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Originalarbeiten/Original articles

Stressbezogene Determinanten für die Aufrechterhaltung von Depressionen bei Mädchen

Published Online:May 20, 2014https://doi.org/10.1024/1422-4917/a000285

Abstract

Major Depression ist bei Kindern und Jugendlichen eine sehr häufige psychiatrische Erkrankung. Stressbezogene Ansätze zur Erklärung adoleszenter Depressionen gehen davon aus, dass akute und chronische Stresssituationen sowohl als Auslöser wie auch in Folge der depressiven Störung auftreten. Postuliert wird, dass solche Stresssituationen langfristig bestehen bleiben, weil depressive Jugendliche vorwiegend ungünstige Stressbewältigungsstrategien anwenden. Die vorliegende Studie prüft stressbezogene Risikofaktoren für das Fortbestehen einer Major Depression bei Mädchen. Untersucht wurden 68 15-jährige Mädchen in einem Längsschnitt Design mit zwei Messzeitpunkten. Die Stressbelastung und Stressverarbeitung wurde mit dem Fragebogen zur Erhebung von Stress und Stressbewältigung im Kindes- und Jugendalter (SSKJ) gemessen. Die stressinduzierte Speichelcortisolausschüttung und die Cortisol Aufwachreaktion beim ersten Messzeitpunkt dienten als Indikatoren für die Funktion der HHN-Achse. Durch eine logistische Regressionsanalyse wurde der prädiktive Beitrag der einzelnen Risikofaktoren ermittelt. Signifikante Effekte zeigten sich für stressvermeidende Bewältigungsstrategien, eine hohe psychische Stressbelastung sowie eine hohe Stressvulnerabilität, während körperliche Beschwerden oder die Funktion der HHN-Achse unerheblich waren. Die Ergebnisse bestätigen theoretische Ansätze, die Stressbelastung und Stressverarbeitung als ursächlich für das Fortbestehen einer Major Depression bei Kindern postulieren.


Stress-related risk factors for depression in girls

Major depression is a frequent psychiatric disorder among adolescents. Stress-related approaches to adolescent depression postulate acute or chronic stressors as a cause of as well as a consequence of depressive symptomatology. Stress situations persist because the child uses mainly unfavorable stress-coping strategies. The present study investigates stress-related risk factors for the maintenance of depression in 68 young girls in a longitudinal design with two measurement points. Stress load and stress coping were assessed by the Fragebogen zur Erhebung von Stress und Stressbewältigung im Kindes- und Jugendalter (SSKJ). Data on stress-induced salivary cortisol and cortisol-awakening response at first measurement point were also available. A logistic regression model tested the relative contribution of stress-related risk factors. Significant effects were obtained for avoidant coping, a high psychological stress load, and a high stress vulnerability, while physical complaints and cortisol were not relevant. These results confirm theories that postulate stress load and stress coping as causal links for maintenance of depression in youth.

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