جلوگیری از افسردگی جوانان: شبیه سازی تاثیر مداخلات والدین Preventing youth depression: simulating the impact of parenting interventions

Introduction Depression is an increasing world-wide problem, ranked by the World Health Organization as the leading contributor to global disability in 2015 (World Health Organization, 2017). In that year, the global prevalence of depression among youth (aged 15-19 years) was estimated to be 4.5% in females and 3.2% in males (World Health Organization, 2017). Against this backdrop, the mental health of youth has become a pressing public health issue (Kieling et al., 2011). The most recent information from New Zealand (NZ) in 2015/16 shows that 8.6% of youth (aged 15-24) suffered with major depressive disorder (Ministry of Health, 2016), while, in 2003/4, the lifetime prevalence in youth (aged 16-24) was estimated to be 15.1% (Oakley Brown, Wells, & Scott, 2006). In 2012, 12.8% of NZ secondary school students reported clinically significant depressive symptoms in the last 12 months, while 31.1% of students reported feeling depressed most of the day for at least two consecutive weeks in the last 12 months (Adolescent Health Research Group, 2013). Adolescence is a critical developmental period (Beardslee, Gladstone, & O’Connor, 2012; Ben-Shlomo & Kuh, 2002). The brain and body systems develop substantially in this period of life (Corna, 2013). Healthy adolescents are not only more likely to grow into healthy adults, they are also more likely to have greater economic security and stability in adulthood. Psychosocial health problems are most likely to emerge during adolescence (Braveman, 2014). Depression occurring at this intermediate life stage has continuing adverse consequences for their later trajectory as youth develop from children into adults (Meeus, 2016). In this respect, a life-course perspective is advantageous in accounting for both lagged and concurrent influences that may persist or accumulate over time (Reiss, 2013; Landry, Smith, Swank, & Guttentag, 2008), and in understanding the generation of social inequalities in health (Fuhrmann, Knoll, & Blakemore, 2015; Kessler et al., 2005). Further down the track, most crucially for their life chances, depressed youth are more likely to have worse social and economic outcomes as adults (Sawyer et al., 2012). In terms of changing the precursors to, and thereby preventing, youth depression, a life-course perspective points to, for example, early parenting intervention in childhood for maximum impact (Viner et al., 2012). Parental behaviors toward offspring have been shown variously to be either protective or risk factors for depression (Chapman, Parkinson, & Halligan, 2016; Schwartz, Sheeber, Dudgeon, & Allen, 2012). Maccoby and Martin (1983) characterized these parental behaviors along the two dimensions of being responsive, and being demanding towards their child, to form a four-fold typology of parenting style. Thus according to the authoritative type, held to be the optimal style, the parent is both highly responsive – i.e. being nurturing, encouraging and warm towards their child – and highly demanding – i.e. having expectations of and setting limits for their child, along with fair and reasonable discipline. Across all cultures, parenting styles have been shown to vary by socio-economic position. For example, Hoff, Laursen, & Tardiff (2002) found that parents in lower socio-economic positions are more likely to use ‘authoritarian’ (non-responsive and demanding) parenting styles, than those in higher socioeconomic positions.