“Did I bring it on myself?” An exploratory study of the beliefs that adolescents referred to mental health services have about the causes of their depression

Abstract

The causal beliefs which adults have regarding their mental health difficulties have been linked to help-seeking behaviour, treatment preferences, and the outcome of therapy; yet, the topic remains a relatively unexplored one in the adolescent literature. This exploratory study aims to explore the causal beliefs regarding depression among a sample of clinically referred adolescents. Seventy seven adolescents, aged between 11 and 17, all diagnosed with moderate to severe depression, were interviewed using a semi-structured interview schedule, at the beginning of their participation in a randomised controlled trial. Data were analysed qualitatively using framework analysis. The study identified three themes related to causal beliefs: (1) bewilderment about why they were depressed; (2) depression as a result of rejection, victimisation, and stress; and (3) something inside is to blame. Although some adolescents struggled to identify the causes of their depression, many identified stressful life experiences as the cause of their current depression. They also tended to emphasise their own negative ways of interpreting those events, and some believed that their depression was caused by something inside them. Adolescents’ causal beliefs are likely to have implications for the way they seek help and engage in treatment, making it important to understand how adolescents understand their difficulties.

The therapeutic relationship in Cognitive Behaviour Therapy with depressed adolescents: A qualitative study of good‐outcome cases

“…The IMPACT study recruited 465 adolescents diagnosed with major depressive disorder of moderate to severe impairment as rated on the Kiddie— Schedule for Affective Disorders and Schizophrenia (K‐SADS; Kaufman et al ., ). The study compared the effectiveness of three psychological treatments for adolescent depression: CBT, Short‐Term Psychoanalytic Psychotherapy and Specialist Clinical Care termed Brief Psychosocial Intervention (Midgley et al ., ).…”

Group cognitive behavioural therapy can reduce stigma and improve treatment compliance in major depressive disorder patients

“…Stigmatizing beliefs, such as that MDD is caused by insufficient self‐control or lack of willpower, often result in a sense of shame and embarrassment for MDD (Corrigan, ; Midgley et al, ). Research shows that patients with MDD can benefit from psychological interventions (De Jonge, Bockting, Kikkert, Bosmans, & Dekker, ; Driessen et al, ).…”

“…Stigmatizing beliefs, such as that MDD is caused by insufficient selfcontrol or lack of willpower, often result in a sense of shame and embarrassment for MDD (Corrigan, 2004;Midgley et al, 2017).…”

“…Thus, they avoid treatment, and consequently, their MDD symptoms become aggravated. Patients tend to attribute the cause of the disease to their own personality defects or incapability (Midgley et al, 2017;Picco et al, 2017).…”

Do beliefs about depression etiologies influence the type and severity of depression stigma? The case of Arab adolescents

“…Research on adolescents has shown similar findings regarding the etiology of depression. For example, a study of adolescents living in London showed that participants endorse unknown factors/uncertainty, stressful life events, genetics, physical or environmental factors, and self‐blame as the causes of depression . This same study found that some adolescents are uncertain of the cause of their depression, and they assume that it either just happened with no connection to any event in their lives or as a combination of pressure and stress.…”