Health Behavior Correlates of Depression in a Sample of High School Students

Article excerpt

Symptoms of depression are experienced commonly by adolescents and young adults, (1-8) and may be present even in relatively young children. (9-11) Albert and Beck (12) identified moderate to severe depression in 33.3% of seventh and eighth grade students in a suburban Philadelphia parochial school. Craig and Van Natta (3) suggested reporting of symptoms of depression declines with age after adolescence, but among high school and college populations, symptom reporting is frequent, and depression constitutes a significant health problem. (13,14) Depression is the most commonly identified mental health problem among university students. (1,7) McDermott (4) found depression to be a greater problem among females than males in a study of 349 undergraduate students at a midwestern university. According to Schoenbach et al, (6) while depression in youth populations is common, it is transient for the most part. However, depression can manifest both severely and persistently in some young people. (6,11)

The relationship between mental health status and physical health status over time is not completely understood. Vaillant (15) showed in a sample of males studied over four decades that maintenance of positive mental health could retard midlife deterioration of physical health. Studies of older adults also indicated positive mental health can prolong physical hardiness, (16,17) Other investigators proposed that a relationship exists between mental health status and certain health practices. (5,18) Schoenbach et al (6) expressed concern that too little is known about symptoms of depression and youth involvement in hazardous behavior.

While several studies have examined depression to some degree among adolescents and young adults, few have examined associated behavior, especially behavior that could influence physical health status. To assess these concerns, an exploratory study of high school students was undertaken to: 1) assess the prevalence of depression in a sample of high school youth, 2) field test an instrument pertinent to adolescent health practices, and 3) assess the extent to which depression correlated with specific health-related practices and events.

METHOD

Instrumentation

The study used a cross-sectional survey research design. Instrumentation consisted of the Center for Epidemiologic Studies Depression (CES-D) Scale (19) and the Health Scale. The 20-item CES-D Scale, developed for use in the general population, examines the frequency with which respondents have experienced specific symptoms of depression during the past week (Table 1). Radloff (19) reported the validity, reliability, and other psychometric properties of the CES-D Scale.

Table 1

Center for Epidemiologic Studies Depression Scale (CES-D Scale)

I was bothered by things that usually don't bother me.
I did not feel like eating; my appetite was poor.
I felt that I could not shade off the blues even with help from
  my family or friends.
I felt that I was just as good as other people.
I had trouble keeping my mind on what I was doing.
I felt depressed.
I felt that everything I did was an effort.
I felt hopeful about the future.
I thought my life had been a failure.
I felt fearful.
My sleep was restless.
I was happy,
I talked less than usual.
I felt lonely.
Peole were unfriendly.
I enjoyed life.
I had crying spells.
I felt sad.
I felt that people disliked me.
I could not get "going."

For internal consistency, measures using coefficient alpha that range from .85 to .90 were calculated by Radloff. (19) Internal consistency of the instrument also was confirmed in use with the general population, and in a clinical population by the Spearman-Brown split-halves method. (19) Factor structures across subgroups (males vs. females; blacks vs. whites; less than high school educated vs. high school educated vs. more than high school educated) were found to be similar, suggesting construct validity for the instrument. …