussed, and recommendations that tie to the implications of the findings were proposed. Future directions for research were also presented in light of the limitations of the study.

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More About This Work

Thesis Advisors
Verdeli, Helen
Ph.D., Columbia University
Published Here
October 10, 2018