Horsley_Depression Research Paper

Running head: SUFFERING IN SILENCE: DEPRESSION 1
Suffering in Silence:
Depression in Secondary School Adolescents
Thomas Horsley
Gordon College

SUFFERING IN SILENCE: DEPRESSION 2
Abstract
The World Health Organization has found depression to be the leading cause of disability
worldwide. Adolescent depression is becoming increasingly more common in high schools
across the U.S, occurring in 5-8% of students. The subtle indicators of depression, as well as
other internalizing disorders such as anxiety, make initial detection very difficult. This all too
often results in students suffering in silence, as they battle depression alone. Depression and
anxiety can prevent students from learning in school, contributes to reduced attendance,
increases the likelihood of dropping out, and reduces future employment opportunities.
Furthermore, depression is significantly associated suicide, which is the third most common
source of mortality in adolescents. Therefore, early detection and treatment are critical. However,
research has indicated that teachers and parents lack the expertise necessary for accurately and
comprehensively identifying adolescent depression, supporting increased education and
professional development on recognition, ill effects, and treatments of internalizing disorders.
School-wide universal intervention in combination with strong, personal student-teacher
relationships, communicate caring and understanding to students, paving the way for initial
recognition and ultimate relief from detrimental effects of depression.

Suffering in Silence: Depression in Secondary School Adolescents
“I don’t think any of my teachers knew that I was depressed. I don’t think any of my classmates
knew either. For months I was missing classes, falling asleep in classes, and just doing really
poorly. But none of my teachers really asked about it.” - Amber, a student in reflection (personal
communication, February 26, 2015)
In my conversation with Amber, a student recovering from depression, she articulated a
situation that is all too often the case for high school students as they suffer in silence, battling
depression; they feel alone and as if no one else understands, many times not realizing what’s
wrong with them (Koplewicz, 2002; Trudgen and Lawn, 2011; Amber, personal communication,
February 26, 2015). Their struggles go unnoticed by those who are meant to make a difference in
their lives, as their engagement in class, attendance, and grades plummet as a result of this
internalizing disorder. Students’ depression continues to worsen, until finally symptoms become
so severe that the condition is finally recognized. At this point, counseling and treatment can
potentially bring relief to struggling adolescents, as they try and lift themselves up and recover
the time they have lost (Koplewicz, 2002). Amber, now a graduate student studying to become a
teacher, described her experiences with depression beginning in high school, that lead to a
diagnosis in her junior year of college. Through her story, this review will explore adolescent
depression; it’s effects on academic performance, the difficulty of initial recognition, and what
can be done to combat this condition in schools.
It is well known that depression in adolescents can lead to major consequences for
afflicted individuals. Teens suffering from this disorder have an increased likelihood of inhibited
academic performance, dropping out from school, reduced future employment opportunities,
increased potential for drug use, reduced ability to establish intimate relationships, repressed
relationships with parents and other family members, and higher probability of involvement in
the U.S. justice and welfare systems later in life (Glied and Pine, 2002; Kandel & Davies, 1986;

Koplewicz, 2002; Liu, Chen, and Lewis, 2011; Von Emeringen, Mancini, and Farvolden, 2003).
Furthermore, depression is significantly associated with suicide, which is the third leading cause
of death in youth ages 10 to 24, claiming 4600 lives each year (CDC, 2015; Flisher, 1999).
Moreover, adolescent depression can impede a student’s growth and development during a time
when they are meant to “find their own identities (Gardner, 2003, p 29).” Teens with depression
see their peers’ social and developmental growth and wonder why they cannot share in this
experience, often feeling “different” and alone. Depression during this time can cause a student
to loose a year or more of school, which can result in reduced confidence and social impairment,
furthering what is often times a downward spiral of this condition (Koplewicz, 2002).
Depression, being an internalizing disorder, is directed inward and is reflective of a
child’s psychological and emotional health. External indicators can be subtle, and as a result,
initial detection can be difficult (Liu et al., 2011). Furthermore, many potential causes and
symptoms overlap among internalizing disorders, and many of these disorders co-occur with
each other and other conditions. For instance, symptoms such as irregular sleep patterns, social
withdrawal, depressed mood, over sensitivity, mood swings, and disengagement from class could
be indicative of depression, anxiety, or both (Koplewicz, 2002; Trudgen and Lawn, 2011). Any
combination of the aforementioned indicators (among many others), manifesting themselves
with varying degrees of severity, can be representative of depression – no two cases will
necessarily be represented by the same set of symptoms (Koplewicz, 2002).
When I asked Amber what brought about her depression, she replied, “I’m not entirely
sure, but I think the cause … was anxiety. I had anxiety throughout high school, and would
sometimes have panic attacks so bad that I would hyperventilate. I even passed out once.” In her
college classes, depression inhibited Amber’s ability to focus and complete assignments, which

negatively impacted her grades, resulting in failing a class. These events compounded the
already severe symptoms of the condition:
“… I would go to the library and sleep for hours instead of going to class. And when I did
go to class, I would sometimes just get up and leave because I didn’t feel like I could
handle it. And because of this, I also missed a lot of homework assignments. I know this
was all because of the depression, but I think it also made the depression even worse
because I felt like a failure that couldn’t accomplish anything (Amber, personal
communication, February 26, 2015).”
Each morning, it seemed “impossible” for Amber to get out of bed, and when she made it to
class she felt “exhausted.” To make matters worse, there was no effort made by Amber’s
teachers to reach out to her in an effort to understand the reasons behind her lack of attendance
and deteriorating academic performance. This lack of communication lead Amber to assume that
her professors thought she was a bad student, only worsening her depression.
An additional underlying factor in the difficulty of initial recognition stems from
misconceptions about how depression is seen in adolescents vs. adults (Koplewicz, 2002). Both
adults and adolescents may appear lethargic, indecisive, and self-critical, and may lose interest in
activities they enjoy and feel unloved and pessimistic about the their future (Koplewicz, 2002).
However, depressed teens may additionally exhibit greater than usual irritability, characterized
by over-sensitivity that can result in aggression or acting out (Koplewicz, 2002). Furthermore,
adolescents are more likely to develop somatic symptoms such as general aches and pains,
stomachaches, and headaches (Bernstein, Massie, Thuras, Perwien, Borchardt, and Crosby,
1997; Koplewicz, 2002). Perhaps the most marked difference between adult and adolescent
depression is inconsistency in the exhibition of symptoms. A diagnosably depressed teen can
undergo periods where they appear fine, as expressed by a parent as quoted in Koplewicz (2002),
“He went to a party and was fine, having a good time. Then at home he was impossible to be
around. What’s going on? (p. 9).” This phenomenon, referred to as “atypical depression,” and

occurs in the majority of adolescent depression cases (Koplewicz, 2002). In other cases,
depressed students will not elicit any noticeable symptoms in the classroom, as “…capable
students are creative in masking their agony with smiles and participation and work turned in on
time (Gardner, 2003 p. 30).”
The combination of these factors contributes to adolescent depression being “greatly
underdiagnosed (Maurice Blackman as quoted in Gardner, 2003 p. 29),” with one in five
teenagers having had a major depressive disorder that went untreated (Lewinsohn, Hops,
Roberts, Seeley, and Andrews, 1993). This debilitating condition is too commonly dismissed as a
“normal” part of development, as teachers and parents lack the expertise to distinguish between
normal adolescent behaviors and major depressive disorders (Koplewicz, 2002; Trudgen and
Lawn, 2011). Furthermore, prior research has suggested that teachers lack the confidence and/or
accuracy to consistently and comprehensively identify children at risk of internalizing disorders
(Dwyer et al., 2006; Moor, Maguire, McQueen, Elton, and Wrate, 2007), suggesting the need for
increased professional development and education regarding identification and treatment.
Trudgen and Lawn (2011) sought to identify the criteria by which teachers of secondary
school students recognized anxiety and depression and the threshold for these criteria required
before teachers acted on their concerns. To do so, they conducted in-depth interviews of 20
teachers from four secondary schools in Victoria, Australia (see Appendix A for example
questions). When asked about their level of prior professional development and education
regarding internalizing disorders such as anxiety and depression, most participating teachers
revealed that they had no prior formal training, “I can’t recall any professional development that
zeroed in on that. I have attended lots over the 41 years as a teacher.” (A teacher as quoted by
Trudgen and Lawn, 2011). Of the 20 teachers, six reported having had some formal training

(“recognized training specific to anxiety and depression of students”), six reported having some
informal training (unofficial, casual interactions that increased the participant’s knowledge), and
three spoke of having attended professional learning experiences that had touched on the issue of
students’ mental health. Participants’ knowledge of mental health disorders was informed
through media exposure, connections to personal experience, or through their experience as a
teacher, ranging from having taught students with mental disorders to having experienced a
mental disorder first hand.
Overall, participating teachers’ were knowledgeable about physical indicators and
behaviors associated with anxiety and depression. However, despite their apparent awareness of
potential indicators, many participants had difficulty translating this knowledge into daily
practice. Teachers cited students going through the transition from primary to secondary school
and not knowing the student as factors that can obscure identification of mental health indicators.
Additionally, teachers had trouble distinguishing between normal adolescent behaviors and what
could be anxiety and/or depression, with some teachers claiming anxiety was a “normal” part of
adolescence. Eight of the participants indicated that the presented information on the prevalence
and effect of mental disorders in adolescents was new information. There was no correlation
between years of teaching experience and knowledge of mental disorders. However, most
participants noticed that incidences of mental health disorders had increased over the course of
their careers, and that they felt relatively hopeless in their efforts to make a difference for
students with anxiety and/or depression.
Participating teachers stated that they rely primarily on intuition in identifying and
reporting potential incidents of mental health disorders in their students. This was primarily due
to the lack of any formal procedures or guidelines on the part of their schools. Thus, the

threshold for reporting was very subjective, varying from teacher to teacher. Most teachers felt it
was their duty to report potential cases. However, some suggested their lack of understanding of
mental illness had influenced how and when they reported. Familiarity with their school’s
student welfare coordinator, not wanting to overwhelm the student welfare coordinator, stigmas
associated with mental illness, and not finding out what was done to help the student as a result
of their reporting were identified by participants as potential barriers to reporting cases of mental
illness. The authors suggest that mental health literacy initiatives need to go beyond informing
and encouraging students to self-report, but must seek to inform teachers about indicators of
internalizing disorders and their ill effects on students.
Many studies beyond Trudgen and Lawn (2011) have highlighted the need for increased
teacher education on the indicators, ill effects, and treatments for adolescent depression in
seeking to increase initial recognition and prevention of more severe symptoms (E.g. Gardner,
2003; Koplewicz, 2002; Moor et al., 2007). Others studies go a step further in highlighting the
need for school-wide intervention (Hoagwood, Olin, Kerker, Kratochiwill, Crowe, and Saka,
2007; Liu et al., 2011; Rones and Hoagwood, 2000; Kuo et al., 2013), as a key objective of the
U.S. Department of Heath and Human Services is to increase “the proportion of children with
mental health problems who receive treatment (4 to 17-year-olds)” by 2020 (USDHHS, 2014).
School-based preventative programs can be considered universal (being applied to all students),
selected (applied to subsets of students), or indicated (which are applied to students who have
elicited symptoms of depression) (Kuo et al., 2013).
Kuo et al. (2013) set out to evaluate the use of school record reviews, when compared
with self-report screens, as an effective means to determine student eligibility for school-based
depression intervention. In doing so, the authors sought to find a more cost effective and efficient

means for school nurses to screen students for indicated prevention programs. The authors used
school record data from a sample of 3,320 eighth grade students from Seattle, WA. In preparing
a self-screen evaluation for each student, the authors tested for signs of depression using the
Mood and Feelings Questionnaire (MFQ) developed by Angold and Costello (1987). The results
of MFQ screening were then compared to predictive algorithms produced using two different
methods (multiple logistic regression analysis and regression tree analysis), deriving models
from the following variables: grades, attendance, suspensions, and basic demographic
information.
Of the 3,320 students, 2,006 were screened using the MFQ, 627 (31.3%) of which were
eligible for depression intervention. Students who were eligible had lower GPAs, were absent
more often, required more disciplinary actions, were more often female, more likely to be in
special education or ELL programs, were most likely not Caucasian, and were more likely to
speak a language other than English at home. (Note: Gardner (2003) indicates that depression is
equally likely to occurring in gifted students.) Using the MFQ results as a basis for comparison,
the multiple logistic regression model would have correctly predicted eligible students in 71% of
cases. Regression tree analysis had a lower positive predictive value of 65%. These results
significantly differed from the MFQ results, suggesting that the use of school records as
predictive variables in determining depression intervention eligibility is not a viable substitute
for the more expensive and time-consuming self-screening measures. However, the authors
suggest school records could be used to identify groups of students who should be screened by
the school nurse to determine their eligibility for intervention. This form of selected intervention
would be far more efficient and cost effective than universal screenings. Additionally, the
authors emphasize the importance of communication between nurses, teachers, administration,

parents, and students in determining eligibility during and post intervention. Finding more
efficient and cost-effective methods to identify students in need of depression intervention will
maximize the number of students who ultimately receive such intervention, which could reduce
the tremendously negative impact of depression in adolescent students.
In my conversation with Amber, I asked if she thought schools should reach out to
students with depression. Amber echoed, Kuo et al. (2013) in supporting the need for school
wide intervention:
“Yes… at the beginning of the school year, have a talk with all the students … Let them
know that they can come and talk to anyone if they are having thoughts of depression.
Tell them that this can not only help them with the depression, but their teachers may
then also be able to help accommodate them so they can do better in class… I feel like
it’s better than just not talking about it at all. Especially since when a lot of people are
depressed, they feel like they are alone (Amber, personal communication, February 26,
2015).”
In addressing depression at the school-wide level, this communicates empathy and caring to
students who, as Amber has noted, might feel alone in their struggles. Universal intervention on
the part of their school, communicates to students that, “We acknowledge that depression is real
and impacts your ability to learn, we care about you, and we want to help.” This form of
intervention could set the stage for mitigating the detrimental effects of depression in facilitating
initial recognition through students’ self-reporting (Kuo et al., 2013; Wang, Brinkworth, and
Eccles, 2013). Evidence shows school-wide, universal interventions offer the following benefits:
reduces recruitment, screening, and attrition difficulty, reaches a broad range of adolescents with
varying levels of risk for developing depression, reduces stigmatization, enhances peer support,
reduces psychological difficulties within the classroom, which promotes learning and healthy
development (Evans, 1999; Kubiszyn, 1999 as cited in Barrett, Farrell, Ollendick, and Dadds,

2006). However, the majority of schools do not offer such services (Gottfredson and
Gottfredson, 2002).
Beyond universal intervention programs, one of the most important factors in making a
difference in the lives of depressed students, and what ultimately made the difference for Amber,
is a strong, personal relationship with a teacher (Wang et al., 2013). There is an association
between strong student-teacher relationships (STRs) and student motivation, retention,
achievement, intellectual and social competence, behavior, self-efficacy, and aspirations
(Daniels, 2005; Eccles, Midgley, Wigfield, Buchanan, Reuman, Flanagan, and Mac Iver, 1993;
Marzano, Marzano, and Pickering, 2003; Newberry, 2013; Saphier, Haley-Speca, and Gower,
2008). Furthermore, strong STRs enable teachers to promote students’ sense of belonging,
safety, and willingness to work hard and take academic risks (Saphier et al., 2008). Increased
involvement and engagement derived from strong STRs often results from lowering of affective
barriers, as the emotional and social needs of students are met (Daniels, 2005). Medina and Luna
(1999) suggest that a teacher’s empathy and understanding are characteristics most valued by
students with emotional disabilities, and can go a long way in addressing their affective concerns
and mitigating the devastating effects of depression.
Nel Noddings (1984) suggests that an empathetic approach goes beyond the typical
notion of “putting one’s self in another’s shoes” in an effort to understand how students are
feeling. She describes empathy as “feeling with” another individual, in which a person does not
ask his or her self, “How would I feel in such a situation?” - in projecting themself onto another
person. Instead, Noddings (1984) says, “she does not project; she receives the other into herself,
and sees and feels with the other (p. 30).” Noddings’ (1984) definition is a deeper sense of
empathy in which the whole of the other individual is taken into consideration in attempting to

perceive her or his situation fully from her or his perspective, based on their individual
background. Teachers must be with their students in a nonjudgmental fashion, completely
removing themselves from their students’ situation.
For Amber, the relationship she had with a single teacher was a major force in helping
her to rise above depression. Her teacher fostered a kind, empathic relationship while
communicating high expectations and an undying willingness to do what ever it took to help
Amber meet those expectations. When I asked Amber to describe what a teacher should do to
help students dealing with depression, she replied:
“I think the main thing a teacher can do is be there for the student. Show them that you
care, and also that you are willing to do whatever they need to help… I think just
knowing that she [Amber’s teacher] believed in me, and was going out of her way to help
me, made me not want to let her down. And since I didn’t want to let her down, I did
well. And because I did well, I slowly started feeling less overwhelmed and depressed
(Amber, personal communication, February 26, 2015).”
When teachers set high expectations and are persistent in supporting students as they work to
meet their expectations, students realize that “you wouldn’t take the time or exert the energy to
push me and persist with me if you didn’t think I was a worthwhile person… I know you value
me (Saphier et al., 2008 p. 322).” If a teacher fundamentally believes that their students can and
will achieve, then they will. It is for this reason that communicating these beliefs through high
expectations constitutes the basis for relationship building (Saphier et al., 2008).
The topic of depression in adolescents is of personal interest to me, as both my brother
and I have had our own battles with this crippling internalizing disorder. Depression was
uniquely manifested in each of our lives, leading to a differing set of symptoms in each case.
Much like Amber, my own depression was driven by anxiety, often leaving me feeling
immensely overwhelmed and entirely on my own in trying to overcome. However, contrary to
Amber’s case, my anxiety drove me to perfectionism in working through my academics. I’ve

frequently felt that that relief can only come from completing my assigned work and striving to
meet and exceed expectations. However, often times when the work is done, I have felt anxious
in that I should still be working. I have strived to find ways to balance my anxiety, with
maintaining and growing relationships with friends and family. In my brother’s case, depression
was absolutely crippling. His experience echoed Amber’s in that the initial symptoms,
particularly sensitivity to failure (brought on by negative familial and other social relationships),
affected his academic performance, which in turn compounded into a downward spiral. For my
brother, strong relationships within our family, particularly with my mother, as well as new
friendships and some academic successes, have made the difference.
In conducting this review, I sought to explore ways in which I could be the difference for
students enduring the effects of depression. In practice, I have a caring and empathetic approach,
establishing relationships with students from the beginning of a class, and fostering positive
relationships amongst students (Wang et al., 2013). Additionally, I strive to provide a safe and
comfortable classroom with consistent routines and procedures (Saphier et al., 2008). In this
way, I seek to minimize common classroom sources of anxiety and stress and their potentially
additive negative impact on students dealing with internalizing disorders. I am very passionate
about the material I teach and draw from my own experiences in biology, incorporating pictures
and real world examples in presentations. Additionally, I try to teach using diverse presentation
styles, incorporating videos, live demonstrations, music, guest speakers, etc. in an effort to fully
engage students in learning. Furthermore, prior to instruction, I survey students’ interests and
incorporate them into instruction, allowing students choice in how the curriculum is shaped
(Skinner and Belmont, 1993). In this way, I hope that students exhibiting internalizing behaviors
(and the class as a whole) would be more engaged in a given lesson, perhaps temporarily

forgetting the causative agents behind the behaviors. Additionally, I am flexible in differentiating
instruction and assignments in accommodating students based on their individual needs
(Gardner, 2003). Furthermore, I use humor as a way to loosen up a class and foster student
engagement.
On a day-to-day basis, I am mindful of potential indicators in students such as reclusivity,
perfectionism, anxiety, mutism, excessive fear of public embarrassment, consistently displaying
symptoms resulting from a lack of sleep, etc., documenting daily observations. If trends in a
student’s behavior arise, I make a special effort to let her or him know that I am available outside
of class if him or her is in need of help, and gently encourage hers or his interaction in
collaborative learning and participation in class discussions. If he or she does not seem receptive
and the behaviors persist, I would notify student guidance, and seek their advise in how to best
help the student. If I have the opportunity to speak with the student apart from the overall class, I
would tactfully seek to establish the cause of his or her internalizing behavior, empathizing with
the student and further encouraging him or her to participate in class and engage with the class
material. I would then document my findings and inform student guidance. Furthermore, I will
reach out to administration of any school where I teach, asking for specific guidelines and
procedures for reporting potential cases of mental illness in my students. If no such procedures
exist, I will make an initiative to put them in place. The frequency and ill effects of mental health
concerns in adolescents are astonishing, and I believe teachers are obligated to do all they can to
make a difference. In parting, I asked Amber, “What would you say to help a student struggling
with depression?” I believe her response is a fitting conclusion:
“It WILL get better. I know right now it seems like it won’t, but I know it will. You just have to
stay strong and do what you can. Don’t push yourself too hard. Your health is what’s most
important. But if you can push yourself just to get through one day at a time, you will make it
(Amber, personal communication, February 26, 2015).”

References
Angold, A., & Costello, E. J. (1987). Mood and Feelings Questionnaire (MFQ). Durham, NC:
Developmental Epidemiology Program, Duke University.
Barrett, P. M., Farrell, L. J., Ollendick, T. H., & Dadds, M. (2006). Long-term outcomes of an
Australian universal prevention trial of anxiety and depression symptoms in children and
youth: An evaluation of the friends program. Journal of Clinical Child and Adolescent
Psychology, 35(3): 403-411.
Bernstein, G. A., Massie, E. D., Thuras, P. D., Perwien, A. R., Borchardt, C. M., Crosby, R. D.
(1997). Somatic symptoms in anxious-depressed school refusers. Journal of the American
Academy of Child and Adolescent Psychiatry, 36: 661-668.
Center for Disease Control (CDC). (2015). Youth suicide. Available from: http://www.cd
c.gov/violenceprevention/pub/youth_suicide.html. Date accessed: 12 March 2015.
Daniels, E. (2005). On the minds of middle schoolers. Educational Leadership, 62(7): 52-54.
Dwyer, S. B., Nicholson, J. M., & Battistutta, D. (2006). Parent and teacher identification
of children at risk of developing internalizing or externalizing mental health
problems: A comparison of screening methods. Prevention Science, 7, 343–357.
Eccles, J. S., Midgley, C., Wigfield, A., Buchanan, C. M., Reuman, D., Flanagan, C., & Mac
Iver, D. (1993). Development during adolescence: The impact of stage– environment fit
on young adolescents’ experience in schools and families. American Psychologist, 48,
90–101.
Evans, S. W. (1999). Mental health services in schools: Utilization, effectiveness, and consent.
Clinical Psychology Review, 19: 165-178.

Flisher, A. J. (1999). Annotation: Mood disorder in suicidal children and adolescents. Recent
developments. Journal of Child Psychology and Psychiatry and Allied Disciplines, 40(3):
315-324.
Gardner, S. A. (2003). The unrecognized exceptionality: Teaching gifted adolescents with
depression. The English Journal, 92(4): 28-32.
Glied, S., & Pine, D. S. (2002). Consequences and correlates of adolescent depression.
Archives of Pediatric Adolescent Medicine. 156: 1009-1014.
Gottfredson, D. C., & Gottfredson, G. D. (2002). Quality of school-based prevention programs:
Results from a national survey. Journal of Research in Crime and Delinquency, 39(1): 3-
35.
Hoagwood, K. E., Olin, S. S., Kerker, B. D., Kratochiwill, T. R., Crowe, M., & Saka, N. (2007).
Empirically based school interventions targeted at academic and mental health
functioning. Journal of Emotional and Behavioral Disorders, 15:66-92.
Kandel, D. B., & Davies, M. (1986). Adult sequelae of adolescent depressive symptoms.
Archives of General Psychiatry, 43: 255-262.
Koplewicz, H. S. (2002). More than moody: Recognizing and treating adolescent depression.
New York, NY: The Berkley Publishing Group.
Kubiszyn, T. (1999). Integrating health and mental health services in schools: Psychologists
collaborating with primary care providers. Clinical Psychology Review, 19: 179-198.
Kuo, E. S., Vander Stoep, A., Herting, J. R., Grupp, K., & McCauley, E. (2013). How to
identify students for school-based depression intervention: can school record review be
substituted for universal depression screening? Journal of Child and Adolescent
Psychiatric Nursing. 26, 42-5210.

Lewinsohn, P. M., Hops, H., Roberts, R. E., Seeley, J. R., & Andrews, J. A. (1993).
Adolescent psychopathology. I: Prevalence and incidence of depression and other DSM-
III-R disorders in high school students. Journal of Abnormal Psychology, 102: 133-144.
Liu, J., Chen, X., & Lewis, G. (2011). Childhood internalizing behavior: analysis and
implications, Journal of Psychiatric and Mental Health Nursing. 18, 884-894.
Marzano, R., Marzano, J. S., & Pickering, D. J. (2003). Classroom management that works:
Research-based strategies for every teacher. Alexandria, VA: Association for
Supervision & Curriculum Development.
Medina, C. & Luna, G. (1999). Teacher as caregiver: Making meaning with students with
emotional/behavioral disabilities. Teacher Development, 3(3): 449-465.
Moor, S., Maguire, A., McQueen, H., Wells, E. J., Elton, R., & Wrate, R. C. B. (2007).
Improving the recognition of depression in adolescence: Can we teach the teachers?
Journal of Adolescence. 30, 81-95.
Newberry, M. (2013). Reconsidering differential behaviors: reflection and teacher judgment
when forming classroom relationships. Teacher Development, 17(2): 195-213.
Noddings, N. (1984). Caring, a Feminine Approach to Ethics & Moral Education. Berkley:
University of California Press.
Rones, M., & Hoagwood, K. (2000). School-based mental health services: a research review.
Clinical Child and Family Psychology Review, 3: 223-241.
Saphier, J., Haley-Speca, M. A., & Gower, R. R. (2008). The skillful teacher: Building your
teaching skills. Acton, MA: Research for Better Teaching, Inc.
Skinner, E. A., & Belmont, M. J. (1993). Motivation in the classroom: Reciprocal effects of
teacher behavior and student engagement across the school year. Journal of Educational

Psychology, 85(4): 571-581.
Trudgen, M., & Lawn, S. (2011). What is the threshold of teachers’ recognition and report of
concerns about anxiety and depression in students? An exploratory study with teachers of
adolescents in regional Australia. Australian Journal of Guidance and Counselling,
21(2): 126-141.
U.S. Department of Health and Human Services (USDHHS). (2014). Healthy People
2020.Washington, DC: Office of Disease Prevention and Health Promotion.
Available from: https://www.healthypeople.gov/2020/topics-
objectives/topic/mental-health-and-mental-disorders/objectives. Date Accessed: 15
March 2015.
Von Emeringen, M., Mancini, C., & Farvolden, P. (2003). The impact of anxiety disorders on
educational achievement. Journal of Anxiety Disorders, 17, 561–571.
Wang, M., Brinkworth, M., & Eccles, J. (2013). Moderating effects of teacher–student
relationship in adolescent trajectories of emotional and behavioral adjustment.
Developmental Psychology, 49(4): 690-705.
Yousefi, F., Mansor, M. B., Juhari, R. B., Redzuan, M. R., & Talib, M. A. (2010). The
relationship between gender, age, depression and academic achievement, Current
Research in Psychology. 6, 61-66.

Appendix A
Example interview questions used to assess criteria by which teachers recognize anxiety and
depression in students, and the threshold for such criteria that brought about action in response to
teachers’ concerns (Trudgen and Lawn, 2011).
1. What informs your understanding of mental illness?
2. What are the behaviors of students that indicate to you a student has anxiety
or depression?
3. When do you as a teacher decide to report your concern about a student?
4. If you had a concern about a student who would you tell?
5. Are there any barriers that discourage you from reporting students with suspected
anxiety and depression to your school wellbeing co-coordinator/school counselor?

Horsley_Depression Research Paper

Recommended

Recommended

More Related Content

Viewers also liked

Viewers also liked (8)

Similar to Horsley_Depression Research Paper

Similar to Horsley_Depression Research Paper (20)

Horsley_Depression Research Paper