when friendships bring you down: peer relationship predictors of adolescent depression joseph p....

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When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia State University Cynthia Moore Harvard Medical School Copies of Related Papers are available at: Teenresearch.org Collaborators : Maryfrances Porter, Ph.D. Christy McFarland Penny Marsh Kathleen McElhaney, Ph.D. Nell Manning Jennifer Haynes Heather Tencer, Ph.D. Sally Kaufman Farah Williams Debbie Land, Ph.D. Jill Antonishak Katie Little Martin Ho Jess Meyer Mindy Schmidt, Ph.D. Glenda Insabella, Ph.D. Liz Ball Wrenn Thompson

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Background Increasing Incidence of Depressive Symptoms During Adolescence Therapies Emphasize Dysfunctional Social Relationships Lack of Knowledge About HOW and WHY Relationships go Awry

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Page 1: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

When Friendships Bring You Down:Peer Relationship Predictors of Adolescent Depression

Joseph P. AllenUniversity of Virginia

Gabriel P. KupermincGeorgia State University

Cynthia MooreHarvard Medical School

Copies of Related Papers are available at:Teenresearch.org

Collaborators:Maryfrances Porter, Ph.D.Christy McFarlandPenny MarshKathleen McElhaney, Ph.D.Nell ManningJennifer Haynes

Heather Tencer, Ph.D.Sally KaufmanFarah WilliamsDebbie Land, Ph.D.Jill AntonishakKatie Little

Martin HoJess MeyerMindy Schmidt, Ph.D.Glenda Insabella, Ph.D.Liz BallWrenn Thompson

Page 2: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

In what ways are social relationships important in understanding the development of early adolescent depression?

Page 3: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Background

• Increasing Incidence of Depressive Symptoms During Adolescence

• Therapies Emphasize Dysfunctional Social Relationships

• Lack of Knowledge About HOW and WHY Relationships go Awry

Page 4: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

The University of Virginia “KLIFF” Project Kids’ Lives, Families, & Friends

• 168 Adolescents, their Parents, Best Friends, and Other Friends

• Equal numbers of Males and Females

• Assessed Annually, Beginning at Age 13

• Highly Socio-economically Diverse (Median Family Income= $40- $60K)

• 31% African American; 69% European American

• Intensive Interviews and Observations with all parties (Parents, teens, best friends, other friends) (Total N over first 3 years ~ 900).

Page 5: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Measures: Depressive Symptoms

• Teen reported via Children’s Depression Inventory (Kovacs & Beck, 1977).

• Child/Adolescent version of Beck Depression Inventory

• 27-items. Examples:I am sad all the time.I hate myself.

• Continuum/severity approach • Symptoms below diagnostic thresholds are nevertheless important predictors of

dysfunction.

Page 6: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Simple Correlation

Adolescent Depressive Symptoms At Age 13 and Age 14: .58***

Page 7: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Changing Over Time in Depressive Symptoms

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Age 13 Age 14

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achm

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Page 8: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Change Over Time in Depressive Symptoms

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Age 13 Age 14

Att

achm

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ecur

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Page 9: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Change Over Time in Depressive Symptoms: “Spaghetti Plot” of Individual Participants Change

Page 10: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Developmental Psychopathology Perspective

Areas of greatest vulnerability in interpersonal relationships occur when progress in critical developmental tasks is threatened.

Page 11: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Handling the “Give & Take” of Peer Relationships

• A fundamental developmental task linked to establishment of

Autonomy & Relatedness in Social Relationships

• 3 Kinds of Potential Failures to Engage

• Becoming Hostile when Disagreeing

• Withdrawing from Peers

• Becoming Overly Dependent upon one’s Peers

Page 12: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Failures to Engage: Becoming Hostile When Disagreeing

• Coded from Videotaped Discussions of “Mars Task”• 2 best friends separately decide which hypothetical characters will be rescued first following a space accident.

• The 2 friends are then brought together and come to a “consensus” answer.

• Autonomy-Undermining/Enmeshing Behavior:• overpersonalizing disagreements• pressuring with threats or intimidation• false “concessions” and “recantations”

• Relatedness-Undermining/Hostile Behavior:• Rudeness, hostility, sarcasm• Ignoring other person, distracting interruptions

Page 13: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Peer Relationship Qualities as Predictors of Age 14 Depressive Symptoms (Controlling for Age 13 Depression)

Depressive Symptoms (Age 14) R2 Total R2

Step I. Depressive Symptoms (Age 13) .58*** .33*** .33***Step II. Gender .04 .00 .33***

Page 14: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Peer Relationship Qualities as Predictors of Age 14 Depressive Symptoms (Controlling for Age 13 Depression)

Depressive Symptoms (Age 14) R2 Total R2

Step I. Depressive Symptoms (Age 13) .58*** .33*** .33***Step II. Gender .04 .00 .33***Step III. Undermining Autonomy with Peer Undermining Relatedness with Peer

-.12.28***

.06** .39***

Hostility while Disagreeing Predicts Increasing Depression Over Time

Page 15: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Failure to Engage: Social Withdrawal

• Withdrawal scale from Pupil Evaluation Inventory (Pekarik, Prinz, Liebert, Weintraub, & Neale, 1976)

• Rated by best friend

• 9 items tapping socially withdrawn behavior, e.g.:• “S/he often doesn’t want to hang out or do things with other kids.”

Page 16: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Peer Relationship Qualities as Predictors of Age 14 Depressive Symptoms (Controlling for Age 13 Depression)

Depressive Symptoms (Age 14) R2 Total R2

Step I. Depressive Symptoms (Age 13) .58*** .33*** .33***Step II. Gender .04 .00 .33***Step III. Peer-Ratings of Teen Social Withdrawal

.19** .04** .37***

Social Withdrawal Predicts Increasing Depression Over Time

Page 17: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Predicting Change in Depression from Social Withdrawal

Withdrawal (13)

Depression (13) Depression (14).59***

.19**

Page 18: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Reciprocal Effects of Depression and Social Withdrawal

Withdrawal (13)

Depression (13) Depression (14)

Withdrawal (14)

.59***

.24**

.20*

.19**

Page 19: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Failure to Engage: Becoming Overly Dependent on One’s Best Friend

• Videotaped Discussions - Supportive Behavior Task with Peers

• Teens discuss “a problem they were having that they could use some advice or support about.”

• Topics included dating, problems with peers or siblings, raising money, decisions about participating in teams or clubs

• Call for Emotional Support:• Intensity of emotional distress conveyed to their friend and persistence

in asking for help with it during the interaction.

Page 20: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Peer Relationship Qualities as Predictors of Age 14 Depressive Symptoms (Controlling for Age 13 Depression)

Depressive Symptoms (Age 14) R2 Total R2

Step I. Depressive Symptoms (Age 13) .58*** .33*** .33***Step II. Gender .04 .00 .33***Step III. Undermining Autonomy with Peer Undermining Relatedness with Peer

-.12.28***

.06** .39***Step IV. Calls for Emotional Support from Peer

.14* .02* .41***

High Calls for Emotional Support from Peers Predict Increasing Depression Over Time

Page 21: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Peer Relationship Qualities as Predictors of Age 14 Depressive Symptoms (Controlling for Age 13 Depression)

Depressive Symptoms (Age 14) R2 Total R2

Step I. Depressive Symptoms (Age 13) .58*** .33*** .33***Step II. Gender .04 .00 .33***Step III. Undermining Autonomy with Peer Undermining Relatedness with Peer

-.12.28***

.06** .39***Step IV. Calls for Emotional Support from Peer

.14* .02* .41***

Step V. Peer-Ratings of Teen Social Withdrawal

.17** .03** .44***

Additive Effects of Predictors of Increasing Depression Over TimeTotal R2 = 11%

Page 22: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Relationship Qualities as Predictors of Age 14 Depressive Symptoms (Controlling for Age 13 Depression)

Depressive Symptoms (Age 14) R2 Total R2

Step I. Depressive Symptoms (Age 13) .58*** .33*** .33***Step II. Gender .04 .00 .33***Step III. Undermining Autonomy & Relatedness with Mother

.23*** .05*** .38***

Autonomy & Relatedness Struggles with Mothers Predict Increasing Depression Over Time

Page 23: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Peer Relationship Qualities as Predictors of Age 14 Depressive Symptoms (Controlling for Age 13 Depression)

Depressive Symptoms (Age 14) R2 Total R2

Step I. Depressive Symptoms (Age 13) .58*** .33*** .33***Step II. Gender .04 .00 .33***Step III. Undermining Autonomy & Relatedness with Mother

.23*** .05*** .38***

Step IV. Undermining Relatedness with Peer

.19** .04** .42***

Step V. Call for Peer Emotional Support .13* .02* .44***

Step VI. Social Withdrawal from Peers .13* .02* .46***

Peer Factors Continue to Predict Over and Above Maternal Relationship Factors

Total R2 = 13% Multiple R change predictors = .36***

Page 24: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Behavioral Pathways for Handling Give & Take of Relationships that Predict Increasing Depression

Challenge of Peer

Relation-ships

Page 25: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Behavioral Pathways for Handling Give & Take of Relationships that Predict Increasing Depression

Challenge of Peer

Relation-ships

Hostility“Fight”

Page 26: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Behavioral Pathways for Handling Give & Take of Relationships that Predict Increasing Depression

Challenge of Peer

Relation-ships

Hostility“Fight”

Withdrawal“Run”

Page 27: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Behavioral Pathways for Handling Give & Take of Relationships that Predict Increasing Depression

Challenge of Peer

Relation-ships

Routes Leading TowardDepression

Hostility“Fight”

Withdrawal“Run”

Excessive Dependence “Cling”

Page 28: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Behavioral Pathways for Handling Give & Take of Relationships that Predict Increasing Depression

Challenge of Peer

Relation-ships

Route Leading AwayFrom Depression

Routes Leading TowardDepression

Hostility“Fight”

Withdrawal“Run”

Excessive Dependence “Cling”

Autonomous Engagement

Page 29: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia

Limitations

• Correlational Nature of Data & Alternative Causal Models

• Short Time Frame Assessed

• Not focusing on “high-risk” adolescents

• Depressive Symptoms within Community Samples

• But rates of suicidal ideation across adolescence exceed 60% even in

“community samples.”

Copies of Related Papers are available at:Teenresearch.org

Page 30: When Friendships Bring You Down: Peer Relationship Predictors of Adolescent Depression Joseph P. Allen University of Virginia Gabriel P. Kuperminc Georgia