PARENT-ADOLESCENT COMMUNICATION AND ADOLESCENT DEPRESSION AFTER A ...

159 Pages·2016·1.19 MB·English

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PARENT-ADOLESCENT COMMUNICATION AND ADOLESCENT DEPRESSION
AFTER A PARTIAL HOSPITALIZATION PROGRAM
A Dissertation
Presented to
The Graduate Faculty of The University of Akron
In Partial Fulfillment
of the Requirements of the Degree of
Doctor of Philosophy
Ryan M. Cook
August, 2016
PARENT-ADOLESCENT COMMUNICATION AND ADOLESCENT DEPRESSION
AFTER A PARTIAL HOSPITALIZATION PROGRAM
Ryan M. Cook
Dissertation
Approved: Accepted:
Advisor Department Chair
Karin Jordan, Ph.D. Karin Jordan, Ph.D.
Committee Member Dean of the College
Rebecca Boyle, Ph.D. David Gordon, M.D.
Committee Member Dean of the Graduate School
Cynthia Reynolds, Ph.D. Chand Midha, Ph.D.
Committee Member Date
Ingrid Weigold, Ph.D.
Committee Member
Evonn N. Welton, Ph.D.
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ABSTRACT
The purpose of this present study was to examine the relationship between
parents’ and adolescent’s’ perceptions of family communication and adolescents’ reports
of depression symptoms. Data for this study came from an existing data set. Participants
included 167 adolescents and 118 mothers. The Family Communication Scale (mother
and adolescent), and the Revised Child Anxiety and Depression Scale Major Depression
Subscale (adolescent only) were completed pre and post treatment. A correlational
research design was used for this study. The results of the study found no correlation
between mothers’ and the adolescent’s perception of family communication and
adolescent depression prior to treatment. After treatment a correlation between
adolescent’s perception of family communication and adolescent’s report of depression
was found. It was also found that adolescent’s perception of family communication
accounted for more variance than the mothers’ perception of communication in relation
to adolescent report of depression.
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ACKNOWLEDGEMENTS

The author is grateful to the many individuals who have supported, encouraged,
and inspired the preparation and completion of this doctoral dissertation. I cannot forgo
acknowledging the divine support I have had personally, professionally, and
academically in the process of completing this doctoral dissertation. I must acknowledge
the support from my best friend and wife, Linnea, for her continued encouragement, love,
and long-suffering throughout this process. Additionally, I would like to thank our
wonderful children (Caleb, Jensen, and Liana), who make this all worth it. I appreciate
their support as Daddy worked for many hours and their little celebrations along the way
of completing the dissertation. I also want to acknowledge our families and friends for
their continued encouragement and prayers.
Academically and professionally, I want to acknowledge my advisor, Dr. Karin
Jordan, for her continued encouragement and example of how to carry oneself in a
professional but personal manner. Thanks to Dr. Ingrid Weigold for her assistance and
availability in the statistical analysis process. Additionally, I appreciate the guidance
provided by Dr. Rebecca Boyle, Dr. Cynthia Reynolds, and Dr. Evonn Welton for their
continued suggestions and direction for the completion of the dissertation. I also want to
thank Dr. Linda Perosa for her suggestions and passion that lead to the initial
development of the study.
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Additionally, I acknowledge my work family for their encouragement and time in
assisting with the organizing of the data for the study. I admire and respect their
continued encouragement and collaboration in providing critical and exceptional care to
the families and adolescents who were served during the duration of this study.
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TABLE OF CONTENTS
Page
LIST OF TABLES ..................................................................................................... xi
LIST OF FIGURES ................................................................................................... xii
CHAPTER
I. INTRODUCTION ............................................................................................. 1
Adolescent Depression ............................................................................... 2
Prevalence ........................................................................................... 2
Risks .................................................................................................... 3
Parent-Adolescent Communication ............................................................ 3
Statement of the Problem ........................................................................... 5
Conceptual Framework for the Study ......................................................... 5
Parent-Adolescent Communication .................................................... 6
Impact of Communication ................................................................... 7
Treatments for Adolescent Depression ....................................................... 8
Psychopharmacology .......................................................................... 9
Individual Focused Psychotherapy ..................................................... 9
Family Therapy .................................................................................. 10
Purpose of the Study .................................................................................. 11
Research Objectives .................................................................................... 11
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General Research Questions ...................................................................... 12
Significance of the Study ........................................................................... 13
Definition of Terms .................................................................................... 14
Limitations ................................................................................................. 15
Organization of the Study ........................................................................... 15
Summary .................................................................................................... 15
II. REVIEW OF THE LITERATURE .................................................................... 17
Adolescent Depression ............................................................................... 17
Depression Symptoms ............................................................................... 21
Adolescent Depression Treatment .............................................................. 26
Psychopharmacology / Psychopharmacology and Psychotherapy ..... 26
Individual Focused Psychotherapy ..................................................... 29
Family Therapy .................................................................................. 37
Summary ............................................................................................. 43
General Systems Theory ............................................................................. 44
Communication ........................................................................................... 46
Parent-Adolescent Communication ..................................................... 47
Depression Symptom Development and Communication .................. 50
Summary .................................................................................................... 58
III. METHODOLOGY ............................................................................................. 59
Statement of Problem .................................................................................. 59
Research Design.......................................................................................... 59
Description of Setting and Data Collection Procedures ............................. 63
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Data ..................................................................................................... 64
Participants .................................................................................................. 65
Inclusion and Exclusion Criteria ......................................................... 65
Instruments .................................................................................................. 66
Revised Child Anxiety and Depression Scale (RCADS) ................... 66
Family Communication Scale ............................................................ 68
Statistical Analyses .................................................................................... 71
Limitation ........................................................................................... 72
Research Question and Hypothesis One - (Correlation) ............................. 73
Research Question and Hypothesis Two - (Correlation) ............................ 73
Research Question and Hypothesis Three - (Hierarchical Regression) ...... 74
Summary .................................................................................................... 75
IV. RESULTS .......................................................................................................... 76
Descriptive Statistics ................................................................................... 76
Data Cleaning ...................................................................................... 77
Demographic Statistics ....................................................................... 80
Research Hypothesis Test Results ............................................................. 82
Hypothesis 1 ....................................................................................... 83
Hypothesis 2 ........................................................................................ 84
Hypothesis 3 ....................................................................................... 85
Summary .................................................................................................... 87
V. DISCUSSION .................................................................................................... 88
Summary of the Study ................................................................................ 88
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Research Hypotheses .................................................................................. 89
Research Hypothesis 1 ........................................................................ 89
Discussion of Hypothesis 1 ................................................................. 90
Research Hypothesis 2 ....................................................................... 90
Discussion of Hypothesis 2 ................................................................. 91
Research Hypothesis 3 ....................................................................... 91
Discussion of Hypothesis 3 ................................................................. 92
Research Contributions and Implications ................................................... 92
Future Research Recommendations ............................................................ 94
Limitations of the Study ............................................................................. 97
Summary .................................................................................................... 99
REFERENCES .......................................................................................................... 101
APPENDICES .......................................................................................................... 123
APPENDIX A. INFORMED CONSENT FOR PARENTS (CONSENT
FOR ADOLESCENTS) .............................................................................. 124
APPENDIX B. INFORMED CONSENT FOR PARENTS ............................. 126
APPENDIX C. ADOLESCENT ASSENT FORM ........................................... 128
APPENDIX D. DEMOGRAPHIC INFORMATION ....................................... 130
APPENDIX E. FAMILY COMMUNICATION SCALE: DIRECTIONS
FOR SCORING & INTERPRETATION ................................................... 132
APPENDIX F. SUMMARY OF REVISED CHILD ANXIETY AND
DEPRESSION SCALE (RCADS) ............................................................. 134
APPENDIX G. CITI COLLABORATIVE INSTITUTIONAL
TRAINING INITIATIVE ........................................................................... 137
APPENDIX H. IRB PERMISSION LETTER ................................................. 139
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APPENDIX I. NOTICE OF APPROVAL ....................................................... 140
APPENDIX J. PERMISSION TO USE FAMILY COMMUNICATION
SCALE ....................................................................................................... 141
APPENDIX K. REVISED CHILD ANXIETY AND DEPRESSION
SCALE ....................................................................................................... 142
APPENDIX L. FAMILY COMMUNICATION SCALE ................................ 145
APPENDIX M. MAJOR DEPRESSION EPISODE CRITERIA ..................... 146
APPENDIX N. FIGURE 1 ................................................................................ 147
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