DEPRESSIONall types of depressed states than are men and
this seems to occur from an early age. There are
no gender differences in depression rates in
prepubescent children, but after the age of fifteen,
girls and women are about twice as likely to be
depressed as boys and men. Many models have
been advanced for how gender differences in de-
pression might develop in early adolescence. For
example, one model suggests that the causes of
depression can be assumed to be the same for girls
and boys, but these causes become more prevalent
in girls than in boys in early adolescence. Accord-
ing to another model, there are different causes of
depression in girls and boys, and the causes of
girls’ depression become more prevalent than the
causes of boys’ depression in early adolescence.
The model that has received the most support
suggests that girls are more likely than boys to
carry risk factors for depression even before early
adolescence, but these risk factors lead to depres-
sion only in the face of challenges that increase in
early adolescence (Nolen-Hoeksema and Girgus
1994). For a review of the epidemiology of gender
differences in depression including prominent theo-
ries for why women are more vulnerable to de-
pression, cross-cultural studies of gender differ-
ences in depression, biological explanations for
the gender difference in depression (including
postpartum depression, premenstrual depression,
pubescent depression), personality theories (rela-
tionship with others, assertiveness), and social fac-
tors for the gender difference (increases in sexual
abuse in adolescent females) see Susan Nolen-
Hoeksema (1995).
Age by itself is a major risk factor for depres-
sion, although as described this varies for each
gender. For women, the risk for a first episode of
depression is highest between the ages of twenty
and twenty-nine. For men, the risk for a first
episode is highest for those aged forty to forty-
nine. A related risk concerns when a person was
born. People born in recent decades have been
found to have an increased risk for depression as
compared to those born in earlier cohorts.
Another significant risk factor for depression
is the availability and perception of social support.
People who lack close supportive relationships are
at added risk for depression. Additionally, the
presence of supportive others may prevent depres-
sion in the face of severe life stressors. Support is
especially important in the context of short-term
depression that can result from events like conflictual
work or personal interactions, unemployment, the
loss of a job, a relationship break-up, or the loss of
a loved one.MEASUREMENT OF DEPRESSIONMost of the commonly used techniques to assess
for depression come from clinical psychology and
are heavily influenced by the cognitive theories of
depression. For example, the work of Beck and
other cognitive theorists has led to the develop-
ment of many ways to measure the thoughts that
depressed individuals may have. Most of these
measures are completed by the individuals them-
selves, while some are administered in an inter-
view format where the therapist asks a series of
questions. Some interviews are delivered by trained
clinical administrators (e.g., the Structured Clini-
cal Interview for DSM-IV), while others are highly
structured, can be computer scored to achieve
diagnoses based on the DSM-IV, and can be ad-
ministered by lay interviewers with minimal train-
ing (e.g., the Diagnostic Interview Schedule). Sepa-
rate measures have also been designed for adults
and children to compensate for differences in
level of comprehension and sophistication, al-
though measures of symptoms and diagnoses in
children and adolescents are less-extensively stud-
ied. The methods used work well for children
provided that information from both parent and
child sources are included in the final decisions.There are different types of self-report meas-
ures for depression. It can be assessed by having
the patient fill out a questionnaire. Because our
thought processes may operate at varying levels of
consciousness, we may not always be able to access
what they are to report on them. For this reason
different cognitive measures of depression were
designed to operate at various levels of conscious-
ness. For example, the most direct measures ask
about the frequency with which negative automat-
ic thoughts have ‘‘popped’’ into a person’s head in
the past week (e.g., ‘‘no one understands me’’).
Another type of measure attempts to get at the
cognitive and social cognitive mechanisms by which
people formulate their beliefs and expectations.
Because many negative thoughts take the form of
comparing the self with others, these types of