Preventive Maintenance for the pre-adolescent
Kyle Nichols
Eastern Washington University

Abstract

This research proposal is a study to look at the preventive maintenance in pre-adolescent girls, before they reach puberty. This is a longitudinal study designed to research how preventive maintenance can help lower anxiety and depression in adolescence. This is an ongoing investigation with other research that has implemented other types of intervention models for depression. However, the focus of this study is to help young girls in discovering their true identity when reaching a period in their life where stress from school, social pressure and media have an effect on their way of thinking.

Introduction
There is a significant difference in depression in adolescent girls compared to that in boys. A lot of research has been developed to find reasons which may explain the increased rate of depression, but very little research has been done on the preventive side to help adolescents in dealing with stress and anxiety. The reason for this research is to help facilitate a better way of coping and managing a young person’s stress and anxiety; by helping minister better alternatives to solutions that they may not be fully aware of. The groups which will be examined are pre-adolescents girls, ages 8 to 11, more specifically the 4th and 6th grade level.
Proposal
Earlier studies concluded that young girls experience more anxiety/depression then boys around the ages of 13 to 15 years old. (Stephanie J. Cox, 2010). One research concludes that adolescent girls will ruminate more about negative emotions than boys. In this study, they connect the copying behaviors of negative emotions with traditional socialization process, (gender role identity) which is suggested by social learning theory. (Stephanie J. Cox, 2010). Gender Identity is typically not seen in pre-adolescents until around age 11 and rumination of negative emotions is not seen till about age 15. (Stephanie J. Cox, 2010)There are other issues today which young girls are struggling with in their adolescent years, other than just stress from peers, media, school and other social pressures. It is seen that the earlier young girls experience menarche, the more severe their depression, as well as the length of time the depression will last. (Conger, 2001). It is assumed that girls who deal with later pubertal transition will have more struggles in dealing with depression, however research shows that depression will last well into their senior year in high school. Research will also conclude that adolescents that experience earlier onset of pubertal transition will have depressive symptoms well into secondary school. (Conger, 2001).
The research in this study is to help create preventive measures in pre-adolescents before reaching the age of pubertal transition and depressive symptoms. What the research will allow, is to see if there is any significance in group discussions and/or meditation that may help young girls cope with stress and depression. The hypothesis of this study is to show a decrease in depressive symptoms and anxiety in comparison to no preventive maintenance. Earlier research examined the prevention of child anxiety with primary caregivers suffering from anxiety disorder by using an intervention model known as, “Coping and promoting strength programs (CAPS). The research showed that adults had lower levels of anxiety then the control group. (Ginsburg, 2009). However, there was not a significant difference among the children, which could be due to the fact that the ages were ranging between 7-12 years of age. The problem with this study was the ages of the children would not show a decrease in anxiety from the intervention until they reached the ages of 13-15 years. This preventive maintenance study is taking an additional approach which will extend into their 13-15 years of age.
Method
For this research participants will be randomly selected from various counties in the State of Washington and different schools within the demographic area of that county. They will randomly be selected in accordance with the newspaper ads and teacher/parent discussions about the proposal. To help with parent’s approval there is an incentive to pay for the child’s lunch on the days their child is attending preventive group sessions. Parents will be informed about the reassurance of the child’s confidentiality during and after the study, parents will have the right to withdraw their child at any time and any incentives they were given may be kept, but additional payments will be stopped after the withdrawal. It will be given that each girl will be randomly selected to be in one of three groups. All groups will consist of 4th through 6th graders, in which they will be given a tutorial about what is to be discussed in the class. The first group (CG) that is the control group will have a regular group discussion about life in general and any topics that they would like to freely share. The second group (G2) will have assigned homework and then group discussions about what issues they may be having. The third group (G3) will be a learned relaxation group with general discussion and minor homework assignments. They will be given a set of instructions explaining the confidentiality of the program as well as a reminder to keep with them, explaining that everything discussed in group stays in group. In the first group session, all three groups will be given a packet with a questionnaire to measure depressive symptoms, the Symptom-checklist-90 revised (SCL-90-R;Deroatis, 1983). The SCL-90-R has been shown to have strong validity and reliability. The SCL-90-R will be revised in order as to not have the sexual content because it may be inappropriate. In addition to the SCL-90-R, another measurement, the Adolescent Peer Experiences (APEX) survey will be given to assess the psychological wellbeing, stressful peer experiences and the responses to stress. (Graber, 2010). All group sessions will be no longer than 30 minutes before or after school. After the first group session each group will meet every other week for the first three months of the school year. The last three months of the school year, groups will come back together as a follow-up. During the last group meeting of the year, they will be given the same two surveys to see if there was any difference in depression and stress with peers. Since this is a longitudinal study, every year will remain the same in comparison to the first and last three months of the year. Surveys will be issued to keep a record of stress in the girls’ throughout the study. The length of the study will be 6 years with 6 interventions during the first three years. There will be 6 survey studies for all groups and 3 years with 2 intervals for each school year for group preventive maintenance. The end of the preventive maintenance groups will be when the 4th graders have reached 7th grade and the 6th graders have reached 9th grade. At the end of the 3 years, there will be an overall survey that will be conducted with the same measurements. Any last thoughts or suggestions will be written to explain if the group interventions had any impact on the individual. An additional three years will be conducted to collect the additional measurements of depression/anxiety in the adolescent girls.
Hypothesis
The goal of this is to keep a consistent record of the number of girls in each group when changing grade levels. There is also a need to see if there is a group bond that develops which may help in coping with stress as well as dealing with the pressures of their social environment. The goal is to not just study what causes depression, but what are effective strategies that young adolescent girls can use to cope with depression. What I am hoping to find, is a pattern in the personal relationships within the groups, such as coercion and communication skills.
My hypothesis for the G2 is that they will become more cognitively aware of issues in their lives as well as concerns for others. They will develop a sense of truth that will be their own with minor events that they will struggle with. However, because of the open group discussion about issues they may have had, they will not be afraid to find social support. The homework assignments that are given will be questions dealing with personal issues they may want to discuss, keeping a record of how many times they helped others. The idea is to have them not only think about their surroundings, but how to deal with their surroundings in healthy ways.
The G3 is administering relaxation techniques, like mindfulness created by JON KABAT-ZINN, PH.D., (Kabat-Zinn), which will help the girls learn to deal with stress and anxiety better than the G2 and CG. They will have ways to cope with stress which will help lower levels of depression. This group should also have a means to develop an environment with strong social support and be less aptly to make impulsive decisions. My hypothesis for this group should show the most significance in anxiety and depression symptoms.
The hypothesis for the CG is that they will develop social support within the group but will lack skills for developing better coping techniques to deal with stress and anxiety. Because of the lack of knowledge of how to deal with stressful situations, we will see a significant increase in depressive symptoms and impulsive decisions. Since the CG is using only group discussions, it should be noted that they will have more freedom to express whatever issues or topics they want. This may lead to the biggest difference in the control group because the lack of discussion on big topics such as with issues or struggles of their daily life.
Discussion
The previous research suggests that intervention seen in adults that suffer from psychological anxiety had decreased, and as for children there was no change. (Ginsburg, 2009). Knowing that the onset of depression and anxiety is seen at age 13, our goal is to find a solution that can help prevent an increase in depression. If we can show a significant decrease of depression in adolescent girls then that will help them with bigger issues such as teen pregnancy and sexual harassment. This research will be in addition to other research that has focused on reasons for depression in adolescent girls. In addition, this research would help build a research group project that can be used not only for intervention, but also preventive measures regarding depression in teenage girls.

Reference

Conger, X. G. (2001). Pubertal Transistion, Stressful Life Events, and the Emergence of Gender Differences in Adolescent Depressive Symptoms. Developmental Psychology, 404-417.
Ginsburg, G. S. (2009). The Child Anxiety Prevention Study: Intervention Model and Primary Outcomes. Journal of Counsling and Clinical Psychology, 580-587.
Graber, L. M. (2010). Coping with Perceived Peer Stress: Gender-Specific and Common Pathways to Symptoms of Psychopathology. Dvelopmental Psychology, 1605-1620.
Kabat-Zinn, J. (n.d.). Jon Kabat-Zinn: Biographical Information. Retrieved 11 27, 2011, from Center of Mindfulness in Medicine, Health Care, and Society: http://www.umassmed.edu/Content.aspx?id=43102
Stephanie J. Cox, A. H. (2010). The Influence of Child Gender Role and Maternal Feedback to Child Stress on the Emergence of the Gender Difference in Depressive Rumination in Adolescence. Developmental Psychology, 842-852.