The increasing prevalence of chronic illness among adolescents presents major challenges. Despite the fact that many chronic illnesses, such as diabetes and asthma, can be controlled through proper self-care, rates of illness-related preventable school absences, ER visits, and hospitalizations remain high. Additionally, the burdens of a chronic illness can impede meeting important developmental tasks of adolescence, increasing the risk for depressive symptoms. Those who suffer from chronic illness and comorbid depression may have even more difficulty with developmental tasks while simultaneously being susceptible to poor disease control. Positive Youth Development (PYD) theory postulates that developmental assets, or positive qualities, foster optimal development. Assets are both internal (e.g., active motivation, ability to complete homework) and external (e.g., family support, caring neighborhood). Research in healthy adolescent samples has shown that having a higher number of assets leads to positive outcomes, such as reduced risk of depression. Similar findings have begun to emerge in adolescents with a chronic illness. Yet, research that examines assets in adolescents with chronic illness and comorbid depression is lacking, particularly in regards to the relationship between assets and depressive symptoms in individuals who are already diagnosed with depression. The proposed study will address these gaps through a secondary analysis using data from the recent 2016 National Survey of Children's Health, a nationally representative sample. There are two specific aims to this study.
The first aim i s to describe and compare the number of developmental assets in adolescents with differing health statuses (i.e., healthy adolescents, adolescents with a chronic illness, and adolescents with chronic illness and comorbid depression). A log-linear model will be used to test for significant differences in the mean number of assets between each sample.
The second aim i s to examine the relationship between developmental assets and depressive symptom severity in adolescents with chronic illness and comorbid depression. A proportional odds model will be run to examine whether the number of assets is inversely associated with depressive symptom severity. Findings will provide valuable insights about developmental disparities that may exist among adolescents with differing health statuses and inform future strategies to help alleviate depressive symptoms in those living with chronic illness and comorbid depression. The objective of this study aligns with the National Institute of Nursing Research (NINR) priority area of symptom science. Additionally, this fellowship will provide a valuable opportunity for a predoctoral student who hopes to become an independent nurse researcher contributing to the evidence base geared towards improving the lives of adolescents with chronic conditions.
Chronic illness management and symptom control are challenging for adolescents, particularly among those with comorbid depression. Developmental assets, qualities that promote optimal development, have been shown to improve chronic illness outcomes but have not been studied in adolescents with chronic illness and comorbid depression. By examining developmental assets in adolescents with chronic illness and comorbid depression using a nationally representative sample, findings from this study could inform future clinical strategies that may alleviate depressive symptoms and optimize health for this unique population.
