Black adolescents may express depression symptoms differently than people from other age or racial groups—something clinicians need to keep in mind when planning treatment—a new study suggests.
“Adolescent depression is a dire public concern in the United States, and even greater concern among black adolescents, where, if left untreated, can disproportionately lead to an escalation of various mental disorders, academic failure, and related issues,” says Wenhau Lu, assistant professor of childhood studies at Rutgers University-Camden.
According to the study’s findings, which the researchers report in the Journal of the Society for Social Work and Research, black adolescents experiencing depressive symptoms tend to express their depressed feelings by complaining about conflicts with others and physical pains.
“When assessing and treating black adolescents’ depression, clinicians need to pay particular attention to their complaints about interpersonal struggles and physical discomfort,” Lu says. “Treatments such as interpersonal psychotherapy may work better for this population.”
Previous studies have shown that black adolescents who live in disadvantaged community environments—urban public housing, for example—are more likely to experience elevated levels of substance abuse, violence, and poverty.
“Black adolescents who are exposed to such environmental and social risk factors without sufficient social-support networks are at a higher risk of depression,” says Lu.
Furthermore, say the researchers, youth who have been diagnosed with depression are six times more likely to commit suicide than their peers, and black youth have a much higher suicide rate than white youth.
“It is imperative, therefore, to identify the unique ways black adolescents express depressive symptoms, and calibrate existing assessment tools to improve their psychometric property for this population,” the researchers write in the study.
A total of 792 black adolescents, ages 11 to 21, who lived in nine public housing developments in four major US cities (including two in North Philadelphia), completed a survey that contained a mixture of 20 negatively and positively worded items—such as “I felt sad,” “I enjoyed life,” “My appetite was poor,” and “People are unfriendly to me”—in the Center for Epidemiologic Studies Depression Scale (CES-D).
Lu explains that the CES-D is a commonly used self-report tool to assess depressive symptoms in community-based populations, and the 20 items are usually grouped into four major domains: depression affect, somatic symptoms, interpersonal relations, and positive affect.
“However, this scale was developed primarily to assess clinical depression among white adults,” says Lu. “It has not been fully validated as a screening tool in black adolescents.”
Source: Rutgers University