New research indicates that screening children for symptoms of depression, the most common mental health disorder in the United States, can begin a lot earlier than previously thought, as early as the second grade.
A University of Washington study that followed nearly 1,000 children from the second to the eighth grades also found five distinct patterns for the way symptoms of depression develop among adolescents.
"Some children are reporting that they don't have as many friends, feel lonelier and are more anxious than their peers," said James Mazza, a UW professor of educational psychology and lead author of the study. "They are telling us that they feel different from the typical happy- go-lucky second grader.
"We can start to build a profile of children's mental health in the second grade. This is important because children who are experiencing depression symptoms early on may be at great risk for mental health concerns during adolescence, based on other research studies. We want to reassure parents that everyone, including children, may feel sad or depressed once in a while, but that doesn't mean they will go on to develop depression. We are trying to understand how depression starts and evolves in childhood so that we can develop interventions to help children," Mazza said.
The new study relied on annual self reports from the children as well as parental and teacher evaluations collected as part of the Raising Healthy Children study, a larger, long-term investigation looking at the development of healthy and problem behaviors among children at 10 suburban schools in the Pacific Northwest. The depression study used data from 511 boys and 440 girls, and 81 percent of the participants were white.
The study identified five patterns of depression symptoms, but 56 percent of the children showed no or very few symptoms of depression in the second grade.
The five patterns of depression symptoms the researchers found and the percentage of students in each group are:
- Low stables – 26 percent. These children showed none or very few signs of depression in the second grade and their rates didn't change over time through the eighth grade.
- Low risers – 30 percent. Children in this group also had no or few symptoms in the second grade, but the number went up by a small amount in subsequent years.
- Mild stables – 24 percent. This group had few symptoms and then went up by a small amount in subsequent years.
- Moderate changers – 11 percent. These children started out with a few more symptoms than the previous group and their number of symptoms rose through elementary school and then dropped in middle school.
- Moderate risers – 9 percent. This group started off with a similar number of symptoms as the moderate changers, however their symptoms did not decrease in middle school.
The study identified different early depression risk factors for boys and girls. For boys, behavior and attention problems predicted membership in the different depression groups. For girls anxiety was an early risk factor. The research also reaffirmed previous findings showing gender differences in underlying depressive symptoms, with girls experiencing more symptoms than boys in the eighth grade
"Our children are our best resource in knowing what they are feeling inside. But it is also important to have multiple perspectives. Collecting assessments from parents, teachers and the child to identify children at early risk for depression is a good method for spotting those who may go on to have later mental health risks," Mazza said.
The National Institute on Drug Abuse funded the study, which was published in the Journal of Youth and Adolescence. Co-authors are Charles Fleming, Kevin Haggerty and Richard Catalano of the UW's Social Development Research Group, a part of the School of Social Work, and Robert Abbott, of educational psychology.
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