Nursing Paper on Stress, Bullying, Cortisol, and Depressive Symptoms

Stress, Bullying, Cortisol, and Depressive Symptoms in 9th Grade Adolescents


Susan Williams’ (2015)  research problem focuses on the fact that the American population is increasingly getting worried about  the rise of symptoms of depression witnessed among youth and teenagers. She cites a CDC (2013) statistic indicating that on average, 13 to 20 percent of teenagers and youths are found with some kind of mental problem each year. The magnitude of this problem has seen the U.S. Preventative Task Force of 2013 to recommend regular diagnosis of signs of depression particularly among the teenagers in primary care environments (Arseneault, Bowes & Shakoor, 2010). Besides, the author identifies the Healthy People 2020 objective, which is to work towards reduction of the number of individuals experiencing any kind of a depressive scenario while striving to increase the number of the young population receiving health assistance for their respective mental health problems.

In exploring how the signs of depression are manifested in the young population in the contemporary society, the research shows that common occurrences such as bullying and stress among the teenagers are directly connected with depression. The author emphasizes the need to recognize depression symptoms as early as possible if a long-term tragedy is to be prevented or avoided regarding the implications of this problem. According to Williams’ research, the significance of the research problem is the fact that some disabilities may result from mental health concerns (Peskin, Tortolero & Markham, 2006). Most importantly is the idea that depression is a significant component of the overall mental disorder cases, constituting up to 40.5 percent of mental health disorders. Additionally, the article affirms the high likelihood of a good number of mental illnesses, especially symptoms of depression, occurring initially when the children transition into adolescence at the age of 13 years.

Regarding the research questions, Williams (2015) indicated several primary questions to help in the comprehension of the problem and in searching for results. The first question asks what the descriptive features and indicators of life episodes of depression, perceived depression, bullying and stress signs are among the teenagers in the 9th grade. The second question seeks to find out if there are any connections that exist between bullying, perceived depression, stressful life scenarios, and signs of depression among these teenagers. The third question asks if bullying, perceived stress and stressful life episodes actually result in signs of depression in the teenagers in the 9th grade.

The Author’s Initial Objectives, Hypothesis and Results

This research involves three initial objectives, the first being to determine the descriptive features of such variables as signs depression, bullying, perceived stress and stressful life situations as they manifest in teenagers in the 9th grade (Rahdar & Galván, 2014). Another objective is to explore the connections that may exist between all these variables if any. The other key objective is to find out how much implication is brought about by the above variable among adolescents in the 9th grade. In order to meet these objectives, Williams (2015) resorted to the use of descriptive statistics such as standard deviation, range, and mean as these were appropriate for examining the features of the sample linked to the variables indicated above. Furthermore, descriptive data distinguishing each independent variable of symptoms of depression, bullying, perceived stress, and stressful life experiences were considered as well. The results show that a connection exists between these variables and depression among the 9th grade adolescents.



Evaluation of the Paper

The author has provided a detailed and illustrative review of a variety of  literature relevant to the research. As expected, she involved the use of appropriate databases like Scopus, Pub Med and CINAHL  to establish all the relevant pieces of literature expounding on the research and its objectives. Further, Williams (2015) explored twenty-six publications with the assistance of three special search engines. She went further to review various seminal works, advocacy and professional articles and government websites to establish relevant information on which to base the research.

This research is very current as it deals with a critical health concern that affects a considerable portion of the society. Having over 40 percent of the mental health problem cases identified as depression (Avenevoli et al., 2015), and the fact that disability is highly dependent on mental health, this study is valuable in contemporary life. In my opinion, this research, having been conducted among the 9th grade teenagers, is very relevant to the current health situation because the initial occurrences of symptoms of depression are recorded as the children transition from their adolescence to the early adulthood stage of life.  Mental health problems have remained part of the major health concerns affecting many of the citizens in America as well as in other nations across the globe. Since the article is purposed to comprehensively bring about a deeper understanding to the origin, effects, challenges and possible solutions to the problem, the relevance and value of this particular research is undoubted.

The research type used is a non-experimental study because no actual health experiments are conducted to prove the facts, but descriptive information is relied on instead. The author of the article still managed to capture very critical and valuable facts and information concerning the subject using previous literature, observations, interviews and questionnaires.

Concerning the sampling applied in this research by the author, it is evident that a convenience, non-probability method was useful. In light of this, Williams (2015) made a decision to recruit 9th grade students of only two publicly owned high schools in urban environments. This is because accessing the targeted participants became easier and more efficient.  I also support the fact that the author decided to involve teenagers of between 14 to 16 years of age exclusively since the majority of the issues of concern for this research, namely bullying, stressful life encounters and peer relations not only occur during the adolescence stage but also in high school environments (Hamilton et al., 2014). However, to some degree, this sample seems biased since it has completely ignored the rural high school setting which could provide different outcomes because of the variations in the environments and experiences existing there.

In my view, this work seems extremely important not only to the health sector but also to general population as well as globally. The reason for saying this is that every single aspect of life is linked to the mental state in one way or another and any factor that interferes in any way with the well-being of the human’s mental health is of a great concern. According to Williams (2015), the results of the study can be incorporated practically in the professional health and medical practices since early identification of the cause of mental health conditions could lead to prevention, which is far better than treatment of the same. In my opinion, the results could be helpful in formulating policies to deal appropriately with the mental health problems. This study can however be improved to take into account samples from rural school setting (Pratt, Brody & Qiuping, 2011). The writing in the article is however very straightforward and clear, and provides an avenue for further research to bring out more details and clarity of the phenomenon. From the statement of the research problems to outlining of the research questions and objectives, the author has brought about enough clarity on the matter and the reasons for conducting study (Paredes & Zumalde, 2014). This subject is very complex and therefore gives room for further studies.

One of the fundamental factors that determine the authenticity and credibility of any research is the references used in supporting arguments. The author of this article has used peer-reviewed journal articles, secondary and primary sources to reinforce her viewpoints and findings. This gives credibility to their arguments. Additionally, the use of both recent and old sources gives a corroborating platform as well as a historical perspective on the topic being researched.


Generally, Susan Williams’ research is very well articulated and has covered almost all special details with the weight with which they should be tackled. In my analysis of her methodology and results of the study, I established that Williams has provided proper and sophisticated ways of her data collection, analysis and presentation, leaving out no vital information or sources unexplained. Finally, if not for the adjustment needed for the sample to include rural institutions, the overall study meets the expectations of a good research.




Arseneault, L., Bowes, L. & Shakoor, S. (2010). Bullying victimization in adolescents and mental health problems: ‘Much ado about nothing’?  Psychological Medicine, 40(5), 717-729. doi:10.1017/S0033291709991383.

Avenevoli, A., Swendsen, J., He, P. P., Burnstein, M. & Merikangas, K. R. (2015). Major depression in the National Comorbidity Survey-Adolescent Supplement: Prevalence, correlates and treatment. Journal of the American Academy of Child and Adolescent Psychiatry, 54(1),37-47. doi:10.1016/j.jaac.2014.10.010.

Hamilton, J. L., Hamlat, E. J., Stange, J. P., Abramson, L. Y., & Alloy, L. B. (2014). Pubertal timing and vulnerabilities to depression in early adolescence: Differential pathways to depressive symptoms by sex. Journal of Adolescence, 37(2), 165-174. doi:10.1016/j.adolescence.2013.11.010

Paredes, P. P., & Zumalde, E. C. (2014). A test of the vulnerability-stress model with brooding and reflection to explain depressive symptoms in adolescence. Journal of Youth and Adolescence. doi:10.1007/s10964-014-0148-1

Peskin, M. F., Tortolero, S. R., & Markham, C. M. (2006). Bullying and victimization among black and hispanic adolescents. Adolescence, 41(163), 467-484. Retrieved at

Pratt, L. A., Brody, D. J., & Qiuping, G. (2011). Antidepressant use in persons aged 12 and over: United States, 2005-2008. National Center for Health Statistics Data Brief, 76. Retrieved from

Rahdar, A. & Galván, A. (2014). The cognitive and neurobiological effects of daily stress in adolescents. NeuroImage, 92, 267-273. Retrieved from

Williams, S. G. (2015). Stress, bullying, cortisol, and depressive symptoms in 9th grade adolescents. The University of Alabama at Birmingham.