Academic journal article Journal of Mental Health Counseling

Adolescents' Perceptions of the Gendered Context of Depression: "Tough" Boys and Objectified Girls

Academic journal article Journal of Mental Health Counseling

Adolescents' Perceptions of the Gendered Context of Depression: "Tough" Boys and Objectified Girls

Article excerpt

Gender-specific attributes and socialization influence the development of depression in adolescents, but little research has addressed adolescents' views on this topic. We interviewed 22 adolescents regarding their views on the impact of sex and gender role influence in depression. Male and female participants: (a) described societal expectations and cultural messages, including high and conflicting expectations for girls, and consistent messages of being "macho" and unemotional for boys, as related to adolescent depression; (b) perceived physical changes during puberty as contributors to depression for girls, but not for boys; and (c) associated loneliness and rejection with depression for both boys and girls. We discuss implications for treatment that include directly addressing gender roles with depressed adolescents.


Depression among adolescents is a costly phenomenon with wide-ranging health sequelae, including increased likelihood of difficulties related to academic and occupational performance, interpersonal relationships, tobacco and substance abuse, and suicide attempts (Birmaher et al., 1996; Lewinsohn, Clarke, Seeley, & Rohde, 1994; Luber et al., 2000; Petersen et al., 1993; Pincus & Pettit, 2001; Schradley, Gotlib, & Hayward, 1999). Depression during adolescence also predicts future illness (Lewinsohn, Rohde, Seeley, Klein, & Gotlib, 2000; Mufson & Moreau, 1997; Weissman et al., 1999). Environmental influences related to the development of depression include stressful life events (Rudolph, 2002), family problems (Sheeber, Hops, Alpert, Davis, & Andrews, 1997), and peer problems (Kaslow, Brown, & Mee, 1994).

A number of treatments for depression in adolescents have demonstrated empirical support. Cognitive behavioral therapies, interpersonal psychotherapy, and antidepressant medications have been found to be very effective treatments with adult populations, and studies in recent years have tested these treatments on adolescents. Antidepressant medications have demonstrated effectiveness in use with adolescents, especially selective serotonin reuptake inhibitors (SSRIs). Psychotherapy is recommended prior to or in conjunction with antidepressant medication, and adolescents on antidepressant medication need to be monitored closely for increased suicide risk (Whittington et al., 2004). Both CBT and Interpersonal Psychotherapy--Adolescent (IPT-A) have been demonstrated to decrease depressive symptoms (for reviews see: Michael & Crowley, 2002; Mellin & Beamish, 2002; Millin, Walker, & Chow, 2003) Although these treatments have been demonstrated as efficacious, there is no single treatment that has been found to work with all adolescents at all times (Michael & Crowley, 2002). Continuing theory building and research is therefore needed to expand on the empirically supported treatment base.

An area within these domains that has been suggested as important in adolescent treatment is attention to gender role (Hazler & Mellin, 2004). As early as 1990, the American Psychological Association's National Task Force on Women and Depression (McGrath, Keita, Strickland, & Russo, 1990) recommended that therapies address sociocultural factors that impact women's depression. More recently, others have called for attention to the particular needs of men with depression (Mahalik & Cournoyer, 2000). Although a large body of research has been developed on gender differences in depression, specific treatments that address these gender differences are still in early stages.

Outcome and efficacy research regarding gender and depression treatment in adolescents has generally been limited to exploring the outcome of specific treatments by sex. For instance, in their meta-analytic review, Michael and Crowley (2002) found that treatments obtained higher mean effect sizes when the sample was more than 60% females, leading to the possibility that treatments may be less effective for males. …

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