Links between mental health problems and future thinking from the perspective of adolescents with experience of depression and anxiety: a qualitative study

Peiyao Tang; Georgia Pavlopoulou; Katarzyna Kostyrka-Allchorne; Jacqueline Phillips-Owen; Edmund Sonuga-Barke

doi:10.1186/s13034-023-00679-8

Links between mental health problems and future thinking from the perspective of adolescents with experience of depression and anxiety: a qualitative study

Child Adolesc Psychiatry Ment Health. 2023 Dec 21;17(1):143. doi: 10.1186/s13034-023-00679-8.

Authors

Peiyao Tang¹, Georgia Pavlopoulou^{2

3}, Katarzyna Kostyrka-Allchorne⁴, Jacqueline Phillips-Owen⁵, Edmund Sonuga-Barke^{5

6}

Affiliations

¹ School of Academic Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, 16 De Crespigny Park, London, SE5 8AF, UK. peiyao.tang@kcl.ac.uk.
² Group for Research in Relationships and Neurodiversity (GRRAND), Clinical, Education & Health Psychology, Division of Psychology & Language Sciences, Faculty of Brain Sciences, University College London, London, UK.
³ Anna Freud Centre, London, UK.
⁴ Department of Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK.
⁵ School of Academic Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, 16 De Crespigny Park, London, SE5 8AF, UK.
⁶ Department of Child & Adolescent Psychiatry, Aarhus University, Aarhus, Denmark.

Abstract

Background: Depression and anxiety are common during adolescence and could have detrimental impacts on young people's ability to make and implement plans for their future. However, to the best of our knowledge, no other study has adopted a qualitative approach in investigating these effects from the perspective of adolescents with lived experiences of depression and anxiety. We sought to understand how young people perceive and interpret the impact of mental health conditions on their thinking about the future.

Methods: We conducted semi-structured interviews with 19 adolescents aged 16-19 years in the UK (median age = 19, IQR = 1.5), who had a history of protracted periods of clinical or subclinical depression and/or anxiety. They were asked to reflect on how their ability to think about the future and the content of the future-related thinking was impacted during periods of poor mental health, compared with periods of feeling well. Interviews were transcribed verbatim and subjected to thematic content analysis.

Results: Five domains were identified. First, the impact of mood on future thinking capability focuses on reduced ability and motivation to engage in future thinking. Second, the impact of mood on images, thoughts, and feelings about the future includes the emotional valence of future-related thoughts, their vividness, structure, and the extent to which they intimated subjective feelings of control (i.e., agency). Third, social influences focuses on social factors that might ameliorate or exacerbate future thinking. Fourth, reflections on personal worries and expectations about the future captures personal interpretations of past worries and hopes and how future thinking affected mood. Finally, personal coping refers to how young people cope with the negative emotions that come with future thinking.

Conclusions: This study provided a nuanced and granular account of how depression and anxiety impacted young people's future thinking based on their lived experiences. By highlighting the different ways that variations in future thinking were experienced as a function of depression and anxiety, our analysis highlighted new factors that should be considered in studies of adolescent mental health risk, which could inform the development of new therapeutic approaches.

Keywords: Adolescence; Anxiety; Depression; Future thinking; Prospection; Qualitative interview.