Ethnic Differences in Adolescents' Mental Distress, Social Stress, and Resources

By Choi, Heeseung; Meininger, Janet C. et al. | Adolescence, Summer 2006 | Go to article overview

Ethnic Differences in Adolescents' Mental Distress, Social Stress, and Resources


Choi, Heeseung, Meininger, Janet C., Roberts, Robert E., Adolescence


INTRODUCTION

Studies, using the Diagnostic and Statistical Manual of Mental Disorders-IV ([DSM-IV] American Psychiatric Association [APA], 1994) criteria, estimated that about 15-28% of adolescents would experience depression at least once before reaching adulthood (Lewinsohn, Rohde, & Seeley, 1998; Lewinsohn, Rohde, Seeley, Klein, & Gotlib, 2000). Comorbidity and the recurrence rates of adolescent depression are comparable to, or even higher than, those for adults (Birmaher, Brent, & Benson, 1998; Costello, Mustillo, Erkanli, Keeler, & Angold, 2003; Lewinsohn et al., 1998; Son & Kirchner, 2000). Along with teenage pregnancy and substance abuse, depression is a significant predictor of school dropout (Rickert, Wiemann, & Berenson, 2000; Thornberry, Ireland, & Smith, 2001). Young adults who have experienced adolescent-onset depression have lower education and socioeconomic levels during adult life (Weissman et al., 1999).

Evaluating ethnic group differences in the prevalence of depression is difficult because of the sparsity of epidemiologic data that compare ethnic groups within the same study, using the same measures. According to one of only a few studies that has yielded data on prevalence of major depression in an ethically diverse sample of adolescents (N = 5,412), prevalence was lowest for Chinese Americans (2.9%) and highest for adolescents of Mexican origin (12.0%), followed by African Americans (AAs) (9.0%); European Americans (EAs) showed a midrange prevalence (6.3%) within the sample (Roberts, Roberts, & Chen, 1997). In contrast, other studies reported comparable or higher rates of depression among Asian American (Chinese or Korean) adolescents when compared with EAs (Choi, Stafford, Meininger, Roberts, & Smith, 2002; Stewart et al., 1999). In general, Hispanic Americans (HAs) consistently reported higher rates of depression than other ethnic groups across the different studies (Healthy People 2010, 2001).

Children and adolescents who are not yet cognitively mature may display irritability, negativity, sarcasm, criticism, and somatic symptoms, rather than sadness, when they are depressed (APA, 2000; Elliott & Smiga, 2003; Emslie, Mayes, Laptook, & Batt, 2003; Hauenstein, 2003). Headache, abdominal pain, muscular skeletal pain, weight loss, and decreased appetite are commonly exhibited somatic complaints among depressed adolescents (Rhee, 2003). Chen, Roberts, and Aday (1998) recommended that assessment instruments include items that measure somatic symptoms to increase their cultural sensitivity. In spite of consensus among researchers on the notable association between somatic symptoms and adolescents' mental distress, studies on ethnic differences in somatic symptoms are still limited (Rhee, 2003). Moreover, existing studies have focused on a few symptoms, not a wide spectrum of symptoms. Thus, this study measured a variety of somatic symptoms in addition to general depressive symptoms to more fully capture the signs and symptoms of depression in adolescents.

During the last decades, suicide rates have increased considerably among children younger than 15 years of age while death rates from other causes (e.g., influenza, cancer, and congenital anomalies) have decreased (Centers for Disease Control and Prevention, 1997). Ideas about harming self were more prevalent among younger than older adolescents (Puskar, Tusaie-Mumford, Sereika, & Lamb, 1999). More than 40% of depressed adolescents reported suicidal ideation (Lewinsohn et al., 1998).

Data on suicidal behaviors among minority ethnic groups are even more scant (Healthy People 2010, 2001). While some studies reported higher rates of suicidal behaviors among minority adolescents than EAs (Roberts & Chen, 1995; Vega, Git, Zimmerman, & Warheit, 1993), other studies have failed to demonstrate significant differences among ethnic groups (Grunbaum, Basen-Engquist, & Pandey, 1998; Warheit, Zimmerman, Khoury, Vega, & Gil, 1996). …

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