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International Journal of Adolescent Medicine and Health

Editor-in-Chief: Merrick, Joav

Editorial Board: Birch, Diana ML / Blum, Robert W. / Greydanus, MD, Dr. HC (Athens), Donald E. / Hardoff, Daniel / Kerr, Mike / Levy, Howard B / Morad, Mohammed / Omar, Hatim A. / de Paul, Joaquin / Rydelius, Per-Anders / Shek, Daniel T.L. / Sher, Leo / Silber, Tomas J. / Towns, Susan / Urkin, Jacob / Verhofstadt-Deneve, Leni / Zeltzer, Lonnie / Tenenbaum, Ariel

CiteScore 2018: 0.79

SCImago Journal Rank (SJR) 2018: 0.350
Source Normalized Impact per Paper (SNIP) 2018: 0.476

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Volume 30, Issue 1


Depressive symptoms, hostility, and hopelessness in inner-city adolescent health clinic patients: factor structure and demographic correlates

Kathleen A. Pajer
  • Corresponding author
  • Department of Psychiatry, Children’s Hospital of Eastern Ontario and Professor of Psychiatry, University of Ottawa Faculty of Medicine, 401 Smyth Rd., Ottawa, ON K1H 8L1 Canada, Phone: +1-613-737-7600 Ext. 2723, Fax: +1-613-737-2257
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/ Michael C. Edwards / Andrea E. Lourie / Sherecce Fields / Savannah Kalman
Published Online: 2016-08-10 | DOI: https://doi.org/10.1515/ijamh-2016-0009



Depression, hostility, and hopelessness are risk factors for adult cardiovascular disease (CVD). People living in inner-city environments are particularly vulnerable. These associations may begin in adolescence, but research in this area is hampered by inadequate knowledge about how these negative psychological factors are related in teens and how they are affected by demographic characteristics. We hypothesized that depression, hostility, and hopelessness are one construct, and that this construct would be associated with race and gender in attendees at an inner-city adolescent health clinic.


Two hundred and forty-six 15–18-year-old patients filled out instruments measuring depressive symptoms, hostility, and hopelessness. Confirmatory factor analysis was used to determine whether the negative psychological factors comprised a single construct or three separate ones. General linear modeling (GLM) was used to test the associations between demographic characteristics and the results of the factor analysis.


Depressive symptoms, hostility, and hopelessness were best characterized as three separate constructs, not one (root mean square error of approximation (RMSEA)=0.041, 90% confidence interval (CI)=(0.035, 0.047), comparative fit index (CFI)=0.98). There were no significant relationships between demographic variables and depressive symptoms or hostility. Six percent of the variance in hopelessness scores was accounted for by gender, race, and the interaction between the two (F=3.76; p=0.006), with White males, reporting the highest levels of hopelessness.


In an urban adolescent health clinic population, depressive symptoms, hostility, and hopelessness were best understood as three separate constructs. Hopelessness was significantly higher in White males. Implications for future clinical research on negative psychological factors in teens are discussed.

Keywords: adolescent health clinics; adolescents; depressive symptoms; hopelessness; hostility


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About the article

Received: 2016-01-24

Accepted: 2016-06-29

Published Online: 2016-08-10

Funding Source: National Institutes of Health

Award identifier / Grant number: 1R01MH066003-01A1

The authors thank Cynthia Holland-Hall, M.D. the staff of the Nationwide Children’s Hospital’s (NCH) Adolescent Medicine Clinic, and Elaine Damo from the NCH Research Data Center. We also thank the study participants for their time and effort. The study was supported by the National Institutes of Health: 1R01MH066003-01A1 (Pajer-PI) and the Research Institute for Nationwide Children’s Hospital, Internal Funds (Pajer-PI).

Citation Information: International Journal of Adolescent Medicine and Health, Volume 30, Issue 1, 20160009, ISSN (Online) 2191-0278, DOI: https://doi.org/10.1515/ijamh-2016-0009.

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