Ordinary sounding expressions of teen angst may signal early depression
PAS Meeting Updates
SAN FRANCISCO – While it’s estimated at least one in 10 teens in the U.S. suffer from
depression at some point, few will use the word “depressed” to describe negative emotions
hanging over them. Instead, new research at the 2017 Pediatric Academic Societies
Meeting in San Francisco suggests, they’re likely to use terms such as “stressed,”
or “down,” and other words that may sound like ordinary teen angst but could be a
signal of more serious, pre-depressive symptoms.
Researchers will present the abstract, “Understanding teen expression of sadness in
primary care: A qualitative exploration” on Sunday, May 7, at the Moscone West Convention
Center. For the study, they analyzed a sample of screening interviews with 369 teens
ages 13 and 18 at risk for depression who participated in the Promoting Adolescent
Health Study (PATH), a large, randomized control trial funded by the National Institutes
of Mental Health.
“Much of what a teen is feeling and experiencing is easy to attribute to the ups and
downs of teen angst,” said abstract co-author Daniela DeFrino, P.hD., R.N., an assistant
professor of research in the University of Illinois at Chicago College of Medicine
and College of Nursing. “But, sometimes, there is so much more under the surface that
can lead to depression,” she said.
For the PATH study, adolescents who reported feeling down irritable or hopeless during
the past two weeks in private, written responses to two brief screening questions
received a call from the study team. During the call, researchers used validated measures
to screen for those at risk for depression.
“Teens rarely stated they were depressed, but described bursts of feeling stressed
and sad that often came and went,” DeFrino said. For example, a teen might say, “I
always find somehow to go back to stressful mode,” DeFrino said, or, “I get really
mad at people very easily. They don’t understand why I’m upset. Sometimes I don’t
Other common symptoms the teens in the study reported:
Increased anger and irritability toward others.
Loss of interest in activities they previously enjoyed.
Marked difficulty falling and staying asleep, as well as sleeping too much.
Recruited from the Chicago and Boston areas, PATH study participants were 68% female,
21% Hispanic, 26% African-American and 43% white. More than half of the teens’ mothers
and fathers (60% and 54%, respectively) were college graduates.
DeFrino said the teens often noted school pressure related to homework and expectations
to succeed as sources of stress and difficulty. Arguments with parents, verbal and
emotional abuse, divorce, separation, neglect, sexual abuse and home relocation were
among major reasons cited for worsening mood. Teens also often attributed new feelings
of sadness to deaths from illness and suicides of family members or friends.
The researchers also noted that, unrelated to expressed feelings of depression, two-thirds
of the teens had visited their primary healthcare providers for physical illnesses
such as ulcers, migraines, stomach pains and fatigue. These visits could offer an
opportunity for a health care provider to identify feelings and check in with mental
health concerns as well, DeFrino said.
“Teens may be experiencing a lot of internal turmoil and difficult life stresses that
we can easily overlook if we don’t probe with sensitive questioning and understanding,”
DeFrino said. “Reframing these feelings as outward symptoms of pre-depression by the
primary care provider would allow for connection to and discussion about the importance
of mental health with the teen and parent.”
The Pediatric Academic Societies (PAS) Meeting brings together thousands of individuals
united by a common mission: to improve child health and well-being worldwide. This
international gathering includes pediatric researchers, leaders in academic pediatrics,
experts in child health, and practitioners. The PAS Meeting is produced through a
partnership of four organizations leading the advancement of pediatric research and
child advocacy: Academic Pediatric Association, American Academy of Pediatrics, American
Pediatric Society, and Society for Pediatric Research. For more information, visit
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