Depression and treatment with inner city pregnant and parenting teens.
BACKGROUND
Between a quarter and half of pregnant adolescents are estimated to be depressed (Beardslee et al. 1988). Two recent open clinical trials found significant drops in depression levels among pregnant and newly parenting inner city teenagers after 12 weeks of Interpersonal Psychotherapy modified for pregnant teenagers (Miller et al. submitted). The current study addresses the nature of and contributors to participants' depression, and the active ingredients in their healing.


METHODS
Qualitative analyses of therapy sessions, clinical notes and post hoc interviews of clinicians were integrated with questionnaire data.


RESULTS
The most common symptoms of participant depression (n = 80) were anger/irritability and sadness and the cluster of depressive symptoms with the greatest variance was characterized by shame and guilt. Participants attributed symptoms of depression to feeling trapped or wronged, when family members were sad or rejecting and when the symptoms functioned to help participants meet their needs. Experiences associated with symptom relief were validation of pregnancies, successful use of self-advocacy and boundary setting skills and recognition of passage through important transitions. Support from participants' mothers was instrumental.


CONCLUSIONS
Interpersonal contexts may be pivotal in contributing, maintaining and/or alleviating depression among poor urban pregnant and newly parenting adolescents.
Shanok
A F
AF
Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY 10027, USA. arielleshanok@yahoo.com
Miller
L
L
D000293:Adolescent; D002986:Clinical Trials as Topic; D019052:Depression, Postpartum / Q000517:prevention & control / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D016487:Parenting / Q000523:psychology*; D010552:Personality Assessment; D010865:Pilot Projects; D011204:Poverty Areas; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D011253:Pregnancy in Adolescence / Q000523:psychology*; D011614:Psychotherapy, Brief; D011615:Psychotherapy, Group; D012931:Social Environment; D012944:Social Support; D029181:Spirituality; D014754:Violence / Q000517:prevention & control / Q000523:psychology