NURS600: Factors Influencing Adolescent Depression in Australia

This report presents a comprehensive research proposal focusing on adolescent depression, particularly within the context of indigenous teenagers in Australia. The study aims to understand the factors contributing to increased instances of depression, explore potential interventions, and identify available support systems. The proposal outlines a qualitative research design, employing primary data collection methods such as individual and focus group interviews. The methodology includes detailed descriptions of the study population, eligibility criteria, sampling methods, and data analysis techniques. Rigor, trustworthiness, and potential limitations are discussed, alongside a thorough examination of the ethical implications, particularly concerning vulnerable populations. The research questions address the underlying causes of depression, potential mitigation strategies, and the improvement of existing support facilities. The literature review synthesizes existing research on the topic, including studies on body image, dietary habits, family dynamics, and polydrug use. The report emphasizes the importance of ethical considerations, including informed consent and the protection of participant confidentiality. The goal of the study is to enhance understanding of adolescent depression and inform the development of more effective interventions and support services.

Running head: NURS600
NURS600
Name of the Student
Name of the University
Author Note

1NURS600
Table of Contents
INTRODUCTION......................................................................................................................2
BACKGROUND OF THE STUDY......................................................................................2
AIMS AND OBJECTIVES....................................................................................................3
RESEARCH QUESTIONS....................................................................................................3
LITERATURE REVIEW...........................................................................................................4
METHODOLOGY.....................................................................................................................6
RESEARCH DESIGN...........................................................................................................6
SAMPLE OF THE STUDY...................................................................................................6
SAMPLE SIZE.......................................................................................................................6
INCLUSION AND EXCLUSION CRITERIA.....................................................................7
DATA COLLECTION...........................................................................................................7
DATA ANALYSIS................................................................................................................8
RIGOUR, TRUSTWORTHINESS AND STUDY LIMITATIONS.....................................8
ETHICAL IMPLICATION....................................................................................................8
REFERENCES...........................................................................................................................9
APPENDIX..............................................................................................................................11

2NURS600
INTRODUCTION
BACKGROUND OF THE STUDY
Clinical Depression is a form of mental disorder which affects an individual’s thought
process, feelings, motivation and well-being. Depression if not identified or kept untreated
for a longer period it also gives rise to various other issues such as difficulty in concentrating,
difficulty in sleeping or excessive sleeping, increase or decrease in appetite beyond the
average level, increased level of dejection and often it takes an arc towards suicidal thoughts.
Depression can be of two types: short term and long term (De Zwart, Jeronimus and De
Jonge 2019). Depression in adolescent teenagers is a common and serious issue which is
observed across all the countries. It has similarities with the adult depression, but it differs in
points like self-destructive behaviour, increased aggression and increased irritability. The
maximum risk for depression is of teenagers who are observed to be under any loss, stress,
lacks attention and are abused at some point of time.
Studies show that about 9% of adolescent teens have any mental illnesses where the
percentage of teens suffering from clinical depression is about 60%. The research also shows
there is a high chance of 70% that depression will recur sometime in the future (Hoare et al.
2017). Till the age of 13, there are no gender differences in contracting depression. But from
the age of 13 to the age of 19, it is observed that adolescent females are at a higher risk of
contracting clinical depression. This is mostly because of hormonal changes leading to
physical modification and various social issues (Soak et al. 2016). Thus, this proposal is
aimed to uncover all the factors leading to an increase in depression in adolescent teenagers
and the ways in which the rate of increase can be lowered. There is also a huge chance of
comorbidity rate with depression in adolescent teens with anxiety and faulty social

3NURS600
functioning which may also vary greatly by ethnicity and race (Weller, Blanford and Butler
2018).
AIMS AND OBJECTIVES
The aim of this study is to analyze and understand the underlying reasons for the
increase in instances of depression in adolescent teenagers and the ways in which the rate of
increase can be lowered along with the available support available.
Objectives:
 To understand the reasons and factors leading to an increase in depression among
adolescent teenagers.
 To identify the ways in which the increase in instances of adolescent depression can
be lowered.
 To identify the support facilities already available in Australia and how can it be
further improved in treating the adolescent teens suffering from depression.
RESEARCH QUESTIONS
Q1. What are the reasons and factors that are raising the instances of depression in
indigenous adolescent teenagers?
Q2. How can be the instances of adolescent depression among indigenous teenagers
be decreased?
Q3. What are the support facilities available for indigenous adolescent teens suffering
from clinical depression, and how can it be improved further?

4NURS600
LITERATURE REVIEW
There is a substantial increase in depressive symptoms in adolescent teens but there is
not much research are conducted on this topic which is done from a broad perspective
proving one of the main reasons for the increase in depression. For this reason, a study was
conducted about the relationship between body image distortion and depression on 2,139
adolescent boys for 13 years from the year 1996 to 2009 and the maximum age was chosen
16. Results showed that the boys who thought themselves to be either underweight or
overweight showed more significant levels of depression symptoms and the boys who
considered themselves to be of a proper weight showed no such depressive symptoms. This
effect was found to remain constant throughout the 13 years the research was conducted for.
Thus, this study concluded that the distortion of body image increases the risk of clinical
depression in adolescent boys (Blashill and Wilhelm 2014).
Another study was conducted to identify the relationship between the diet of
adolescent girls and clinical depression. Dietary habits are crucial for the psychological and
physical development of adolescent girls and that is the reason this topic was chosen for the
study. The study was conducted on 849 girls varying in age from 12 to 18 years. The
participants were handed over a questionnaire based on which their depression levels were
identified. The subjects who scored more than 16 in the survey were identified to be clinically
depressed. Their dietary habits were also noted for 12 months. The results showed 116 girls
were having depression, and the mean age of the subjects was 15.0 ± 1.5 years. It showed that
the girls who mostly consumed processed food were at a greater risk of depression. The girls
who consumed green vegetables and proper nutritious foods were not showing any symptoms
of depression. It was also seen that depression was positively related to fast food and
negatively related to vegetables and food containing β-carotene, fibre, vitamins, zinc,

5NURS600
potassium and folate. Thus, it can be concluded that the consumption of fast foods can lead to
clinical depression in adolescent girls (Kim et al. 2015).
A study was conducted in Australia on depression the aim of which was to determine
the association of family-based problems with depression in adolescent teenagers. The study
was conducted on a subject count of 6,552 teens. The symptoms of depression were analysed
by the Short Mood and Feelings Questionnaire and Pubertal Development Scale. Three
indicators were taken into account during the survey, which are family conflicts, low
emotional attachment with parents and school or residential transitions. This result showed
that all three taken indicators were associated with adolescent depression. The result also
showed that females were at greater risk of depression when they faced these issues. This
observation leads to the conclusion that female adolescent teens are more susceptible to
family stressors and which leads them towards clinical depression (Lewis et al. 2015).
Use of polydrugs is getting more common in adolescent teens. So, research was
conducted to observe if there is any connection between adolescent depression with polydrug
use. The study was performed on 10,273 students from the age of 12 to 17. The participants’
frequency of various intoxications and psychological distress were measured. The result
segregated students and their drug use in three parts, which are individuals with no drug use
was 47.7% of the subjects, individuals consuming alcohol was 44.1% and 8.2% of the
individuals used polydrugs. The result showed that individuals who used alcohol and
polydrugs showed greater psychological distress and symptoms of depression than
individuals with no drug use. The distress level was more in the cases of the individuals using
polydrug. Thus, it can be concluded that polydrug use leads to psychological distress and
depression (Kelly et al. 2015).

6NURS600
METHODOLOGY
RESEARCH DESIGN
This research will be based on primary research and will be qualitative. Primary
Research can be defined as the kind of research where the data are collected by the researcher
himself by conducting interviews, surveys, ethnographic research and observations (Norris
2015). Qualitative Research is defined as the type of research that is based on scientific
observations and does not include non-numerical data (Silverman 2016). Primary research
will be the best method for conducting this study as accurate data will be available from the
conducted surveys and there will be no dependency on any journal or article for data. Primary
research will also help in accumulating new data, information or factors that are not yet
recorded or in print whereas Qualitative research will be the best way of conducting this
study as the characteristics, factors and descriptions are best understood in this form of
research.
SAMPLE OF THE STUDY
Research participants will be selected from three mental health facilities situated in
three different districts in Australia based on Convenience Sampling Method. Convenience
Sampling Method can be defined as the process that does not involve any probability and is
taken from people who can be easily reached or contacted (Etikan, Musa, and Alkassim,
2016). This procedure will be used as it is cost-effective, easy, fast and mostly accurate
results are recorded.
SAMPLE SIZE
There will be no particular number of subjects that will be taken into consideration.
Data Saturation procedure will be used. Data Saturation is the point of time where the
researchers collect a sufficient amount of data and start encountering repetition of the same

7NURS600
data and further data collection will result in the collection of similar data (Fusch and Ness
2015). This process will be used so that there is no scope of any data getting repeated and the
whole procedure will proceed without inputting any wrong data.
INCLUSION AND EXCLUSION CRITERIA
Inclusion criteria Exclusion criteria
Healthcare Professional either Psychologist
or Social Worker
Working in other units like ICU
Work experience of at least one year in a
mental health facility
Work experience less than one year at the
hospital
Provides mental health services to
indigenous adolescents suffering from
depression
Provides care to non-indigenous adolescents
suffering from depression and other diseases
Proficiency in English Non-proficiency in English
Table: Eligibility Criteria for Selection of participants
DATA COLLECTION
Data will be collected by conducting individual and focus group interviews.
Individual interviews are conducted in one on one pattern, whereas Focus Groups Interviews
are conducted in groups. In the individual interview, an in-depth discussion takes place that
makes the data rich whereas the focus group interview, a much diverse discussion takes place
and is also cheap in nature (Guest 2017). During both types of interviews, open-ended
questions (refer to the appendix) will be asked on the topic in the timeframe of 30 minutes
and the audio of participants’ answers will be recorded. Open-ended questions are questions
that can not be answered with ‘yes’ or ‘no’. These questions need to be answered in a proper
response form with the information asked for (Popping 2015).

8NURS600
DATA ANALYSIS
The data collected will need proper analysis to reach a valid conclusion. The recorded
audio of the interview will be transcribed by using Verbatim Transcription software. This will
lead to the availability of the spoken word in written format. The data will be then put into
Thematic Analysis, a form of analysis used in qualitative research to analyse, identify and
interpret various themes as per the collected data (Clarke, Braun and Hayfield 2015).
RIGOUR, TRUSTWORTHINESS AND STUDY LIMITATIONS
Rigour of the study will be quite high as the audio of the taken interviews are audio
recorded and then with the help of Verbatim Transcription software transcribed to text format
resulting in high accuracy rate. Thus, the study will end up being a reliable and accurate one.
The trustworthiness of the study will also be maintained throughout. To ensure high
trustworthiness, Pilot Test will be conducted which will examine the duration, feasibility,
cost and will help in upgrading the research design (Hazzi and Maldaon 2015).
The limitation of the study lies in the facts that it is quite time-consuming process to
gather data and the respondent might not understand a question and answer by guessing.
Primary research is also expensive and not always feasible. There is also a slim possibility of
technical glitches in verbatim transcription software. However, these problems can be
overcome by working with precision and diligence.
ETHICAL IMPLICATION
Approval will be taken from the head of the medical centre from where the
participants will be selected. The participants will be informed about the research and its
objective. They will be also given a consent form to sign before roping them up for the study.
The participants will be provided with an assurance of keeping their identity upheld and their
answers confidential.

9NURS600
REFERENCES
De Zwart, P.L., Jeronimus, B.F. and De Jonge, P., 2019. Empirical evidence for definitions of
episode, remission, recovery, relapse and recurrence in depression: a systematic
review. Epidemiology and psychiatric sciences, 28(5), pp.544-562.
Hoare, E., Milton, K., Foster, C. and Allender, S., 2017. Depression, psychological distress
and Internet use among community-based Australian adolescents: a cross-sectional
study. BMC public health, 17(1), p.365.
Salk, R.H., Petersen, J.L., Abramson, L.Y. and Hyde, J.S., 2016. The contemporary face of
gender differences and similarities in depression throughout adolescence: Development and
chronicity. Journal of affective disorders, 205, pp.28-35.
Weller, B.E., Blanford, K.L. and Butler, A.M., 2018. Estimated Prevalence of Psychiatric
Comorbidities in US Adolescents With Depression by Race/Ethnicity, 2011–2012. Journal of
Adolescent Health, 62(6), pp.716-721.
Fusch, P.I. and Ness, L.R., 2015. Are we there yet? Data saturation in qualitative
research. The qualitative report, 20(9), p.1408.
Blashill, A.J. and Wilhelm, S., 2014. Body image distortions, weight, and depression in
adolescent boys: Longitudinal trajectories into adulthood. Psychology of men &
masculinity, 15(4), p.445.
Kim, T.H., Choi, J.Y., Lee, H.H. and Park, Y., 2015. Associations between dietary pattern
and depression in Korean adolescent girls. Journal of pediatric and adolescent
gynecology, 28(6), pp.533-537.
Lewis, A.J., Kremer, P., Douglas, K., Toumborou, J.W., Hameed, M.A., Patton, G.C. and
Williams, J., 2015. Gender differences in adolescent depression: Differential female

10NURS600
susceptibility to stressors affecting family functioning. Australian Journal of
Psychology, 67(3), pp.131-139.
Kelly, A.B., Chan, G.C., Mason, W.A. and Williams, J.W., 2015. The relationship between
psychological distress and adolescent polydrug use. Psychology of Addictive
Behaviors, 29(3), p.787.
Norris, J.M., Plonsky, L., Ross, S.J. and Schoonen, R., 2015. Guidelines for reporting
quantitative methods and results in primary research. Language Learning, 65(2), pp.470-476.
Silverman, D. ed., 2016. Qualitative research. Sage.
Etikan, I., Musa, S.A. and Alkassim, R.S., 2016. Comparison of convenience sampling and
purposive sampling. American journal of theoretical and applied statistics, 5(1), pp.1-4.
Guest, G., Namey, E., Taylor, J., Eley, N. and McKenna, K., 2017. Comparing focus groups
and individual interviews: findings from a randomized study. International Journal of Social
Research Methodology, 20(6), pp.693-708.
Popping, R., 2015. Analyzing open-ended questions by means of text analysis
procedures. Bulletin of Sociological Methodology/Bulletin de Méthodologie
Sociologique, 128(1), pp.23-39.
Clarke, V., Braun, V. and Hayfield, N., 2015. Thematic analysis. Qualitative psychology: A
practical guide to research methods, pp.222-248.
Hazzi, O. and Maldaon, I., 2015. A pilot study: Vital methodological issues. Business:
Theory and Practice, 16(1), pp.53-62.

11NURS600
APPENDIX
Questions to be asked in the individual interview:
1. Prevalence of adolescence depression.
2. Who are at a higher risk of adolescent depression and why?
3. What are the available treatments available for depression in Australia?
Questions to be asked in the focus group interview:
1. How can the prevalence of adolescent depression be reduced in Australia?
2. What are the steps that can be taken to improve depression or mental care facility in
Australia?