The purpose of this study is to describe common interaction patterns between adolescents who are depressed and the important adults in their lives, with special attention given to interactions that influence the course of the teens’ depression. Data are drawn from an ongoing grounded theory study of the management strategies and service usage patterns of adolescents who are depressed. The sample includes 52 young adults between the ages of 18 and 21 who experienced depressive symptoms as adolescents, 4 of their parents, and 8 professionals who work with youths. All participants discussed how both adolescents and adults ignore, hide, or minimize the adolescents’distress by putting up a façade. The three common interaction patterns that were identified (maintaining the façade, poking holes in the façade, breaking down the façade) are responses to the façade. The author discusses interaction patterns and their influence on the course of the adolescents’ depression.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
2.
Armsden, G. C., McCauley, E., Greenberg, M. T., Burke, P. M., & Mitchell, J. R. (1990). Parent and peer attachment in early adolescent depression. Journal of Abnormal Child Psychology, 18(6), 638-697.
3.
Asarnow, J. R., Goldstein, M. J., Tompson, M., & Guthrie, D. (1993). One-year outcomes of depressive disorders in child psychiatric inpatients: Evaluation of the prognositic power of a brief measure of expressed emotion. Journal of Child Psychology and Psychiatry, 34, 129-137.
4.
Asarnow, J. R., Tompson, M., Hamilton, E. B., Goldstein, M. J., & Guthrie, D. (1994). Family-expressed emotion, childhood-onset depression, and childhood-onset schizophrenia spectrum disorders: Is expressed emotion a nonspecific correlate of child psychopathology or a specific risk factor for depression?Journal of Abnormal Child Psychology, 22(2), 129-146.
5.
Blumer, H. (1969). Symbolic interactionism: Perspective and method. Englewood Cliffs, NJ: Prentice Hall.
6.
Campbell, R., & Salem, D. A. (1999). Concept mapping as a feminist research method: Examining the community response to rape. Psychology of Women Quarterly, 23, 67-91.
7.
Centers for Disease Control and Prevention. (2003). Health, United States. Retrieved April 10, 2004, from http://www.cdc.gov/nchs/fastas/suicide.htm
8.
Cook, W. L., Asarnow, J. R., Goldstein, M. J., Marshall, V. G., & Weber, E. (1990). Mother-child dynamics in early-onset depression and childhood schizophrenia spectrum disorders. Development and Psychopathology, 2, 71-84.
9.
Department of Health and Human Services. (1999). Mental health: A report of the Surgeon General. Rockville, MD: U.S. DHHS, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.
10.
Draucker, C. B. (in press). Processes of mental health service use by adolescents with depression. Journal of Nursing Scholarship.
11.
Fombonne, E. (1998). Interpersonal psychotherapy for adolescent depression. Child Psychology and Psychiatric Review, 3(4), 169-175.
12.
Glaser, B. G. (1978). Theoretical sensitivity. Mill Valley, CA: Sociology Press.
13.
Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine.
14.
Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Englewood Cliffs, NJ: Prentice Hall.
15.
Greenberger, E., Chen, C., & Beam, M. R. (1998). The role of “very important” nonparental adults in adolescent development. Journal of Youth and Adolescent, 27(3), 321-343.
16.
Kazdin, A. E. (2004). Psychotherapy for children and adolescents. In M. J. Lambert (Ed.), Handbook of psychotherapy and behavior change (pp. 543-587). New York: John Wiley.
17.
Klaw, E. L., Rhodes, J. E., & Fitzgerald, L. F. (2003). Natural mentors in the lives of African American adolescent mothers: Tracking relationships across time. Journal of Youth and Adolescents, 32(3), 223-232.
18.
Kovacs, M., & Sherrill, J. T. (2001). The psychotherapeutic management of major depressive and dysthymic disorders in childhood and adolescence: Issues and prospects. In I. M. Goodyear (Ed.), The depressed child and adolescent (pp. 325-352). Cambridge, UK: Cambridge University Press.
19.
McCauley, E., & Myers, K. (1992). Family interactions in mood-disordered youth. Child and Adolescent Psychiatric Clinics of North America, 1(1), 111-127.
20.
McCauley, E., Pavlidis, K., & Kendall, K. (2001). Development precursors of depression: The child and the social environment. In I. M. Goodyear (Ed.), The depressed child and adolescent (pp. 46-78). New York: Cambridge University Press.
21.
Mufson, L., Moreau, D., Weissman, W., & Klerman, G. (1993). Interpersonal psychotherapy for depressed adolescents. New York: Guilford.
22.
Prus, R. (1996). Symbolic interaction and ethnographic research. Albany: State University of New York Press.
23.
Puig-Antich, J., Goetz, D., Davies, M., Kaplan, T., Davies, S., Ostrow, L., et al. (1989). A controlled family history study of prepubertal major depressive disorder. Archives of General Psychiatry, 46, 406-418.
24.
Puig-Antich, J., Kaufman, J., Ryan, N. D., Williamson, D. E., Dahl, R. E., Lukens, E., et al. (1993). The psychosocial functioning and family environment of adolescents living with depression. Journal of the American Academy of Child and Adolescent Psychiatry, 32(2), 244-253.
25.
Puig-Antich, J., Lukens, E., Davies, M., Goetz, D., Brennan-Quattrock, J., & Todak, G. (1985a). Psychosocial functioning in prepubertal major depressive disorders, I: Interpersonal relationships during the depressive episode. Archives of General Psychiatry, 42, 500-507.
26.
Puig-Antich, J., Lukens, E., Davies, M., Goetz, D., Brennan-Quattrock, J., & Todak, G. (1985b). Psychosocial functioning in prepubertal major depressive disorders, II: Interpersonal relationships affective sustained recovery from affective episode. Archives of General Psychiatry, 42, 511-517.
27.
Roschelle, A. R., & Kaufman, P. (2004). Fitting in and fighting back: Stigma management strategies among homeless kids. Symbolic Interactionism, 27(1), 23-46.
28.
Thompson, S. K., & Seber, G. A. G. (1996). Adaptive sampling. New York: John Wiley.
29.
Weigert, A. J., & Gecas, V. (2003). Self. In L. T. Reynolds & N. J. Herman-Kinney (Eds.), Handbook of symbolic interactionism (pp. 289-306). New York: Rowman & Littlefield.
