| Title
Predictors of Depression and Attitudes to Risk Taking among Rural
Adolescents
Author
Details
Christine Barallon M.Psych
& David Harvey PhD
Correct
Reference
Barallon, C., & Harvey, D. (2002) Predictors of Depression
and Attitudes to Risk Taking among Rural Adolescents, International
Journal of Rural Psychology, Vol 3, No. 12, URL
http://www.ruralpsych.com/Members/RefereedResearchNotes/RRN-Barallon-Harvey.htm
Affiliation
& Contact Details
Assoc
Prof David Harvey
david.harvey@education.monash.edu.au
PO
Box 6
Monash
University
Victoria
3800
03
9905 2856
Abstract
The
following study investigated the predictors of depression and
risk-taking attitudes among Australian rural adolescents in terms
age, self-esteem and social support. The sample comprised 80 female
adolescents ranging from 11 to 16 years (M = 13.7 years)
in Years 7, 9 and 11. All were attending rural secondary schools
in the Western-Barwon region of Victoria. Participants completed
the Rosenberg Self-Esteem Scale, Reynolds Adolescent Depression
Scale, Social Support Appraisals Scale and a list of risk taking
behaviours. Risk taking attitudes were positively correlated with
social support to a low degree; depression was positively correlated
with negative self-esteem at a moderate level but was also negatively
correlated with social support at a high level. Social support
was negatively correlated with negative self-esteem at a moderate
level. A regression analysis indicated that family support, self-esteem
and peer support were significant predictors of depression, accounting
for 63.7% of the variance. In comparison, significant predictors
were not found for risk taking attitudes.
A
major concern for mental health professionals is the increase
in the suicide rate of adolescents over the past two decades.
On average, eight young people commit suicide a week in Australia
(Burdekin, 1994; Carr-Gregg, 2000). In addition, many adolescents
contemplate or engage in deliberate self-harm (Graham, Reser,
Scuderi, Zubrick, Smith & Turley, 2000) and there is an apparent
increase in accident or injury rates among adolescents (Blum &
Rinehart, 1997). It is postulated that the high rate of suicide
is related to depressive illness while the high accident rate
is related to aspects of risk taking behaviour. In particular,
adolescents living in rural or remote areas are over represented
in suicide and a number of risk taking behaviours (Blum &
Reinehart, 1997; Shanahan & Hewitt, 1999). With more than
five million Australians living outside major metropolitan centres
it is imperative that predictors of psychological health of rural
youth are thoroughly explored (Burdekin, 1994).
Depression
A
depressive illness is generally defined as a constant lowering
of mood with approximately 20% of the Australian population affected
(Raphael & National Health and Medical Research Council, 1992).
Rates of depression increase with age. Statistics show that around
3% of children aged 4 to 11 years suffer depression, the rate
increasing to 5% of youth between 12 and 16 years. It is common
therefore for the first episodes of depression to occur during
adolescence presumably as the major developmental tasks of that
period put individual young people under increasing levels of
stress. It has also been shown that females are twice as likely
as males to report depressive symptoms although this trend may
be biased by a reluctance of males to report their emotions (Roberts,
1999).
In
terms of locality, Peterson et al, (1993) noted that a review
of the literature showed rural adolescents may be at greater risk
of suffering depression than suburban or urban adolescents. The
greater risks may be associated with a greater sense of isolation
or the lack of psychological resources in rural areas (Harvey
& Hodgson, 1985). There is a disturbingly high rate of suicide
in rural areas, particularly for male adolescents (Burdekin, 1994).
As depression is linked to suicide it is imperative that research
explores the predictors of depressive illness among adolescents
living in rural areas.
Depression and Self-esteem
The
experience of depression during adolescence is associated with
behavioural and emotional problems (Youngren & Lewinsohn,
1980), one of the major consequences being a negative level of
self-esteem. Self-esteem is generally defined as a personal judgement
of one’s self-worthiness, and includes associated positive or
negative emotions (Dusek, 1991). Individuals with negative self-esteem
are characterised by feelings of dissatisfaction, unhappiness
and the inability to recognise personal strengths. As with depression,
several studies have found that females tend to report lower levels
of positive self-esteem than males both during adolescence (Finn
& Rock, 1997; Watkins, Dong & Xia, 1997) and early adulthood
(Fleming & Courtney, 1984; Nell & Ashton, 1996).
Depression and Risk
Taking
Depression
during adolesence is linked to higher rates of risk taking behaviour
(Carr-Gregg, 2000). Adolescents who report depressive symptoms
are more likely to be involved in drug use, drop-out of school
early and engage in unsafe sex practices. Risk taking may increase
when adolescents report high levels of depression due to different
perceptions of risk, and it may therefore be a predictor of depression
as depressed adolescents appear to be more vulnerable to engaging
in high levels of risk taking.
Research
has shown that adolescents in general often participate in high
amounts of risk taking behaviour that endangers their physical
and psychological health (Bond, Thomas, Toumbourou, Patton &
Catalano, 2000; Tonkin, 1987) but it must also be recalled that
adolescence is by definition a time of, “exploration, exuberance
and youthful searching” (Coon, 1989, p. 425). These characteristics
mean then that adolescents will be trying out various new ways
of looking at life and enjoying their new freedoms. The risk taking
behaviours which cause concern to mental health professionals
however are those which are defined as involving an uncertain
outcome where the potential for negative consequences for the
self and/or others outweighs the positive consequences (Moore
& Gullone, 1994). Nicotine addiction, binge drinking, excessive
and/or continuous alcohol use, cannabis and/or heroin addiction,
designer drug use, unsafe sexual activity and dangerous driving
are the kinds of behaviours that are targetted in such discussions.
Risk Taking and Social
Support
Some
research has explored the possible moderating role of social support
on adolescent risk taking behaviour and psychological health.
Social support refers to “those social interactions or relationships
that provide individuals with actual assistance or with a feeling
of attachment to a person or group that is perceived as caring
or loving” (Hobfoll, Freedy, Lane & Gellar, 1990, p. 467).
It
has been hypothesised that adolescent risk taking behaviour and
depressive disorders are moderated by perceived social support
(Armsden & Greenberg, 1987; Jacobvitz & Bush, 1996). That
is, the more adolescents perceive the availability of social support,
the greater will be their resistance to engaging in serious risk
taking behaviours and to developing depression (Booth, Rubin,
& Rose-Krasmor, 1998; Cohen & Wills, 1985).
Risk Taking Attitudes
and Behaviour
The
protective and risk patterns of social support on adolescent risk
taking suggest that the socialisation experiences of an adolescent
are critical to behaviour. Socialisation refers to the process
where adolescents learn the, “skills, attitudes, beliefs and behaviour”
(Bouma, Dixon & Robarts, 1989, p. 288) required for participation
in society. Adolescents therefore adopt attitudes that are shaped
by their family, peers and school experiences. Attitudes are defined
as “a general feeling or evaluation - positive or negative - about
some person, object or issue” (Hogg & Vaughan, 1998, p. 116).
There is some evidence that individual attitudes towards risky
behaviour are predictive of actual participation in risk taking
such as non-use of condoms, reckless driving, excess drinking
and smoking (Finken, Jacobs & Laguna, 1988; Gibbons, Gerrard,
Blunton & Russell, 1998). Finken et al. (1998) studied the
drink driving attitudes and behaviours of 135 young people between
17 and 24 years. Their results confirmed that attitudes towards
the acceptability of drinking and driving were significant predictors
of actual driving or riding while intoxicated.
Hypotheses
The
present study is aimed at exploring the predictors of psychological
health and risk taking attitudes of female adolescents living
in rural Australia. In accordance with previous research
it is hypothesised:
(1)
That risk taking attitudes will be positively correlated
with social support;
(2)
That risk taking attitudes will be negatively correlated
with depression and negative self-esteem;
(3)
That self-reported depression will be positively correlated
with negative self-esteem;
(4)
That self-reported depression will be negatively correlated
with social support;
(5)
That social support will be negatively correlated with
negative self-esteem;
(6)
That age, risk taking attitudes, social support and self-esteem
will be significant predictors of self-reported depression;
(7)
That age, self-reported depression, social support and
self-esteem will be significant predictors of
risk taking attitudes.
Participants.
Eighty
female adolescents from five rural public secondary schools in
the Western Barwon region of Victoria, Australia participated
in the study. The students were aged between 11 and 16 years,
and enrolled in Years 7 (n = 34), 9 (n = 28) and
11 (n = 28).
Materials
Rosenberg
Self-Esteem Scale (RSES) (Hagborg, 1993; Rosenberg, 1965).
The
RSES is a 10 item scale developed to identify the social factors
influencing adolescent self-esteem on attitudes and behaviour.
Its modern form involves scoring on a 4 point scale ranging from
1 = strongly agree to 4 = strongly disagree with
five items reversed scored to give a possible total of 40. High
scores are indicative of high levels of negative self-esteem.
Items are of the type, ‘I feel that I have a number of good qualities’
and ‘I feel that I do not have much to be proud of’ with the latter
being reverse scored.
Considerable
research has demonstrated the reliability of the RSES with Cronbach
alphas around .87 and .88 (Fleming & Courtney, 1984; Fontaine
& Jones, 1997). Test-retest is reported at .82 after two weeks
(Fleming & Courtney, 1984) and .57 after one year (McCarthy
& Hoge, 1982).
Reynolds
Adolescent Depression Scale (RADS) (Reynolds, 1987).
The
RADS was designed to measure depression in adolescents aged from
13 to 18 years. It is composed of 30 items scored on a four point
scale ranging from 1 = almost never to 4 = most of the
time. High scores are indicative of high levels of depressive
symptoms. Test-retest reliability ranges from .80 after six weeks
to .63 after one year. Internal consistency ranges from .90 to
.94 (Kundert, 1992) and correlates well with DSM-III and other
measures of depression (Kaplan, 1992).
Social
Support Appraisals Scale (SSAS) (Dubow & Ullman, 1989).
The
SSAS contains 31 items used to measure adolescent perceptions
of social support. Ten items concern peer support, eleven concern
family support, and ten concern school support. Each item is rated
on a five-point Likert scale ranging from 1 = never to
5 = always. Scores can be computed for the total and the
three subscales. High scores are indicative of high levels of
perceived support.
The
SSAS was originally developed to assess children’s perceptions
of support but it has been shown to be reliable and valid for
adolescent populations. Test-retest reliabilities range from .66
to .73 and internal consistency ranges from .81 to .88 (Dubow,
Tusak, Causey Hryshko & Reid, 1991).
Risk
Taking Attitudes Inventory (RTAI)
The
RTAI was constructed for the purposes of the present study. Respondents
rated a list of 28 behaviours on a five-point scale ranging from
1 = never risky to 5 = always risky. High scores
are indicative of higher levels of perceived risk. The 28 behaviours
were selected on the basis of research into sexual risk taking,
academic risk taking, criminal activity, road related risk taking
and drug related risk taking.
1.
Using marijuana
2.
Casual sex
3.
Using condoms
4.
Smoking cigarettes
5.
Binge drinking
6.
Skipping school
7.
Long term relationships
8.
Having sex
9.
Using drugs
10.
Walking down the street
11.
Moving house
12.
Studying
13.
Helping a friend
14.
Doing homework
15.
Wagging school
16.
Borrowing money
17.
Drink driving
18.
Having unprotected sex
19.
Rock climbing
20.
Going to parties
21.
Racing cars
22.
Not attending classes
23. Shoplifting
from stores
24.
Writing graffiti on walls
25.
Fist fights
26.
Carrying a weapon (knife)
27.
Making telephone pranks
28.
Riding with a drunk driver
Statistical
examination of the RTAS revealed a high level of internal reliability
of the 28 items (Alpha = .86).
Procedure
Following
approval by the Ethics Committees of the Department of Education
Employment and Training and Monash University, a number of schools
in the West Barwon region were approached. Five schools agreed
to participate and letters of invitation to parents and students
were sent out by each school. Completed consent forms were received
from 30% of the possible sample. The first author attended each
school to administer the questionnaire booklet. A list of participating
students was compiled and code numbers assigned. As had been agreed
with the schools and all parents and students invited to participate,
a debriefing session was given the students about the purpose
of the research and how the information they had given would be
treated. The researcher remained at the school for the day to
meet with any students who wished to discuss any matters raised
in the questionnaires. The original (and only) list of students
and their code numbers was then left with the Principal. Following
protocol discussed with each school, the Reynold’s Adolescent
Depression Scale was scored the evening of data collection. The
principals of each school were promptly contacted to identify
any student with a total score of 77 or greater on the RADS, to
ensure support for at-risk students.
All
data were checked for normality and descriptive statistics compiled
for all variables. Normality was assessed using the Kolmogorov-Smirnov
(Lilliefors) test with the following results: Self-esteem, mean
= 20.8 out of possible 40, K-S Lilliefors (72) = .12, p
<.01, negatively skewed due to over representation of higher
scores; Depression, mean = 58.9 out of possible 120, K-S
Lilliefors (72) = .07, ns, positively skewed as sample over represented
on low depression scores; Risk-taking attitudes, mean = 90.2 out
of possible 140, K-S Lilliefors (72) = .05, ns, scores
normally distributed; Social Support, mean = 121.1 out of a possible
155, K-S Lilliefors (72) = .08, ns, scores normally distributed;
Peer Support, mean = 39.1 out of a possible 50, K-S Lilliefors
(72) = .13, p <.004, negatively skewed due to over representation
of high peer support; Family Support, mean = 45.6 out of a possible
55, K-S Lilliefors (72) = .16, p <.000, negatively
skewed due to high levels of family support; and School Support,
mean = 36.2 out of a possible 50, K-S Lilliefors (72) =
.08, ns, normally distributed.
In
view of the minor violations of normality it was conservatively
decided to use Spearman’s rank order correlations to undertake
the planned correlation analyses.
Table
1.
Correlation
Coefficients Between Depression, Social Support, Self-esteem and
Risk Taking Attitudes. N = 72.
|
|
Depression |
Self-esteem |
|
Risk-taking
attitudes |
|
Depression
|
--- |
.56** |
-.64** |
-.02 |
|
Self-esteem
|
|
--- |
-.53** |
-.07 |
|
Social
support
|
|
|
--- |
.97** |
Note:
**
<.01, one-tailed
As
social support was significantly correlated with self-esteem and
depression, post-hoc correlations were performed to investigate
the associations with the three types of social support and the
remaining dependent variables.
Table
2.
Post
Hoc Correlations Between Type of Social Support and Depression
and Self-esteem.
|
|
Peer
support
|
Family
support |
School
support |
|
Depression
|
-.64** |
-.72** |
-.66** |
|
Self-esteem
|
-.53** |
-.45** |
-.51** |
Note:
** <.01, one-tailed.
A
multiple regression analysis was conducted to examine the significant
predictors related to risk taking attitudes. The results indicated
that when the variables of depression, self-esteem, social support
(total and/or family, peer and school) and age combined they account
for only 5% of the variance [R2 = .05] in predicting
risk taking attitudes.
A
multiple regression analysis was conducted to examine the significant
predictors related to depression including risk-taking attitudes.
Table
3.
Summary
of Multiple Regression Analysis for Variables Predicting Depression.
|
Variable |
B |
Beta |
t
|
Sig |
|
Self-esteem |
.97 |
.25 |
2.83
|
.006 |
|
Peer
support |
-.64 |
-.27 |
-2.64
|
.01 |
|
Family
support |
-.92 |
-.39 |
-4.59
|
.000 |
|
School
support |
-.31 |
.13 |
-1.19 |
.237
|
|
Risk-taking |
-.00 |
.06 |
.922 |
.360
|
Note:
R2 = .706, p <.01.
The
results in Table 3 indicate that when the variables of self-esteem,
family and peer support are combined they account for a significant
amount of variance in the prediction of depression (70.6%). Further
analysis showed that self-esteem (t = 2.83, p <
.01), family support (t = -4.59, p < .001) and
peer support (t = 2.64, p <.01) were statistically
significant predictors of depression.
The
present study supports the theoretical prediction that positive
self-esteem is inconsistent with high levels of self-reported
depression. Positive self-esteem is based on a realistic evaluation
of personal characteristics and abilities, an acknowledgment of
difficulties, and an expectation of improvement in the future
(Berk, 1994). Negative self-esteem is based on feelings of dissatisfaction,
unhappiness and the inability to recognise personal strengths.
In contrast to self-esteem, depression is a measure of psychological
health, associated with physical and psychological problems (Roberts,
1999). The results of this study suggest that the association
between negative self-esteem and depression is moderate, but is
nevertheless in the expected direction supporting other research
which has shown adolescents with positive self-esteem are less
likely to report depressive symptoms (Fleming & Courtney,
1984; Roberts & Gotlib, 1997). The findings also support the
theory of social comparison as negative evaluations appear to
be related to increased levels of depression. It is possible that
depression both arises from, and leads to, negative comparisons
and self-evaluations. As the study is cross-sectional in nature,
the results do not however make clear whether depression leads
to negative self-evaluations or if negative self evaluations lead
to depression, as it is known that depression can reduce self-esteem
(Dusek, 1991).
The
significant negative correlation between depression and social
support supports the hypothesis that the latter plays a moderating
role for female adolescent depression (Cohen & Wills, 1985).
It suggests that the experience of psychological problems, including
depression, are directly affected by social support as found by
Bell-Dohan, Reaven and Petersen (1993), Goodyer, Wright and Altham
(1990), Kennedy, Spence and Hensley (1989) and Greenberger and
Chen (1996). The results mean that the more a female adolescent
perceives a friend, parent or teacher as supportive, the less
likely the adolescent is to have high levels of depressive symptoms.
Thus social support can act as a buffer to reduce the likelihood
of an adolescent developing depression. Conversely, depressed
female youth tend to report social withdrawal, and consequently
may perceive a lack of social support as a consequence of depression
(Roberts, 1999).
Similarly,
the results support the idea that social support enhances self-esteem
reflecting the positive effect of social support on an adolescent’s
self evaluations. Van Aken and Asendorpf (1997) reported that
German adolescents who perceived low social support, in particular
from parents, also reported decreased feelings of self-worth.
The present study indicates a similar process among this group
of rural females. Furthermore, the results indicate that the source
of the support, be it from family, peers and, to a much lesser
extent, school is not important. All three sources show positive
correlations with self-esteem and each plays an important role
in fostering positive self-evaluations for female adolescents.
The
failure of the present study to show risk taking attitudes as
predictive of depression or negative self-esteem may be due to
methodological limitations, as past research has shown risk taking
attitudes vary with depression and self esteem levels (Carr-Gregg,
2000). The measurement of risk taking attitudes may underestimate
the association between risk taking and the dependent variables
of depression and self- esteem. Furthermore, the sample excluded
males. Consequently gender differences were unable to be investigated.
In
addition, the results of the present study may be biased due to
the low level of consent forms that were returned. It is possible
that differences exist between the sample of adolescents whose
parental consent forms were returned and those whose consent forms
were not returned in time. In future research, a longer period
between the recruitment of participants and administration of
the questionnaire would be necessary in order to gain a larger
and more representative sample of rural adolescents. Future research
involving a larger and more representative sample could explore
whether the relationship between depression and risk taking attitudes
during adolescence is moderated by gender and age.
The
results of the present study suggest that family, peers and school
life all play an important role in the prevention and remediation
of depressive tendencies and negative self evaluations. Strategies
that enhance the social supports available through these three
avenues should be encouraged and expanded. For peers, forums on
what it means to provide support for each other including peer
counselling opportunities could be followed up. For families,
programs that support communication and positive relationships
between family members would be of benefit. In addition, programs
that foster all aspects of personal achievement and skills development
seem very appropriate for the young people represented by this
sample.
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