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Risk and Protective Factors of Depressive Symptoms
image   MARGARET LOMBE AND VON E. NEBBITT
INTRODUCTION
AFRICAN AMERICAN ADOLESCENTS ARE ONE of the most vulnerable, victimized, and disenfranchised groups in contemporary American society (Gibbs & Huang 2003). Several theories attempt to explicate the myriad challenges that urban African American youth face (Herrnstein & Murray 1999; Jensen 1969; Ogbu 1985; Shuey 1966; Wilson 1987). Most of these theories are deficit-based, focusing on risk factors, maladaptations, and negative outcomes in youth. Deficit-based explanations have greatly increased our understanding of how risk factors in various domains (e.g., individual, peer, family, community) negatively affect African American youth. However, these approaches have failed to address multifinality in this vulnerable population of youth. Indeed, many urban African American youth avoid life-compromising circumstances and become well-functioning citizens (Furstenberg et al. 1999).
During the 1970s and 1980s, theories on child and adolescent development underwent a paradigm shift, which undergirded the development of new theoretical propositions and ushered in a systematic approach to understand factors that differentiated youth with positive adaptations from those with negative adaptations (Garmezy 1974; Rutter 1979; Werner & Smith 1982). The shift initiated a body of research that focused on “invulnerable” and “stress-resistant” children (Anthony 1987; Werner & Smith 1982). This emerging body of evidence has enhanced our understanding of how risk factors interact with protective factors to enhance positive adaptations in youth. Using a sample of 788 African American youth living in urban public housing, this chapter contributes to the body of research by assessing how the downward extension of adult responsibilities to adolescence (i.e., adultification) and community cohesion buffer the effects of delinquent behavior, exposure to deviant peers, and exposure to neighborhood hazard on depressive symptoms.
OVERVIEW OF THE ISSUE
Significance of Community Context
African American youth are more likely than white and Latino youth to reside in urban neighborhoods marked by concentrated poverty and isolation (National Center for Child Poverty 2001; Urban Institute 1997). Theorists (Coll et al. 1996; Nebbitt et al. 2010) have argued that this experience can have a simultaneous inhibiting and promoting effect on youths’ developmental competences. Indeed, youth and families must make positive adaptations to survive and thrive in harsh urban neighborhoods. Jarrett (2003) argued that one adaptation used by adolescents and families in low-income urban neighborhoods is accelerated development or the downward extension of adult responsibilities to adolescent offspring—a process conceptualized as adultification. Others (e.g., Cook 2000; Williams & Kornblum 1994) argued that nonfamilial community members facilitate adolescents’ adaptation to life in urban neighborhoods through increased community cohesion and nurturing social networks.
Qualitative research (Jarrett 2003; Cook 2000) has suggested that unique individual and community adaptations promote resilience in urban African American adolescents. Despite this evidence, most quantitative research has focused on mainstream protective factors (i.e., intelligence quotient, internal locus of control and academic achievement), leading to the neglect of research examining how unique adaptations (adultification and collective cohesiveness) may buffer the negative effects of living in urban neighborhoods on adolescents’ well-being.
REVIEW OF THE LITERATURE
Neighborhood Risk
The prevalence of adolescent exposure to neighborhood hazard and violence is well documented in the extant literature (Cooley-Quille et al. 2001; Myers & Thompson 2000; O’Keefe 1997). During the past few decades, research has emerged linking exposure to community hazard and violence to a variety of emotional and behavioral problems in African American youth (Aneshensel & Sucoff 1996; Flannery, Wester, & Singer 2004; Gorman-Smith, Henry, & Tolan 2004; Myers & Thompson 2000; Schwartz & Gorman 2003). Among these are increased risks for symptoms of depression and anxiety disorders (Fitzpatrick & Boldizar 1993; Mazza & Reynolds 1999; Morenoff & Lynch 2004). This is an area of concern given the co-occurrence of depression and health-risk behavior, including suicide, in urban African American adolescents.
Delinquent Peers
The developmental period of adolescence involves individualization from family and identification with a peer group (Brown & Klute 2006). As a result of this change, peers exert relatively greater influence and form an important behavioral reference during adolescence. Research has documented similarities in levels of risk behavior among adolescents within the same peer group (Boyer, Tschann, & Shafer 1999). In fact, one of the most consistent and strongest predictors of adolescents’ behavior is peer affiliations (e.g., Keenan et al. 1995). Moreover, research has reported a link between peer affiliation and emotional well-being in adolescents (Brendgen, Vitaro, & Bukowski 2000; Fergusson & Woodward 2002). For example, Brendgen et al. (2000) found that youth who affiliate with delinquent peers reported more depressive feelings compared to those who affiliate with nondelinquent peers. This observation has been reported by others (Nebbitt & Lombe 2008). A question of interest, therefore, may be whether unique adaptations to life in harsh urban neighborhoods buffer the negative effects of this experience.
Delinquent Behavior
The prevalence of co-occurring depressive disorders and problem behavior among adolescents is well established in the juvenile delinquency literature (Angold, Costello, & Erkanli 1999; Pliszka, Sherman, & Barrow 2000). Research suggests that delinquent youth have higher levels of mental disorders compared to nondelinquent youth (Huizinga & Jakob-Chien 1998). Depression disorders have been identified as significant correlates of antisocial behavior among youth (Chiles, Miller, & Cox 1980; Pliszka, Sherman, & Barrow 2000; Vermeiren, Deboutte, & Ruchkin 2002). Studies with diverse groups of incarcerated and adjudicated youth seem to reflect these findings (Pliszka, Sherman, & Barrow 2000; Vermeiren, Deboutte, & Ruchkin 2002). It is estimated that approximately 60 percent of the youth in the juvenile justice system (residential and nonresidential) with a diagnosable mental disorder are African American (Teplin, Abram, & McClelland 2002; Wasserman et al. 2004). When adjusting for oppositional defiant disorder and substance abuse, depression is one of the most commonly diagnosed mental disorders among these youth (Shufelt & Cocozza 2007). The high prevalence of depressive disorders among African American youth in the juvenile justice system should be a major concern to the public health and mental health communities (Shufelt & Cocozza 2007). This situation may reflect inadequate community-based mental health surveillance systems and a lack of community-based mental health services in urban African American communities.
Adultification
The presumption that adolescence development is an extension of childhood implies some sort of moratorium transition before adolescents take on adult responsibilities (Luthar & Burack 2000). Notwithstanding the fact that for upper- and middle-income youth adolescence may be a hiatus, numerous complications arise when attempting to apply this presupposition of adolescence to urban low-income adolescents (Luthar & Burack 2000). African American adolescents living in urban neighborhoods are likely to undergo an alternative developmental trajectory (Jarrett 2003; McLoyd 1998). Due to various socioeconomic and cultural factors, urban African American adolescents are often prematurely required to assume adult roles and do not often experience adolescence as a transitional phase (Burton, Allison, & Obeidallah 1995).
Evidence has documented multiple environmental, social, and familial factors that urban African American youth must adapt to, which shape their developmental trajectories (Jarrett 2003). One salient developmental adaptation is adultification—the downward extension of adult responsibilities to adolescence (Jarrett 1990, 2003). Simply put, adultification is the process through which an adolescent acquires or assumes behaviors and roles that are typically adult. Socialization into adult roles and behaviors may be influenced by circumstances that make up the subjective experience of an urban adolescent. Indeed, in an environment where a single parent may be overburdened by working multiple jobs or incapacitated by substance abuse, health problems, ineffective parenting, and/or premature parenting; a youth may rise to the challenge by assuming unmanned responsibilities, such as caring for siblings, household chores, and other adult tasks (Jarrett 2003). Adultification may be contentious for the youth in that while these adult roles and behaviors may be validated/affirmed by his or her family and community because the youth is performing critical tasks for the family, assuming such roles and behaviors may be frowned upon or even sanctioned because they diverge from what is defined/perceived as age-appropriate and normal in mainstream society, (e.g., scholastic success; Furstenberg et al. 1999). Because developmental competences are defined by the social context, it is likely that adultification may be a protective factor within urban neighborhoods (Ogbu 1985).
Although qualitative research has begun to pay attention to the process of adultification, there is a paucity of quantitative research that explores adultification as a developmental adaptation in urban minority youth (e.g., Jarrett 1990, 2003). Moreover, research efforts have not been devoted to understanding whether adultification buffers the negative aspects of life in urban environments. Our position is that adultification, among African American adolescents in public housing, may be a source of efficacious behavior and self-esteem that is validated by both a youth’s family and community. Hence, it may serve as a protective factor.
Community Cohesion
Youth in urban neighborhoods often rely on various factors to help them overcome the harmful effects of their living environments. One such factor is social cohesion, perceived as supportive relationships beyond a youth’s immediate home environment (Gutman, Sameroff, & Eccles 2002). Social cohesion generally consists of a network of peers and caring adults within a youth’s community and is evaluated on the basis of people’s perceptions of how community members relate to each other (Rountree & Warner 1999)
Evidence suggests that supportive relationships outside a youth’s immediate family buffer environmental challenges by providing a youth with an avenue to process experiences with peers or caring adults within their community (Garbarino & Kostelny 1992; Sandler et al. 1989). Moreover, adolescents are more likely to avoid risky behaviors when they perceive themselves to be socially integrated and exposed to more community assets, including social support (Benson et al. 2006; Hawkins et al. 2007; Xue et al. 2005). Furthermore, higher perceived community cohesion is associated with higher perceived self-efficacy, which is associated with positive emotionality (Nebbitt 2009).
Although scholars are increasingly paying attention to the role of community assets, including social cohesion, in influencing outcomes among adults, few studies have examined community-level variables, such as social cohesion, as a potential mechanism moderating the effects of exposure to community violence in youth (e.g., Morenoff & Lynch 2004). A rigorous examination of these relationships may have important implications for promoting resilience among African American youth in urban public housing developments.
Resilience
Resilience research that focuses exclusively on urban African American adolescents is limited (Luthar 1991, 1995; Luthar, Doernberger, & Zigler 1993; Luthar & Zigler 1992; Miller & MacIntosh 1999). Specific theories to guide this research are also rare (see Coll et al. 1996 for an exception). Of the limited resilience research conducted with urban African American adolescents, studies have found that individual, family, and community features act as protective, compensatory, and vulnerability factors within high-risk situations. For example, an internal locus of control was found to be positively related to assertiveness in the classroom, and social expressiveness was found to be a protective factor against stress on youth popularity with their peers. Intelligence, on the other hand, was found to be a vulnerability mechanism under high-stress situations (Luthar 1991). Luthar (1995) also found, among a sample of inner-city African American adolescents, a gender difference in resilient functioning. She found that being female was associated with higher competences; however, for girls, early anxiety and depression were negatively related to later sociability and grades.
This review of the literature provides sound empirical evidence linking a number of ecological factors to African American adolescents’ psychological functioning. We build on this evidence and the integrated model introduced in chapter 3 by exploring how individual and community factors moderate the relationship between neighborhood risk and youths’ emotional well-being. We extend this area of research by assessing how unique (adultification and collective community) adaptations to life in urban public housing neighborhoods buffer the negative effects of living in these neighborhoods.
THEORETICAL ORIENTATION
The integrated model introduced in chapter 3 postulates that two salient constructs—adultification (Jarrett 2003) and community cohesion—in urban public housing communities buffer the negative effects of other risk factors within these communities. Therefore, we test the section of the model which posits that community risk, exposure to deviant peers, and delinquent behavior are positively related to depressive symptoms, and that community cohesion and adultification are negatively related to depressive symptoms. Furthermore, we test the section of the model which argues that the influences of community risk, exposure to deviant peers, and delinquent behavior on depressive symptoms are mitigated by social cohesion and adultification. Lastly, we test whether the relationships above depend on the research city (figure 8.1).
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FIGURE 8.1   Ecological inhibiting versus promoting protective factor model.
Research Questions
This study advances three research questions:
1.  How are community risk, community cohesion, peer behavior, delinquent behavior, and adultification related to depressive symptoms?
2.  Is there evidence that the influences, if any, of community risk, peer behavior, and delinquent behavior on depressive symptoms are buffered by adultification and community cohesion?
3.  How do relationships, if any, within housing developments differ by city of research?
METHODS
Research Sites
Data from all four cities (i.e., New York City, Philadelphia, St. Louis, & Washington, DC) were used for this chapter. It should be noted, however, that the second research site in New York City Ravenswood was excluded from the final analysis due to missing observations on key indicators. Protocol and procedures are described in chapter 4.
Measures
The following measures were used:
1.  Depression was measured using the Center for Epidemiologic Studies Depression Scale (Radloff 1977).
2.  Neighborhood risk and social cohesion were assessed using the Subjective Neighborhood Scale (Aneshensel & Sucoff 1996).
3.  Exposure to delinquent peers was assessed using the Exposure to Delinquent Peers Scale from the National Youth Survey (Elliot 1987).
4.  Adultification (e.g., the downward extension of adult responsibility to adolescents) was measured using the two items described in chapter 4.
5.  Delinquent behavior was assessed using the Self-Report Delinquent Behavior Scale from the National Youth Survey (Elliot 1987).
Analytic Procedures and Regression Diagnostics
Prior to the analyses, data were evaluated for missing observations, outliers, normality, multicollinearity, and homoscedasticity. Maximum missing scores, on selected observations, were lower than 3 percent. Listwise deletion was employed. Seriously skewed observations were not detected. Regression diagnostics (e.g., scatter plot of the standardized residual and the standardized predictors, variance inflation factor, and tolerance values) indicated that the assumptions of our test were not violated. All variables were centered to reduce multicollinearity with the addition of interaction terms.
The primary analytic procedure included a general linear model (GLM). We used the custom function to create a direct and indirect effect model. The direct effects model included age, gender, research city, adultification, delinquent behavior, exposure to delinquent peers, neighborhood risk, and social cohesion. The two-way indirect model included six interaction terms: adultification by delinquency, adultification by exposure to delinquent peers, adultification by neighborhood risk, social cohesion by delinquency, social cohesion by exposure to delinquent peers, and social cohesion by neighborhood risk. The three-way interaction variables were research site × adultification × delinquent behavior; research site × adultification × delinquent peers; research site × adultification × neighborhood risk; research site × social cohesion × delinquent behavior; research site × social cohesion × delinquent peers; and research site × social cohesion × neighborhood risk. In addition to GLM, univariate and bivariate analyses were conducted.
RESULTS
Sample Characteristics
A total of 788 African American adolescents from public housing developments in four large U.S. cities participated in this study: 30.1 percent lived in New York City; 20.8 percent in Washington, DC; 30.2 percent in St. Louis; and 19 percent in Philadelphia. Ages ranged from 13 to 19 years, with a mean age of 15.6 years and a standard deviation of 2 years. The sample had slightly more males (52 percent). The sample reported a mean depression score of 17.89, with a standard deviation of 11.41 points. Youth reported a 56 percent prevalence of depressive symptoms based on a cutoff point of 16. However, using a cutoff point of 24 yielded a depressive symptom prevalence of 34 percent (table 8.1).
TABLE 8.1   Descriptive Statistics and Comparison by Gender for Study Variables
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NS, not significant; *p < .05, ** p < .01, *** p < .000.
Mean Comparisons
Males reported a higher prevalence of depression than females. Symptoms did not vary between youth in New York and youth living in Washington, DC; however, New York youth reported significantly lower symptoms than youth in St. Louis and Philadelphia. Youth in Washington, DC, also reported significantly lower symptoms than youth in St. Louis and Philadelphia. Depressive symptoms did not differ between youth in St. Louis and Philadelphia. See table 8.2 for results
TABLE 8.2   One-Way ANOVA Mean Comparisons Across Cities
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NS, not significant; *p < .05, ** p < .01, *** p < .000.
aClasses 1 and 2 are different.
bClasses 1 and 3 are different.
cClasses 1 and 4 are different.
dClasses 2 and 3 are different.
eClasses 2 and 4 are different.
fClasses 3 and 4 are different.
Bivariate Results
Depressive symptoms were positively related to exposure to delinquent peers, social cohesion, and neighborhood risk. Depressive symptoms were negatively related to adultification and unrelated to social cohesion (table 8.3).
TABLE 8.3   Bivariate Correlation Coefficients for Study Variables
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*p < .05, ** p < .01, *** p < .000.
Multivariate Results
The GLM model explained 26 percent of the variance in depressive symptoms (R2 = .259; p < .000). The results from the direct effects model indicated that depressive symptoms had positive relationships with city of residents, delinquent behavior, exposure to delinquent peers, and social cohesion.
The results from the two-way interactions model found significant interactions between adultification by delinquency, adultification by neighborhood risk, and community cohesion by delinquency on depressive symptoms. The positive relationship between delinquent behaviors and depressive symptoms was significantly weaker under high adultification. This positive relationship was also significantly weaker under high social cohesion. Neighborhood risk was inversely related to depressive symptoms under high adultification; however, neighborhood risk was unrelated to depressive symptoms under low adultification conditions. See figures 8.28.4 for interaction slopes.
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FIGURE 8.2   Community disorganization interaction slopes: adultifaction low, dashed line; adultification high, solid line.
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FIGURE 8.3   Delinquent behavior interaction slopes: cohesion low, dashed line; cohesion high, solid line.
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FIGURE 8.4   Community disorganization interaction slopes: cohesion low, dashed line; cohesion high, solid line.
Results from the three-way interactions indicate that all three two-way interactions (i.e., social cohesion and delinquent behavior, adultification and delinquent behavior, and adultification and neighborhood risk) depend on the city where a youth resides. Parameter estimates suggest that all significant two-way interactions mentioned above were only present among youth who lived in New York City. See table 8.4 for results.
TABLE 8.4   General Linear Model Univariate Analysis of Variance: Criterion—Depressive Symptoms (n = 785)
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NS, not significant; *p < .05, ** p < .01, *** p < .000.
DISCUSSION
African American adolescents living in urban public housing face many challenges. Their living environments are often marked by dilapidation and disorganization, as well as a high prevalence of violence and other crimes. Despite their challenging environments, many African American youth avoid life-compromising situations and become well-functioning citizens (Furstenberg et al. 1999). Indeed, it must take enormous individual and community adaptations to maintain functional competences in environments where risk factors do not have a discrete onset or remittance. Identifying factors that buffer the negative effects of living in harsh urban environments is critical to the development of preventative interventions targeting African American youth living in urban public housing. Using the integrated ecological perspective outlined in chapter 3, this chapter examined how constructs (e.g., adultification and community cohesion) salient in urban African American communities buffer the negative effects of delinquent behavior, exposure to deviant peers, and exposure to neighborhood hazard on depressive symptoms among African American youth living in urban public housing.
As predicted by our integrated model, delinquency, exposure to neighborhood hazard, and exposure to delinquent peers were associated with adverse emotionality (e.g., increased depressive symptoms). These findings were consistent with previous research (Aneshensel & Sucoff 1996; Mazza & Reynolds 1999; Morenoff & Lynch 2004; Schwab-Stone et al., 1999). Unlike as predicted, youth who played a greater role in household responsibility (i.e., adultification) did not report a higher sense of emotional well-being (i.e., decreased depressive symptoms). However, adultification did emerge as a protective factor in the face of neighborhood risk and delinquent behaviors. Although adultification has been identified as a protective factor in the qualitative literature (Jarrett 2003), this finding (i.e., the protective factors of adultification) is unique to quantitative research. Unlike predicted, community cohesion negatively influenced adolescents’ sense of emotional well-being. This finding is in consistent with previous research that found more cohesive communities to be associated with improved adolescent emotionality (Garbarino & Kostelny 1992; Sandler et al. 1989). It is important to note that social cohesion emerged in the presence of threat/risk. These observations are consistent with resiliency and protective factor models.
Unlike expected, adultification did not play a dual role in a youth’s life. On the one hand, it was not related to depression. On the other hand, adultification is a protective factor, such that assuming a high degree of adult responsibilities was indirectly related to increased emotional well-being.
Site variations were also noted in depressive symptoms, suggesting that depressive symptoms were directly related to the city where a youth lives. More specifically, youth in Washington, DC, reported significantly lower symptoms than youth in St. Louis and Philadelphia. Depressive symptoms, however, did not differ between youth in St. Louis and Philadelphia.
We believe that the findings reported in this study have not been previously reported in quantitative research. We further believe that these findings move the literature beyond mainstream approaches and may help to identify natural adaptations, with great potential to promote resilience within urban African American neighborhoods.
Limitations
Although this study has important implications to practice and research, its limitations must be acknowledged. First, because of the difficulties in gaining access to this population, the study used nonprobability sampling techniques (e.g., convenience and snowball sampling). These approaches ensured adequate sample size; however, they increased the chances of threats to external validity, compromising generalizability. Second, the cross-sectional design prevents us from establishing causality. Third, other factors, such as antisocial behavior and parental influences, may affect an adolescent’s depressive symptoms (e.g., Nebbitt & Lombe 2008). Fourth, the construct of adultification is crudely operationalized. The concept may encompass other dimensions of a youth’s life beyond simply helping parents with siblings. Finally, conclusions are based on self-reported data obtained from African American youth in urban public housing in the Midwest, Mid-Atlantic, and Northeastern regions. Generalizing these findings to youth in public housing from other regions should be done with caution.
Implications
Several implications to guide policy decisions and develop interventions to support positive adaptations among youth in urban environments emerge from this study. A primary focus of policy could be addressing the systemic/structural disadvantages that characterize urban neighborhoods and shape the experience of African American youth in these environments. Social workers have the mandate to take a proactive role in advocating for the transformation of the socioeconomic conditions prevailing in these neighborhoods. A fuller discussion of the implications of research, service delivery, and policy is discussed in the next section of this book.