Cascade effects emerged between school problems and depression for girls in our study, providing evidence that school failure can be considered an indicator of psychological health. Our model suggested a true transactional relation, in that childhood depressive symptoms predicted school failures in adolescence, which in turn predicted a major depressive episode in emerging adulthood. Thus, girls' failure in the school arena, such as dropping out of school or being suspended or expelled during adolescence, accounts for some of the long-term continuity between depressive symptoms in childhood and clinical depression in young adulthood.
Our findings on school failure are quite consistent with Masten and colleagues' finding that adolescents with less academic competence are more vulnerable to internalizing problems in young adulthood [1
]. Our focus, however, was on major failure experiences in the school environment, broadly speaking. Almost half of all failures to complete secondary school is attributable to mental health symptoms [31
], suggesting a great deal of overlap between academic and behaviorally based problems. Disruptive behavior in the school setting, for example, can interfere with learning in a classroom; conversely, students with low achievement may be prone to get in trouble. We found that relations to depression were similar regardless of which type of “school failure” was examined (see Table 4). Thus “school failure,” as defined by the current study, can be considered a marker for identifying girls who are at increased risk, though both academic and behavioral reasons may contribute to these failures. Consistent with our gender-specific findings, Reinherz and colleagues [7
] found that poor academic achievement at age 9 was a risk factor for women but not for men. Other research has shown girls to be more sensitive to competency evaluations [32
], so it possible that girls may be psychologically more vulnerable to actual failure experiences in the school domain, particularly since they were less common for girls than for boys.
We did not find evidence for adolescent adaptation problems predicting young adult depression among boys. Previous literature has identified neonatal and childhood health problems as a gender-specific risk factor predicting depression among men during the transition to adulthood [7
]. There may be other risk factors not accounted for by our model that are important for boys, or depressive risk may emerge at a different developmental time point for boys. Our results diverge in some respects from those of Patterson and Stoolmiller [33
] who tested the Dual Failure Model among 2 distinct samples of preadolescent boys. They found a negative association between good peer relations and depressed mood, and the association between achievement and depressed mood was mixed. However, the current study differs in at least 2 important ways from their study. First, we examined relationships longitudinally, following participants from late childhood through emerging adulthood, whereas Patterson and Stoolmiller conducted cross-sectional analyses of preadolescent boys. Second, we utilized a structured diagnostic clinical interview to determine those who qualified for a major depressive episode, in contrast to examining ratings of sadness based on parent and teacher reports, as was done by Patterson & Stoolmiller. Thus, it may be the case that transient symptoms of depression or negative mood are related to social and school failures for boys, as is suggested by the left-hand side of our model. Yet we did not find that these types of “failures” were associated with lasting clinical levels of depression, at least at age 21.
One explanation for these findings is that conduct problems and school failure are relatively more atypical and less accepted for girls than for boys, and may signal more impaired functioning or may be associated with more severe consequences [34
]. It is also possible that boys and girls with conduct problems and school failures both have vulnerability, but that specificity of risk diverges with development, with girls becoming more prone to internalizing problems during adolescence, and boys manifesting problems in a broader variety of ways, such as problems with substance use, externalizing problems, and other social failures.
In addition to the effect of school failures, a positive association was found between conduct problems at age 10 and depressive symptoms at age 21 for girls, while no significant association was observed for boys in this multivariate modeling context. Early conduct problems, above and beyond adolescent problems with adaptation, directly predispose girls to depression in young adulthood. This is consistent with the literature suggesting that heterotypic continuity is more common among girls [19
]. Indeed, externalizing symptomatology marked by conduct problems appears to be one of several posited childhood pathways to depression [10
In addition to examining moderation by gender, we went further than previous studies by using rigorous longitudinal analyses in which we controlled for early depression and simultaneously tested adaptation problems in different areas. We found support for the continuity between childhood and adolescent adaptation problems within specific areas. In our sample, this was indicated by higher levels of fifth-grade conduct problems being significantly associated with more delinquency throughout high school; more social problems in childhood predicting adolescent social problems; and problems with early school achievement predicting school failure experiences. We also found that for boys and girls, early conduct problems had somewhat broad consequences for other problems. For girls, early conduct problems predicted later social problems, whereas, for boys, reciprocal associations emerged between conduct problems/delinquency and achievement/school failure. Previous research has shown that problems of conduct and self-control early in development lead to academic or conduct problems, or both [35
], but gender differences have not reliably been examined. Neither social nor behavioral problems predicted major depressive episode in adulthood. This lack of findings is contradictory to a body of literature finding that interpersonal difficulties and depression are closely related for children and adolescents [2
]. This difference may have resulted in part from our fairly conservative methodological approach. Since our purpose was to test an etiological framework, we controlled for co-occurrence of depression and social difficulties within time, as well as stability effects for each over time. Moreover, very few previous studies have examined depression and social problems over such an extended period of time, cutting across distinct developmental phases.
Several limitations need to be kept in mind in considering these results. We used a sample of children that represent a range of the urban populace, with particular oversampling of children from schools from high-crime neighborhoods. Thus, our sample provides an opportunity to examine a wide range of variability in children, neighborhoods, and school experiences, but this regional sample with somewhat higher risk may not generalize to other populations. Also, we limited our measures of developmental adaptation to those that have emerged from Masten's empirical studies of this topic [36
]. It is possible that alternative constructs or measures may account for the relationship between adaptation and depressive symptoms. Third, the inclusion of a more complete measure of early depression, including self-report of depressive symptoms, would have been preferable. In the absence of this, we used teacher reports of depressive problems, which are limited by exposure to one particular context (school) as well as teachers' inability to directly observe the more internal phenomenology of depression. Correlations between teacher reports and self-reports of depression range from .20 to .50 [32
]. Fourth, analyses using the WLSMV estimator were based on the standard untested assumption that a continuous latent response variable that is normally conditioned on the exogenous variables underlies the observed dichotomous outcome. Recent simulation work supports the use of WLSMV estimation over traditional estimation procedures, such as maximum likelihood, for structural equation models with categorical endogenous variables. [27
] Finally, our measure for academic achievement in grade 5 was based upon parent and child report only, and did not include any objective indicators.
This study offered prospective longitudinal analyses, testing the theory that adaptation problems in various domains of adolescent development may create risk for adult depression. The results suggest that both early conduct problems and adolescent school failures are promising explanatory mechanisms for the development of depression among girls. This study highlights the mutual interplay between school and psychological functioning during adolescence and emerging adulthood, and offers several implications for adolescent health professionals. First, staying in school in adolescence should be promoted as one way to enhance emotional well-being. Conversely, identifying girls with early conduct problems and school failures and reducing those problems might be a way to reduce later depressive symptoms. Second, if pathways toward depression differ by gender, this suggests that prevention strategies might need to be tailored to the unique needs of girls and boys. Third, a better understanding of the mechanisms of this school failure-depression pathway is needed to help identify the most salient potential targets that could be incorporated into efforts to break the chain of events leading toward depression for many girls.