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NUR 630

Stacy Weiner

Module 3 discussion

Depression does occur at the adolescent stage, adulthood, and even children in
elementary school can also experience clinically significant depressive disorders. Nevertheless,
these are not always taken into account or even understood within the U.S. primary education
and pediatrics. The difficulty is in identifying depression when it is manifested differently, as in
adults. Problems related to development, diagnosis, and culture in the United States only
complicate correct diagnosis and prompt treatment (Beck et al., 2024; Xiang et al., 2024).

Challenges in Assessing Childhood Depression

Childhood depression is challenging to measure in the U.S. due to a lack of
emotional words or the ability to analyze feelings in young children who can fail to express
sadness, guilt, or hopelessness. Beck et al. (2024) argue that depression screening is important in
providing the needed primary care among youths. The reason is that it is based on self-report
scales. As such, it becomes easier to evaluate the severity of depressive symptoms among
younger children. Instead, children can experience irritability, aggression, somatic complaints,
or academic regression, which are likely to be confused with the signs of conduct problems or
attention-deficit disorders, as opposed to the signs of mood disturbance.

The discussion presented by Xiang et al. (2024) remains essential in discussing the
fact that a terrifying rise in children and young adults in the United States having depressive and
anxiety disorders. With this, the results include attributing causes to sociocultural stressors like
academic competitiveness, exposure to social media, and post-pandemic disruptions. The
current-day demands are blunting the distinction between normative distress and clinical
depression, thus necessitating a more accurate screening and diagnosis. The study conducted by
Mundy et al. (2023) also revealed that emotional dysregulation at an early stage of schooling is
strongly related to subsequent academic and social dysfunction, which proves the long-term
developmental consequences of under-recognition.

Cultural Comparison of Depression Beliefs

Being an African American person born and brought up in the U.S., I have seen the
cultural perceptions’ impact on the identification and management of childhood depression.
Emotional strength is greatly treasured in most African American communities, and depressive
symptoms can be neglected or redefined as a short-lived lack of stamina or spiritual response.
Families can choose to seek professional mental health services only after a period of prayer,
community support, or self-reliance. This method may postpone diagnosis and be supported by
stigma, although symptoms are at clinical levels.

By contrast, the Euro-American model of mainstream culture tends to view
depression as a medical and psychological condition, which should be identified promptly and

treated by a professional (Beck et al., 2024; Xiang et al., 2024). Although this is a good way of
encouraging early intervention, it will also overpathologize healthy emotional struggles. These
cultural differences are imperative considerations in the practice of clinicians and educators in
order to prevent prejudice and guarantee culturally competent assessment in schools in the
United States.

Conclusion

Overall, children in the United States elementary school may be affected by real
and impairing depression. However, this disease is still underdiagnosed because of
developmental factors, poor screening instruments, and misconceptions about the culture.
Cultural sensitivity should be ensured. This entails alignment of proper development assessments
with important areas between the relationship parents share with their children, and as a result,
the parents can be assured of the acquisition of the proper education that can make it easier for
them to partner with teachers through school-based manipulation to close such gaps. The
culturally sensitive approach that is balanced is the agreement of the emotional well-being of
U.S. children that should be reassured and, at the same time, comprehended and approved.

Leeann Chang

Module 3 Discussion

Children in elementary school are also able to become depressed, but their forms
and context of expression are not similar to those of adolescents and adults. It has been found
that depressive disorders may appear as early as age six and have an impact on emotional, social,
and academic development when not treated in the United States (Walter et al., 2023). The
diagnoses of depression in small children are complicated by developmental, diagnostic, and
cultural factors that compromise clinical accuracy, regardless of the increased awareness.

Challenges in Assessing Childhood Depression

It is hard to measure the level of depression among elementary-aged children for
several reasons. To begin with, the emotional vocabulary and mental maturity of children are not
well-developed, and they are restricted in expressing inner distress. They do not express sadness,
but are usually irritable, aggressive, or experience somatic complaints, which can be mistakenly
taken as behavior problems (Walter et al., 2023). Second, the diagnostic instruments created to
be used with adolescents or adults do not usually have a measurement invariance across
developmental stages. Schlechter et al. (2024) highlight the fact that the validity of most
depression scales is inconsistent between age and gender, which implies that younger and older
children differ significantly in terms of symptom expression and reporting. In turn, clinicians
should take scores with caution and use standardized screening, which should be used in
conjunction with behavioral observation and parental feedback.

The other significant challenge is the similarity of the depressive symptoms and the
other developmental or environmental stressors. Without satisfying any diagnostic criteria,
children who are traumatized, are in family strife, or frustrated in school might display
depressive symptoms. The authors suggest that data collection through multi-informant
assessment (including parents, teachers, and the child) should be used by Walter et al. (2023) to
identify the patterns of symptoms in different settings and guarantee the reliability of the data.
This is a multidimensional method needed to differentiate transient sadness from clinically
relevant depression.

Cultural and Ethnic Considerations in Understanding Depression

The culture significantly influences the way depression is identified and how it is
managed. This argument is a comparative approach where mainstream White Americans are
contrasted with the attitudes of Hispanic cultural groups in the United States of America.
Feliciano et al. (2024) noted that White Americans tend to understand depression in biomedical
terms and prefer professional treatment and psychotherapy. On the other hand, in most Hispanic

communities, the symptom of depression is explained in a spiritual or family context, whereby
Hispanics focus on faith, social support, or hardiness before resorting to medical care.

These discrepancies affect the help-seeking patterns and evaluation results. Among
Hispanic families, children can exhibit emotional agony. Still, this agony may be perceived as a
behavioral or moral problem, but not as a psychological disorder, and suspends access to
professional assessment. Stigma and cultural mistrust of mental health systems also lessen
engagement when seeking care due to language barriers (Feliciano et al., 2024). In the case of
White families, increased knowledge of mental health services can lead to earlier diagnosis, but
it can also promote the over-pathologizing of normal emotional conditions. Understanding these
differences is essential in culturally sensitive assessment, which can guarantee the clinician
customizes the screening questions and perceives the behaviors in the proper cultural contexts.

Conclusion

Overall, children in elementary schools are susceptible to clinical depression, but
this would require sensitivity to developmental and cultural variations to be correctly identified.
The complexity of diagnostics is based on the low level of emotional expression, age-related
symptoms manifestation, and the inconsistency of assessment tools. The cultural constructs also
affect parental identification and help-seeking, and Hispanic and White American households
have different attitudes toward mental illness and treatment (Feliciano et al., 2024). Good
practice in the United States will need to incorporate culturally informed practices. These child-
specific tools are valid and multi-informant measures to guarantee the early and fair
identification of childhood depression.

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