Academic journal article Research and Theory for Nursing Practice

Evaluating an Interpersonal Model of Depression among Adults with Down Syndrome

Academic journal article Research and Theory for Nursing Practice

Evaluating an Interpersonal Model of Depression among Adults with Down Syndrome

Article excerpt

The Interpersonal Model of Depression (IMD) based on the Theory of Human Relatedness (Hagerty, Lynch-Sauer, Patusky, & Bouwsema, 1993) is evaluated among adults with Down syndrome. One hundred subjects participated, with 32% having elevated depression scores and 40% stating they felt lonely. The relationship between depression, perceived social support, loneliness, and life satisfaction is statistically significant, F(6, 172) = 4.36, p < .001. Loneliness, social isolation, loss of sense of well-being, self-hate, and social withdrawal are important interpersonal manifestations and represent increasing levels of depression. Social and emotional loneliness are two dimensions of loneliness. The IMD provides a framework to assess depression in this population. Research on the efficacy of depression treatment based on the IMD is needed.

Keywords: developmental disability; mental retardation; loneliness; social isolation

Each year between 5.9% and 7.3% of adults in the United States develop major depression, and the lifetime prevalence is 15% to 17% (Kessler et al., 2003). Point prevalence of major depression is reported as 2% to 6% among community-dwelling individuals with mild or moderate intellectual and developmental disability (I/DD), based on semistructured clinical interviews (Cooper, 1997; Deb, Thomas, & Bright, 2001), although this figure is thought to be low (Lunsky & Palucka, 2004; Smiley & Cooper, 2003). Powell (2003) found that among 120 community-living adults with mild or moderate I/DD, 9.2% had severe and 19.2% had moderate depression scores on the Beck Depression Inventory (BDI). Sensitivity and specificity of scores on depression screening measures compared to clinical interviews has not been addressed in research (Ailey, 2005), and epidemiological investigation comparable to the general population is lacking. Prevalence of depression among individuals with I/DD is thought to be at least as high, if not higher, than among the general population (Lunsky & Palucka, 2004).

In individuals with I/DD, depression is associated with aggressive behavior and conduct problems (Moss et al., 2000), and can cause significant problems in work and living. Individuals with Down syndrome are among the approximately 1.5 million individuals aged 6 to 64 years in the U.S. with I/DD (CDC, 1996). Approximately 350,000 individuals in the United States have Down syndrome and, due to decreasing mortality rates and new births, the number of individuals with Down syndrome is expected to double in the U.S. over the next 10 years (National Down Syndrome Society, 2006). Some research indicates that individuals with Down syndrome are susceptible to depression (Collacott, 1999).

Both biological and psychosocial risk factors influence the development of depression. Theories about the psychosocial risk factors of depression provide frameworks to understand, assess, and treat the interaction of psychosocial risk factors with depression. Theories about the psychosocial risk factors of depression include psychoanalytic, behavioral, cognitive, and interpersonal (Joiner, Coyne, & Blalock, 1999). The theories affect how depression is viewed and treated. Models based on behavioral theories of depression are used widely and some models based on cognitive theories of depression are used with individuals with I/DD (Ailey & Miller, 2004). Models based on interpersonal theories of depression are broader, specifically address social and interpersonal contexts affecting depression, and provide improved frameworks for addressing depression risks among individuals with I/DD (Ailey & Miller, 2004). However, no previous research has evaluated models based on interpersonal theories of depression with individuals with Down syndrome and/or I/DD. The purpose of this study was to evaluate the Interpersonal Model of Depression (IMD), adapted from an interpersonal model of depression (Hagerty & Williams, 1999) based on the Theory of Human Relatedness (THR) (Hagerty et al. …

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