For a long period of time the scientific community, for strict theoretical reasons, held that the Childhood Depression did not exist (coinciding with the little importance that was given to the mental health of the kids),. However, in the real world there were depressed children and some clinicians began to rebel against the orthodoxy that denied the possibility of their existence. This began to occur around the 1940s in different fields of applied psychology, and studies related to childhood depression, under the names of Akerson (1942); Spitz (1945); Bowlby (1951), among others.
Index
- Definition of childhood depression
- Criteria and emotional symptoms
- Why childhood depression occurs
- Epidemiology of childhood depression
- Influence of family and school on childhood depression
- Assessment instruments for childhood depression
- Treatment of childhood depression
Definition of childhood depression.
In the early 1960s Harlow (1961) observed, in monkeys separated from their mothers, exactly the same type of behavior that Spitz and Bowlby had reported in children. The experimental character of comparative psychology produced a special impact for this type of findings and a little more seriously the possibility of the existence of depression in children, since monkeys seemed to be capable of develop them.
But really acceptance of the existence of childhood depression it was possible thanks to the rise of the cognitive paradigm of the sixties, which allowed the study of internalized processes. Already in 1975 childhood depression (DI) was accepted by the National Institute of Mental Health, as a concept and psychopathological entity.
The childhood depression can be defined as a affective situation of greater sadness in intensity and duration that occurs in a child. We speak of major depression, when the symptoms are greater than 2 weeks, and dysthymic disorder, when these symptoms exceed a month.
The supporters of a specific childhood depression are located in two tendencies, namely: the evolutionists, who believe that childhood depression is transformed according to the time evolutionary life of the child in which it is presented, therefore support the existence of an Evolutionary ID, and those who support the existence of childhood depression with a Its own symptoms, not comparable to that of adults, especially related to behavior problems, hence the name of DI Enmascarada, since many professionals make mistakes your diagnosis.
Criteria and emotional symptoms.
Experts on the subject of childhood depression, through numerous investigations, have come to accept the following characteristic symptoms and criteria of childhood depression (Del Barrio 1997): sadness, irritability, anhedonia (loss of pleasure), easy crying, lack of sense of humor, feeling of not being loved, low self-esteem, social isolation, changes in sleep, changes in appetite and weight, hyperactivity, dysphoria and ideation suicide.
This operational definition can be used as a diagnostic guide and has the advantage of representing a nucleus of agreement from a broad spectrum of the scientific community.
Why childhood depression occurs.
There are several theoretical frameworks that try to explain the origin of childhood depression, thus we have:
- Behavioral: through the absence of reinforcements (Lazarus), deficiency of social skills and negative events that occurred in the child's life.
- Cognitive: the existence of negative judgments (Beck), experiences of failures, depressive models (Bandura), learned helplessness (Seligman), lack of control, negative attributions.
- Psychodynamic: in relation to the loss of self-esteem (of the self-according to Freud), and the loss of the good object (Spiz).
- Biological: due to a dysfunction of the neuroendocrine system (cortisol levels increase and growth hormone decreases), by a decrease in the activity of serotonin (brain neurotransmitter), and due to heredity (in the case of parents depressive).
Nowadays, rather, a complex interaction of different factors of both character biological as well as social that serve as the basis for the appearance of the different normal and pathological. It is necessary that there is a certain personal, family and environmental vulnerability that, combined, give rise to the appearance of a maladjusted behavior.
In the case of ID, the elements that imply vulnerability are biological, personal, social and demographic in nature. (Del Barrio, 1997).
Epidemiology of childhood depression.
The percentages of ID detected among the child population is about 8-10%, according to numerous investigations.
Several studies indicate that the female sex has been systematically associated with an increase in the probability of developing depression, indeed the symptoms are more higher in girls than in boys, especially in the ranges that exceed 12 years, before this age it is rare to find differences between the two sexes (Del Barrio, 1997).
Regarding social class, some authors point out that it is found more frequently in the lower and middle class children than in the upper class.
Influence of family and school on childhood depression.
The family is the child's most immediate environment, Its microcosm and its care and attention are based on the possibility of survival of the human subject, but not only its physical survival, but also its personal one, since the child from 0 months to 3 years, develops all the basic elements with which he will later build his future life: language, affections, habits, motivations.
The attachment with which the mother and the child imprint each other is the vehicle of an adequate social and personal integration of the child. Insecure attachments have been linked to all kinds of behavior problems and also to depression, as well as a secure attachment is the ideal goal of preventing the onset of depression childish. Likewise maternal depression appears clearly defined as one of the risk factor's associated with the triggering of depression in the child.
Later on, good relationships with parents are also essential for the normal emotional development of the child. Over and over again, numerous experts have pointed out how bad relationships with parents are the specific source of a wide range of childhood problems, and of course depression as well.
In relation to the family, it has also been studied the position he occupies among the brothers. In many investigations, the intermediate position appears as the most vulnerable to developing emotional disorders.
Parents should pay special attention to building a proper self-esteem and self-efficacy in the child, as well as encouraging in them the ability to cope, and the proper management of frustration, all this constitutes the primary prevention of ID.
Regarding the school, we know that the early location of any learning deficiency in a child and its prompt solution is essential for achieve a situation of normal and acceptable progress, thus eliminating the possibility of affective disorders that lead to the onset of depression childish.
Many authors have linked ID to school performance, sometimes considering it as a cause and other times as an effect of depression. In fact, a depressed child can lower his performance in school, but he can also start his depressive symptoms by academic failure. Hence the importance of a good evaluation and follow-up by the teacher to detect these changes in the student.
Assessment instruments for childhood depression.
DI assessment instruments vary depending on the theoretical framework from which they are derived and from what they intend to measure. Thus, when we want to measure internalized behaviors, pencil tests and tests are fundamentally used. role that can be: standardized interviews, inventories, scales, questionnaires, pictorial tests, and others. When what is intended is to measure manifest behavior, observation of behaviors, recording of behaviors, and application of children's play are made.
The evaluation of the biological aspects of childhood depression is carried out with objective analysis and testing of the physical elements that have been shown related to it. Thus we have endocrine tests, such as the determination of cortisol and growth hormone levels. Tests such as the EEG electroencephalogram (especially during sleep) and the EMG electromyogram (related to the facial muscles involved in expressiveness).
When the specialized literature is reviewed, it is clearly defined that the instruments most widely used in the evaluation of DI are fundamentally two: the Child Depression Inventory CDI (Kovacs and Beck, 1977) and the Child Depression Scale CDS (Tisher and Lang, 1974). Currently, the most widely used questionnaire is the modified one by M. Kovacs CDI from 1992.
By using these assessment tools some factors should be taken into account such as: the level of development of the child, his degree of intellectual maturity, his emotional lability and internalized character of depressed behavior, therefore it is convenient to pass the questionnaire two times.
The parent interview emerges as an important instrument for data collection, both for the depressed child and the family. As well as interviewing teachers and classmates.
Treatment of childhood depression.
Treating childhood depression first and foremost must be individualized, adapted to each particular case and to the stage of development that the child is in, based on: their cognitive functioning, their social maturation and their ability to maintain attention.
Must also actively involve parents, and carry out interventions towards the child's environment (family, social and school). Treatment is divided into acute phase treatment and maintenance phase. Treatment in Acute Phase includes: Psychological, Pharmacological and Combined.
Psychological Therapies
- Cognitive-Behavioral: it is based on the premise that the depressed patient has a distorted vision of himself, the world and the future. Such distortions contribute to your depression and can be identified and treated with this technique.
- Behavioral: it is based on the application of behavioral modification techniques, proper handling of situations, etc.
- Psychodynamics.
- Interpersonal
- Family.
- Group and Support.
Pharmacological Treatment
It is based on the use of drugs such as:
- Tricyclic antidepressants, for which a baseline EEG is required, and measurements of blood pressure, heart rate and weight.
- Selective serotonin reuptake inhibitors SSRIs are currently the most widely used, due to their efficacy, apparent low side-effect profile, low overdose lethality, and easy once-daily administration day.
- Combined Treatment, which includes drugs and psychological therapies, has proven to be the most appropriate today.
Likewise, the Treatment in the Maintenance Phase it will depend on the clinical status of the patient, their intellectual functioning, their support system, the presence or absence of environmental stressors and their response to treatment.
By way of conclusion, today the existence of childhood depression is a common fact accepted by the specialized scientific community, for which its study and treatment. Some have come to call depression the disease of the 21st century.
This article is merely informative, in Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.
If you want to read more articles similar to Childhood depression: causes, diagnosis and treatment, we recommend that you enter our category of Emotional and behavioral disorders.
