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Psychosocial mechanisms underlying the rise in depression during puberty


Bristol Medical School

About the Project

Rationale
Depression is a leading contributor to disease burden in young people with devastating effects on social functioning, academic achievement and increased risks of substance abuse, self-harm and suicidal behaviour. Women are around twice as likely to experience depression than men and this unequal sex ratio emerges during adolescence.

There is strong evidence that the rise in depression in girls during adolescence is more strongly related to pubertal maturation than increasing age, but the contribution of puberty to the emergence of depression in boys is poorly understood.

The profound biological and psychosocial changes of puberty are believed to increase the risk of depression, but few studies have sought to identify underlying mechanisms. In particular, there is little understanding of the mechanisms that generate the unequal sex ratio in depression during puberty. It is unlikely that the rise in depression during puberty is explained by biological mechanisms alone. Psychosocial theories propose that individual and social factors explain more of the variance in adolescent depression than hormones.

Aims & Objectives
This PhD project has the potential to shed light on the complex causal pathways that explain the relationships between pubertal development and the rise in depression during adolescence. The aim is to examine potential psychosocial mediators of the relationship between pubertal development and depression in girls and boys. Possible mediators include risky behaviours, relationships with family and friends, peer victimisation, body image, cognitive functioning, and educational attainment. The project will take advantage of existing data from the Avon Longitudinal Study of Parents and Children (ALSPAC) to answer research questions including the following:

1. What psychosocial factors explain the link between pubertal development and depression?
2. Are particular psychosocial factors more important for girls than boys?
3. Can these factors explain the greater rise in depression during puberty in girls compared with boys?

Methods
The project will use a causal mediation approach to examine the extent to which psychosocial factors mediate the link between pubertal development and depression. Causal mediation methods provide a powerful set of techniques for understanding causal pathways between an exposure and outcome. These methods permit the examination of continuous and binary/categorical mediators and outcomes; multiple mediators; interactions between exposures and mediators or between mediators, and intermediate confounding of the mediator-outcome relationship.

References

Hyde JS1, Mezulis AH, Abramson LY. Psychol Rev. 2008;115(2):291-313.

Sequeira ME, Lewis SJ, Bonilla C, Smith GD, Joinson C. Br J Psychiatry. 2017;210(1):39-46.

VanderWeele TJ. Annual Review of Public Health. 2015;37:17-32.

Wang H, Lin SL, Leung GM, Schooling CM. Pediatrics. 2016;137(6). pii: e20153231.

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