A Comparison of Dependent and Self-Critically Depressed Hospitalized Adolescents

One hundred ninety-four hospitalized adolescents were administered the Adolescent Depressive Experiences Questionnaire (DEQ-A). The DEQ-A factors (dependency, self-criticism) correlated well with independent measures of depression, hopelessness, self-esteem, and suicide risk. After controlling for depression, self-criticism and dependency showed differential associations with hopelessness, violence potential, and impulsivity. A subgroup of 84 inpatients identified as either highly self-critical or highly dependent based on the DEQ-A was also compared for differences in personality and symptomatic behavior. Self-critical and dependent patients exhibited equally high levels of depression, hopelessness, suicidality, and low self-esteem. Few differences were observed in personality or symptomatic behavior between the two groups. These findings, while extending previous research that relied on community samples of young adults, provide only mixed support for a distinction between these two categories of depression.     

A comparison of adolescent inpatients with and without substance abuse using the Millon Adolescent Clinical Inventory

We compared clinical syndromes, expressed concerns, and personality styles of adolescent inpatients with substance use disorders (SUD; n=44) vs. without substance use disorders (non-SUD; n=61) using the Millon Adolescent Clinical Inventory. The two groups did not differ with regard to age, sex, ethnicity, functional severity, or the frequency of other major psychiatric disorders, and were drawn from the same overall sample population. SUD subjects showed significantly higher levels of delinquent predisposition and lower levels of anxiety. Consistent with these syndromal findings, we found that SUD subjects were characterized by higher levels of unruliness and social insensitivity and lower levels of submissiveness. Our findings suggest that, in severely disturbed adolescents who require psychiatric hospitalization, externalizing phenomena are closely associated with SUD. Our findings also suggest that internalizing problems also exist in SUD, although not at levels greater than that observed in non-SUD inpatients.Received Ph.D. in clinical psychology from the University of Pittsburgh. Research interests include eating and weight disorders, addictive behaviors, behavioral medicine, psychological assessment, and psychiatric comorbidity.Received Psy.D. in clinical psychology from the University of Hartford. Research interests include psychological assessment, adolescent psychopathology, and psychiatric comorbidity.Received B.A. in Psychology from Swarthmore College. Research interests include perception, developmental psychopathology, and psychosis proneness.Received Ph.D. in clinical psychiatry from DePaul University. Research interests include the assessment and treatment of substance abusing psychiatric populations.     

Psychiatric Morbidity Differences in Male and Female Adolescent Inpatients With Alcohol Use Disorders

Objective: To examine gender differences in demography, cooccurrence of Diagnostic Statistical Manual (third edition, revised; DSM-III-R) axis I disorders and axis II personality disorders, and self-reported psychological distress in adolescent psychiatric inpatients with alcohol use disorders. Method: A consecutive series of 61 adolescent inpatients (36 boys and 25 girls) with either alcohol abuse or dependence were reliably assessed with structured diagnostic interviews for DSM-III-R Axis I and Axis II personality disorders. Results: Boys and girls did not differ in age, ethnicity, socioeconomic status, global functioning, age at first psychiatric contact, or number of hospitalizations. Girls were more likely to meet criteria for oppositional defiant disorder, eating disorders, and additional drug use disorders. Girls were also more likely than boys to meet criteria for at least one personality disorder and borderline personality Contrary to gender patterns in the general population, the proportion of girls and boys with affective disorders and conduct disorders did not differ significantly. Conclusions: Relatively few gender differences were found in adolescent inpatient alcohol abusers even where they would be expected, based on non substance-abuse general population gender patterns. When observed, gender differences were in the direction of greater psychiatric disturbance among girls. Some of the gender patterns observed among alcohol abusing adolescents are at odds with gender differences observed in non substance-abuse samples.