My dissertation research project is centered around the concept of a depression spectrum among adolescent depression. I employed a study design that was in some ways similar to an epidemiological approach developed by Wade Hampton Frost in the 1930s for tuberculosis (TB) mortality research. My research assessed the experiences of individual birth cohorts, with cross-sectional snapshots that begin when each survivor of a birth cohort reaches the 12th-13th birthday interval with an end date just before the 18th birthday. As an extension of our group's prior contributions to depression epidemiology, my dissertation project also examines health disparities in these mood disorder spectrum transitions (e.g., variations across the US Census 'race-ethnicity' subgroups).The main results of my dissertation can be summarized as follows: Study 1: In terms of female-to-male variation, studying US nationally representative samples of 12-17-year-olds male and female adolescents, I found a female excess occurrence of the DSM-IV-specified Major Depressive Disorder (MDD) once a Brief Depression Spell had occurred. In estimates for females and males together, among every 100 12-year-olds who experienced BDS, there were roughly five who had transitioned to the MDD experience. The corresponding estimate for 17-year-olds was roughly 40 MDD cases for every set of 100 BDS cases.Study 2: My results highlight that disparity in adolescent mental health-related ethnic self-identification persists between Non-Hispanic Blacks and Non-Hispanic Whites. Additionally, younger aged Hispanics and non-Hispanic white adolescents were more likely to experience MDE, given a history of BDS.Study 3: According to my meta-analysis approach, statistically robust and reproducible non-null estimates suggest a general age-associated excess occurrence of Brief Depressive Spells. More recently born cohorts are more likely to become cases of major depressive disorder once a brief depressive spell has already occurred. For this dissertation, nonparticipation levels and self-reporting might be the most significant measurement issues. Whether recruitment of participants via social media or advertisements will yield increasingly definitive evidence on the epidemiology of mood disturbances is uncertain. The reliance on self-reports in mood disturbances field studies most likely will be a limitation that others will face in the future. It is necessary to ask people about experiences such as Brief Depression Spells and Depression Syndromes because there now is no alternative to measurement of these facets of the Depression Spectrum.
Read
