INTRODUCTION

Investigating the influential factors among particular population requires assessing the relations between factors included in this complex such as psychological or demographical variables.[1] Some examples of the potential psychogenic factors related to depression are stress and self efficacy.[2]

Depression during adolescence has been shown to be highly prevalent and associated with life stressors.[3] Studies found that depressed children were more likely to have had significant stresses in the previous year prior to depression compared to non-depressed children.[4, 5]

It has been estimated that between 25% and 30% of US students suffer from adverse effects of examination stress. Furthermore, it is assumed that 10 million school students underachieve because of anxiety-related performance impairments.[6]

The stresses that occur during adolescence may have a substantial negative impact on emotional well-being and result in the adoption of unhealthy or maladaptive behaviors.[7, 8] Stress and stress-associated distress or depressions are important factors in self-efficacy. For both adults and adolescents, stress has been shown to be positively associated with levels of self-efficacy.[9, 10] According to Bandura, self-efficacy plays a central role in the self-regulation of affective states. Briefly, when people perceive themselves as unable to gain highly valued outcomes, they will be depressed.[11]

There are few studies that have reported a negative correlation between self-efficacy and depression among adolescents. In these studies, the low self-efficacy of children was associated with their high level of depression.[12, 13]

Similarly, there are few studies that have examined the relations between self-efficacy and adolescent depression and stress. Depression has been shown to be negatively correlated with self-efficacy among Iranian student.[14] Depressed mood has also been found to be related with a high stress rate,[15] and self-efficacy turned out to be a mediator in this relationship.

In Iran, as a developing country, approximately 1/3 of population are adolescents.[16] Studies from Iran report serious mental problems such as depression and distress among Iranian adolescents.[17, 18]

The parameters such as depression, stress, and self-efficacy have culture-based nature[19] and may be different in countries and regions with various sociodemographical specifications. Therefore, we should consider the important role of demographics to better recognize the potential associations between them.

It is hypothesized in this research that high levels of depressive symptoms would be associated with high levels of stress and low level of self-efficacy. Thus, the present study aimed to determine the relationships between stress and self-efficacy with depression among a sample of Iranian male adolescents. Additionally, we were interested in examining how self-efficacy and perceived stress along with demographic variables may predict the depressive symptoms.

METHODS

RESULTS

Descriptive statistics

As it could be seen in the Table 1, the mean age of participants was 15.44 (SD = 0.68). The most of them had large nuclear (with parents) families with five or more members (52.7%). The secondary education level of both parents is the highest among subjects (fathers = 54.5% and mothers = 55.5%). Results of comparisons between normal and depressed groups revealed that there were significant differences between groups in term of father's job and past semester grade point average (P < 0.05). The total mean score of depression was 16.02 ± 9.14. According to Zich et al., classification of scores,[25] 249 (61.9%) of participants were without any considerable symptoms of depression, 106 (26.4%) of subjects had mild depressive symptoms and the rest (47 persons or 11.7%) had major depressive symptoms.

Table 1. Sample characteristics

The total mean score of self- efficacy scale was 27.24 ± 5.11. Using the median split, which is to dichotomize the sample, 213 (53%) of participants were found low self-efficacious and the rest (189 persons or 47%) were high self-efficacious.

The mean score of perceives stress was 17.99 (SD = 6.02). By categorizing the scale to a dichotomous organization, 282 (70.1%) of participants were placed in low stress group (≤20) and 120 persons (29.9%) were in high stress group (>20).

Relations between depression related factors

Results obtained from Pearson correlation test showed that there is a significant negative relationship between self-efficacy and depression (r = −0.322). Moreover, there was negative correlation between perceived stress and self-efficacy (r = −0.439). A positive significant relationship also was found between depression and perceived stress (r = 0.649).

Results obtained from the linear regression analysis revealed that perceived stress, self-efficacy, father's job (P < 0.01), and past semester grade point average (P < 0.05) were associated significantly with depression among the adolescents [Table 2]. The variation of depression in the model was about 45%.

Table 2. Multivariate regression analyses of depression score against some sociodemographic and related factors

DISCUSSION

The initial hypotheses regarding the inter-correlations between the scales were supported by the findings of this study. There were high correlations between CES-D, PSS, and GSE.

The prevalence of depressive syndromes among our participants was considerable and showed that more than 1/3 of them have different points of depression. This finding has been reported in other studies with a range from 10 to 34%.[26, 27, 28]

As predicted, results revealed that high levels of depression were generally accompanied by low levels of self-efficacy and also high levels of perceived stress.

This finding agrees with earlier findings.[29, 30] Furthermore, as Stein et al., have stated, the cultural stressors could have a significant role in forming the depressive symptoms. They found that discrimination, parent child conflict, and economic stress are culturally based stress among Latino youth which could predict the depression.[31] These results are somewhat different from our results that could indicate the different nature of stressors among various cultures.

Previous studies on depression in adolescent's affective disorders have predominantly focused on anxiety and treatment of depressive symptoms.[32] Present findings suggest that it is important to include the role of demographic variables, self-efficacy, and stress in the line of research as the considerable markers toward depression.

Father's job was one of the demographic specifications of participants that predicted depression in our sample. A possible explanation about its prediction power could be related to cultural effects. In Iranian families, father's job is one of the main components that decrease anxiety in terms of economic issues. In other words, when father, as core of financial situation in nuclear family, can provide family members economic security, this can develop a sense of confidence and optimism among the members. This sense may be contributed to prevention of depressive symptoms among children.

In our study, a relationship between grade point average and depression was detected. This implies that academic achievement may be a variable related to depression. Therefore, appropriate educational programming and more attention to academic performance from parents and teachers can be a mechanism to reduce stress among teenagers. The relation between depressive symptoms and low academic achievement has been shown in the other similar studies.[33, 34] In addition, it has been indicated that this low academic performance may contribute to major depression in adulthood.[35]

The results of the present study are in line with those obtained by Bandura et al., showing that self-efficacy is related to depression.[36] Also, the strong relationship between stress and depression, which was similar to findings in the previous studies,[2, 4, 5, 19] suggests that these variables may have many interfaces and their causative relationships should be further investigated.

Methodological limitations of the current cross-sectional study warrant some caution in the interpretation of the present results. First, the current study utilized self-report measures to examine perceived stress, self-efficacy, and depressive symptoms. While each of the measures utilized possesses strong reliability and validity, self-report measures are subject to a number of response biases.[37] Given the methodological shortcoming, future research would benefit from assessing the parameters with more sophisticated assessment techniques including semi-structured interviews, peer or parent ratings, and direct behavioral assessments. Second, due to limited financial support and restricted time, the girls were not assessed in the study and comparison between genders was impossible. Third, with regard to this point that our sample was selected from regions having low socioeconomic status, we cannot generalize the finding to all adolescents from different SES areas.

CONCLUSIONS

It has been shown that depression could be prevalent among Iranian male adolescents. The results suggested that self-efficacy and perceived stress can play important roles in development of depressive symptoms in adolescents. However, future studies should further examine these specific connections between domains of depression and various types of psychological concepts such as self-efficacy and stress.