Depressive symptoms in adolescent girls may be related to increased risk of partner violence later

March 06, 2006

Teenage girls with symptoms of depression may have a higher risk of subsequent physical abuse by their partners than those who don't have symptoms of depression, according to a study in the March issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Major depressive disorder affects about 21 percent of girls and women aged 15 to 24 years, and an additional 10 percent experience minor depression, according to background information in the article. Depressive symptoms and disorders during adolescence have been linked to a number of negative outcomes later in life, including low self-esteem, interpersonal difficulties, divorce, impaired social functioning and problems at work. Depression is understood to often occur as a consequence of partner violence, but few studies have examined whether depression early in life puts women at an increased risk for subsequent exposure to such violence.

Jocelyn A. Lehrer, Sc.D., of the University of California, San Francisco, and colleagues examined whether depressive symptoms in adolescent girls are predictive of subsequent partner violence in late adolescence and early adulthood, using data from a national survey of middle school and high school students. In the national survey, students were interviewed twice in their homes--once in 1996 and again in 2001 or 2002. The study focused on a total of 1,659 girls who were involved in an opposite-sex relationship of three or more months' duration at the time of the second interview. The girls' average age was 15.9 years in 1996 and 21.3 years at their second interview. During the first interview, participants were assessed for symptoms of depression during the previous week. In the second interview, participants were asked whether they had been physically abused by their current partner during the past year. The study examined exposure to mild violence (including being threatened with violence, pushed or shoved) and moderate to severe violence (defined as being hit, slapped, kicked, or receiving an injury).

At the beginning of the study, 10.2 percent of participants had depressive symptom scores that were above a threshold for "high" depressive symptoms. In the second interview, 18.6 percent of participants reported experiencing some form of violence or injury at the hands of their current partner. Among those who reported high levels of depressive symptoms during the first interview, 28 percent reported at the second interview that they had experienced some form of abuse by their partner in the past year, compared with 17.5 percent of those with lower levels of depressive symptoms. Those with high depressive symptoms were 86 percent more likely to experience subsequent moderate to severe partner violence.

"The time of transition from adolescence to adulthood is one of increasing independence from parents, strengthening self-concept and critical decision making regarding education, occupation and intimate relationships, all of which have a salient impact on the long-term social trajectory of the individual," the authors write. "Depression that occurs during this time of transition may have a particularly significant impact on maturational processes and choices made, generating a trajectory of risk for continued psychosocial impairment and psychopathology."

Further studies are needed to determine whether depression itself actually contributes to increasing the chances of future physical abuse, or whether it might just serve as a marker or indicator of risk, the authors write. "If depressive symptomatology among adolescent girls becomes recognized as an independent predictor of subsequent intimate partner violence exposure, this will be one more reason to increase efforts in the prevention, identification and treatment of depressive symptomatology among adolescent girls," they conclude.
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(Arch Pediatr Adolesc Med. 2006; 160:270-276. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: This research uses data from Add Health, a program project funded by a grant from the National Institute of Child Health and Human Development, Rockville, Md., with cooperative funding from 17 other agencies. Partial funding for research came from the National Institute of Mental Health Academic Fellowship on Mental Health and Developmental Disorders.

The JAMA Network Journals

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