Central Mindanao University College of Nursing University Town, Mususan, Maramag, Bukidnon

THE EFFECTS OF DEPRESSION ON THE SOCIAL BEHAVIOR AMONG HIGH SCHOOL STUDENTS

Ana Lea Monica T. Duco Princess Dianne D. Esmeralda Proponents

Pilar V. Domagsang, RN, MN Research-Clinical Instructor

15 January 2013

INTRODUCTION The suffering endured by people with depression and the lives lost to suicide attest to the great burden of this disorder on individuals, families, and society. Major depression is a mood disorder characterized by one or more major depressive episodes, for a period of at least two weeks of depressed mood or loss of interest or pleasure in nearly all activities accompanied by at least four additional symptoms such as changes in sleep, appetite, or weight, and psychomotor activity; decreased energy; feelings of worthlessness or guilt; difficulty thinking, concentrating, or making decisions; or recurrent thoughts of death or suicidal ideation, plans, or attempts (American Psychiatric Association, 1994, p. 317). According to major surveys, major depressive disorder affects nearly 15 million Americans, nearly 7% of the adult population in a given year. While depression is an illness that can afflict anyone at any time in their life, the median age of onset is 32 (although adults age 49 -54 years are the age group with the highest rates of depression.). Other major risk factors for depression include being female, being African-American, and living in poverty. Women approximately experience depression two times more likely than men (Research Agenda for Psychosocial and Behavioral Factors in Women's Health., 1996). It has been called the most significant mental health

risk for women, especially younger women of childbearing and childrearing age (Glied & Kofman, 1995). Depression in women is misdiagnosed approximately 30 to 50% of the time. It is believed that about 121 million people worldwide suffer from depression. In developed countries, 15% suffer from depression. Experts predict that depression will be the worlds second most common illness in this decade. In 2004, the Philippines had 4.5 million reported cases of depression. Unreported cases could equal the number of reported cases (Retrieved: http://showbizandstyle.inquirer.net/sim/sim/view/20101030-300600/22-MoreFacts-About-Depression-That-Can-Save-Lives). Approximately 20% of teens experience depression before they reach adulthood, and between 10 to 15% suffer from symptoms at any one time. Only 30% of depressed teens are being treated for it. Some teens are more at risk for teen depression and suicide than others with suicide as the third leading cause of death among teenagers. This makes depression a common and serious illness that is important to identify and treat early in the course of the disease.

THEORETICAL FRAMEWORK Each individual grow and goes through changes that is evident in every ones dynamic yet basic human needs with specifications as to how these needs are met. This continuous change, planned or unplanned brings about great impact on ones self esteem and to ones feeling of safety and security. This may affect not only the emotional state of well being but also the physical, mental or social aspects, for even if these key areas has independent roles still they are correlated. And though these changes occur throughout ones life process, the adolescent stage has been one of the most crucial parts that are altered. Along with the fast paced development of technology and modernization is the surprising prevalent increase in statistics of teen depression. As man is viewed as a dynamic institution we must understand that he is made up of different aspects, each with an effect to another. As it is in the theory of Dorothy Johnson, the Behavioral System theory she proposed that a person is made up of seven subsystems that make up mans behavioral system. This theory directs that each behavior of an individual can be attributed whether in his need of attachment, selfpreservation or for self nurture. Furthermore one of the four goals of nursing care in this theory is to assist an individual/patient who is able to modify his behavior in ways that supports biological imperatives. Thus, this gives us access to help understand and assist each individual especially teenagers to reach their full potential of functioning. As this model of nursing care is

proposed as fostering of the efficient and effective behavioral functioning in the patient to prevent illness (Johnson, D. 1968). Thus making us realize how a certain dysfunction in each state affects another. Unable to take grasp of these connections, teens are most susceptible to the development of depression since they are vulnerable, sensitive and emotionally unstable. There are a lot of factors that affects the emotional health of teenagers. For one an unresolved prior conflict surface during adolescence as stated in the Genital stage of Sigmund Freuds Psychoanalytic Model of Personality Development. Furthermore, this theory believes that only when these conflicts are resolved can an individual be capable to handle a mature adult sexual relationship. In a given point we all engage in forming relationships and the inability to do so is of great concern as this may cause strain to ones knack to interact and find meaning in life. And we form relationship also to sate our endless craving to be appreciated. Often times they make mistakes by believing appearance is the main contributor and basis into building successful relationships. As it is in Erik Eriksons Psychosocial Model, during the adolescence developmental task of Identity vs. Role Confusion, a dramatic physiological change is linked with sexual maturation. This will define limits to an adolescents normal behavior as a child and can be shocking if not guided accordingly. Here, there is obsession with appearance and body image. One might think s/he is too fat or too plain and believes that this will hinder her/him to belong in a group and establish a

relationship especially to the opposite sex. This will cause distress as an additional to a low self esteem and inability to form social bonds. In addition, an essential part of making an adult decision such as choosing career or a partner in marriage is the attainment of the sense of identity. Inability to recognize what one wants can be frustrating and greatly cause a glitch to ones outlooks in life. Lastly to support the claims of the given points, we have Abraham Maslows Hierarchy of needs. This theory explains that for a person to develop his/her fullest potential in life or the self actualization he must achieve all the needs of the hierarchy which starts from physiological need, safety and security needs, love and belonging needs and esteem needs. Traumatic circumstances, present physiological ailment or emotional instability may cause one to regress to a lower level of motivation then affecting social interaction, relationship.

STATEMENT OF THE PROBLEM This study aims to identify the effects of depression in relationship to the social behavior among Central Mindanao University High School students. Specifically, this study seeks to: 1. Identify the demographic profile of students in terms of: a. Age b. Gender c. Family Structure d. Family History e. Self-Esteem 2. Determine the factors affecting depression in high school students. 3. To determine whether there is a significant relationship between the respondents profile and social behavior; and lastly 4. To determine whether there is a significant relationship between depression and social behavior.

OBJECTIVES OF THE STUDY This study would help identify the effects of depression in relationship to the social behavior among Central Mindanao University High School students. Specifically, this study seeks to:

Identify the demographic profile of responents in terms of age, gender, family structure, family history and self-esteem; and

Determine the factors affecting depression in the students of Central Mindanao University.

To determine whether there is a significant relationship between the respondents profile and social behavior; and lastly

To determine whether there is a significant relationship between depression and social behavior.

HYPOTHESIS OF THE STUDY No: There is a significant relationship between depression and on the social behavior among high school students N1: There is no significant relationship between depression and on the social behavior among high school students

RESEARCH PARADIGM

Independent Variables: Age Gender Family structure Family history Self-esteem

Moderator Variable

Dependent Variable: Social behavior of students

1.1 The illustration shows that the independent and dependent variable plays a great role in in determining the whether ther is a significant relationship between depression and on the social behavior among students.

SIGNIFICANCE OF THE STUDY The findings of this research study would benefit the people especially the students who would be able to identify the effects of depression so that proper intervention can be given to the depressed person. This will also make them aware of the growing incidence of depression. Findings in this research study would provide basis for the conduction of future research about the effects of depression on the social behavior among high school students.

SCOPE AND DELIMITATIONS OF THE STUDY The extent of this study includes the overall data gathered from the students of Central Mindanao University Laboratory High School who are enrolled for the school year 2013-2014. The limitations of this study are the respondents profile in terms of age, gender, family structure, family history and self-esteem. DEFINITION OF TERMS Depression- a mental state wherein one is incapable of feeling or achieving a state of happiness and experiencing bliss Effect- is the outcome or the alteration caused about by a certain stimulus, phenomena or any other entity can cause deviations

Social behavior- it is a behavior directed towards the society or taking place between members of the same species. Students- are individuals that in educational institutions that seeks to gain knowledge or earn a degree in assistance to acquiring success in a chosen career in the future Teens- individuals whose age is between 13 to 19 years of age

REVIEW OF RELATED LITERATURE There are multiple reasons why a teenager might become depressed. Teens can develop feelings of worthlessness and inadequacy over their grades. School performance, social status with peers, sexual orientation, or family life can each have a major effect on how a teen feels. Environmental stress may sometimes be a result of teenage depression. But whatever the cause, when friends or family -- or things that the teen usually enjoys -- don't help to improve his or her sadness or sense of isolation, there's a good chance that he or she has teen depression. Age According to the World Health Organization, major depressive disorder is the leading cause of disability among Americans age 15 to 44. (Depression in Children and Adolescents-Fact Sheet., Retrieved:

http://www.nimh.nih.gov/health/publications/depression-in-children-andadolescents/index.shtml) About 11% of adolescents have a depressive disorder by age 18. The risk for depression increases as a child gets older (National Comorbidity Survey-Adolescent Supplement)

Coincidently, the peak age of depression and low self-esteem coincides with the transition from elementary to junior high school. This age may have

an inability to deal with the new social demands as well as academic demands of a new school (Feldman & Elliot, 1990; Eccles, et. al., 1993).

Gender A Canadian study shows that about 1 in 10 teenage girls suffer a major depression each year. (DeNoon, D.J., 2010) About 4% of teenagers have major depressive disorder at any one time. Among teens, girls are more often affected than boys. MDD frequently interferes with home, school and family life, including causing a lot of family stress. Premenstrual Dysphoric Disorder, which is a severe form of premenstrual syndrome that is characterized by severely impairing behavior and mood changes is experienced approximately 2 to 10 percent of women (http://www.mentalhealthscreening.org/info-and-facts/depression.aspx). Family Structure A link between parental depression and youth social dysfunction has been commonly observed in families of depressed parents (Goodman and Gotlib 1999; Lovejoy et al. 2000).

Difficulty in establishing autonomy in the adolescent's relationship with parents is another factor associated with adolescent depression and negative behaviors is. Adolescent depression is seen in higher frequency in families where the children have difficulty establishing their own identity because of

negative communication patterns and other dysfunctional family attributes (Allen, et. al., 1994).

Family History Teens that have a family history of depression or mental illness are at risk of developing depression. Between 20 to 50% of teens who are suffering from depression have at least a family member with depression or some other mental disorder. Teens who spends more time alone those who experienced trauma or disruptions at home, including divorce and deaths of parents are more likely to develop depression (Borchard, T., 2010). Self Esteem

There is a strong correlation between a person's emotional reactions and their involvement in social relationships. Therefore, one need to improve one's standing in interpersonal relationships rather than trying to fix some perception about themselves in order to increase ones self-esteem

One of the chief differences between adult and adolescent depression is that depression in adolescents usually involves more social and interpersonal difficulties which directly leads to self-esteem problems. Adolescents are also more likely to idealize suicide as a solution to feelings of helplessness. Adolescents may also socially isolate themselves when depressed out of feelings of guilt. Depression is usually accompanied with

dramatic behaviors such as aggression, obsession or even fascination with death (Lamarine, 1995). New research indicates that the behaviors are not the result of low selfesteem, but rather the result of social rejection which leads to low self-esteem. In other words, self-esteem does not cause a person to behave a particular way, it is the result of poor social relationships (New model, 1995; Rao, 1994).