CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
The well-being of humans in general, and their depression state in particular, are important themes in recent discussions in the Western world. The social integration and participation of humans in society are seen as indicators of productive aging, and the alleviation of depression forms part of policies aimed at achieving the goal of ‘successful’ aging, (Theeke, 2013). The ability of an individual to have close relationships with another is one of the most important features of a healthy personality, (Perris, Arrindell, Perris, Eisemann, VanderEnde, & Von Knorring, 2015). Close relationships influence the personal and social development processes of people considerably. From a perspective of attachment theory, the quality of one’s closest relationships beginning in infancy set the stage for subsequent development. When these relationships are secure, they promote self-reliance, confident exploration of the environment, and resiliency in dealing with life’s stresses and crises, (Bowlby, 1979). On the other hand, lack of secure attachment can lead to difficulties in regulating emotions and relating to others, engendering a vulnerability to psychological distress, loneliness and depression, (Ouellette & Di Placido, 2012).
According to the report by the World Health Organization (World Health Organization, 2014) summarized key risk factors for depression including isolation, loneliness, relationship conflict or loss, previous suicide attempt, mental disorder, harmful use of alcohol, loss of employment, financial problems, chronic pain, family history of suicide and genetic and biological factors, as well as influences from a wider systemic level such as access to means and the availability of appropriate health care. The report further emphasized that vulnerability to depression is likely to result from the cumulative effect of a number of risk factors.
Man experiences a wide spectrum of mood from low to high. Mood may be high, motivated, depressed and sad. Depressive disorder is one of the commonest psychiatric disorders which is present either as offensive reactions to internal or external factors or as a certain disease as one of the common manifestations of mental disturbance in human communities, (Peltzer, 2014). Depression is common in adolescents and especially in high school students and is one of the most frequent mental disorders among teenagers. In this age group, fundamental impairments due to this illness, not only influence on the performance of daily tasks, but as well can lead to fatal acts such as suicidal behavior, (Cantwell, & Carlson, 2011). This may cause formation of unstable families in the future and finally a desperate society. Depression often has a considerable effect on quality of life, health, social and vocational performance and physical activities.
A recent review highlighted depression as one of the key psychological risk factors for suicidal ideation and behaviour, (O'Connor & Nock, 2014). Feelings of depression have been found to be associated with initiation of self-harm, (Milnes, David, & Blenkiron, 2002), risk of repeat self-harm (McMillan, Gilbody, Beresford, & Neilly, 2007) and suicide (Beck et al., 2010). In a recent international review of case-control and cohort studies, depression was found to be associated with a greater than twofold increase in risk of suicide amongst people with loneliness, (Hawton, Harriss, Hall, Simkin, Bale, & Bond, 2013). Pincus et al., (2013) in their article, declared that between 2005 and 2010 patient visits to primary care providers for the treatment of depression are doubled. Furthermore, researches show failure to detect major depression and suboptimal use of antidepressant medications in the primary care settings and disorders remain under diagnosed and under treated, (Rouchelle et al., 2000). A study related to patients who receive care at a variety of primary care centers and specialists care offices showed that only 29% of those with high severity depression have received an antidepressant, (Wells et al., 2011). Another study revealed that only 45% patients who were high users of primary care services, have been diagnosed with depression and in need of treatment, moreover, only 1 in 9 patients have received adequate dose and duration of antidepressant treatment, (Kato & Schuberg, 2013).
However, family support has been observed to be one of the variables that may be associated with depression among young adults especially undergraduates. In this study, family support is when parents have good information about their children and they use this to provide emotional and social support to help them care for their children. Support from family, especially the parents play a vital and significant part in initiating and maintaining help-seeking for psychological health problems among their children. Due to young people’s preferences for informal support (Leavey, Rothi, & Paul, 2011), they depend on their parents to recognize the signs of depression, poor mental health and instigate help-seeking, (Logan & King, 2013). Parental engagement in care is crucial largely because it reinforces the efficacy of treatment outcomes, (Haine-Schlagel & Walsh, 2015). However, support from parents can be inhibited by a lack of awareness of available services, stigma, time constraints, and financial costs (Patil et al., 2016; Reardon et al., 2017). It is estimated that up to 40% of parents are unaware of their children’s psychological health difficulties, (Teagle, 2012), believing that the issues do not warrant treatment or will resolve with time, (Girio-Herrera & Sarno Owens, 2017). Among parents that have sought help, many feel that their needs have not been met, (Lawrence et al., 2015). Services have been described as inflexible, inaccessible, and unresponsive (Boulter & Rickwood, 2013). Parents report that unhelpful advice, insufficient information, poor emotional support, perceived judgement, and delayed diagnoses inhibit their help-seeking, (Boulter & Rickwood, 2013). As a result, many young people do not receive psychological healthcare that is ongoing and effective.
Another factor of interest in this study is the past history (personal and/or family history) of depression. This refers to the records showing traces of depression or loneliness in the past among the family members or records of an individual with traces of depressing in the past. Regrettably, adolescents who experience depression at an early age often struggle with depression throughout their lives (Brooks, Harris, Thrall & Woods, 2002). Furthermore, early onset of depression predicts more severe depression during adulthood. Even subclinical depression during adolescence increases the risk of major depression disorders 2- to 3-fold as an adult (Chinawa, Manyike, Obu, Aronu, Odutola, & Chinawa, 2015).
Therefore, this study is set out to assess the factors (past history of depression and family support) associated with depression among undergraduates at Babcock University Ilishan, Ogun State.
1.2 Statement of the Problem
Depression is a complex issue that is associated with physical, emotional, and psychological well-being, and influenced by personal, community, and societal factors. It is defined as a state in which a person lacks engagement with others, has few social contacts, lacks quality and fulfillment in their relationships, and lacks a sense of belonging. Depressed persons face an increased risk for numerous physical health issues, including impaired mobility, lung disease, arthritis, infectious illness, heart disease, and death.
Depression has as well been demonstrated to impact psychological health and well-being, and has been linked to loneliness, anxiety, social stigma, dementia, and increased risk of cognitive decline. Relatedly, experiences of depression can lead to low self-esteem, internalization of blame, feelings of powerlessness, and avoidance of community engagement. A review of several studies showed that, individuals with strong social relationships (i.e. higher participation in social networks and greater social support) were 50percent less likely to die early than those without, and that the mortality risk associated with social disconnection was on par with smoking up to 15 cigarettes a day or excessive drinking, more harmful than not exercising, and twice as harmful as obesity. Additionally, high levels of depression have been concurrently and prospectively linked with clinical results like hopelessness (Gabarron, Serrano, Wynn, & Lau, 2016), and suicidality (Milnes, David, & Blenkiron, 2002). All in all, depression is a phenomenon that deserves great clinical and research attention.
Depression has also been linked to a range of behaviours that increase the risk of disease. Studies have indicated that unemployed and less socially connected people are more likely to smoke, consume fewer fruits and vegetables, be less physically active, and drink more heavily. Depression among students has also been linked to a negative impact on food intake and poor nutrition. In their study, Peltzer (2014) revealed that high depression was linked with more problems in school functioning and academic performance. They go on to say that convinced that his or her best efforts will not guarantee future success, a student may consider his or her performance in the scholastic sphere to be irrelevant and useless. Sheftall, Mathias, Furr, and Dougherty (2010) affirmed that, it can be argued that children who have little hope for the close future show weaker intrinsic motivation for learning and school activities. He revealed that, depression scores are significantly correlated with weaker motivation scores. In other words, if the hopeless individual consistently experienced negative situations or failures, that individual may simply just give up.
McLaughlin, Miller, and Warwick (2014) stress the significance of school problems in a study of students who report feelings of depression. They discovered that students engaging in acts of deliberate self-harm are more likely to report feelings of depression concerning their future (even after depression is taken into account). In actual fact, the results of the study suggest that a substantial proportion of the deliberate self-harm group felt unable to provide solutions to their problems. Perhaps in this group, their lack of ability to see different ways out of a problem may lead them into a cycle of depression and eventual self-harm, (McLaughlin et al., 2014). It is apparent, then, that the phenomenon of depression can have far-reaching implications and can be extremely detrimental to those who suffer from it. With the intention to create and institute suitable interventions that will bring relief to school age children and students who are oppressed by depression, more investigation of this issue should be executed; no amount of research in this area should be seen as trivial. The nature of our humanity shows that whatever our nationality, gender, color or creed, there are some things that have the potential to affect us all. Depression is one of these entities
Based on the above, only a few studies on the factors associated with depression focused on family support and past history as factors associated with depression. This study aims to narrow down and validate the results of previous studies by examining the factors associated with depression among undergraduates at Babcock University Ilishan, Ogun State.
1.3 Research Objectives
The primary aim of this study is to assess factors associated with depression among undergraduates at Babcock University Ilishan, Ogun State. The specific objectives will be to:
- examine the level of depression among the undergraduates
- assess the past history of depression among the undergraduates
- assess the level of perceived family support among the undergraduates
- determine the significant relationship between history of depression and levels of depression
- assess the significant relationship between history of depression and perceived family support.
1.4 Research Questions
Based on the above research objectives, the following research questions were raised:
- What is the past history of depression among the undergraduates?
- What is the level of depression among the undergraduates?
- What is the level of perceived family support among the undergraduates?
1.5 Research Hypotheses
The following research hypotheses will be formulated in their null form.
Ho1: There is no significant relationship between history of depression and levels of depression.
Ho2: There is no significant relationship between history of depression and perceived family support.
1.6 Significance of the Study
In view of the fact that adolescence is the time for teens to develop the personal strengths and social skills that promote effective functioning within the adult world. It is a period that involves great emotional swings, a focus on oneself, and increasingly depressive behaviour.
Thus, the significance of this study lies in the fact that it would help parents and guidance understand and appreciate the nature of their youngsters as well as to guide their adjustment. Also, this study will give/acquaint the parents with the necessary and valuable information about their own role-played in increasing the disciplinary problems of the youngsters. These teens tend to model their parents' habits or behaviour e.g. smoking, hostility etc.
This research will also be an eye opener to all caregivers, governments and all those who care about the well-being of our future leaders. It will also instill in our leaders (Government) the relevance of guidance services in the total educational setting; this may now help in the proper implementation of the mooted policy of Guidance and Counselling Services as it is unambiguously expressed in the National Policy on Education.
This study is quite significant in the sense that it will be of great advantage to help the:
(i) Parents reappraise their roles and their contributions to the well being of their children and wards.
(ii) Society reexamine the values and norms they adhere to and teach their young ones (acculturation) to rush for material wealth etc.
(iii) Government to revisit most of their policies on economy, education, social etc, so as to make life more comfortable for her citizenry.
(iv) Schools to reshape the features of the home culture into new practices, which support academic goals and moral development as a means to achieve social transformation.
(v) Guidance-counsellors/Counselling-psychologists to reappraise their roles in the accountability of their services to students who are the direct recipients of guidance and counseling services in schools.
In a nutshell, it will help to increase people's awareness of the menace of depression in our society and the collective roles of every individual in remediating this problem.
1.7 Scope of the Study
The study is limited to finding out the factors associated with depression among undergraduates at Babcock University Ilishan, Ogun State. Furthermore, the research intends to study the history of depression among undergraduates and to provide remedy for it. The study would also be limited to undergraduates’ perceived family support. This is due to constraints like degree of precision, cost and time involved. Further, the study will be limited to the use of questionnaires as a primary source of data to gather the opinion of the respondents.
1.8 Operational Definition of Terms
Depression: is a mood disorder that can affect a person’s daily life. It may be described as feelings of sadness, loss, or anger.
Family Support: This is when parents have good information about their children and they use this to provide emotional and social support to help them care for their children.
Family history: refers to the records within the showing traces of depression or loneliness in the past among the family members.
Personal history: refers to the records of an individual with traces of depression in the past.
Loneliness: is a situation experienced by the individual as one where there is an unpleasant or inadmissible lack of (quality of) certain relationships.
Undergraduates: These are students in higher education who have not yet earned a bachelor’s or equivalent degree.
