Original article
Heterogeneity in Youth Depressive Symptom Trajectories: Social Stratification and Implications for Young Adult Physical Health

https://doi.org/10.1016/j.jadohealth.2009.04.018Get rights and content

Abstract

Purpose

The first objective of this study was to investigate young adult physical health implications of adolescent depressive symptom trajectories. The second objective was to investigate the social stratification of adolescent depressive symptom trajectories.

Methods

Data came from the National Longitudinal Study of Adolescent Health. The analysis included the identification of depressive symptom trajectory groups. These four groups were then compared in terms of socioeconomic characteristics and change in physical health problems, from adolescence to young adulthood.

Results

Youth in the chronically high, increasing, and decreasing depressive symptoms groups showed significantly higher increases in physical health problems and poorer socioeconomic characteristics than did the consistently low group.

Conclusions

The associations of adolescent depressive symptom trajectory groups with changes in physical health provide evidence for the etiological processes through which depression influences physical health. Differing socioeconomic characteristics of depressive symptom trajectory groups suggest social stratification of trajectories.

Section snippets

Adolescent depressive symptom trajectories

Previous research documents that more than 20% of adolescents report significantly high levels of depressive symptoms. Most youth experience their first episode of depressive disorder during adolescence [6]. On average, depressive symptoms increase from relatively low levels in childhood to much higher levels in early–middle adolescence, followed by a decrease in late adolescence [6], [7]. Starting in early adolescence, girls report higher levels of depressive symptoms than do boys. Previous

Specific study hypotheses

The specific study hypotheses are:

  • 1.

    Youth who experience chronically high, increasing, and decreasing levels of depressive symptoms (three nonnormative groups) would show a greater increase in physical health problems from adolescence to young adulthood than youth who experience consistently low levels of depressive symptoms (the normative group).

  • 2.

    Youth who belong to the nonnormative depressive symptom trajectory groups tend to have disadvantaged family socioeconomic characteristics and represent

Sample

Data for this study came from a nationally representative school-based sample of adolescents participating in the National Longitudinal Study of Adolescent Health (Addhealth). In 1995, the baseline (W1) data were derived from a complex stratified cluster-sampling of middle and high school students, yielding 20,745 respondents of 12 to 19 years of age, from 134 middle and high schools. To ensure diversity, the sample was stratified by region, urbanicity, school type (public vs. private), racial

Results

Table 1 presents (a) prevalence rates of adolescent physical health problems in 1995 (ANOVA results), (b) the change in prevalence rates of physical health problems from adolescence (1995) to young adulthood (2001) (ANOVA results), and (c) corresponding odds ratios for nonnormative groups for those changes (compared to consistently low group) after controlling for the influence of socioeconomic characteristics, race/ethnicity, age, and gender (binary logistic regression results). All groups

Discussion

Our analysis began with the identification of theoretically based depressive symptom trajectory groups. As expected, the identified heterogeneous groups showed different physical health outcomes and background socioeconomic characteristics.

The findings are consistent with the hypothesized influence of youth depression on change in physical health problems. Youth in both the chronically high group and the increasing group differed significantly from those in the consistently low normative group

Acknowledgments

This research is based on data from the Add Health project, a program project designed by J. Richard Udry (PI) and Peter Bearman, and funded by grant P01-HD31921 from the National Institute of Child Health and Human Development to the Carolina Population Center, University of North Carolina at Chapel Hill, with cooperative funding participation by the National Cancer Institute; the National Institute of Alcohol Abuse and Alcoholism; the National Institute on Deafness and Other Communication

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    Copyright © 2009 Society for Adolescent Medicine. Published by Elsevier Inc. All rights reserved.