Which Psychosocial Risks Are Necessary for Developing Depression During Adolescence? A Novel Approach Applying Necessary Condition Analysis

ObjectiveAlthough many factors predict adolescent depression, risks that operate as necessary conditions (i.e., the absence of the factor conveys the absence of the outcome) have been largely unexplored. This study aimed to evaluate which psychosocial risk factors might serve as necessary conditions for future onset of depression across adolescence.MethodAt baseline we assessed cognitive and personality risks, symptom severity, stressful events, and past depression history among 382 adolescents (225 girls; age M = 12.6), who were then followed over 2 years with repeated diagnostic interviews to ascertain depression onset. We applied an innovative statistical approach in mental health research, namely Necessary Condition Analysis (NCA).ResultsResults showed that baseline rumination (d = .50), stressful events (d = .37), depressive symptoms (d = .23), and self-criticism (d = .35) all emerged as significant necessary conditions for adolescents to be diagnosed with depressive disorder(s) over subsequent 24 months. Overall, 13.5% of the sample did not show all the necessary conditions (i.e., they lacked one or more conditions) and were therefore virtually immune from experiencing one or more major depressive episodes (MDEs) over the follow-up, and 65.5% did not meet all those conditions for experiencing three or more MDEs (i.e., recurrent depression).ConclusionThe findings can inform future theory building and testing as well as clinical applications via screening of necessary risk to future pediatric depression so that youth who may most benefit from effective interventions can be identified.Study preregistration informationThe Necessary Conditions for Depressive Symptomsand Major Depressionin Adolescence; https://osf.io; b5ced.Diversity & Inclusion StatementWe worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure sex and gender balance in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science.