Sunday 22 April 2018

Is the expectation for young girls too high?

Mind matters ...

Photo posed
Photo posed

Patricia Casey

Many countries conduct long terms studies of their population to examine various aspects of health, mental and physical - as well as psychosocial and education issues - in the lives of children as they mature into adults. And in some countries the studies continue for decades. In Ireland we have Growing Up In Ireland which commenced in 2006. In Britain there is the Millennium Cohort study which began in the millennium and the third wave of results, after 14 years, have recently been published and in the news. The data relates to mental health.

The participants are almost 20,000 children born in 2000 and their parents. They completed online questionnaires, some requiring the input of the researchers and others exclusively self-rated. There are literally hundreds of questions relating to many aspects of their lives including physical and mental health symptoms, relationships, social and academic activities to name just a few. Parents were also questioned about their teenage children's health.

The results made headlines with claims that 25pc of girls aged 14 were depressed while 9pc of boys were also depressed. What was even more striking was that parents seemed unaware of the unhappiness of their daughters while being more conscious of problems that their sons might have. A possible explanation may stem from the belief that girls are more mature and street-wise than boys at that age and so are a source of less worry to their parents. On the other hand, the vulnerability of boys, evidenced by their very much higher suicide rate than girls, may increase parents' vigilance regarding their mental health. The belief that girls are better at emotional expression compared to boys must also be factored into this. Yet the results demonstrate a lack of appreciation of the reality that girls are more vulnerable that was previously assumed. Although not examined in this study, other large research investigations as well as data from emergency departments have confirmed this vulnerability that manifests itself as overdosing and cutting. In short, young men die by suicide, young women harm themselves.

Other interesting findings were that those from poorer socio-economic backgrounds are more likely to report depressive symptoms than peers from better-off families. Girls from mixed and white ethnic backgrounds were the most likely to report high depressive symptoms, while those of African origin were the least likely to. For boys on the other hand, those from mixed and other ethnic backgrounds were the most likely to report depressive symptoms and those of Bangladeshi and Indian origins the least likely.

Although the term "depression" is used, it is unlikely that this is clinical depression as we understand it in psychiatry, although commentators on the study have pointed to the importance of treatment. But if these young people are sad at their current circumstances, the idea that this can in some way be treated might be considered yet again the medicalisation of unhappiness. Yet there is no doubting the deep unhappiness and sadness that blights the lives of these young people. The study was not really designed to examine the cause of this but a number of possibilities spring to mind.

The first is that perhaps expectations are too high for girls. They have a reputation for being better achievers than their male peers but perhaps this is an additional burden on them. Girls of 14 are often very sensitive about appearance and image generally and perhaps this, along with the widespread use of social media to criticise and bully as well as to admire and praise troubles them, is a further factor. Are they under pressure to engage in early sexual activity or to use illicit drugs? That these symptoms are more common in lower socio-economic groups suggests that the prospect of not achieving their full potential may already be recognised by girls in the poorer groups and lead to demoralisation and a sense of helpless and hopelessness.

Studies such as this grab headlines and media time. However, the methodology used, computer rather than face-to-face personal interviews, has a tendency to over-estimate prevalence and this is a possibility also. Nonetheless, even if the prevalence was over-estimated by 30pc, the findings still point to a large number of girls, on the cusp of womanhood, already having to confront emotions that ordinarily rear their heads at a much later stage in life. This is worrying for society as a whole and for the impact it will have on their adult lives and those of their children. Will the cycle of misery and desolation repeat itself into the future? There most definitely needs to be a discussion about the social, economic and inter-personal factors that may be feeding into this for the sake of generations to come.

But please, let's not medicalise it.

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