An exploration of caregivers' and peers' support-giving responses to adolescents showing signs of depression.

Abstract

Background: Adolescent depression is linked to significant impairment, recurrence in adulthood, heightened risk of suicide, and increased all-cause mortality (Schubert, Clark, Van, Collinson, & Baune, 2017; Shore, Toumbourou, Lewis, & Kremer, 2018). Compounding the significance and complexity of this issue is the fact that most adolescents experiencing depression do not seek or receive professional help (Sheppard, Deane, & Ciarrochi, 2018; Thornicroft et al., 2017). Multiple strategies have been developed to address this "treatment gap". However, the provision of support from family and friends appears to have been overlooked, with little research existing on this topic despite evidence that this "informal" support may play an important role in determining illness outcomes. Drawing on relevant theories, including the Theory of Planned Behaviour (Ajzen, 1991) and the Attribution-Empathy Model of Helping Behaviour (Betancourt, 1990), the current study aimed to address this gap. The aim of the study was to explore caregivers' and peers' responses to the presentation of symptoms of depression in adolescents. Methods: This cross-sectional study employed a mixed within-between groups design. Participants were 12- to 18-year-old adolescents (n = 535, 47.9% female), and adults who were primary caregivers of adolescent children (n = 321, 73.8% mothers). Data were collected through the use of a questionnaire constructed for the current study, which comprised a selection of instruments measuring each study variable. As no standardised measure of support-giving intentions was identified, the Modes of Intended Mental Health Support (MIMHS) scale was developed, and initial exploratory factor analyses were conducted. Key Results: Caregivers' responses reflect greater mental health literacy than those of adolescents, with adolescents' responses becoming more similar to those of caregivers with increasing age. Sex differences exist in both caregivers' and adolescents' responses' for example, girls and female caregivers feel significantly greater sympathy and less anger towards the adolescent vignette characters. Caregivers and adolescents have very different beliefs about the helpfulness and harmfulness of several support-giving responses, including suicide risk assessment. Young people tend to encourage "insular" support, whereby adult help is not engaged. Some caregivers respond to the presentation of depressive symptoms by attempting to minimise adolescents' problems. The ability to label a cluster of symptoms as "depression" is associated with increased intentions to encourage or facilitate professional support. Discussion: The results of this study thus provide foundational knowledge that can be used to inform future theory and research on this topic. The results also have important implications for guiding efforts to improve the support that caregivers and peers may provide to young people experiencing symptoms of depression. In particular, several factors are highlighted which may be potentially modifiable, and therefore suitable to target through intervention. This study addresses a critical gap in the literature, and provides valuable insight into informal support-giving behaviour in the context of adolescent depression.