Adolescent Development HC 11
Depression, Self Harm and Suicide - Judith Semon Dubas
Lecture Outline
Adolescent moods and emotions (briefly)
Depressed affect & depression (briefly)
NSSI
Suicide
Moods and emotions
1. Relatively sudden changes in both positively- and negatively-valenced affect
a. The intensity and/or frequency of negative emotion peaks in early
adolescence (fluctuations)
b. Young adolescents also experience less positive emotions
2. Emotions become more complex with a comprehension of mixed emotions (they
understand emotions much better)
3. Dramatic changes of mood
a. The incidence of dysphoric or depressed moods radically increases,
especially for girls
4. Social aspects of emotion expression and regulation become more developed.
a. Increases in the ability to mask emotions (Rosenblum & Lewis, 2003)
b. The use of emotion to manage relationships (Saarni, 1999)
i. Say we are much sadder than in reality to get what we want
c. Yet, emotional expression can be inappropriate during adolescence (too
intense feelings)
5. Social referencing aspects of emotion become highly attuned.
a. In early adolescence, there is sharp increase in the awareness of other’s
perceptions of the self, and therefore shame (Rosenblum & Lewis, 2003)
b. More daily fluctuations in self-esteem (Alsaker & Olweus, 1992)
i. For instance: a course of a schoolday
6. Adolescents are more “moody” or variable in their emotions across the course of a
day or week (Csikszentmihalyi & Larson, 1984; Larson, et al., 2002)
7. Developmental affective neuroscience results suggest that adolescence
a. Begins with increased emotionality,
b. Increased sensitivity to stress,
c. Decreased sensitivity to rewards (we need more rewards, more risk-taking),
d. And a lag of years before the regulatory capacities of the pre-frontal cortex
become fully engaged (Dahl, 2004; Spear, 2003).
e. “Starting the engines without a skilled driver” (Dahl, 2001, p. 69).
Significant drop of positive mood!
, Adolescent Development HC 11
Depression in all its forms
Depression – an enduring period of sadness
Depressed mood – an enduring period of sadness, without any other related
symptoms
Depressive syndrome – sadness plus other symptoms such as crying, feelings of
worthlessness, and feeling guilty, lonely or worried
Major Depressive disorder – Depressed mood or loss of interest or pleasure in almost
all activities plus 4 of other symptoms. research does not measure this clinically
depression!
o Depressed mood most of the day, nearly every day, (in children and
adolescents – irritable mood.)
o Markedly diminished interest or pleasure in all, or almost all, activities most of
the day, nearly every day
o Significant weight loss when not dieting or weight gain (e.g., a change of more
than 5 of body weight in a month), or decrease or increase in appetite nearly
every day.
o Insomnia or hypersomnia nearly every day
o Psychomotor agitation or retardation nearly every day
o Fatigue or loss of energy nearly every day
o Feelings of worthlessness or excessive or inappropriate guilt nearly every day
o Diminished ability to think or concentrate, or indecisiveness, nearly every day
o Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation
without a specific plan, or a suicide attempt or a specific plan for committing
suicide.
This mood must represent a change from the person's normal mood; social,
occupational, educational or other important functioning must also be negatively
impaired by the change in mood.
Increase in testostoron as a protective factor?
, Adolescent Development HC 11
From the adolescence on (life-span), women as a groupd are more depressed than men.
Self-harm terms
"Self-injury"
"Self-mutilation"
"Cutting”
"Non-suicidal self-injury”
NSSI
What is self-harm?
A variety of behaviors in which an individual intentionally inflicts harm to his or her
body for purposes not socially recognized or sanctioned and without suicidal intent
Includes:
o Intentional carving or cutting of the skin and subdermal tissue,
o Scratching,
o Burning,
o Ripping or pulling skin or hair,
o Swallowing toxic substances,
o Self bruising,
o Breaking bones.
o Tatoos and body piercing are NOT unless undertaken with the intention to
harm the body
Prevalence (changing more research on this topic, the field is growing)
Time effect cohort effect, taboo?
4% of adults report a history (not now!) forgot it?
14% of adolescents
High school populations in the US and Canada consistently show a 13-24%
prevalence rate (Laye-Gindhu; & Schonert-Reichl, 2005; Muehlenkamp & Gutierrez,
2004; Muehlenkamp & Gutierrez, 2007; Ross & Health, 2002).
10% youth aged 11-25 in Britain (Young People and Self-Harm: A National Inquiry,
2004).
17% of young adults
Developmental course
Two developmental pathways: early onset and long-lasting, adolescence-limited
Early onset self-injury is common around the age of 7
Most often, however, self-injury behaviors begin in middle adolescence between the
ages of 12 and 15 (Yates, 2004)
Depression, Self Harm and Suicide - Judith Semon Dubas
Lecture Outline
Adolescent moods and emotions (briefly)
Depressed affect & depression (briefly)
NSSI
Suicide
Moods and emotions
1. Relatively sudden changes in both positively- and negatively-valenced affect
a. The intensity and/or frequency of negative emotion peaks in early
adolescence (fluctuations)
b. Young adolescents also experience less positive emotions
2. Emotions become more complex with a comprehension of mixed emotions (they
understand emotions much better)
3. Dramatic changes of mood
a. The incidence of dysphoric or depressed moods radically increases,
especially for girls
4. Social aspects of emotion expression and regulation become more developed.
a. Increases in the ability to mask emotions (Rosenblum & Lewis, 2003)
b. The use of emotion to manage relationships (Saarni, 1999)
i. Say we are much sadder than in reality to get what we want
c. Yet, emotional expression can be inappropriate during adolescence (too
intense feelings)
5. Social referencing aspects of emotion become highly attuned.
a. In early adolescence, there is sharp increase in the awareness of other’s
perceptions of the self, and therefore shame (Rosenblum & Lewis, 2003)
b. More daily fluctuations in self-esteem (Alsaker & Olweus, 1992)
i. For instance: a course of a schoolday
6. Adolescents are more “moody” or variable in their emotions across the course of a
day or week (Csikszentmihalyi & Larson, 1984; Larson, et al., 2002)
7. Developmental affective neuroscience results suggest that adolescence
a. Begins with increased emotionality,
b. Increased sensitivity to stress,
c. Decreased sensitivity to rewards (we need more rewards, more risk-taking),
d. And a lag of years before the regulatory capacities of the pre-frontal cortex
become fully engaged (Dahl, 2004; Spear, 2003).
e. “Starting the engines without a skilled driver” (Dahl, 2001, p. 69).
Significant drop of positive mood!
, Adolescent Development HC 11
Depression in all its forms
Depression – an enduring period of sadness
Depressed mood – an enduring period of sadness, without any other related
symptoms
Depressive syndrome – sadness plus other symptoms such as crying, feelings of
worthlessness, and feeling guilty, lonely or worried
Major Depressive disorder – Depressed mood or loss of interest or pleasure in almost
all activities plus 4 of other symptoms. research does not measure this clinically
depression!
o Depressed mood most of the day, nearly every day, (in children and
adolescents – irritable mood.)
o Markedly diminished interest or pleasure in all, or almost all, activities most of
the day, nearly every day
o Significant weight loss when not dieting or weight gain (e.g., a change of more
than 5 of body weight in a month), or decrease or increase in appetite nearly
every day.
o Insomnia or hypersomnia nearly every day
o Psychomotor agitation or retardation nearly every day
o Fatigue or loss of energy nearly every day
o Feelings of worthlessness or excessive or inappropriate guilt nearly every day
o Diminished ability to think or concentrate, or indecisiveness, nearly every day
o Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation
without a specific plan, or a suicide attempt or a specific plan for committing
suicide.
This mood must represent a change from the person's normal mood; social,
occupational, educational or other important functioning must also be negatively
impaired by the change in mood.
Increase in testostoron as a protective factor?
, Adolescent Development HC 11
From the adolescence on (life-span), women as a groupd are more depressed than men.
Self-harm terms
"Self-injury"
"Self-mutilation"
"Cutting”
"Non-suicidal self-injury”
NSSI
What is self-harm?
A variety of behaviors in which an individual intentionally inflicts harm to his or her
body for purposes not socially recognized or sanctioned and without suicidal intent
Includes:
o Intentional carving or cutting of the skin and subdermal tissue,
o Scratching,
o Burning,
o Ripping or pulling skin or hair,
o Swallowing toxic substances,
o Self bruising,
o Breaking bones.
o Tatoos and body piercing are NOT unless undertaken with the intention to
harm the body
Prevalence (changing more research on this topic, the field is growing)
Time effect cohort effect, taboo?
4% of adults report a history (not now!) forgot it?
14% of adolescents
High school populations in the US and Canada consistently show a 13-24%
prevalence rate (Laye-Gindhu; & Schonert-Reichl, 2005; Muehlenkamp & Gutierrez,
2004; Muehlenkamp & Gutierrez, 2007; Ross & Health, 2002).
10% youth aged 11-25 in Britain (Young People and Self-Harm: A National Inquiry,
2004).
17% of young adults
Developmental course
Two developmental pathways: early onset and long-lasting, adolescence-limited
Early onset self-injury is common around the age of 7
Most often, however, self-injury behaviors begin in middle adolescence between the
ages of 12 and 15 (Yates, 2004)
