S.T. Snow et al
Today, hyperactivity is widely understood to be a neurological problem that involves problems in the brain's behavioral inhibition circuitry (that is, children with hyperactivity lack the ability to "put the brakes" on impulsive behavior). Nicole describes herself during second grade as a disruptive, hyperactive child with a short attention span, a child who could not help but think and behave differently from others. These kinds of externalizing problems have social consequences, namely rejection by peers. Nicole reports that other children routinely excluded her from games; that teachers did not like her because she was "antsy," disruptive, and did not pay attention; and that no one wanted to be her friend. Not only are the kinds of behavior problems displayed by Nicole known to lead to rejection by peers (Vaughn, Hogan, Lancelotta, & Shapiro, 1992), but any victimization by peers also predicts further peer rejection (Hodges & Perry, 1999). Once you are down in the social world of children, the deck is stacked against your ever climbing back up.
Rejection by one's peers sets in motion forces that lead to feelings of low self-worth, self-dislike, and lack of acceptance. Research has shown that seeing oneself as rejected or victimized by peers is associated with self-blame, loneliness, anxiety, and low self-worth (Graham & Juvonen, 1998). Loneliness can be self-perpetuating: children tend to stigmatize others who are chronically lonely, with greater loneliness leading to ever-greater levels of rejection (Rotenberg, Bartley, & Toivonen, 1997). Nicole writes of her desperation, yearning for recognition as a worthwhile person, and feeling as if the entire world hated her. She did, however, tell of having one friend. Researchers have seen that when the "popular" children dislike a child, that child is more likely to find solace in the company of other children who are also "outcasts" for one reason or another. Sometimes, the friend may become an outcast simply by befriending a rejected child. This differential association can tend to intensify one's sense of being "different," because the qualities that caused the rejection are often reinforced within the subgroup.
The socially constructed view of the self as rejected and lonely, combined with biological vulnerability, often leads to depression. Biological risk factors can include both imbalances in brain chemistry as well as the changes that puberty brings on. Depression can manifest itself in many different ways in children and youth. Nicole describes how she could rarely make it through a day at school without crying, and how she pulled hairs out of her head and hurt herself physically (selfmutilation). Children may also exhibit changes in eating or sleeping habits, withdraw from family and friends for extended periods of time, and talk about, threaten, or attempt suicide. When there are stressful situations in a child's life, such as the transition to middle school, problems like low self-worth are known to predict depressive symptoms (Robinson, Garber, & Hilsman, 1995). One current model of adolescent depression assumes that low-self esteem and stressful recent events are major predisposing factors (Allgood-Merten, Lewinsohn, & Hops, 1990; Roberts & Gotlib, 1997).
As we noted, girls are especially vulnerable to the shift from externalizing problems to depression in adolescence. Before adolescence, rates of depression are about the same for boys and girls (Nolen-Hoeksema, Girgus, & Seligman, 1991). By adolescence, however, girls' rates are significantly higher than boys' (Petersen, Sarigiani, & Kennedy, 1991). One theory for this marked increase in girls' rates of depression is that puberty for girls tends to activate a number of risk factors for depression, including changes in hormone levels and body shape, changes in their ruminative coping skills, and the onset or intensification of gender-based expectations and sex roles (Nolen-Hoeksema & Girgus, 1994). In addition, girls tend to depend more on social relationships for a sense of self-worth, a tendency called "sociotropy," whereas boys in general base their self-worth on achievement, which is called "autonomy" (Beck, 1983). For a young girl and a young boy with externalizing problems, the resulting peer rejection is likely to affect the girl more strongly, because she values social relationships more highly than the boy does. As girls move through puberty, social relationships become more important, and consequently, the intensity with which they perceive peer rejection increases as well.
Snow, S.T.; Hoffman, C.C.; Kendziora, K.T. & Quinn, M.M.
(1999). Depression in adolescent girls: Emerging themes from the research
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Vaughn, S., Hogan, A., Lancelotta, G., & Shapiro, S. (1992). Subgroups of children with severe and mild behavior problems: Social competence and reading achievement. Journal of Clinical Child Psychology, 21, pp. 98-106.