Title:
Internalizing and externalizing depressive profiles as predictors of mental health service usage
Author:
Ryan Karzar
Thesis Advisor:
Sharon Green-Hennessy
Committee Member:
Marianna E. Carclucci
Committee Member:
Jen L. Lowry
Committee Member:
Frank D. Golom
Committee Member:
Jason M. Prenoveau
Degree Granting Institution:
Loyola University Maryland--College of Arts and Sciences
Place:
Baltimore (Md.)
Publisher:
Loyola University Maryland
Date Created:
2024
Type of Resource:
text
Genre:
thesis
Language:
eng
Format:
application/pdf
Physical Form:
electronic
Digital Source:
born digital
Abstract:
Adolescent depression merits further research due to its prevalence and association with functioning. Depression has been found to have different symptomology profiles with research finding that both externalizing and internalizing symptoms can be factors in the adolescent depression picture. Theories and cluster analyses have been able to support the idea that adolescents diagnosed with depression tend to have two clusters of symptoms: internalizing and externalizing. Separately, research has found that some adolescents with depression are receiving services while others are being overlooked. However, little research examined the theorized depressive symptom profiles and their potential association with service use. This study explored if there was a connection between identified depressive symptom profiles and service visit frequency, inpatient service admission, and breadth of services used. An archival database, National Comorbidity Survey Replication Adolescent Supplement (NCS-A), was used for this study due to its broad focus on multiple diagnostic criteria and emphasis on service usage. A subsample was selected for analysis consisting of adolescents who had been diagnosed with DSM-IV (American Psychiatric Association [APA], 1994) major depressive disorder within the prior year. Internalizing and externalizing symptoms often associated with major depression in adolescence were entered into a two-step cluster analysis. Participants were able to be clustered into two groups with a fair goodness of fit. However, the clusters were heavily determined by externalizing symptoms associated with substance usage, illegal behaviors, suspensions, fighting, breaking things, lying, oppositionality, and risk taking. Only two internal symptoms, frequency, and impairment of depressive affect, were useful in differentiating the cluster participants. Therefore, the cluster groups were best characterized as high externalizing versus low externalizing. Regression analyses determined that the cluster groups differed based on service frequency, likelihood of inpatient services, and breadth of services used in the past year. Results demonstrated that the depressed group with high externalizing behaviors had more outpatient service visits, were more likely to receive inpatient care, and had a larger breadth of services than the depressed group with relatively low externalizing behaviors. As some degree of externalizing behavior was seen in both clusters, study results support the conceptualizations of some adolescent mood disorders with both externalizing and depressive symptoms.
Subject:
Academic theses
Subject:
Electronic dissertations
Subject:
Thèses et écrits académiques
Subject:
Thèses électroniques
Subject:
dissertations
Degree:
Doctor of Clinical Psychology
Level:
Doctoral
Discipline:
Psychology
Restrictions on Access:
Author has given permission to make this work available online.
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Identifier:
KarzarR-24
