Childhood Depression Disorder - Research Proposal Example

Childhood Depression Inserts His/Her Inserts Inserts Introduction Childhood depression also referred to as paediatric depression is an emotional and social disorder that affects children at various developmental stages with varying symptomatic features (Cowen, 2012). In the past, this disorder was discounted with various stakeholders holding that it did not exist rather symptoms presented were simply a transitory state in normal development. Previous psychoanalytic theories held that children did not have sufficiently developed super egos that could be used to direct anger against themselves (Famularo, Kinscherff, & Fenton, 1992). However, current research has dispelled such notion and as such many important figures in childhood psychopathology has taken interest in this disorder. Rate of Occurrence Childhood depression affects 2-4% of children and about 5-8% of adolescents (Lake & Dulcan, 2011). Researchers worldwide have however found out that the rates of depression are on the rise that there is a trend of earlier ages of onset. The disorder has equal rates of boys and girls during childhood, but favours girls more than boys during the adolescent age by a ratio of 2:1 (Faraone et al. 2005). Key Features Most of the developmental difficulties arising from this disorder can usually be identified at both the home and the school setting. In order to diagnose this disorder, the Diagnostic Statistical Manual – Fourth Edition (DSM-IV) is used. According to the manual, criteria for diagnosis of massive childhood depression include (Willcutt, 2012): i. The presence of five of more of the following symptoms for periods longer than two weeks, demonstrating a deviation from previous functioning: • Irritable or depressed mood • Failure to reach projected weight gains in children • Sleeping problems • Remarkable changes in activity levels • Fatigue • Indecisiveness or the difficulty to concentrate and make decisions • Lack of interest ii. The symptoms have a significant impact on the performance normal activities4. iii. The symptoms are not due to medication, medical conditions or substance abuse4. iv. The symptoms cannot be better explained by bereavement4. Episodes of childhood depression frequently last a period of 8 months in children and most usually recover within 1-2 years. Confusion usually arises in the field of childhood depression same as adult depression due to different application of the term “depression” and variation in the method of diagnosis. In childhood depression studies, the term has been used to categorize those with depressed mood, those with a combination of depressed mood plus other symptoms creating a syndrome, or those who have a set of symptoms that have been identified by official diagnostic criteria for a depressive disorder. Researchers have found out that various genetic, environmental and social factors can contribute to the onset of depression in children. It has been discovered that there is a link between prenatal and perinatal maternal depression and childhood depression (Glover, 2011). Researchers have found out that fetal exposure to stress and stress hormones may affect infant temperament and may result in childhood depression as the child grows. Pregnant women who are under constant stress, anxiety and depression have very high levels of endocrine (cortisol) which may be passed on to children, hence causing them to be susceptible to depression during early stages of development (Lifford, Harold & Thapar, 2008). Medical practitioners have also noted comorbidity between depression and other diseases such as ADHD, Dysthymia, eating disorders and conduct disorder. The presence of one or more of these disorders can also cause the onset of depression in the child (Singh, 2008). Certain environmental factors have also been attributes as triggers for childhood depression. Postpartum depression is considered a high risk for the emotional development of children. It has been noted that postpartum depression in women affects the behavioural, cognitive and academic development of toddlers and preschoolers (Eme, 2012). Depressed women usually have less attentiveness and responsiveness to the needs of their children. They also present poor representations for destructive mood regulation and problem resolution. Subjects for the Study The study is meant to study the prevalence of childhood depression and the various possible triggers of the condition. As such, the study will focus on families of children experiencing depression, paying close attention to children between 8 and 15 years old as well as their mothers. The study will include 100 participants, 30 children experiencing depression and their mothers. The control and experimental groups will each contain 15 participants. A suitable location that can comfortably hold all the participants will be selected once the research begins. In choosing subjects for the study, an emphasis will be held for those children who are experiencing two or more symptoms related to childhood depression. The children will be selected using a criteria based on the DSM-IV checklist. Having 8 to 15 participants will be sufficient to offer enough data to complete the research. Apart from the children, the research will also focus on the mothers of these children. According to some studies, prenatal and perinatal maternal depression has a very big impact on childhood depression and as such the mother’s medical history pertaining to depression is very important. The recruitment of participants will be carried out in a selected neighbour where questionnaires listing the DSM-IV list of symptoms will be presented to each family. Families presented with these questionnaires will be requested to engage in the research and given a phone number which they can reach us if interested. The control group will comprise of children without depression. We intend to show how these children behave due to the transitory stage of development and how this differs from depression. By having a control group of children without depression we can sufficiently prove that childhood depression truly exists and that it differs from normal childhood angst. Ethical Considerations According to Greg and Taylor (1999), research should involve children under the following conditions: i. The topic under research is essential to the well-being and health of children. However, a research that does not directly have an impact on the health of children is not necessarily illegal or unethical. ii. The involvement of children is a must since to the information available from research on other individuals is unable to deliver answers posed with respect to children. iii. The method utilized for the study is appropriate to children iv. The situation in which the study is carried out provide for the physical, psychological and emotional well-being of the child. The declaration of Helsinki governs research on all human participants, children included. The declaration holds that all information pertaining to the research should be afforded to the participants (Greig & Taylor, 1999). Secondly, participation must be volunteered, with the knowledge that a participant can withdraw from the study at any given time. Finally, the researcher should obtain informed consent, preferably in written form. When dealing with children, permission from his caretaker should be obtained and holds power over the consent of the child. As such, before a research on children is carried out, consent should be obtained both from the child and their legal guardians. It is imperative that the child participating in the research be given all the information pertaining to the study in order to give their informed consent and that this consent is volunteered freely. The child should also understand that they are free to withdraw from the study at any given time. Information delivered to the child and legal guardian should explain: What is expected to happen, what is being expected from the child, that the child can choose to be involved or not without any adverse impacts, that the child can withdraw at any time, that the language used is such that the child can fully understand what is happening at any level of the study, and that visual aids can be utilized to ensure that the child understand the study (Greig & Taylor, 1999). Confidentiality and anonymity should be explained in a manner that can be understood by the child in question. It must be clear to the legal guardian and the child about who will be allowed to gain access to the data obtained. Anonymity through the deletion of names and other information that could identify the participant should be carried out. Measurement In the study, the independent variables are the mother’s state during pregnancy and environmental situations surrounding the child while the dependent variable will be the score of childhood depression based on the items on the DSM-IV manual. In order to measure these items, two questionnaires will be developed, one to be answered by the parents while one (based on DSM-IV) will be asked to the child by the researchers. I consider a house to house method of collecting data to be most effective so as to ensure confidentiality and anonymity. The parents will be asked on their state during their pregnancy (depressed or not) and the situation surrounding the child, both in the past and at the moment. Another important question posed to the maternal parent is whether the child has shown symptoms of depression in the past or not. The study seeks to find out the prevalence of childhood depression in a given neighbourhood and its causes. As several studies have linked prenatal and perinatal depression as well as environmental factors as a possible cause of childhood depression, they form good independent variables as they can be tested to see if they are the causes. The score on items of the DSM-IV will form the dependent variable as the check whether or not a child has depression. As explained earlier, there will be two questionnaires one for the parent and one for the child. Both questionnaires will have weighted answers that will range from high, medium and low. In the questionnaire presented to the mothers items involved will try to pellet out the mothers emotional stability during the pregnancy and the environment, both at home and at school, that may affect the child. The questionnaire presented by the child will be based on the DSM-IV manual and will try to determine the level of the child’s depression. The child will be asked if for a particular item they can categorize it as very much, moderate or very low/not at all. There is not much study in the field of childhood depression as the term is confusing for many and many symptoms of childhood depression are classified under part of growth. This study will add to existing studies about the condition and its causes. Most studies focus on a specific cause such as abuse or motherhood depression but this study will seek to combine both environmental factors and motherhood emotional conditions in an effort to find if there is a common link. This will provide a whole picture view that can fully explain why the condition occurs and how it differs from growth normal growth stages. Data Collection For this study, a house to house call visit will be utilized. The questionnaires will be prepared and present to various house. At each house, the researcher will ask for consent and explain what the study entails. After this, houses with children and whose parents have given their consent will be visited at a later date as agreed upon by both parties and the study will be carried out. On the research date, the researchers will provide the first questionnaire to the parents and ask the child questions on the second questionnaire in the presence of the parent. After this the data will be collected and analysed. This study is a non-experimental bivariate correlational study. It will describe the behaviours of the subjects and how their current and past status affects the presence of childhood depression. In a bivariate study, scores from two variables are obtained and then used to obtain a correlation coefficient. The two items are assumed to be related and in our case childhood depression and the mother’s emotional state plus environmental factors are our variables. AT each house, the subject will know and understand what is expected from them and that they are subjects for a study. Children who do not have depression and have never experienced it will be used as the control group and their mother’s responses will be important as they will be used as the form of comparison with the study’s experimental subjects. The house to house method is the most effective as one can interact with the child more easily and also ensures to keep the subjects confidentiality intact. The house to house method is also effective in that it helps the researcher view the child’s home environment first hand. The main challenge with this method is ensuring trust as most people do not feel comfortable inviting strangers into their homes. To help with this, an identification form from the school will be used and the subjects chosen will be from my home area as they may have seen me around a time or two. The second obstacle is that most people will not be confortable explaining their past to anyone thus the need to ensure participants understand how important the study is. Analysis Correlation conveys the relationship between two variables numerically. If the variables in questions have a strong correlation, a decrease or an increase in one of the variables will be accompanied by a decrease or an increase in the other variable (Babbie, 2005). This means that the stronger the variable, the easier it is to predict one variable depending on the other. Correlation is expressed on a scale from 0 to 1, with 0 being no correlation the weakest correlation and 1 being the strongest correlation. This study will show the relationship between the dependent and independent variable through the use of a scatter plot. In the scatter plot, correlated variables will present a linear relationship. We shall also look at the significance of the variables. Significance describes the chance that we think that a relationship exists between the variables (Jackson, 2005). Correlation may exist due to accidents and not because there is truly a relationship. The correlation will be interpreted using shared variance. Through the use of Pearson’s r we shall strive to determine how much overlap exists between childhood depression and both the maternal depression as well as the environmental factors. The higher the r2 (coefficient of determination), the more the variance of one variable is shared by the other. To determine correlation the paired scores for the subjects will be entered into an SPSS program or Excel. We shall then find the Pearson’s coefficient from all the data entered. By using the SPSS, the scatter plot will also be developed to give a visual explanation for our findings. Through this, we can determine whether or not childhood depression is affected by the two factors provided. References Babbie, E. (2005). The basics of social research. Belmont, CA: Thompson Wadsworth Cowen, P. (2012). Shorter Oxford Textbook of Psychiatry (6th ed.). Washington D.C.: Oxford University Press. Eme, R. (2012). ADHD: An integration with pediatric tramautic brain injury. Expert Rev Neurother, 12(4), 475-483. Famularo, R., Kinscherff, R., & Fenton, T. (1992). Psychiatric diagnoses of maltreated children: Preliminary findings. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 863-867. Faraone, S. V., Perlis, R. H., Doyle, A. E., Smoller, J. W., & Sklar, P. (2005). Molecular genetics of attention-deficit/hyperactivity disorder. Biological Psychiatry, 1313-1323. Greig, A. & Taylor, J. (1999). Doing Research with Children. London: Sage Publication Glover, V. (2011). Annual Research Review: Prenatal stress and the origins of psychopathology: An evolutionary perspective. Journal of Child Psychology and Psychiatry, 52, 356-367. Jackson, S. L. (2005). Statistics plain and simple. Jacksonsville University. Washington D.C.: Thompson Wadsworth. Lake, M. K., & Dulcan, M. (2011). Concise guide to child and adolescent psychiatry. Washington, DC: American Psychiatric Pub. Lifford, K. J., Harold, G. T., & Thapar, A. (2008). Parent-child relationships and ADHD symptoms: A longitudinal analysis. Journal of Abnormal Child Psychology, 36, 285-296. Singh, I. (2008). Beyond polemics: science and ethics of ADHD. Nature Reviews Neuroscience 9(12), 957-964. Willcutt, E. G. (2012). The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a mete-analytic review. Neurotherapeutics 9(3), 490-499. Read More