Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Susan L. Instone, DNSc, CPNP, Chairperson; Lois Howland, DrPH, MSN, RN; Michael Gottschalk, MD, PhD


adolescents, Depressive symptomatology, nursing, Pediatrics, perceived social support, Type 2 Diabetes


Type 2 diabetes has increased dramatically in the pediatric population in the last decade. One of the comorbidities of diabetes is depression. In the presence of depression, diabetes may be mismanaged by patients and lead to a decline in health. Diabetes with comorbid depression may have better disease management outcomes in the presence of higher levels of social support. Defining childhood depression, which encompasses adolescence, and the subtleties of this disorder compared to the adult counterpart, was needed to better delineate important variables for this research study. There are several instruments that evaluate adolescents' perceived social support, but a fairly new instrument related to this construct not only assesses the availability of social support, but also support for healthy behaviors. The purpose of this dissertation was threefold. First, to explore the definition of childhood depression using a concept analysis approach to describe the critical attributes, antecedents, and consequences of childhood depression through the lens of a diathesis stress model. Second, to review. the psychometric properties of the Child and Adolescent Social Support Scale for Healthy Behaviors (CASSS-HB) and its potential uses. Last, to explore the relationships between depressive symptomatology, social support, and relevant physiological and sociocultural variables in adolescents with type 2 diabetes during the developmental stages of early and middle adolescence. This was a descriptive correlational, cross sectional study using a purposive sample of adolescents with type 2 diabetes. Results indicated that depressive symptoms were not significantly related to other variables, however mean depressive symptoms scores were higher among early adolescents. Middle adolescents had lower BMI percentiles but higher HgAlc levels. Early adolescents had greater mean scores of social support and reported this support was more important compared to middle adolescents. Overall, this research demonstrated that differences exist in perceived social support, depressive symptoms, and HgA1c levels among early and middle adolescents. Keywords: type 2 diabetes, adolescents, childhood depression, social support

Document Type

Dissertation: Open Access



Included in

Nursing Commons