symptoms of anger, and peer rejection (Smith & Thomas). This study highlights the

relevance of exploring the angry and irritable mood symptoms of adolescent girls.

 Lamb and Puskar (1991) conducted a school-based survey of 69 high school

students in order to assess the base-line mental health needs of the school. Rates of

suicidality and depression were 16% and 14%, respectively. Measures of anger

expression and control were also given to the participants. Those who scored high on the

depression and suicidality measures were more likely to report high anger expression and

low anger control (Lamb & Puskar).

 Nursing research has also examined causal models of the depression and

outcomes due to depression in early adolescents (Mahon & Yarcheski, 2001; Yarcheski

& Mahon, 2000). Utilizing large multi-ethnic samples of middle school students,

relationships between stress, state-anxiety, well-being, conflict, social support, and

depression were evaluated. Findings were that state-anxiety had a direct effect on

depression, while stress was found to have a direct and indirect effect on depression

(Yarcheski & Mahon). Outcomes of depression included direct effects on well-being,

conflict, and perceived social support (Mahon & Yarcheski).

 Nurse researchers working in school-based settings have assessed general

psychosocial functioning of adolescents (Gall et al., 2000). In a predominately Hispanic

(62%) high school, 383 adolescents were screened for general psychosocial dysfunction.

Fourteen percent scored above a cutoff criterion to indicate those that may require

intervention. Females, teen-parents, and those with Medicaid insurance were more likely

to be above the cutoff. There was no difference between the ethnic groups. Those with

higher scores had higher rates of tardiness and absenteeism. The adolescents that were

referred for mental health treatment had decreases in their rates of tardiness and