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Influence of the parent–adolescent relationship on mental health help-seeking
Centrum för klinisk forskning, Västerås.
Centrum för klinisk forskning, Västerås.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Uppsala Universitet.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Objective: To investigate help-seeking from specialized mental health services, especially in relation to the parent–adolescent relationship, as measured by attachment, and symptoms of attention deficit hyperactivity disorder (ADHD) and/or depression and sex.

Methods: The study was epidemiological and cross-sectional, and used the Experiences in Close Relationships-Revised-Children (ECR-RC9), the Adult ADHD Self-Report Scale Screener and the Depression Self-Rating Scale-Adolescents. Adolescents, 15 to 18 years old, from the Swedish county of Västmanland participated (N = 4,506, 74% participation rate).

Results: Help-seeking was predicted by co-occurring symptoms of ADHD and depression (OR = 5.4), symptoms of depression (OR = 4.8) and symptoms of ADHD (OR = 2.6), as well as any experience of sexual abuse (OR = 1.7) and being female (OR = 1.6). Secure attachment to parents, assessed with the ECR-RC9, did not increase help-seeking. Furthermore, in interaction analyses secure attachment to parents in combination with experiences of sexual abuse and/or conduct problems, or to be female and have symptoms of ADHD, decreased the probability of help-seeking.

Conclusion: Secure attachment, as a measure of the adolescent’s willingness to communicate with their parents about their problems, did not increase help-seeking. Symptoms of ADHD and/or depression predicted help-seeking more than any psychosocial factor.

Keyword [en]
help-seeking, attachment, ADHD, depression, sex
National Category
Medical and Health Sciences
Research subject
Child and Youth Psychiatry
Identifiers
URN: urn:nbn:se:uu:diva-219109OAI: oai:DiVA.org:uu-219109DiVA: diva2:698372
Available from: 2014-02-21 Created: 2014-02-21 Last updated: 2014-04-29Bibliographically approved
In thesis
1. Co-occurring Symptoms of Attention Deficit Hyperactivity Disorder and Depression: Sex, Aetiology, Help-Seeking and Assessment
Open this publication in new window or tab >>Co-occurring Symptoms of Attention Deficit Hyperactivity Disorder and Depression: Sex, Aetiology, Help-Seeking and Assessment
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The general aim of the thesis was to contribute to the knowledge about co-occurring symptoms of ADHD and depression in adolescence, focusing on sex differences, as well as aetiology, help-seeking and assessment.

Studies I–III used epidemiological samples of self-reports from all students in Västmanland aged 15–16 and 17–18 years. Study I investigated the prevalence of co-occurring symptoms of ADHD and depression, as well as associations between co-occurring symptoms of ADHD and depression and one environmental stress factor; experience of sexual abuse. Study II examined associations between one biological factor—a polymorphism in TFAP-2βand co-occurring symptoms of ADHD with andco-occurringsymptoms of depression. Study III investigated the association between the parent–adolescent relationship and seeking help from specialized mental health services in relation to symptoms of ADHD and/or depression. Study IV was a clinical study among adolescent psychiatric patients that compared self-reported ADHD symptoms via the Adult ADHD Self-Report Scale–Adolescent version (ASRS-A) and the Adult ADHD Self-Report Scale–Adolescent–Screening version (ASRS-A-S) with an ADHD diagnosis determined by the gold-standard method; the Kiddie Schedule of Affective Disorders and Schizophrenia diagnostic interview.

Studies I–III showed that the phenotype of co-occurring symptoms of ADHD and depression is frequent, with a distinct preponderance among girls. Approximately 50% of both boys and girls with co-occurring symptoms of ADHD and depression had also experienced sexual abuse, indicating that this is a group with multiple risk factors for long-term impaired mental health.

Results also support biological sex differences because girls with symptoms of ADHD and a common polymorphism of TFAP-2β (absence of a 9 repeat) reported more symptoms of depression, but boys did not.

Further, only 5% of the adolescents with symptoms of ADHD and/or depression sought help from specialized mental health services. The co-occurrence of symptoms of ADHD and depression was a stronger predictor of help-seeking than all other psychosocial factors investigated, including secure attachment cognitions styles to parents. Among help-seeking girls, co-occurring symptoms of ADHD and depression were more common than symptoms of ADHD without co-occurring symptoms of depression.

The ASRS-A/ASRS-A-S showed promising psychometric properties for further validation in adolescentsresults as a screening tool for use in adolescents.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2014. 90 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 976
Keyword
Attention deficit hyperactivity disorder, depression, adolescent, sex, sexual abuse, transcription factor AP-2β, help-seeking, attachment object, validation study
National Category
Medical and Health Sciences
Research subject
Child and Youth Psychiatry
Identifiers
urn:nbn:se:uu:diva-219389 (URN)978-91-554-8892-5 (ISBN)
Public defence
2014-04-11, Aros Congress Center, Munkgatan 7, Västerås, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2014-03-21 Created: 2014-02-28 Last updated: 2014-04-29

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Sonnby, KarinNilsson, Kent W.Ramklint, Mia

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