HOUSEHOLD PETS AND DEPRESSION AMONG URBAN ADOLESCENTS

by

MARY MARGARET (MOLLY) NEVIN-HAAS

B.S.N., The University of British Columbia, 1987

A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF

THE REQUIREMENTS FOR THE DEGREE OF

MASTER OF SCIENCE IN NURSING

in

THE FACULTY OF GRADUATE STUDIES

(School of Nursing)

We accept this thesis as conforming

to the required standard

THE UNIVERSITY OF BRITISH COLUMBIA

October 1993

© Mary Margaret (Molly) Nevin-Haas, 1993



In presenting this thesis in partial fulfilment of the requirements for an advanced

degree at the University of British Columbia, I agree that the Library shall make it

freely available for reference and study. I further agree that permission for extensive

copying of this thesis for scholarly purposes may be granted by the head of my

department or by his or her representatives. It is understood that copying or

publication of this thesis for financial gain shall not be allowed without my written

permission.

(Signature

Department of  Graduate Studies, School of Nursing

The University of British Columbia
Vancouver, Canada

Date ^13 0c,T,c;>-b-e.■_,, 1q93 

DE-6 (2/88)



II

Abstract

This study was designed to describe the prevalence of depression among

a group of adolescents and examine the relationships between depression and

presence of pets in the home, primary ownership of pets and perceived degree of

attachment to the pets by the subjects. The coping conceptual framework of

Folkman and Lazarus (1988) provided the structure for the study. Subjects were

401 grade nine males and females attending three Vancouver and three Victoria

secondary schools. The instruments utilized to gather the data were the Center

for Epidemiologic Studies Depression Scale (CES-D) (Radloff, 1977) and the

Adolescent and Pet Characteristics Questionnaire, developed by the researcher.

The subjects completed the instruments anonymously in classroom settings.

Among the grade nine students sampled, 48.4% demonstrated no

depressive symptoms, 41.4% demonstrated what were classified as mild

symptoms of depression, 8.7% demonstrated moderate symptoms of depression,

and 1.5% of those sampled indicated severe depressive symptoms. Female

adolescents were significantly more depressed than their male counterparts with

mean depression scores being 18.7 and 15.1, respectively.

Those subjects with pets in the home were significantly less depressed

than their counterparts without household pets. There was no relationship

between gender and pet ownership combined with level of depression. An

analysis of primary pet ownership indicated that subjects who owned their own

pets were significantly more depressed on a whole than those in homes where

the pet was owned by the entire family. Perceived degree of attachment to the

household pet was not related to depression among the subjects. Conclusions

are drawn from the findings and implications for nursing practice and research

are discussed.



III

Table of Contents

Abstract^ ii

Table of Contents^ iii

List of Tables^ vi

List of Figures^ vii

Acknowledgements^ viii

Chapter One: Introduction

Background to the Problem^ 1

Problem Statement^ 3

Purpose^ 4

Research Questions^ 4

Conceptual Framework^ 5

Definition of Terms^ 7

Assumptions^ 8

Limitations^ 8

Significance of the Study^ 9

Organization of Thesis^ 10

Chapter Two: Review of the Literature

Adolescent Depression^ 11

Pets and Health in Humans^ 14

Pets and Physical Indices of Stress in Humans^ 17

Pets and Emotional Health in Humans^ 20

Summary^ 29

Chapter Three: Methods

Instruments^ 31

Adolescent and Pet Characteristics Questionnaire^ 31

Center for Epidemiologic Studies Depression Scale^ 32



IV

Protection of Human Rights^ 34

Sample^ 35

Data Collection^ 35

Data Analysis^ 37

Chapter Four: Presentation and Discussion of Findings

Response Rate^ 41

Demographic Characteristics^ 42

Gender^ 42

Age^ 43

School Performance^ 43

Family Composition^ 44

Country of Origin^ 46

Primary Language^ 48

Residence^ 50

Pet Demographic Information^ 52

Presence of Household Pets^ 52

Types of Pets^ 52

Identified Favorite Pet^ 52

Pet Names^ 53

Duration of Pet Ownership^ 55

Reason for Acquiring Pet^ 56

Primary Ownership of Pet^ 56

Pet Attachment^ 57

Findings Related to Research Questions^ 59

Question One: Prevalence of Depression^ 59

Question Two: Relationship Between Gender, Pet Presence and
Depression^ 61



V

Question Three: Relationship Between Pet Ownership and Depression 64

Question Four: Relationship Between Pet Attachment and Depression^67

Summary^ 68

Chapter Five: Summary, Conclusions, and Implications for Nursing

Summary^ 70

Conclusions^ 72

Implications for Nursing^ 72

Nursing Practice^ 73

Nursing Research^ 76

References^ 78

Appendices

A. Adolescent and Pet Characteristics Questionnaire^89

B. Center for Epidemiologic Studies Depression Scale^91

C. Letter of School Consent and Consent Form^ 93

D. Letter of Parental Informed Consent and Consent Form^96

E. Information and Instructions for Questionnaire^ 99

F. Density Distribution of CES-D Scores^ 101



VI

List of Tables

Table^ Page

1. Ages of Subjects^ 43

2. School Performance of Subjects^ 43

3. Parents Living at Home^ 44

4. Siblings Living at Home^ 45

5. Sibship Position of Subjects^ 46

6. Regions and Countries of Origin of Subjects and Parents^47

7. Subjects and Parental Birth Regions^ 48

8. Primary Languages Used at Home^ 49

9. Years of Residence in Canada and Current Neighbourhood^51

10. Favorite Pet Categories and Types^ 53

11. Pet Name Categories and Examples^ 54

12. Categories of CES-D Scores^ 60

13. ANOVA Summary Table for Gender, Pets, and CES-D Scores (N=401) 62



List of Figures

Figure Page

1. The Coping Conceptual Framework: Pets as Mediators of Emotion in

Adolescent Depression (adapted from Folkman and Lazarus, 1988). 6

2. Numbers and Percentages of Subjects by School 42

3. Pet Ownership 57

4. Perceived Attachment to Pet 58

VII



VIII

Acknowledgements

This thesis could never have been realized in its current form were it not

for the kindness, assistance, and encouragement I received from many special

individuals. Most importantly I would like to thank my thesis supervisors Dr.

Marilyn Willman and Gloria Joachim. Dr. Willman accepted the position of chair

of this committee in her final year as Professor and Director of the School of

Nursing, her dedication and input to this project could not be overemphasized.

Gloria Joachim has been with the project since its conception, her

encouragement and clarity of vision often kept things going though obstacles

such as unfavourable media coverage of school surveys and school board

strikes. These individuals gave me the rare and valued combination of freedom

of content, and direction in structure. I would also like to thank and acknowledge

Dr. Anna Marie Hughes who offered valuable critique in the review of this work;

as well as Janet Ericksen and Dr. Ann Hilton for their assistance in the proposal

stage of this project.

With regard to the long and frequently frustrating process of finding

subjects, Court Brousson, Nicole Chagnon, Eileen Eby, Andree Johansson,

Gordon May, Ian McEwen, Patrick Mitchell, Rhonda Morrisson, Stephanie Nevin,

Jack Nickolichuk, Gary Puder, Janice Phillips-Sim, Lee Simpson, Sharon Reid,

Joyce Tinnion, Frank VanSoldt, and Sheila Wareing all deserve recognition for

their assistance in the recruitment of subjects. Special acknowledgement is

gratefully extended to Janice Phillips-Sim and Frank VanSoldt, whose extra

efforts in promoting this study with their students were instrumental in achieving

the number of subjects for this study. I would also like to thank and acknowledge

the parents of the subjects for granting their consent for their children's

participation as well as the students who took the time and effort to transport

consent forms home and fill out the instruments for this study.



IX

Statistical methods and analyses of this project were patiently and

gratefully clarified by Dana Atagi and Gordon Haas.

Support and encouragement was also always afforded me by my

employers and supervisors throughout these years. For recognition of my

research needs during these times I would like to thank Marsha Ablowitz, Rhea

Arcand, Ralph Buckley, Lee Simpson, Sally Thorne, and Marilyn Willman.

This work was specifically encouraged by Gordon Haas, Louisa Nicholls,

and organizations such as the Human Animal Bond Association of Canada and

the Delta Society of the United States. It was inspired by past and present

animals who have impacted my view of the world. For this, I would like to extend

a unique thank you to Abigail, Amos, Baxter, Franklin, Gremlin, Greta, Oscar,

Taco, and Wrangler. Finally, none of this work could have been enjoyable, much

less possible, without the continuous support, respect and encouragement I

received from my family, and at home from my husband Gordon Haas and our

own set of animal companions (Baxter, Franklin, and Oscar).



1

Chapter One

Introduction

Background to the Problem

Fossil remains indicate that the domestic relationship between humans

and animals dates back approximately 12,000 years to the preagricultural period

of human history just following the end of the last global ice age (Davis & Valla,

1978). Although there is controversy as to the motivation behind the original

formation of the relationship (whether it was one of companionship or one of

utilitarian purpose), there is general consensus that this relationship has

persisted throughout history and is strongly prevalent across a variety of age

groups and human cultures today (Bustad & Hines, 1984; Messant & Serpell,

1980; Odendaal & Weyers, 1990; Ritvo, 1988; Serpell, 1988).

Levinson (1962, 1965, 1970, 1972) was one of the first individuals to study

the nature of the relationship between humans and animals. He addressed the

health value of human contact with the natural environment in an increasingly

industrialized society. "When man is forced to live and work deprived of contact

with nature, he loses much emotional strength" (Levinson, 1972, p.6). He

furthered stated that encounters between people and animals are a form of

contact with nature that may influence emotional strength of humans:

We need animals as allies to reinforce our inner selves. We

must revive our intimate associations with nature and its

animals if we are to survive as the dominant species on

earth. It is of course possible that man can survive without

animals, but we would surely be a depleted race, shorn of

most of our emotional strength (1972, p.29).

Impairment in the emotional strength of individuals is a symptom which is

frequently associated the clinical disorder of depression. Depression has been



2

demonstrated to be more prevalent in urban as opposed to rural settings

(Klerman & Weissman, 1989). Frequently called the "common cold of mental

disorders" (O'Hara, 1984, p.46), depression rates among adults in urban settings

have been reported to be as high as 20% (Klerman & Weissman, 1989).

The etiology of depression in adults is believed to be twofold. Both

physiological genetic make-up as well as psychological response to losses and

stressors contribute to its development (Klerman & Weissman, 1989; Lapierre,

1988). In keeping with this bivariate foundation, the treatment of depression in

adult populations has been shown to be equally effective with the use of

antidepressant medications or cognitive therapy (Beck, Holton, Young,

Bedrosian, & Budenz, 1985; Murphy, Simons, Wetzel, & Lustman, 1984).

Depression among adolescents is not as well understood as that among

adults. The reported prevalence of severe depression in the former group varies

from 3% (Clarke, Lewinsohn & Hopps, 1990) to 16% (Pronovost, Cote & Ross,

1990). In some studies, the use of antidepressant medications has been found

to be no more effective than placebos in treating adolescent depression (Kramer

& Feiguine, 1981; MacLean, 1987; Puig-Antich, et al. 1987; Simeon, 1989).

Such studies suggest that depression among adolescents may be more

commonly a result of psychological factors than of biological determinants.

Despite the vague understanding of adolescent depression, it is well-documented

that adolescents with depression are at increased risk for dropping out of school,

substance abuse, acts of delinquency, non-consensual sexual activity, and

suicide than adolescents without depressive symptoms (Clarke, 1991;

McDermott et al. 1990; Reinherz, Frost, & Pakiz, 1991; Simeon, 1989).

Both of the aforementioned concepts of a human-animal relationship and

depression among adolescents have implications for nursing. Most models of

nursing include individuals' responses to their environment as a factor influencing



3

health (Riehl & Roy, 1980). Domestic animals in the form of household pets are

an integral part of the environment of many individuals. Therefore, the impact

pets may have on the well-being of their owners becomes a concern for all

phases of the nursing process (McMahon, 1991). It remains to be determined

whether the sole presence of a pet in the home may constitute the beneficial

bonding referred to by Levinson (1961, 1972) or if, in fact, there are other factors

which determine whether humans receive health benefits from pets in their

homes (Johnson, Garrity, & Stallones, 1992).

The second concept, depression among the adolescent population, also

has implications for nursing. Nurses care for individuals across the lifespan. The

care provided by nurses encompasses biological, psychological and social

components of each individual's health (Johnson, 1980). The mental health of

adolescents is a specialized health focus of a population of individuals within the

realm of nursing practice (Canadian Nurses Association, 1991).

Problem Statement

It has been postulated that the alienation of humans in an urban setting

from their natural environment may be related to the increased prevalence of

depression (Klerman & Weissman, 1989) as well as an inability to recover quickly

from stressful events (Ulrich, Simons, Losito, Fiorito, Miles, & Zelson, 1991).

Additionally, it has been noted that human contact with animals may be

emotionally strengthening (Levinson, 1972). The presence of pets can potentially

act as a link between people living in an urban setting and their natural

environment (Katcher & Beck, 1988; Phineas, 1974).

The literature notes the effects of pets on the emotional well-being of

several different populations; however, there have been no studies which

describe the relationship between the presence of household pets and



4

prevalence of depression among urban adolescents. If there is such a

relationship, and hence the possibility of altering depression and associated

factors such as suicide, delinquency, and substance abuse, it behooves nursing

to explore this potential. The identification of the possible implications of the

centuries old relationship between humans and animals for the mental health and

future of our youth has significance for nursing knowledge, practice, and

improved health care.

Purpose

The purpose of this study is to describe the prevalence of depression in a

sample of grade nine adolescents from two large urban areas and to examine the

relationships between prevalence of depression, presence of pets in the home,

primary ownership of the pets, and perceived degree of attachment to the pets by

the subjects involved.

Research Questions

This study proposes to answer the following research questions:

1. What is the prevalence of depression in a sample of urban adolescent

males and females currently attending grade nine in selected Vancouver and

Victoria secondary schools?

2. What is the relationship between the prevalence of depression and the

presence of pets in the homes of urban adolescent males and females currently

attending grade nine in selected Vancouver and Victoria secondary schools?

3.^What is the relationship between prevalence of depression and primary

ownership of household pets among urban adolescents currently attending grade

nine in selected Vancouver and Victoria secondary schools?



5

4.^What is the relationship between prevalence of depression and perceived

degree of attachment to pets among urban adolescents currently attending grade

nine in selected Vancouver and Victoria secondary schools?

Conceptual Framework

The theoretical framework of coping as proposed by Folkman & Lazarus

(1988) is utilized in the conceptualization of this study (see Figure 1). This

framework values an open and interactive system between people and their

environment and views coping as a multidimensional process inherent within this

system. It describes coping as a constantly changing response to person-

environment encounters and emotional appraisals. The use of such a coping

framework is consistent with that used in other studies of human-animal

interactions (Carmack, 1988).

The bidirectional relationship between emotion and coping is an important

aspect of the framework. The individual's appraisal of an event is related to an

emotional response, which is related to a mediating method of coping. This

coping behaviour, in turn, leads to an emotional reappraisal of the same event or

an alternate occurrence. Folkman and Lazarus (1988) stress the importance of

the "mediating" act of coping. A mediating variable is a factor which changes the

relationship between the antecedent and the outcome variable. Mediating

variables are created within the context of the encounter. The response of

"coping" is such a mediator. Coping is formulated during the encounter and

changes the original appraisal and its accompanying emotion in some way.

Such a framework correlates well with the conceptualization of this study.

The adolescent assumes the position of the individual in the model, with the

perceived or actual stressors and/or losses representing the environmental



EMOTION
(Study Measurement)

6

PERSON / ENVIRONMENT ENCOUNTER

Adolescent and Etiologic Factors
of Depression

COPING (Use of Pets)
Problem Focussed^Emotion Focussed

New Person -
Environment
Encounter

Figure 1. The Coping Conceptual Framework: Pets as Mediators of Emotion
in Adolescent Depression (adapted from Folkman and Lazarus. 1988). 



7

encounter(s). (The precise etiology of depression cannot be limited to one

occurrence alone.) The preliminary emotional response to the appraisal of these

stressors may then be represented by depression. The presence of household

pets may act as a resource in the formation of mediating coping responses which

may then interact with the depressive response to cause a reappraisal of the

etiologic factor or the initial emotion and provide an alternate emotional response.

Folkman & Lazarus's (1988) model is used in discovering the nature of the

relationship between depression experienced by urban adolescents, pets as a

coping resource, and an altered form of the original depressed emotional

response. As Figure 1 indicates, this model proposes a feedback loop. The use

of mediating coping resources influences emotional responses by providing an

alternate appraisal of events than that which was obtained prior to the use of the

coping resources. The use of this mediating coping resource will then be utilized

by the individual on an ongoing basis in the face of similar emotions, thereby

replacing the original emotion with a more suitable emotional response.

Definition of Terms

For purposes of this study, the following terms will be defined as stated

below:

Adolescent: Any youth between the ages of 13 and 16 currently attending

grade nine in selected Vancouver and Victoria secondary schools;

Attachment: An individual's subjective report of emotional closeness or affection

towards an animal in her / his home, as measured by the Adolescent and

Pet Characteristics Questionnaire (Appendix A);

Depression: An emotional state characterized by low mood, apathy, anhedonia,

and lack of energy, as measured by the Center for Epidemiologic Studies

Depression Scale (CES-D) (Appendix B);



8

Pet: Any non-human, non-utilitarian animal which is currently living in the same

household as the subject and is cared for by some member of that

household;

Primary Ownership: An acknowledgement by the subject as to which

household member has recognized possession of the pet. This generally

implies responsibility for pet care-giving;

Urban: A city and surrounding geographic area characterized by its population

density and non-resource based nature of employment.

Assumptions

The study is based on two primary assumptions. The first assumption is

that those adolescents who are depressed at the time of the survey will have the

concentration and motivation to complete the instruments in their entirety. The

second assumption is that all the adolescents surveyed will respond truthfully to

the questions on the instruments.

Limitations

The limitations inherent within this study involve both design and

environmental factors. The findings of the study are generalizable only to

subjects similar to those of the population sampled. The survey design accounts

only for contact that the adolescents may have with the pets that currently live

within their households. The subjects were sampled over a four-month period

from October 1992 to January 1993. The study followed the implementation of a

survey (McCreary, 1993a, 1993b) that raised some parental objections (Lamb,

1992a, 1992b; Odam, 1992; Truscott, 1992). It is possible that the negative

press from the previous survey may have had an impact on subjects' participation

in this study.



9

Significance of the Study

There is currently a lack of consistent information about the prevalence of

depression in the general population of urban adolescents. Recently, much

attention has been paid to adolescent mental health because of the rising

incidence of suicide (a potential consequence of adolescent depression) in this

age group (Children and Youth At Risk Steering Committee, 1991; Clarke, 1991;

Conrad, 1991; McDermott et al., 1990; Pronovost et al., 1990;). This study will

provide information about the prevalence of adolescent depression in selected

Vancouver and Victoria secondary schools. Also, there is a paucity of research

validating the benefits of pets on individuals' mental health as described in the lay

literature (Robb & Stegman, 1983). This study will add to the body of knowledge

related to the role which pets may play in adolescent mental health.

The above is important for nurses who find themselves in contact with

adolescent clients or families with adolescents. By understanding the prevalence

of depression in this population and its descriptive parameters, nurses can

increase their knowledge and ability to provide early detection and prompt

intervention for those individuals at risk for the more serious consequences of

these pathological "blues" (McDermott et al., 1990; Offer & Schonert-Reichl,

1992; Reinherz, Frost, & Pakiz, 1991). Further, by analyzing the nature of the

relationship between prevalence of depression and pets in the homes of urban

adolescents, differences between the depressed and the mentally healthy

adolescent may be identified. The results of this study may assist the practicing

nurse in determining whether to include an assessment of pet ownership and

interaction (Davis, 1985a, 1985b) when analyzing the coping mechanisms of

youth. As Levinson (1972) so clearly stated two decades ago:

I am sure that the majority of my professional colleagues

would agree that our precious twentieth century youngsters



will probably mature in a chaotic, disturbed environment. If

we have a therapeutic tool such as the use of pets as a

mental hygiene adjunct, it behooves us to explore and

develop fully the possibilities of this adjunct. If we do not, we

as adults must take full responsibility for the consequences

of our neglect (p.11 ).

Organization of Thesis

Chapter One has provided an introduction to the nature of the study,

including the background to the problem, the purpose of the study, the research

questions, conceptual framework, assumptions, limitations, and significance of

the study. Chapter Two outlines the theoretical basis of the study with a review

of selected literature pertaining to the two central themes of the study, namely

depression and the mental health benefits of pets. The research methods used

in the study are described in Chapter Three. In Chapter Four, the findings are

presented and discussed. Finally, Chapter Five presents the summary,

conclusions, and a discussion of the implications for nursing practice, education,

and research.

10



11

Chapter Two

Review of the Literature

The literature review examines the current state of knowledge regarding

adolescent depression as well as the nature of human and animal relationships

and the potential mental health benefits of pets.

Adolescent Depression

Only within the past decade has increased attention been given to the

distinction between normal adolescent frustration or moodiness and its

pathological variant, adolescent depression (Greydanus, 1986; MacLean, 1987;

McDermott et al., 1990; Offer & Schonert-Reichl, 1992; Reinherz et al., 1991;

Simeon, 1989). This recent interest may be largely attributed to the rapidly

increasing numbers of adolescent suicides and a desperate societal attempt to

understand some of the phenomena contributing to suicide, the second leading

cause of death among North American youth (Conrad, 1991). In the past twenty

years, the suicide rate for adolescents between the ages of 15 and 19 has risen

44%, compared with a 2.6% increase for the general population (Conrad, 1991).

In Canada, the suicide rate for 15 to 19 year old adolescents doubled in ten

years. For this age group, the suicide rate is 17.6 deaths per 100,000

representing one out of five deaths (Pronovost et al., 1990).

Depression has been correlated with suicide as well as with other

undesirable outcomes and behaviours among youth. Studies have indicated that

40 to 60% of suicidal adolescents have feelings of depression (Pronovost et al.,

1990). However, not all suicidal individuals are depressed nor are depressed

individuals necessarily suicidal (Greydanus, 1986; McDermott et al., 1990).

Other undesirable outcome correlates of adolescent depression include an

increased risk for dropping out of school, substance abuse, non-consensual



12

sexual activity, and acts of delinquency (Clarke, 1991; McDermott et al., 1990;

Reinherz et al., 1991; Rogers, 1987). Longitudinal studies are currently

underway to test these relationships (Weissman et al., 1987).

Reinherz et al. (1991) studied a group of 386 adolescents from their

freshman to their senior year in high school. They found a significant correlation

between drop-out rates and depressed states in adolescent males over all other

groups. For adolescent females who were also depressed, substance abuse

rates were significantly higher than for non-depressed females or males of either

group. Thirty-three percent of these females reported "being high on marijuana

all day and in school" (p. 61). Depressed females also began drinking alcohol

one year earlier (age 14) than did all other adolescents surveyed. Although the

stability of depressive symptoms from grade 8 to grade 12 was only moderate

(60%), individuals who were depressed in grade 8 were 9.3 times more likely

than their non-depressed peers to also be depressed in grade 12 (Reinherz et

al., 1991). In addition to these behavioural concerns, poor academic

performance has also been frequently correlated with a high incidence of

depression among adolescents (Baron & Perron, 1986; Blechman, McEnroe,

Carella, & Audette, 1986; Reinherz et al., 1991; Weissman et al., 1987).

McDermott et al. (1990) surveyed a random sample of 219 grade eleven

and grade twelve students from a south central United States secondary school.

The Center for Epidemiologic Studies Depression Scale (CES-D) was used to

measure depression symptoms. Scores on the CES-D were then correlated with

a variety of reported health practices. The investigators determined that suicidal

ideation was highly correlated with depression and was reported by 15.2% of the

respondents. Health behaviours which were moderately correlated with

depression included using recreational drugs or alcohol, overeating, and

engaging in non-consensual sexual activity. Health behaviours demonstrating a



13

weak correlation to adolescent depression were abstaining from physical

exercise and missing classes.

Presently, scientific knowledge in regard to adolescent depression

remains at the descriptive level. The prevalence of depression reported for the

general adolescent population currently ranges from 3% (Clarke, 1991) to 16%

(Pronovost et al., 1990). There is no consensus as to the clinical frequency of

adolescent depression (Siegel & Griffin, 1984). It is generally agreed that the

primary etiology of adolescent depression may be either endogenous or reactive

(Greydanus, 1986; MacLean, 1987; Simeon, 1989) with a greater proportion

being of the reactive nature than in the comparable adult population (Kramer &

Feiguine, 1981; Puig-Antich et al., 1987; Simeon, 1989).

Just as there have been conflicting findings about the prevalence of

adolescent depression, so too have there been significant discrepancies

regarding the demographic characteristics of depressed youth. Baron & Perron

(1986), McDermott et al. (1990), Reinherz et al. (1991), Simeon (1989) and

Weissman et al. (1987) have demonstrated significantly increased rates of

depression among adolescent females over males. However, in a similarly

designed study, using the same or a comparable diagnostic tool, Siegel & Griffin

(1984) failed to demonstrate any gender differences.

Baron & Perron (1986) examined the family setting and demonstrated no

significant difference in level of depression and marital status of biological

parents, type of family structure, employment of parents, and presence of

siblings. Utilizing the same instrument and level of significance, Siegel & Griffin

(1984) found a significantly higher level of depression among children of divorced

parents. As Baron and Perron's (1986) study involved a sample from western

Quebec, Canada and Siegel and Griffin's (1984) study was composed of a

sample from Missouri, U.S.A., this variation may be due to the differing value



14

each population places on the traditional nuclear family. Weissman et al. (1987)

and Simeon (1989) demonstrated an increased prevalence of depression among

children and adolescents whose parents were depressed as compared to those

who had non-depressed parents.

Age and socioeconomic status have been found to be positively correlated

with depression in some studies (Greydanus, 1986; Siegel & Griffin, 1984) and

negatively correlated in others (Baron & Perron, 1986; Reinherz et al., 1991).

Cultural and other demographic differences have been found to exist among

urban and rural adolescents who were suicidal (Tonkin, 1984). No studies have

isolated similar factors among adolescents experiencing depression.

Pets and Health in Humans

Similar to the research related to adolescent depression, the literature on

pets and human health has increased greatly in the past several years. An

annotated bibliography of the human-animal bond lists 819 citations prior to 1983

(Allen, 1985), and another lists 350 citations between 1987 and 1990 (Rowan,

1992a). In 1987, Anthrozoos commenced publication as a multidisciplinary

refereed journal concerned with the interaction of people, animals, and

environment. This publication was joined in 1993 by Society and Animals, a

similar refereed journal committed to the scientific study of human and animal

interactions. A number of international organizations are devoted to the study of

human and animal interactions. Thirteen of these came together under the

International Association of Human-Animal Interaction Organization (I.A.H.A.1.0.)

for a conference in 1992 in Montreal, Canada.

There are several levels of rigor and complexity in publications regarding

human and animal interactions in a shared environment. At the most basic level,

articles in the media and lay literature extoll the benefits of pets for one's mental



15

health in decreasing feelings of loneliness and depression and increasing

feelings of love and belongingness (Cohen, 1991; Humeston, 1983; Jaworski,

1990; Meer, 1984; Schultz, 1990; Toufexis, 1987; Wyatt, 1988). These articles

have little scientific merit in most cases but may provide the impetus for empirical

examination of popularly held beliefs.

The next level of literature includes anecdotal case reports which are

generally found in non-research-based journals of nursing or other health

professions. It is in this forum that "helpful hints" for improving patient care are

passed from one professional to another. Such references, like the lay literature,

frequently cite the profoundly positive effects pets have had on the subjective

measurements of happiness and social behavior of various groups of individuals

requiring nursing care (Bibby & Posterski, 1992; Bikales, 1975; Blythe, 1980;

Bossard, 1944; Brickel, 1979, 1980; Carbary, 1975; Davis, 1985a, 1985b; Davis,

1986; Dolan, 1982; Fogel, 1983; Francis, 1981, 1991; Furstenberg, Rhodes, &

Powell, 1988; Gammonley & Yates, 1991; Haggard, 1985; Lago & Knight, 1987;

Manor, 1991; Manor, McCurdy, & Crain, 1988; Mayhew, 1988; Preshlock, 1985;

Ruckert, 1987; Twiname, 1984; Wille, 1984).

One well-known piece of anecdotal pet literature in nursing came from

Florence Nightingale who recognized the effect that the pet owl she carried in her

pocket had on her patients. She wrote, "A small pet is often an excellent

companion for the sick..." (Nightingale, 1860/1967, p. 103). Like the popular lay

literature, attention is best paid to these sources for their inquiry into observed

clinical effects. It is from such sources that the nurse researcher may begin to

plan a course of study to actively test some of the "hunches" held by practicing

colleagues.

The remaining research-based literature on the use of animals in the

health promotion of humans has been split into three distinct groups. The first



16

category is that examining the use of "helping animals" for the physically

disabled. However, this study examines the relationship of pets with mental

health. Therefore, unless the emotional benefits of such a relationship are also

studied, this body of literature is not addressed in the context of this review.

The second category of pet research literature does measure the

emotional or mental effects of pets on humans in pet therapy, or pet-facilitated

therapy. This involves the use of an "outside" animal (which is usually the

therapist's but is almost always unfamiliar to the client) in therapeutic interactions

between a client and a health professional (Corson, 1977; Draper, Gerber, &

Layng, 1990; Hundley, 1991; Levinson, 1962, 1965; Wolfe, 1977). The use of

animal visitation programs with hospitalized or institutionalized individuals is

considered under the category of pet therapy as it involves the use of an

"unknown" animal (Fila, 1991: Francis, Turner, & Johnson, 1985; Kale, 1992;

Kalfon, 1991; Lebeck, 1992; Lee, 1987; Mead, 1992; Moneymaker & Strimple,

1991; Muschel, 1984; Ormerod, 1992; Robb, Boyd, & Pristash, 1980; Thompson,

Kennedy, & Igou, 1983). This aspect of the literature is also not discussed in the

review as it does not directly apply to the proposed study.

The third category of research-based literature discusses the nature of the

relationship between individuals and their own pets. This literature occasionally

refers to pets as "companion animals" to highlight the fact that it refers to an

animal well known to the subject, and not an external animal such as those used

in pet-facilitated therapy. In fact, there has been little clarification of the

terminology differences between "pet" and "companion animal" in the literature

(Veevers, 1992). In this study, the term "pets" refers to both "companion

animals" and "pets" as used in the literature. A definition of pets is included in

Chapter One.



17

The majority of the pet studies to date have been qualitative in design,

examining the nature of pet ownership and/or interaction with a particular health

parameter of a given population. Like the aforementioned state of knowledge

regarding adolescent depression, the current state of knowledge in the study of

human health factors and pets is still in the descriptive stage.

Pets and Physical Indices of Stress in Humans

Stress, one of the possible contributors to depression (Klerman &

Weissman, 1989), is frequently demonstrated by an increase in blood pressure

(Perko & Kreigh, 1988). In a within-subject experimental design study, Baun,

Bergstrom, Langston, and Thoma (1984) examined the effect of pets on stress.

This study demonstrated that stroking a pet dog (with whom the subject had an

established bond) had a significant effect in lowering both the systolic and

diastolic blood pressure when compared to stroking an unfamiliar dog. The

decreased blood pressure response of those subjects stroking a pet dog

paralleled the relaxation response demonstrated by those asked to read quietly

alone. Unfortunately, there was no true control group in the latter study.

A thesis completed by Oetting (cited in Baun, Oetting and Bergstrom,

1991) examined the physiological indices of stress reduction (blood pressure,

heart rate, and peripheral skin temperature) for groups solely stroking a pet dog

or stroking a dog in combination with autogenic relaxation techniques. Although

both groups demonstrated a decrease in stress levels as measured by the above

parameters, there were no significant differences in the stress reduction indices

of the two groups. The two aforementioned studies illustrate the differing findings

in studies of the relationship between people and the effects of pets on certain

parameters (such as the physical indicators of stress) of mental health.



18

Blood pressure was also a variable used by Riddick (1985) in a pre-test,

post-test, control group design that provided fish aquariums to non-

institutionalized elderly. Significant decreases in diastolic blood pressure, and

increases in leisure satisfaction and in relaxation states were noted in the

members of the experimental group. It is unclear, however, if these results were

due to the actual nature of human-animal interactions or were an outcome of a

new leisure hobby.

Allen, Blascovich, Tomaka and Kelsey (1991) measured the physical

autonomic stress responses of 45 adult women asked to respond to

mathematical skill testing questions (as a stimulus of stress) in a laboratory

setting with only the researchers present. These women were then asked to

repeat the exercise two weeks later at home in the company of either their best

female friend (social support), their pet dog, or alone. The results were

consistent across laboratory and field studies. The women with a friend present

at the time of testing scored less well and demonstrated significantly increased

autonomic stress responses. Those women with their dog present at the time of

testing demonstrated significantly less physiological reactivity on all autonomic

stress measurements. The marked difference between support provided by

friends and that of pets was interpreted by the researchers as a result of the non-

evaluative nature of pets as they relate to humans (Allen et al., 1991).

Another study of physiological indices of relaxation and stress reduction in

regard to the presence of animals is that of Friedmann, Katcher, Lynch and

Thomas (1980). These researchers followed 92 patients post-discharge from a

coronary care unit. Findings demonstrated a significant positive relationship

between the presence of household pets and a one-year survival rate. To

control for the physical requirements (and hence possible adherence to

recommended exercise regimes) necessary in caring for a dog, all dog owners



19

were then omitted. The findings of the second analysis also demonstrated a

significant relationship between the presence of non-dog household pets and the

one-year survival rate post-discharge from the coronary care unit. These findings

were consistent across age, gender, severity of illness, marital status, and

personality traits of the subjects. Such findings again suggest the notable effect

household pets have on the health of their human companions.

In a study examining the risk factors related to stress and cardiovascular

disease, Anderson, Reid, and Jennings (1992) studied 5,741 individuals

attending a free clinic in Melbourne, Australia. Two matched groups were

established according to age and sex. Potentially confounding variables of diet,

exercise, weight, socioeconomic status, alcohol intake, and smoking habits

appeared to be equally distributed throughout both the pet owning and non-pet

owning groups of all ages and genders. All the male pet owners demonstrated

significantly lower plasma triglyceride levels, lower plasma cholesterol levels, and

lower systolic blood pressure than did their non-pet owning counterparts. The

female pet owners in the 40 to 59 age group demonstrated significantly lower

plasma triglyceride levels and lower systolic blood pressures than did non-pet

owners in the same group. For all groups, the differences were independent of

the type of pet owned. This is one of the first studies demonstrating a direct

correlation between pet ownership and physiological indices of stress related to

specific disease prevention.

Serpell (1990, 1991) carried out a ten-month prospective study which

examined changes in health status and behaviour in 71 adult subjects following

the acquisition of a new pet (dog or cat). The pet owning groups reported a

significant reduction in minor health problems in the first month following pet

acquisition as compared to a control group of non-pet owners. For dog owners,

the health status improvement was sustained for the entire ten-month study



2 0

period. Similarly, new pet owners also demonstrated a significant improvement

in psychological well-being over the first six months. For dog owners, this

included an increased sense of self-esteem which was sustained for the entire

ten month study period. Serpell's (1990, 1991) findings suggest that acquisition

of a pet may have a causal influence on overall human physical and

psychological health and in some cases these effects may be relatively long

lasting.

Pets and Emotional Health in Humans

The research literature regarding the relationship between pet ownership

and the emotional well-being of the owners has been studied in a variety of ways

on a vast number of populations. Carmack (1991) studied the lived experience of

18 individuals with acquired immunodeficiency syndrome (AIDS) and the role of a

pet in their lives. Identified themes that persons with AIDS attributed to the

presence of their pets included an increased feeling of affection, feeling valued

and needed, an ability to have a confidant, a catalyst for facilitating discussion of

difficult topics, an increased ability to focus on the present, a feeling of consistent

support, and an increased ability to handle anger, as well as a decreased

perception of loneliness and stress.

It becomes apparent that the value which persons with AIDS placed on the

presence of pets may, in fact, also be present among pet owners without AIDS.

According to Folkman and Lazarus's (1988) model, several of these attributes

could be included with the presence of pets as part of the coping response of an

individual experiencing depression. The use of pets (with the identified attributes

cited by Carmack, 1991) may enable individuals experiencing depression to

reappraise that emotion into one of an alternate and perhaps more manageable

nature.



21

Blenner (1991) interviewed 25 infertile couples in a qualitative study to

determine the effects of pets on this population. She concluded that using pets

as therapeutic adjuncts greatly helped to break the cycle of depression,

withdrawal, and stress or isolation in infertile patients' lives.

The effects of pets on depressed individuals has been examined by

McCulloch (1981) who surveyed 31 individuals (ages 22 to 69) with a variety of

chronic physical health concerns and concurrent depression in order to

determine the role of their pets during the course of their physical illness. The

majority (71%) of the subjects indicated that their pets were an important source

of companionship, as well as a valuable force in helping them cope with feelings

of loneliness (83%). A larger majority (94%) of McCulloch's (1981) sample

stressed the importance of the pet in encouraging a sense of humour. Even

among those in the sample who demonstrated social stability and satisfactory

support systems, pets were perceived to provide invaluable additional coping

resources to help the individuals deal with their physical illness as well as the

concurrent depression (McCulloch, 1981).

Mugford and M'Comisky (1975) utilized a pre-test, post-test, control group

experimental study design in which a sample of well elderly who were living alone

were given either begonias, caged birds, or nothing. The results demonstrated

significant improvement in self-concept and attitude toward others for the group

who received the birds for the five-month test period over those who received the

plants or no item.

In contrast, a more recent study by Robb and Stegman (1983) found no

significant difference in measures of morale, locus of control, social interaction,

and mental status among predetermined groups of pet owning and non-pet

owning veteran clients receiving home care services. Utilizing instruments with

established reliability and validity, this study was one of the few to have



2 2

quantitatively measured the findings frequently cited in anecdotal reports. Robb

and Stegman (1983) recommended that further quantitative studies of factors in

human-animal interactions be carried out utilizing established instruments. In

addition, the researchers recommended that critical attention be paid to

situational and personal characteristics of the subjects.

Baun, Cardiello, and Jassen (1992) utilized a pre-test, post-test control

group design in the measurement of depression, loneliness, and morale of older

adults transferred to a rehabilitation unit. Their study demonstrated a significant

decrease in depression among those individuals transferred to the rehabilitation

unit with a pet bird over those in the control group who were not given a bird.

The presence of a bird, however, made no significant difference in the morale or

loneliness of the subjects.

In a study of single seniors in their homes, Lane and De Gale (1992)

measured self-perceptions of health, finances and living situations as well as

indices of depression, loneliness, and life satisfaction among pet owners and

non-pet owners. Overall, pet owners viewed their health, finances, and living

accommodations as significantly better than did the non-pet owners sampled.

Objectively, there was a statistically significant difference between the two groups

only on the life satisfaction scale (pet owners scored higher). Unlike the

previously cited study of Baun et al. (1992), Lane and De Gale (1992) found that

the depression and loneliness indices of their two study groups were

indistinguishable.

In another study of perceived health status among the elderly, Siegel

(1990) reported on a one-year prospective study of 938 individuals. When all

demographic characteristics were controlled for (including social support network

and chronic health problems), those with pets reported fewer physician contacts

during the year than did those without pets. The accumulation of stressful events



2 3

during the year was no different between the two groups; however, the events

resulted in more physician contacts by the non-pet owners than by the pet

owners. Dog owners, in particular, did not utilize their physician in times of

stress. They reported that their pets provided them with companionship (75%),

security (25%), and love (21%). It is hypothesized by the author that those

without dogs or other pets may be using their family physician to fill this

companionship role in times of stressful life occurrences (Siegel, 1990). A

descriptive study (Cookman, 1991) using grounded theory methodology to study

attachment of a similar population of pet owners demonstrated that elderly pet

owners used their animals to fill a perceived void in companionship, thereby

confirming Siegel's (1990) results.

Stallones, Marx, Garrity and Johnson (1990) also studied use of health

care services among pet and non-pet owners. They surveyed 1,300 adults (ages

21 to 64) from the general population in the United States to determine the

relationship between pet ownership and pet attachment with self-reported illness

behaviour and depression. Their telephone survey used numbers of visits to the

doctor, use of prescription medication, and numbers of hospitalizations to

measure illness-related behaviours. The respondents were also questioned as to

their self-perception of health, recent negative life events, support network and

perceived attachment to their pets. The data analysis revealed no significant

difference between pet owners and non-pet owners on comparisons of illness

behaviour, depression, life changes and support network. The results also

demonstrated a significant inverse relationship between attachment to pets and

presence of a human support network. The absence of a human support

network was associated with emotional well-being. On the basis of this study,

Stallones et al. (1990) caution against advocating pet ownership for depressed

individuals as it may lead to a decrease of human supports and provide yet



2 4

"another stressor ... to increase rather than decrease emotional distress" (p.

108). A review of the etiology of depression in adults and the use of a conceptual

framework for the placement of pets in relation to the health parameters may

have further assisted Stallones et al. (1990) in drawing conclusions from the

latter finding.

The interrelationship between human-pet attachments and subsequent

human-human interactions has been another subset of research into the

emotional well-being of pet owners. In one of the original studies in this area,

Brown, Shaw, & Kirkland (1972) reported a positive correlation between human

affection for dogs and affection for humans. In opposition to this view, another of

the original pet researchers determined that pet owners and men in general like

people less than do non-pet owners and women in general (Cameron, 1966).

They conclude that pets seem to function as a deterrent to effective social

relationships and, consequently, to mental health (Cameron & Mattson, 1972).

Given the nature of their sampling procedures and correlational analysis,

Cameron and Mattson (1972) may be presumptuous in their statement of

causation.

More recently, the effect of human-pet relations on human-human

relations has been tested using a variety of study designs. Robins, Sanders, and

Cahill (1991) used a participant observation research design to demonstrate that

dogs facilitate interactions with strangers in a park setting and help to establish

trust among the newly acquainted. Messant (1983) had 40 volunteer dog

walkers, and 40 control group walkers (no dog) observed with behavioural

measurements of the frequency and nature of interactions with other humans.

He concluded that the presence of the animal acted as a "social lubricant"

(similar to the findings of Mugford and M'Comisky, 1975). The presence of a dog

increased the likelihood of interactions with other people. These others usually



2 5

spoke to or touched the dog while also addressing its owner. Such an

observation reinforces the significance of the pet in the interaction in comparison

to those walkers who did not have a dog present.

Rossbach and Wilson (1992) built on the previous research in their study

in which 34 subjects were asked to rate a series of 32 photographs on

dimensions of approachability, happiness, relaxation, and "best" photo. The

photographs consisted of the same four individuals in combinations of seated

and standing positions, alone, with flowers, with their own dog, and with a

strange dog. In all cases, pictures which had dogs in them were rated higher

than all other photographs. In the second stage of the study, 45 subjects were

asked to rate slides of scenery, an individual alone in the scene, and the same

individual with a dog in the scene. The findings demonstrated a preference for

scenery alone on ratings of aesthetics, happiness, relaxation, safety, and "best"

picture. Second to the images of scenery alone, were the scenes with an

individual and a dog. It was only when the subjects were asked to place

themselves in the photo, that the preference on all scales became the slide with

the dog. Rossbach and Wilson (1992) interpreted these results to indicate that

their subjects would rather be with a dog than alone (companionship) and that an

individual with a dog is more appealing than one without (perhaps as a social

lubricant).

Paul and Serpell (1992a) surveyed 385 university students regarding their

childhood relations with pets and current attitudes towards animals and humans.

Their results demonstrated a significant positive relationship between

involvement with pets as children and both positive attitudes to animals in

general, and higher scores on a scale of empathy for other humans. This

confirms an earlier study of childhood pet ownership by Poresky (1990) who

demonstrated that empathy towards children by other children was correlated



2 6

with empathy towards pets. Children with a strong attachment bond to a pet had

higher scores on empathy towards other children than did the children in the

study who did not have pets (Poresky, 1990). This finding conflicts with those of

Stallones et al. (1990) who concluded that pet attachment among adults was

negatively correlated to attachment with humans.

Gage (1992) studied 454 couples with a baby of one year or less. After

controlling for factors of the parental childhood experience, and level of

socialization for marital and parental roles, the findings demonstrated a

significant correlation between the extent of pet experience and competence in

marital and parental roles using established scales for self-esteem, life

satisfaction, marital satisfaction, and parenting competence. Similar to the

aforementioned studies, Gage (1992) demonstrates the effects relations with

pets may effect other relations with humans.

In regard to pets and the adolescent population, Covert, Whiren, Keith,

and Nelson (1985) interviewed 285 urban and rural adolescents from 10 to 14

years old about the nature of their relationship with their pets. Results indicated

that 89% of those surveyed had cared for an animal. The benefits of pet

ownership among those surveyed was found to be significant on the parameters

of reported friendship (dog, fish, bird, and horse owners only), expanded

knowledge (fish, and bird owners only), and acknowledged responsibility (small

mammal and horse owners only).

In a study similar to that of Covert et al. (1985), Stevens (1989) surveyed

490 urban and rural grade eight adolescents. The investigator determined on the

basis of the survey that urban adolescents were significantly more attached to

their pets than were their rural counterparts. There were no significant

differences in the level of pet attachment among male or female adolescents or

between dog or cat owning individuals. The study confirmed the more utilitarian



2 7

role animals play in rural families as well as the lack of gender bias or species

preference in the pet attachment of urban adolescents.

Much of the remaining literature concerning adolescents and pets, groups

adolescents together with children in an analysis of developmental task

achievement. Davis and Juhasz (1985) discuss the formation of a concept of

"self" to be an important developmental task of the preadolescent. Pets may

contribute to adolescent confidence and sense of self by a facilitation of healthy

expression of feelings through play, a non-authoritarian nature, consistent

availability, maintenance of "confidences," and unconditional acceptance. They

indicate that the pet's involvement as a developmental asset will fluctuate over

time and according to the individual needs of the adolescent and caution that "a

rigid relationship indicates limitations in growth potential relative to developmental

progress" (p.91).

Schaufl and Bergler (1992) found that among the 460 nine to fourteen

year olds they surveyed, dogs took on several roles and functions for their

subjects. Namely, the pets represented fantasy, friendship, entertainment,

facilitators of communication, topics of conversation, comforters, "nurses", and

catalysts for family togetherness.

In addition, there are literature reviews and philosophical constructs

discussing the roles played by pets in families with children. Albert and Bulcroft

(1988) interviewed 320 pet owners and 116 non-pet owners to determine the

degree of attachment of pets have to the family system. Their findings suggest

that pets are viewed as family members who play significant emotional and

psychological roles in urban households. The nature of the role the pet holds in

the family system varies over the life cycle and type of family. Cain (1983)

identified both positive and negative aspects of pet ownership dependent on the

life stage and the dynamics in individual families. The pets in the households



2 8

with adolescents frequently served as a confidant for the adolescent as well as

teaching attributes of independence and responsibility and providing a source of

companionship (Albert & Bulcroft, 1988; Schaufl & Bergler, 1992).

Robin and ten Bensel (1990) studied the role played by pets in the

developmental tasks of the adolescent:

Pets function, particularly for adolescents, as transitional

objects, much like the blanket or the teddy bear does for

infants. As transitional objects, pets help children feel safe

without the presence of parents. Pets are more socially

acceptable as transitional objects for older children than are

inanimate objects. Adolescence brings with it a changing

relationship to pets....At this period pets can be a confidant,

an object of love, a protector, a social facilitator, or a status

symbol (p.17).

The literature further indicates that, due to the intense relationship that

adolescents, (more so than elementary school children) have with their pets

(Kidd & Kidd, 1990a, 1990b), it is members of this age group that generally have

the most profound and prolonged periods of grief in the event of loss of a pet

(Robin & ten Bensel, 1990).

In summary, a vast array of lay and anecdotal literature describes the

mental health benefits of pets for their owners. The research-based literature is

as yet unclear as to the exact nature of the benefits of pets to humans.

Consistent with the findings of Baun et al. (1984), Friedmann et al. (1980), and

Robb and Stegman (1983), there appears to be a paucity of controlled

quantitative investigations of particular health parameters in humans in relation to

the presence of household pets. The relationship between measurement of

depression and pet ownership also appears to vary according to the age and



2 9

circumstances of the subjects. In general, the research literature confirms that

animals are able to facilitate human-human contact. Pets in childhood are

instrumental in fostering feelings of empathy towards other humans in adulthood.

However, as previously noted, despite the descriptions of the role pets may play

in the developmental tasks of adolescents, there is little in the research literature

regarding the relationship of pets to the current mental health of adolescents.

Summary

In this chapter an overview of the relevant literature pertaining to the

concepts of adolescent depression and the health benefits of pets has been

presented. The research literature regarding adolescent depression addresses

the demographic correlates of depressed youth as well as the potential etiologic

basis and behavioural representations. There is evidence in the literature that

adolescent depression is related to suicide, delinquency, dropping out of school,

poor academic performance and substance abuse (Rogers, 1987). It is also

clear from the literature that there are recognized differences in adolescent

depression between urban and rural populations and among different cultural

groups. The points on which the literature is not clear relate to important aspects

such as overall prevalence in the population, as well as any demographic

correlations of depression with gender, family structure, age, and socioeconomic

status.

The presence of household pets has not previously been identified as a

factor in dealing with this health concern among adolescents. Literature

regarding the health benefits of pets ranges from lay anecdotal articles to reports

based on rigorous experimental design. The areas pertinent to the concept of

mental health include the relationship of pets to stress responses, as well as

measures of emotional well-being. The literature describes recognized



3 0

differences in the role played by pets for people living in urban and rural settings.

The research literature also confirms that pets provide increased feelings of love,

belongingness, and companionship for their owners. Despite the wealth of

anecdotal articles promoting other emotional health benefits of pets, the findings

of the research-based literature are conflicting as to whether pets are, in fact,

correlated with a change in blood pressure, heart rate, loneliness, depression,

affection for other people, morale, locus of control, and social interactiveness

when examining groups of pet and non-pet owners.

Although findings have indicated that adolescents are one of the age

groups most affected by the death of a pet, and rate as much more attached to

their pets than do younger children, there have been few studies regarding the

relationship between mental health of adolescents and the presence of pets. For

these reasons, this study helps to fill the void noted in the review of the literature.

The study addresses the need for further clarification of the prevalence and

demographics of depression a selected group of adolescents. The study also

builds on the foundation knowledge in examining the correlation between this

specific mental health concern and the presence of pets among members of the

population. The study adds to knowledge about both the emotional health of

urban grade nine adolescents and the potential correlation of emotional health

with the environmental influence of household pets.



31

Chapter Three

Methods

A multi-method quantitative design was used to address all four research

questions. The first question relating to the prevalence of depression among the

subjects was addressed using a descriptive survey design. The second, third,

and fourth questions concerning the relationships between pets, gender, and

depression, as well as primary ownership of pets and depression, and perceived

pet attachment and depression, were addressed by correlational study designs.

Instruments

The instruments utilized in the study were the Adolescent and Pet

Characteristics Questionnaire (see Appendix A) and the Center for Epidemiologic

Studies Depression Scale (CES-D) (see Appendix B).

Adolescent and Pet Characteristics Questionnaire 

The Adolescent and Pet Characteristics Questionnaire is an instrument

designed by the researcher to collect nominal level, descriptive demographic

data about the subjects (see Appendix A). The following criteria were utilized for

item inclusion on the Questionnaire:

1. Each independent variable was identified in the literature as significant or

potentially significant (content validity);

2. The inclusion of each variable appeared logically relevant in relation to the

research questions and purpose of the study (face validity).

The Questionnaire was submitted to a convenience group of 5 male and 6 female

adolescents (aged 13 to 20) to assess for comprehensiveness, clarity, and face

validity prior to its use. No changes to the instrument were made on the basis of

this preliminary assessment.



3 2

The Questionnaire includes fourteen items related to gender, age, school

performance, current family members at home, immigration (of the subjects as

well as their parents), language, and presence of pets in the home. For those

subjects who have pets, a further seven items (for which short responses are

necessary) gather additional information as to type and number of pets, identified

favorite pet, primary ownership, duration of ownership, and perceived degree of

attachment to the pet. Subjects complete the instrument by circling the nominal

category or briefly describing that which best portrays their current situation.

Center for Epidemiologic Studies Depression Scale 

The Center for Epidemiologic Studies Depression Scale (CES-D)

(Radloff, 1977) was used to measure the prevalence of depression among the

subjects (see Appendix B). Unlike measures used in other studies (Beck, Ward,

Mendelson, Mock & Erbaugh, 1961 ; Siegel & Griffin, 1984), the CES-D was

designed to measure depressive symptoms in the general population as opposed

to the clinical case and is, therefore, particularly pertinent to the subjects in the

study. The CES-D consists of 20 summated Likert-type statements on a

unidimensional measurement of depression. The depression factors include

measurement of depressed affect, positive affect, somatic concerns, slowed

activity, and interpersonal relations. The subjects circle the response which best

describes how frequently each statement pertained to them during the past week.

There are four potential responses to each statement ranging from 0 to 3, with 0

indicating "rarely or none of the time" and 3 indicating "most or all of the time"

(Radloff, 1977). The subjects' circled responses are totalled to obtain an overall

score for the scale, which may range from 0 to 60. The CES-D scoring for adult

populations uses a cut-off value of >15 to indicate the presence of depression

symptoms (Radloff, 1977). Several authors have indicated, however, that this is



3 3

not an adequate indicator for an adolescent population and scores of >20

(Pronovost et al., 1990), >24 (Ackerson, Dick, Manson, & Baron, 1990) or >28

(Clarke, 1991; Manson, Ackerson, Dick, Baron & Fleming, in press) are better

indicators of specific depression-related symptoms in adolescents. Indeed, those

adolescent studies which have utilized the adult cut-off point of >15 for

depression have demonstrated prevalence rates of depression such as 49% and

58% of the population (McDermott et al., 1990). These rates are in excess of the

adolescent depression prevalence rates reported in studies using alternate

measurement instruments (Greydanus, 1986; Simeon, 1989). For the purposes

of this study, no distinct cut-off point was utilized. Rather, a series of four scoring

categories, based on the cut-off points utilized by the above researchers and the

principle of interval data, was used to indicate various degrees of depressive

symptoms. An overall score on the CES-D from 0 to 15 indicated no depression,

a score from 16 to 30 indicated mild depression, a score from 31 to 45 indicated

moderate depression, and a score from 46 to 60 indicated severe depression.

The CES-D was designed for use with English-speaking, Caucasian or

African-American populations of both genders, a wide range of socioeconomic

statuses, and education levels and is freely available for public use. Although

originally designed to measure depression in an adult population, it has

demonstrated high concurrent validity (r = 0.73) and excellent internal

consistency (0.91 for suicidal youth, and 0.81 for non-suicidal youth) among

adolescent populations in both Canada and the United States (Clarke, 1991;

Pronovost, 1990; Roberts, Andrews, Lewinsohn & Hopps, 1991). The exact

reading comprehension level is not known; however the instrument was designed

for use with "less than high school" (Radloff, 1977, p.398) levels of education.

Adolescent subjects complete the instrument in an average of five minutes.



3 4

Factor analysis of the internal sub-scales of the instrument revealed a high

interrelatedness that cautions against separating out any internal measures of

depressed affect, positive affect, somatic retardation, and interpersonal factors.

Rather, Radloff (1977) recommends using the tool only as a whole. The CES-D

also has strong discriminant validity when compared to a series of 12 other

similar scales (Radloff, 1977).

Protection of Human Rights

Approval of procedures for the protection of human rights was obtained

from the University of British Columbia Behavioural Sciences Screening

Committee for Research and Other Studies Involving Human Subjects prior to

commencing the study. Throughout the study, every effort was made to maintain

anonymity of the subjects. Despite the fact that the students and teachers were

aware of who participated in the survey and who did not, no names were

accepted on the completed instruments. The instruments were collected in an

envelope without any observation of results by the researcher or the teacher.

Parents of the children were informed of the study and were offered the

opportunity to view the instruments if they desired prior to providing their consent.

None of the parents contacted elected to do so.

Prior to conducting the study, the researcher, in conjunction with the

school counsellor or principal, identified an individual within the school to whom

the students could go for counselling if they found that the questions asked in the

survey had caused them to think about problems they were experiencing. This

information was verbally given to the students as a group after all the instruments

were collected. Although some of the responses revealed severely depressed

individuals, no effort was made to seek out the identity of those individuals as this

would have constituted a breach of anonymity. Rather, contact was made with



35

the principal or guidance counsellor of the three schools from which the

completed instruments had been collected. Each was informed that there had

been responses indicating depressed students in the school. They were then

provided with information about community resources in the area of the school to

provide class presentations or counselling to self-identified individuals.

Sample

All secondary schools in urban Vancouver (eighteen) and Victoria (eleven)

were approached for participation in the study. Only those in which approval was

received from both the principal and the classroom teacher involved were

included. These schools (three in Vancouver and three in Victoria) represented a

variety of socioeconomic levels in the urban population (Capital Regional District

Health, 1990; Rumel & Costanzo, 1992; Siegel & Griffin, 1984). Participation

was sought from all grade nine students in the six schools. Only those students

who returned a signed parental consent form were included in the sample, which

consisted of both males and females.

The choice of grade nine students was made based on the literature which

documents an increase in the incidence of depression in the 13 to 16 year old

age group (Greydanus, 1986) as well as an increase in suicide rate in the 15 to

18 year old age group (Conrad, 1991; Pronovost et al. 1990). Individuals 13 to

16 years of age are at an optimal age for experiencing depression, but may not

yet have dropped out of school (Reinherz et al. 1991) or been led to suicidal acts.

Data Collection

Approval for completing the study was obtained from the Vancouver

School Board and the Victoria Regional District School Board. The Vancouver

School Board then approached the individual school principals to request their

consent for school participation. The schools within the Victoria School District



3 6

were individually approached by the researcher through a letter introducing the

study and requesting consent (see Appendix C). The principals were then

contacted by telephone to arrange a time to obtain the signed consent, answer

any questions they might have, and complete the final arrangements for the

study. For those principals who did not respond to the initial letter or telephone

call, a FAXed memo was sent requesting their participation.

Once the schools were identified, letters were distributed explaining to the

students and their parents the nature and purpose of the study, as well as the

time and effort required (see Appendix D). Active signed consent was requested

from the parents and required prior to student participation in the study. In four of

the schools, parental consent forms were sent home with the subjects and

returned to class in the same manner. One school had a blanket consent on

record which the parents had signed at the beginning of the school year giving

their consent for voluntary participation by their child in any study approved by

the school board. In the sixth school, the principal requested that the study

information and consents be mailed home to the parents to avoid placing extra

duties on the teaching staff. In the first four schools, the principals or classroom

teachers volunteered to collect the parental consent forms from the students prior

to the survey date. In the last school mentioned, the students either turned their

signed consent form into the school office or brought it with them at the time that

the instruments were completed.

Once consent was obtained from the parents and subjects, the data were

collected. Each school varied slightly as to the procedure which the principal

preferred to have followed. One school with relatively few students gathered all

of those with parental consent from their classrooms into a room at a pre-

arranged time. Another preferred that the students respond to the instruments

during lunch time, and the four remaining schools had the instruments distributed



37

to participating subjects during a guidance class or, in the case of one school, an

English class.

The researcher was able to personally distribute the questionnaires in five

of the six schools. In each of these instances, the researcher introduced herself

as a nurse interested in learning how teenagers currently felt about themselves

and in the degree of involvement they had as individuals with pets in their homes.

It was stressed that there were no right or wrong answers to the questions. The

subjects were encouraged to express how they truly felt and not what they

thought others might want to hear. Finally, it was pointed out again to the

students that there were two pages to be completed and that their names were

not to be put on either form. The students were encouraged to respect each

other's privacy and look only at their own paper, fold it in half when they finished,

and place it in the envelope held by the researcher. In the sixth school, the

guidance classes were held at a time at which it was impossible for the

researcher to be present. The above directions were given to the guidance

counsellor who read the introductory statement and instructions to the

participating subjects in each of his nine classes. In all cases, the subjects were

presented with the CES-D Scale first, followed by the Adolescent and Pet

Characteristics Questionnaire.

Data Analysis

Data from the Adolescent and Pet Characteristics Questionnaire were

tabulated as follows. The questions for which the potential responses were of a

limited number were analyzed at face value as the nominal category which they

represented (gender, age, school performance, number of parents, number of

siblings, birth country, years in current neighbourhood, primary language,

presence of pets, type of pet, primary pet ownership, duration of pet ownership,



3 8

and attachment to pet). Four of the short-answer questions had numerous

potential responses (place in sibship order, overall numbers and types of all

household pets, name of pets, and occasion for pet acquisition). The responses

to these questions were categorically grouped according to common

characteristics. Sibship order was analyzed as eldest, youngest, and anywhere

in the middle of a group of siblings. Overall numbers and types of household

pets were analyzed in groupings of single pet, multiple pets of same species, and

multiple pets of different species. Names of pets were grouped in to categories

of human names, names based on physical characteristics, names based on

social or behavioural characteristics, humourous names, and miscellaneous.

The reason for pet acquisition responses were grouped into categories of no

reason, unplanned finding, gift, planned desire, replacement of a past pet, and

replacement of a past significant other.

The first research question was answered with a prevalence ratio using

the values from the CES-D scale (Glass & Hopkins, 1984; Munro, Visintainer, &

Page, 1986; Radloff, 1977; Zar, 1984) to delineate those respondents who were

not depressed, mildly depressed, moderately depressed, and severely

depressed.

The second research question was analyzed using a two-way fixed effects

analysis of variance (ANOVA) design (Glass & Hopkins, 1984; Munro et al.,

1986; Zar, 1984). In this case, the dependent variable was the interval level

measurement of depression as recorded by the CES-D score. The independent

variables of gender (female/male), and pets in the home (no/yes) were obtained

from the Adolescent and Pet Characteristics Questionnaire.

In order to use the ANOVA statistical analysis procedure, three primary

assumptions about the data must be met (Glass & Hopkins, 1984; Munro et al.,

1986; Zar, 1984). The first ANOVA assumption is that the dependent variable be



3 9

composed of normally distributed continuous data. Secondly, the sampled

groups must have equal (homogeneous) variances. Finally, the factor effects

must be linear or additive in nature. To determine the distribution (normality) of

the CES-D scores, the results were plotted graphically using a density distribution

histogram and a normal curve. The results showed a positively skewed

distribution with a long right-sided tail (see Appendix F) (Glass & Hopkins, 1984).

To utilize parametric analysis procedures with these data as they existed in their

raw numerical form would be in violation of the assumption of normal distribution

(Glass & Hopkins, 1984; Zar, 1984).

A logarithmic (base 10) data transformation was used to correct for the

positively skewed distribution of CES-D scores. The conversion equation of X'=

log 10 (x+1) was utilized due to the presence of several "0" scores in the data set

and an inability to provide a log 10 value for 0 (Zar, 1984). This resulted in a

normal distribution (see Appendix F). In addition to obtaining a normal

distribution of data, logarithmic transformations ensure data linearity or additivity

(Zar, 1984). Therefore, the analysis of research questions three, and four

(utilizing parametric analysis of variance procedures) also used logarithmic 10

(x+1) transformed data.

The third research question was addressed using a one-way fixed effects

ANOVA design (Glass & Hopkins, 1984; Munro et al., 1986; Zar, 1984). This

utilized a subset of the dependent variable of depression (CES-D score) which

included only those individuals who had pets in examination of combinations of

independent pet ownership (individual / family / parent / sibling) as reported on

the Adolescent and Pet Characteristics Questionnaire. Post hoc analysis of the

data was completed using the Tukey test for honest significant difference as

provided by SYSTAT with Tukey-Kramer adjustment for unequal group numbers

(Wilkinson, 1990). This adjustment is reported to provide more consistent



4 0

protection against type I and type II errors than the Newman-Keuls or Duncan

post hoc analyses (Wilkinson, 1990).

The fourth research question was also addressed using a one-way fixed

effects ANOVA design (Glass & Hopkins, 1984; Munro et al., 1986; Zar, 1984).

Once again the dependent variable was the subset of depression (CES-D)

scores for those individuals with pets in examination of the relationship with

perceived attachment as reported on a scale from 1 to 5 (not attached /

somewhat attached / very attached / extremely attached) on the Adolescent and

Pet Characteristics Questionnaire. Post hoc analysis of the data was also

completed using the Tukey test for honest significant difference as provided by

SYSTAT with Tukey-Kramer adjustment for unequal group numbers (Wilkinson,

1990).



41

Chapter Four

Presentation and Discussion of Findings

Response Rate

Grade nine students of three Vancouver and three Victoria secondary

schools were the subjects for this study. Of a possible 710, 411 consent forms

were returned for an overall response rate of 58%. A response rate between

50% and 60% is expected when employing active parental consent procedures

(Ellickson & Hawes, 1989). Such a consent procedure has been criticized for its

potential underrepresentation of ethnic minority groups, low achieving students,

and "those at risk for engaging in problem behavior" (Ellickson & Hawes, 1989,

p.46). Although it is probable that some parents did return the signed consent

forms because they were unable to read English, a demographic review of the

subjects' ethnic origins later in this chapter will demonstrate that such an

underrepresentation was not likely the case in this study. This is likewise the

same for scholastic ability. Only eight of the 411 returned consents (1.9%)

indicated parental refusal to grant permission for their child to participate in the

study. As shown in Figure 2, the majority of the participants came from two

schools in which the teachers strongly encouraged and reminded the students to

return their signed parental consent forms.

Of the 403 completed instruments, 401 were usable. Two instruments

were discarded; one was incomplete and the other had obviously fictitious

answers. The remaining instruments were filled out in their entirety by the

subjects. Many were returned with elaborate explanations included in the

margins to further describe the subject's circumstances to the researcher.

Due to the profound differences in size among sample groups, before any

analysis was completed, the differences between sample sites and depression

scores were analyzed to ensure homogeneity of variance (Zar, 1984). The



134
33.4%

42

results of this preliminary one-way fixed effects ANOVA (with log 10 (x+1) CES-D

scores as the dependent variable and school as the independent variable)

indicated a probability statistic of p = 0.393. With statistical significance set at a <

0.05 alpha level, this result clearly indicates that there is no significant difference

between the depression values among the sampled school groups. Therefore,

despite the selection bias of most subjects being from two schools, the analysis

indicates homogeneity of variance across all sites. For the remainder of the

analyses, all school values were pooled and treated as one sample (Zar, 1984).

250
■

- 51.1%
205^ -200

50

0

3.7%
15

1
^

I

      

4.7%^4.74^2.2%
19^19 ^9 

I^I^1^I^I

      

A C D E F

Schools

Figure 2. Numbers and Percentages of Subjects by School

Demographic Characteristics

Gender

The sample was composed of 53.6% female and 46.4% male subjects.



43

Age

All subjects were in grade nine at the time of the study. Their ages ranged

from 13 to 16, with almost 80% of the sample being 14 years of age (see Table

1).

Table 1

Ages of Subjects 

Age (Years)

Subjects (N=401)

Number Percentage (%)

13 12 3.0

14 316 78.8

15 70 17.5

16 3 0.7

School Performance 

Almost 85% of the subjects reported receiving either B or C grades ( see

Table 2). These grades have been interpreted by the investigator as "high-

average" or "average," respectively. The reported grades for the subjects

Table 2

School Performance of Subjects 

Grades

Subjects (N=401)

Number Percentage (%)

A 45 11.2

B 193 48.1

C 149 37.2

D 14 3.5



4 4

in this study are similar to those reported in the larger adolescent health survey in

Vancouver and Victoria which were generally above average (McCreary, 1993a,

1993b).

Family Composition 

Subjects reported the number of parents and siblings currently living at

home with them and their position in the overall sibship order of the family. The

majority of subjects (78.8%) reported living with two parents, while 20.4%

reported that they lived with only one parent and three subjects (0.7%) lived with

older siblings in lieu of their parents (see Table 3). During the completion of the

instruments, a total of six students asked if they were to count their parent's

spouse as a second parent on the instrument. The students were encouraged to

do so only if they thought of that person as a parent. The percentage of two

parent families is slightly larger than reported in other studies: 75% for Canada

(Bibby & Posterski, 1992); and 71% and 59% for Vancouver and Victoria

respectively (McCreary, 1993a, 1993b).

Table 3

Parents Living at Home 

Subjects (N=401)

Parents at Home^Number^Percentage (%)

0 3 0.7

1 82 20.4

2 316 78.8

With regard to siblings living with the subject, the numbers ranged from

zero to seven (see Table 4). The largest representative group was 42.4% of the

subjects who reported one sibling living at home with them. Almost 13% reported

being the only child in the house, while nearly 28% reported having two siblings



45

at home. Seventeen percent of the respondents reported 3 or more siblings at

home.

Table 4

Siblings Living at Home

Subjects (N=401)

Siblings at Home

 

Number^Percentage (%)

   

0 51 12.7

1 170 42.4

2 112 27.9

3 42 10.5

4 18 4.5

5 5 1.2

6 2 0.5

7 1 0.2

The number of siblings at home does not always correlate with the overall

number of siblings in the family. This is illustrated by the figures which indicate

12.7% of the subjects as the only child living at home, while only 10.5% of the

subjects were actually the only child in the family (see Table 5). Approximately

two-thirds of the subjects reported being either the eldest or youngest child, while

the remaining 21% reported being somewhere in the middle of the sibship order.

The presence of certain family members in the home may be beneficial in that

they provide additional coping resources for the adolescent in emotional

reappraisals. The absence of certain family may also be beneficial by decreasing

the chance of environmental encounters which result in negative emotions for the



46

adolescent. Obviously, the reverse of each situation is also plausible within the

conceptual framework.

Table 5

Sibship Position of Subjects 

Subjects (N=401)

Position^ Number^Percentage (%)

Eldest 139 34.7

Middle 85 21.2

Youngest 135 33.7

Only Child 42 10.5

Country of Origin 

Cultural practices may be passed on to the children of immigrant parents,

therefore, information regarding country of origin was gathered on both subjects

and their parents. The majority of the families originated in Canada with the next

two largest groups being from China and Hong Kong. However, as shown in

Table 6, there were 49 different countries of familial origin, placed within eight

regional categories. The subjects were highly multicultural as a sample group;

however, the coping conceptual framework allows for differences associated with

a variety of beliefs, values and resources. Cultural beliefs may influence how

adolescents respond to environmental stressors and hence their establishment of

coping responses (Bibby & Posterski, 1992).

As Table 7 indicates, 296 (73.8%) of the subjects were born in Canada or

the United States. Seventy-seven (19.2%) were born in the Orient, and 28 (6.9%

in total) in a variety of places across Asia, Australia/New Zealand, Europe, Latin

America, or the Middle East.



47

Unlike the subjects, the parents were not primarily from North America

(see Table 7). The highest percentage of the parents were born in the Orient

(average 37.4%). Those born in North America were second with an average

representation of 31.9%. Twenty-one percent of the subjects' parents came from

a variety of the countries listed in the European region. Parents of the remainder

Table 6

Regions and Countries of Origin for Subjects and Parents 

Countries of Subjects and All Reported Parents

Asia - Non-orient

Asia - Orient

Region

North America

Latin America

Europe

Canada^(505)

Argentina^(4)
Costa Rica (1)
El Salvador (10)
Honduras^(1)

Austria^(1)
Bulgaria^(3)
Croatia
Czech Rep. r9
England^(39)
Finland^

PFrance
Germany^(7)
Greece^(16)
Holland^(2)
Hungary^(9)

Cambodia (3)
China^(120)
Hong Kong (103)
Japan^(6)
Korea^(4)

Brunei^(2)
Fiji^(19)

Middle East^Israel^(1)

U.S.A. (42)

Jamaica (2)
Peru (2)
Venezuela (4)

Ireland (4)
Italy (16)
Norway
Poland r6
Portugal (27)
Romania (1)
Scotland (7)
Spain (1)
Wales (2)
Yugoslavia (6)
Denmark (2)

Malaysia (15)
Philippines (23)
Taiwan (42)
Viet Nam (55)

India (19)

Lebanon (8)

Africa^Mauritius^(1)
^

South Africa (4)

Australia /
New Zealand
^

Australia^(8)
^

New Zealand (2)



48

were born in Africa, Asia, Australia New Zealand, Latin America and the Middle

East regions (average total of 9.3%). Thus, almost half of the subjects were first

generation Canadian. This is important to note as it may indicate potential areas

of conflict when the values and beliefs of the family are different from those

encountered by the subject when among her / his peer group (Bibby & Posterski,

1992).

Table 7

Subjects and Parental Birth Regions 

Region

Numbers and Percentages

Subjects (N=401)^Mothers (N=396)^Fathers (N=390)

North America 296^(73.8%) 131^(33.1%) 120 (30.8%)

Latin America 6^( 1.5%) 9 ( 2.3%) 9 ( 2.3%)

Europe 14^( 3.5%) 80 (20.2%) 87 (22.3%)

Asia - Orient 77^(19.2%) 149 (37.6%) 145 (37.2%)

Asia - Non-orient 4^( 1.0%) 18 ( 4.5%) 18 ( 4.6%)

Middle East 1^( 0.2%) 4 ( 1.0%) 4 ( 1.0%)

Africa 0 2 ( 0.5%) 3 ( 0.8%)

Australia /
New Zealand 3^( 0.7%) 3 ( 0.7%) 4 ( 1.0%)

Primary Language

In addition to reporting countries of origin, the subjects indicated which

language was primarily spoken at home. Forty-six of the subjects (11%)

indicated that more than one language was spoken at home. If they did not

make clear which was the language most frequently used, the first of the

languages listed was recorded as the primary language used in the home. In

total, 26 specific languages were reported by the subjects as shown in Table 8.



49

As were the countries of origin, the languages were categorized to facilitate

presentation.

Only 58.4% of the subjects reported English as the primary language

spoken at home. The second most frequently spoken languages were in the

Oriental category with 28.2% of the subjects reporting the use of at least one of

these nine languages. The remainder of the subjects (13.4%) reported speaking

a variety of the remaining 16 Asian or European languages. This is a larger

percentage (41.6%) of non-English speaking households than indicated by a

census completed in 1986 in which 21.8% of households in Vancouver were non-

English speaking (Child and Youth At Risk Steering Committee, 1991).

Table 8

Primary Languages Used At Home 

Subjects (N=401)

Category

 

Number^Percentage^Languages

   

English
^

234^58.4%
^

English

Asian - Oriental 113^28.2%^Cantonese (55) Korean^(2)
Chinese^(16) Mandarin (20)
Hakka^(2) Taiwanese (5)
Japanese (1) Vietnamese (11)
Tagalog^(1)

^

2.0%^Hindi^(4) Lebanese^(1)
Punjabi^(3)

Asian -^8
Non-oriental

European -
Latin-based^27^6.7%^French

^
(13) Portuguese (8)

Italian
^

(1) Spanish^(5)

European -
Non-latin-based^19 4.7% Bulgarian

Croatian
Czech
Finnish
German

(1) Greek^(5)
(4) Hungarian (2)
(2) Norwegian (1)
(1) Polish^(1)
(2)



5 0

A reason for the difference in these numbers could be that the 1986 figure

includes all families regardless of composition, whereas this sample includes only

those with a grade nine student in the home. It is also possible that multilingual

families make a concerted effort to speak their native language at home so that

their children who are being educated in English will retain their non-English

language abilities, hence raising the statistical representation of non-English

speaking households for those families with children. It may also be that many

more immigrant families have settled in Vancouver and Victoria since the 1986

census.

Residence

Approximately 70% of the subjects had lived their entire life in Canada

(see Table 9). The remaining 30% of the subjects reported living in Canada

anywhere from two months to twelve years. Within this population, only about

26% had spent their entire life in the same neighbourhood. Similar to the familiar

beliefs and practices found within cultural patterns, living in the same region for a

long period of time may permit the adolescent to cultivate a set of coping

practices which are effective in reappraising emotional circumstances.

Twelve percent of the subjects had been in their current neighbourhood for

less than a year. The remaining 61% of the subjects had lived in their

neighbourhoods anywhere from one to thirteen years (see Table 9). It should be

noted that some of the subjects commented in the margins of the instrument that

they had made several moves throughout their lives; however, always within the

same neighbourhood. It could be assumed, therefore, that support systems and

resources would remain the same for these individuals.



51

Table 9

Years of Residence in Canada and Current Neighbourhood

Years

Numbers and Percentages of Subjects (N=401)

Canada^Current Neighbourhood

< 1 9 ( 2.2%) 49^(12.2%)

1 - 3 32 ( 7.9%) 89 (22.2%)

4 - 6 17 ( 4.2%) 73 (18.2%)

7 - 9 21 ( 5.2%) 40 (10.0%)

10 - 12 40 (10.0%) 47 (11.7%)

13 - 15 282 (70.3%) 103 (25.7%)

In summary, the subjects in the study were generally similar to the cross-

section of adolescent subjects from the same Vancouver and Victoria settings

participating in other studies. There were slightly more female than male

subjects and most were 14 years old at the time of the study. They attended

three Vancouver and three Victoria secondary schools and their school

performance was generally in the average or high-average range. Three-

quarters of the subjects lived with two parents and one to three siblings. The

sample was equally represented by subjects who were the oldest, youngest and

middle in the sibship. Half of the subjects had lived their entire lives in Canada

with approximately half of the group remaining in the same neighbourhood. The

most remarkable characteristic of this sample was its multicultural nature,

representing 49 countries and 26 languages.



52

Pet Demographic Information

Presence of Household Pets 

Within the group of 401 subjects, 226 (56.4%) reported having one or

more pets currently in the home. The remaining 43.6% of the sample had no

pets. This is somewhat higher than the overall statistics which report the

incidence of pet ownership to be approximately 50% of urban households in the

United States and Britain (Beck, 1983; Rowan, 1992b) and approximately 50% of

all households in Canada (Bibby & Posterski, 1992). However, it is well

recognized that households with children, especially between the ages of 6 and

15, are more likely to have pets than those without children (Endenburg, Hart, &

de Vries, 1990). A description of the pet demographics follows.

Types of Pets

Of the 226 subjects with pets in the home, 22.2% reported having several

pets of the same species. Examples of this are the subjects who reported having

two cats or sixteen fish. One subject reported having two adult and ten baby

rats. Approximately 39% of the remaining sample reported having several pets

of different species. Another 39% of the population reported having only one pet.

Identified Favorite Pet

Subjects who reported having more than one animal at home were asked

to answer the remainder of the questions on the Adolescent and Pet

Characteristics Questionnaire with regard to their identified favorite pet. It was

assumed that subjects who had only one pet answered all questions in regard to

that single pet. Four subjects did not answer this question; however, they did

respond to other questions within the pet characteristics section so it is assumed

that they had a pet in the home and merely overlooked the question. Of the

types of single pets identified, 32% were dogs, 31.1% were cats, 11.7% were

fish, 11.3% were small mammals, 7.2% were reptiles or amphibians, and 6.7%



53

were birds (see Table 10). The categories of small mammal and reptile /

amphibian were composed of the animals listed in Table 10.

Table 10

Favorite Pet Categories and Types

Pet Owning Subjects (N=222)

Category Number Percentage^Types

Bird 15 6.7%

Cat 69 31.1%

Dog 71 32.0%

Fish 26 11.7%

Small Mammal 25 11.3% guinea pig (1) rabbit^(6)
hamster (11) rat^(4)
mice (3)

Reptiles and 16 7.2% iguana (1) snake^(1)
Amphibians newt (2) turtles (12)

These findings are consistent with those of other studies involving youth

and pets (Endenburg et al., 1990) but somewhat lower in dogs reported as pets

than in other studies (Kidd & Kidd, 1990b). This may be partially explained by

the fact that the subjects in the study were urban dwellers and there is a trend

towards cat ownership (58% increase in the past ten years) rather than dog

ownership (10% increase in the past ten years) in urban environments (Rowan,

1992b).

Pet Names 

Some pet theorists suggest that the type of name given to the pet may

reflect the type of role the pet owner expects the pet to assume within the

household (Fogel, 1983). The pet names provided by 91% of the subjects are

categorized with examples in Table 11.



54

Table 11

Pet Name Categories and Examples

Pets (N=205)

Category Number Percentage Examples

Human 92 44.9 Includes familiar first names and
surnames

Humourous 11 5.4 Biccardi, Cat (for a dog), Moose
(for a hamster), Scat, Soup (for a
turtle), Stew (for a rabbit), T-
bone, Yertle

None 27 13.0 The majority of fish owners
reported not naming their pet

Physical
Characteristics

45 22.0 Bear, Blackie, Bubbleface,
Chiquita, Diamond, Ginger, Jolie,
Kiwi (for a newt), Pee Wee,
Rabbit, Snowball, Spud, Yeller

Social or
Behavioural
Characteristics

19 9.3 Airwalk, Buddy, Cuddles,
Eternity, Goofball, Hugs, Kisses,
Spunky, Wacky, Undertaker (for a
snake)

Miscellaneous 11 5.4 Brax, Chichu, Cita, Csopi,
Eleven, Mandu, Marmaul, Neko

In this study, the use of pets as coping mediators in the emotional reappraisal of

certain situations might lead one to expect that the pets would be given either

human names or names reflecting emotional or behavioural traits. The name

may reflect the expectation that the pet will act in an emotionally supportive

manner or even as a surrogate human.

In fact, almost 45% of the subjects reported using a human name for their

pet, 22% described their pet by naming it with a physical characteristic, 9.3%

used a social or behavioural trait as the name of their pet, 5.4% used obvious

humour when naming their pet, 5.4% named their pet by a word that could not be

categorized usually because it reflected another language or an unusual concept,



5 5

and 13% reported not having a name for their pet. This last group was largely

composed of fish or bird owners. It is possible that the 9% of the pet owners who

did not answer this question may not have had a name for their pet as many of

them were also fish or bird owners. These names suggest that just over half the

subjects may have named their pet with regard to possible emotional coping

strategies.

Duration of Pet Ownership 

More than half of the subjects (66.8%) reported having their pets for three

years or less, with the largest proportion of the group (19%) having had their pets

for less than one year. The remaining 33.2% of the subjects with pets reported

having their pets anywhere from four to fifteen years.

The framework for the study implies that the coping mediator must be

present in order to be involved in the emotional reappraisal. This is the case for

the subjects in this study who currently owned pets. The study only accounts for

pets presently owned by the subjects. However, there may be instances in which

subjects had had a pet in the past and learned that walking the dog, for example,

allowed them to cope effectively with emotional stress. The subjects may no

longer have their pets; however, they may be still using the coping mechanism

which originated with pet ownership. In this example, however, the original

coping mediator of pet ownership has been replaced within the framework by

walking.

As the majority of subjects were relatively recent pet owners, these

demographic data are best viewed while concurrently examining the reasons for

acquiring the pets (most of which were acquired as the subjects entered

adolescence).



5 6

Reason for Acquiring Pet

The majority of the subjects (51.5%) reported acquiring their pet for no

specific reason. Other subjects cited reasons behind acquiring their pet such as

replacing a previous pet (16.2%), as a gift (14.8%), having found it (7.9%),

because they wanted it (6.9%), and to replace a family member who died (0.9%).

Two subjects reported getting a pet for fun and entertainment (0.9%). An

additional two subjects related other reasons such as "a fight between Mom and

Dad" and "we moved." These findings indicate no specific pattern as to the

reasons for acquiring the pet. It could be that this may have been part of a

parental decision and that the subjects were not generally privy to the

information. The fact that most of these pets were acquired as the subjects

entered adolescence (and many of them may have had siblings who were

already adolescents), and that many of the pets were generally given human

names, may imply they were acquired to act as a non-judgemental support for

the subjects going through a period characterized by change such as the loss of

their childhood, or of a family member, or previous pet. The coping conceptual

framework demonstrates how this support may occur through the process of

emotional reappraisal with the use of a mediating variable such as the pet.

Primary Ownership of Pet

As Figure 3 indicates, the majority (43.4%) of subjects who responded to

this question, reported that the pet was owned by the whole family. The second

largest group of subjects (35.6%) were the primary owners of the pets. Finally,

14.2% of the subjects reported their parents as being the primary pet owners in

the family, and 6.8% reported siblings as being the primary pet owners. Of the

226 subjects with household pets, 7 (3%) did not respond to this question. These

results were similar to those of Paul and Serpell (1992b) who noted primary pet

ownership among adolescents to be somewhat lower than family pet ownership.



57

If the subject is to use the pet as an emotional coping mediator, this would

best be accomplished if the subject has frequent contact with the pet. This is

rn

100

80
CN1

E(
60

0

40

20

0

                  

35.6%

78

6.8%
15

  

95
^

43.4%

14.2%
31

                                    

Family Parents^Self
^

Sibling

Ownership

Figure 3. Pet Ownership

most likely to occur if the pet is solely owned by the subject or if the subject is a

part of family ownership of the pet. The presence of, for example, gerbils in a

sibling's bedroom, would not be expected to provide the coping mediation

necessary to effect emotional change unless the subject was frequently involved

in interactions with these pets. As well as interaction, pet ownership involves

responsibility for providing care for the animal. In addition, there is often a sense

of prestige which may accompany ownership of a pet.

Pet Attachment

The subjects reported perceived degree of attachment to their pets on a

five point Likert-type scale from 1 to 5. On this scale, a rating of 1 was indicative

of no attachment and 5 was indicative of extreme attachment (see Appendix A).



58

Only 8 of the total 226 subjects with household pets did not respond to this

question. As indicated in Figure 4, of the subjects who did respond, 25 subjects

(11.5%) reported that they were not at all attached to their pets. From a brief

80

33.5%

► ► ►

7370

60

23.4%
50

E(
z

40
0

30

20

10

0

11.5%
25 10.5%

21.1%
46

51

23

►

1
^

2^3^4
^

5

Degree of Attachment

Figure 4. Perceived Attachment to Pet

review of the completed instruments, the majority of these subjects were fish

owners. Twenty-three subjects (10.5%) stated that they were only somewhat

attached to their pets. Forty-six subjects (21.1%) rated their attachment as being

at the midline point on the scale. The remaining half of the subjects reported that

they were either very (23.4%) or extremely (33.5%) attached to their pets. In

order for the pets to be used as coping mediators it may not be entirely

necessary for the subjects to be attached to them. If they are attached, pets may

be utilized as confidants with whom adolescents may voice concerns and explore

possible solutions. If the subjects are not attached to the pets, they may still be

used as emotional coping mediators. However, in this case, the pets may



5 9

become focal objects for the projection or displacement of the subjects' emotions

(both positive and negative) through methods such as confrontation, distancing,

self-control, planful problem solving, avoidance, and positive reappraisal (Pekar,

1992; Puskar & Lamb, 1991).

In summary, the subjects with pets in their homes displayed a broad range

of characteristics. Those with pets were most likely to have either one pet or

many different species of animals in their household. The types of pets were

generally one-third dogs, one-third cats, and one-third birds, fish, reptiles,

amphibians and small mammals. Just under half of the subjects had human

names for their pets. The remainder named their pets a variety of humourous

names, names depicting physical or social/behavioural characteristics, or

unknown names in their primary language. Well over half of the subjects had

had their pets for three years or less and most had acquired them for no

particular reason. Three-quarters of the subjects reported either themselves or

their whole family as the primary pet owner. Finally, approximately half of the

subjects felt they were very or extremely attached to their pets.

Findings Related to Research Questions

Question One : Prevalence of Depression 

The overall scores on the Center for Epidemiologic Studies Depression

Scale (CES-D) were used to measure the prevalence of depression in the study

group. The scoring with the CES-D is directly related to the level of depressive

symptoms. The scores ranged from 0 to 53 out of a potential 60 points. The

mean score was 17.0, the median was 16.0, and the standard deviation was

10.2. There was a difference in depression scores between adolescent females

(mean score 18.7) and males (mean score 15.1).



6 0

Of the 401 subjects in the study, 194 (48.4%) obtained scores of 15 or

below on the CES-D. These scores were interpreted as indicating no depressive

symptoms. Another 166 subjects (41.4%) scored between 16 and 30 and were

classified as being mildly depressed. A third grouping of 35 subjects (8.7%)

scored between 31 and 45 on the CES-D. These subjects were classified as

being moderately depressed. Finally, 6 subjects (1.5%) scored 46 or above on

the CES-D. These individuals were classified as severely depressed, (see Table

12). Thus, approximately half of the adolescents had some feelings of

depression; however, only about 10% of the overall population scored above 30

on the CES-D and could be rated as moderately or severely depressed.

Table 12

Categories of CES-D Scores 

Score Category of Symptoms Number (N=401) Percent (%)

0 - 15 No 194 48.4

16 - 30 Mild 166 41.4

31 - 45 Moderate 35 8.7

46 - 60 Severe 6 1.5

These findings are similar to those of previous studies which reported

mean values on the CES-D for adolescents of 16 (Manson et al.), 17.1 to 20.4

(McDermott et al., 1990), 18 (Pronovost et al., 1991), or 19 (Clarke et al., 1990).

Each of the studies utilized a different "cut-off" point to indicate the presence or

absence of depressive symptoms. The study in which the same cut-off point of

>15 was used found prevalence rates similar to those in this study (McDermott et

al., 1990). Studies using other cut-off points demonstrated prevalence rates for

depression among adolescents similar to those found in the moderately (8.7%)



61

and severely (1.5%) depressed categories of this study (Clarke et al., 1990;

Pronovost et al., 1991). The results of this study indicate that 10.2% of the

subjects could be considered to be depressed, whereas 41.4% of the subjects

clearly have some mild symptoms of depression and 48.4% of the subjects have

no depressive symptoms. In relation to the study framework, clearly 10% of the

subjects are not coping effectively to reappraise the depressive emotions which

in adolescence may be a result of numerous environmental and some

biochemical sources. Despite the multicultural nature of the sample, these

findings are similar to those in studies of more homogeneous ethnic populations.

Therefore, although ethnicity was not a variable considered in this study, based

on comparisons with other studies, it does not appear to be a confounding

variable which may have affected the results. Both genders were represented in

all of the CES-D groupings. Males represented a higher proportion of those

scoring in the not depressed or mildly depressed categories, whereas females

represented a higher proportion of those scoring in the moderately or severely

depressed categories.

Question Two: Relationship Between Gender. Pet Presence and Depression 

The results of the two-way fixed effects ANOVA examine the relationship

between gender and depression, pets and depression and the combined

relationships of gender with pets and depression (see Table 13). With regard to

the first correlational analysis, the results demonstrated a significant relationship

between gender and level of depression among the subjects (p = 0.000). Further

Tukey-Kramer post hoc analysis reveals that the female subjects were

significantly more depressed than their male counterparts (p = 0.001). As the

CES-D instrument has established reliability and validity across both genders

(Radloff, 1977), it can be assumed that this difference in scores is truly



6 2

representative of the population sampled. This gender difference has been noted

by other researchers (Baron & Perron, 1986; McDermott et al., 1990; Reinherz,

1991, Schonert-Reichl & Offer, 1992; Simeon, 1989; Weissman et al., 1987).

Table 13

ANOVA Summary Table for Gender. Pets, and CES-D Scores (N=401) 

Source^Sum-of-Squares Degrees Freedom Mean-Square F-Ratio P

Gender^1.055 1 1.055 13.240 0.000

Pets 0.489 1 0.489 6.142 0.014

Pets*Gender 0.149 1 0.149 1.874 0.172

Error 31.636 367 0.080

Schonert-Reichl & Offer (1992) discuss several possible reasons why

female adolescents have higher prevalence rates of depressive symptoms than

do males. One reason suggested is that male adolescents tend to exhibit

depression in the form of externalized behaviours such as delinquency and

aggression whereas female adolescents express their disturbance in an inward

fashion. Hence, the CES-D tool may be inaccurate for use with male

adolescents as it emphasizes low mood and low energy symptoms as indicators

of depression rather than high energy and destructive behaviour. In addition,

some studies indicate that females report more symptoms than do males, and

also that expressing concerns is more acceptable for females than for males

(Schonert-Reichl & Offer, 1992).

Other influences which might explain the differences between prevalence

and severity of female and male depression symptoms are those of gender

identification and self-esteem. Schonert-Reichl and Offer (1992) report that

during puberty, females and males begin to strongly identify with the extremes of

masculine and feminine stereotypes. Research has demonstrated that



6 3

androgyny and masculinity are linked with higher levels of self-esteem and more

effective coping mechanisms (Schonert-Reichl & Offer, 1992). Therefore,

adolescent females suddenly confronted with extreme feminine stereotypes are

more likely to have lower levels of self-esteem than their male peers. In fact,

among the adolescents in a recent study, Vancouver and Victoria females were

two and four times, respectively, more likely to have low self-esteem than males,

and males were almost twice as likely to have higher self-esteem than females

(McCreary, 1993a, 1993b).

Physical changes during puberty have also been reported to be more

distressing to females than to males (Schonert-Reichl & Offer, 1992). Of the

Vancouver and Victoria adolescents surveyed, 76% and 83%, respectively,

measured within an average / healthy body mass ratio (McCreary, 1993a,

1993b). However, females were two to three times more likely to be dissatisfied

with their weight than males (McCreary, 1993a, 1993b). Given the supporting

data from other adolescent surveys in the Vancouver and Victoria population

(McCreary 1993a, 1993b), it is likely that the differences in depression

prevalence among the females and males in this study are a result of actual

differences in the population rather than instrument selection.

With regard to the second relationship of this ANOVA correlational

comparison, the analysis also revealed a significant relationship between the

presence of pets in the home and lower levels of depression among the subjects

(p = 0.014). Such a result is consistent with the reports in the anecdotal reviews

indicating improved emotional well-being among those children and adolescents

with household pets (Albert & Bulcroft, 1988; Bibby & Posterski, 1992; Covert et

al., 1985; Davis & Juhasz, 1985; Paul & Serpell, 1992a; Poresky, 1990; Robin &

ten Bensel, 1990). The relationship between the presence of household pets and

lower levels of depression in adolescents found in this study is precisely the



6 4

opposite of that found by Stallones et al. (1990) in a population of adults

responding to the same instrument. It is likely that the reason for this

discrepancy is the reactive nature of depression in adolescents as compared to

the endogenous nature of adult depression (Simeon, 1989). As a result, pets in

adolescent households may be viewed in the context of an emotional coping

mediator as described in the conceptual framework.

The third and final portion of this ANOVA analysis indicates that there is

no significant difference in the interrelatedness among gender, pets and level of

depression for the sampled subjects (p = 0.172). Males with pets scored the

lowest on the CES-D instrument (indicating an absence of depressive symptoms)

followed by males without pets, females with pets, and then finally females

without pets. Despite the non-significance of these findings, it quite plausible that

males and females utilize the presence of pets as emotional mediators in

different ways.

Question Three: Relationship Between Pet Ownership and Depression 

The third research question was answered using a sub-set of the overall

CES-D scores for those 219 individuals who had pets. The ownership variable

has four distinct categories of family, parents, sibling, and self. There is a

significant relationship (p = 0.023) between pet ownership and lower levels of

depression among the subjects. Post hoc Tukey-Kramer analyses of the findings

reveal the basis for this conclusion to be in the comparison between those

subjects who owned their own pet and those subjects who were part of a family

ownership of the household pet. Individuals who had sole ownership of the

household pet were significantly more depressed than those who were part of a

shared family ownership (p = 0.028). There was no significant difference in the



6 5

depression scores for those whose household pets belonged to parents or

siblings as compared to either sole ownership or family ownership.

The interpretation of these results involves addressing the value systems

of the adolescent population. Bibby and Posterski (1992) have established that

"values that incite the spirit of individualism dominate what is important to young

people" (p. 289). The valued goals of "friendship" and "being loved" have

dropped behind "freedom" in comparable Canadian teen polls of 1984 and 1992.

In addition, the percentage of young people who value "working hard" has

decreased from 69% in 1984 to 49% in 1992 (Bibby & Posterski, 1992). Given

this value system, the findings become clearer. Of all those subjects with pets,

those who had primary ownership of the pet were the most depressed and those

with familial ownership were the least depressed. Values of adolescents have

changed since Levinson (1970) wrote "caring for a pet provides an opportunity for

the child to toughen his ego...acceptance of responsibility for the care of a pet will

eventually lead to acceptance of responsibility for establishing meaningful,

satisfying human relationships" (p. 1763). It is possible that the freedom from

total responsibility for the care of the pet, yet the recognition of shared ownership

of the pet within the family was the most desirable situation for the mental health

of the subjects.

Indeed, Stallones et al. (1990) caution that pet ownership may create

another stressor for a depressed person rather than a facilitator to decrease

emotional distress. Such was the case with the subject who responded to the

questions of type of pet, pet name, primary ownership, reason for acquisition,

and attachment with the following, "mouses...male: Hugs Eternity and female:

Kisses Obsession....me....I begged for it and it was a big mistake!̂ not

attached" (subject #217). The names given to these mice imply that there may

have been some behavioural expectations of affection from the mice; however, at



6 6

the time of the study, these expectations were clearly not being met. This could

have been a result of the responsibility involved with caring for such pets.

Considering the fact that the majority of subjects' pets were given

recognizable human names, part of their role could be interpreted to be a "family

member" which is common for pets in urban settings (Albert & Bulcroft, 1988;

Fogel, 1983). As a "family member" with joint ownership by all members of the

family, the pet in this circumstance is in a pivotal position to act as a vector for

intrafamilial communication (Albert & Bulcroft, 1988; Schaufl & Bergler, 1992),

and as a buffer or recipient of emotions (Cain, 1991). Pets that are jointly owned

can represent a shared family interest (Paul & Serpell, 1992b; Schaufl & Bergler,

1992), thereby allowing adolescents to have the security of the family unit without

being tied to the family as they strive for independence. As indicated by Robin

and ten Bensel (1990), the pet is the ideal transitional object for the adolescent.

These findings indicate the inappropriateness of implying that obtaining

pets for depressed adolescents may help to "cheer them up," as the adolescents

in this study who owned their own pet were the most depressed among those

with household pets. Rather, the usefulness of obtaining a pet for the family

when one of its adolescents is depressed may be worthy of consideration. It

should be noted, however, that several authors caution against suggesting pets

to severely disturbed families, as the pet may be harmed or threatened as an

abusive strategy directed at the child (Levinson, 1969; Robin, 1984; Robin, ten

Bensel, Quigley, & Anderson, 1981). Although having pets in the home is more

highly correlated with an absence of depression than not having pets, the least

favoured situation regarding adolescent depression appears to be for the

adolescent to own the pet.



6 7

Question Four: Relationship Between Pet Attachment and Depression 

The final research question was also answered using a sub-set of the

overall CES-D scores for the 218 individuals who had pets. This variable has five

distinct categories of not attached, somewhat attached, attached, very attached,

and extremely attached.

The analysis indicates that depression levels are lower with increased

perceived attachment to the household pet; however, the relationship is not

statistically significant. This finding is difficult to interpret. First, one must

assume that the report of the subjects' perceived level of attachment (on a Liken-

type scale from 1 to 5) adequately represents their actual perception of

attachment. It is important to note that this report does not attempt to represent

actual attachment as it is recognized in the literature as being a highly complex

concept (Johnson, Garrity & Stallones, 1992; Stallones et al., 1990; Zasloff,

1992).

The absence of any significant difference between those who reported

being extremely attached to their pets and those who reported not being attached

to their pets has provided an alternate view of the concept of attachment to that

reported by other researchers (Friedmann, 1990; Melson & Taylor, 1990;

Michaels, 1989). The results receive support from the work of Albert and Bulcroft

(1988) who report, "Pet ownership is particularly high among families with

grammar-school-age and teenage children. Yet, attachment to pets is relatively

low during this period." (p. 550). Kidd and Kidd (1990b) report that high school

students indicate greater love for their pets than do elementary school students.

However, the constructs of love and attachment can be only loosely compared.

Similar to the results of this study, Zasloff (1992) determined no difference in

degree of loneliness in owners according to attachment to pets.



6 8

These findings could be indicative of the mediating role which pets may

provide in families with adolescents. It may be possible that adolescents receive

emotional support from sources outside the family system (Bibby & Posterski,

1992) and, therefore, the household pet is used to meet intrafamilial

communication needs rather than individual emotional needs. In the context of

the conceptual framework, it is possible that the pet may serve as a coping

mediator for emotional reappraisal through processes such as emotional

projection, and displacement. The adolescent could utilize the pet (which, for

example, s/he may hate to walk or groom) as an outlet for frustration and anger

s/he may have for authority figures and/or peers. By expressing negative

emotions through the pet, the adolescent avoids internalizing these feelings as

well as any potential social consequences should s/he express these feelings to

the source of the conflict. These mechanisms of pet utilization would coincide

with the adolescent coping methods of confrontation, avoidance, distancing, and

self-control discussed by Puskar and Lamb (1991). Subject #217 who was cited

earlier as not being attached to the mice she begged to acquire, obtained a CES-

D score of 4 (no depression). It is important to note that correlation does not

imply causation and these results could simply be due to the fact that non-

depressed individuals tend to acquire pets and whether they are attached to

those pets is irrelevant.

Summary

The sample in this study was equally divided between males and females,

multicultural in nature, generally born in Canada, and was living at home with two

parents and some siblings. The subjects were either average or high-average in

their scholastic abilities. Pet owners and non-pet owners were equally

represented in the sample. Female subjects were more depressed than males,

and non-pet owners were more depressed than pet owners. Subjects who



6 9

owned their own pet were more depressed than those in homes where the pet

was owned by the entire family. In addition, there was no relationship between

perceived attachment to the pet and level of depression among the subjects.

This suggests that the manner in which the subjects used their pets as emotional

coping mediators occurred in the context of complex family dynamics and may

not necessarily have reflected a supportive bond or attachment between

adolescent and pet.



Chapter Five

Summary, Conclusions, and Implications for Nursing

Summary

The purpose of this study was to describe the prevalence of depression

among a group of adolescents and to examine the relationships between

depression and presence of pets in the home, primary ownership of pets and

perceived degree of attachment to the pets by the subjects. Subjects were 401

grade nine males and females attending three Vancouver and three Victoria

secondary schools over the period from October 1992 through January 1993.

The instruments utilized to gather the data where the Center for Epidemiologic

Studies Depression Scale (CES-D) (Radloff, 1977) and the Adolescent and Pet

Characteristics Questionnaire, developed by the researcher. The subjects

completed the instruments anonymously in classroom settings. The data were

transformed using logarithmic 10 (x+1) data transformation techniques to ensure

normality and linearity. The transformed data were analyzed using the SYSTAT

5.01 computer programming for two-way and one-way fixed effects analysis of

variance (ANOVA) and subsequent Tukey-Kramer post hoc analysis of pairwise

comparisons as necessary.

The majority of the subjects surveyed were fourteen years old, had

average or high-average school performance, and generally lived at home with

two parents and one to three siblings. The sample was definitely multicultural in

its representation. Most of the subjects were born in Canada; however,

approximately two-thirds of the subjects reported having parents who were not

born in Canada. Indeed, the sampled group included families which originated in

forty-six different countries. Only half of the subjects reported English as the

primary language used at home. Twenty-seven different languages were

70



71

reported to be used by the survey subjects. Just over half of the subjects had

household pets at the time of the survey.

Approximately two-thirds of those having household pets reported owning

dogs or cats, with the remaining third of the subjects owning a variety of birds,

fish, reptiles, amphibians and small mammals. Approximately half of the subjects

had human names for their pets and had had their pets for only three years or

less. Most of the subjects acquired their pets for no particular reason. Three-

quarters of the subjects reported either themselves or their whole family as the

primary pet owners. Finally, approximately half of the subjects felt they were very

or extremely attached to their pets.

Of the Vancouver and Victoria grade nine students sampled, 48.4%

demonstrated no depressive symptoms, 41.4% demonstrated what were

classified as mild symptoms of depression, 8.7% demonstrated moderate

symptoms of depression, and 1.5% of those sampled indicated severe

depressive symptoms. Findings indicated that female adolescents were

significantly more depressed than their male counterparts (p = 0.001) with mean

scores of 18.7 and 15.1, respectively.

The findings also revealed that those subjects with pets in the home were

significantly less depressed than their counterparts without household pets (p =

0.014). There was no significant relationship between gender and pet ownership

combined with level of depression (p = 0.172). An analysis of primary pet

ownership indicated that subjects who owned their own pets were significantly

more depressed on a whole than those in homes where the pet was owned by

the entire family (p = 0.028). Perceived degree of attachment to the household

pet showed no relationship with depression (p = 0.725).



7 2

Conclusions

The results of this study indicate the following five conclusions. The grade

nine adolescents in this study demonstrated depression prevalence rates

comparable to those of other Canadian adolescents. Symptoms of depression

were much higher among female subjects than among males. The presence of

pets in the household was directly related to decreased prevalence of

depression. The strongest relationship between household pets and absence of

adolescent depression appears to occur when the pet is owned and cared for by

the entire family. The conceptual coping framework as proposed by Folkman

and Lazarus (1988) was useful in demonstrating the process by which the

presence of pets may influence the outcome measurement of depression in this

sample of adolescents.

Implications for Nursing

The Canadian Nurses Association (1991) has officially recognized that

there is a lack of information and resources for mental health promotion and

illness prevention particularly regarding conditions encountered in adolescence.

The Association's (1991) recommendations for reform include amongst others to:

a) encourage research on the value of natural support networks and self-help

programs in caring for persons with emotional or mental health problems;

b) develop proposals for the implementation of prevention programs;

c) encourage research to identify risk factors and groups at risk by virtue of

either psychosocial or biological events;

d) support policies and programs that enable infants, children, and adolescents

to accomplish normal developmental tasks;



7 3

e) support programs that strengthen the ability of individuals, families, and

communities to cope or successfully negotiate situational stress

throughout the human life cycle (p.28-29).

These recommendations are consistent with the direction provided by Health and

Welfare Canada (1988) which emphasizes a commitment to generating new

interdisciplinary knowledge in the search for mental illness prevention and mental

health promotion practices in enhancing people's capacity to cope with stress.

As demonstrated in this study, the concept of human and pet interaction

has a positive relationship to the emotional health of urban adolescents. The

incorporation of pets as an environmental influence in the coping practices and

health behaviours of individuals and families has implications for both nursing

practice and research.

Nursing Practice 

Florence Nightingale (1860 / 1967) noted the positive effects of a pet owl

on the health of those for whom she was providing nursing care. As indicated in

the literature review for this study, nurses have utilized a variety of different

practice routes to include pets in the provision of health care. Most nursing

models contain the components of person, health, environment, and nurse in

their configuration (Reihl & Roy, 1980). In most totality systems models for

nursing, the pet assumes the position of an external system, stimulus, therapy,

resource, or force within the model (McMahon, 1991). For those utilizing a

person-environment simultaneity paradigm such as that of Rogers (Reihl & Roy,

1980), the pet would be viewed as "a part of the sphere of health generating

energies, forces, and stressors...as a vital, often symbiotic or energizing

component of the individual's state of being" (McMahon, 1991). Regardless of

where the pet is viewed in the system, there exist no models for nursing that do



7 4

not have a place for the inclusion of pets and their potential influence in

promoting the health of individuals.

In a country where more than 50% of the homes with children also have

household pets, the inclusion of pet relationships in the assessment of the

emotional health of adolescents should occur at all phases of the nursing

process. In order to complete a comprehensive view of the biological,

psychological, social and spiritual aspects of any individual or family system, an

acknowledgement of the potential influence of household pets should be included

when assessing coping behaviours, supports, and forces. This study has

demonstrated that almost 10% of the adolescents surveyed had symptoms of

moderate or severe depression, and that the presence of pets in the household is

related to decreased prevalence of depression. This finding alone should

encourage nurses to incorporate an assessment of pet presence, ownership and

characteristics when caring for the adolescent client. By asking about pets in the

home, the nurse may open lines of communication into traditionally unspoken

areas of support which the patient may view as important. This will facilitate the

establishment of rapport as well as identify potential coping mediators for the

individual in regard to emotional reappraisal.

The planning of any nursing care must be based on individualized

assessment and directed towards client-specific interventions. Nurses can

devise strategies to include clients' pets in the establishment of coping mediators

for selected adolescents at risk for mental health concerns. This practice would

be in keeping with theory-directed nursing practice, as well as representing

movement towards the new vision for innovative, consumer-focussed mental

health promotion and illness prevention care. The practice of including pets in

the mental health care of adolescents would likely also be welcomed by clients

and their families, the exceptions being those families with adolescents who were



7 5

already severely depressed (Stallones et al., 1990) or those families where there

may be situations of abuse (Robin, 1984; Robin et al., 1981). The findings of this

study also direct the nurse to incorporate the entire family when working with the

adolescent and pet, as the least depressed adolescents were from those

households where pet ownership was an acknowledged family venture. It is also

important to remember, however, that even those who were not particularly

attached to their pets, derived benefit from the animals in the home. Therefore,

planned care may include the involvement of animals to which the client does not

even seem to be particularly attached.

Once the plans are made for integration of pets into the mental health care

of the adolescent, implementation should proceed with the objectivity and

continual evaluation and reassessment required for any nursing intervention.

The descriptive parameters of nursing care applications of human - pet - health

interactions must be documented to add to the existing knowledge base about

this relationship. It is important that all interventions be client-focused and family-

focused and not the result of a program designed to meet nursing's goals.

Evaluation of the interventions should focus on the health or illness

parameters of the adolescent as well as identifying the role which the pet played

in any change in health status. The use of familiar conceptual frameworks such

as coping, social support, family systems, attachment, loss, pain, stress

management, pain management, and adaptation may assist by providing

guidance as to the process by which the pet may influence the adolescent's

health system. The use of a model for nursing and conceptual framework for the

role of the pet within the adolescent's system will provide both direction for

nursing care and facilitation of growth in pet-related coping behaviours for the

client. The systematic inclusion of pet assessment in the parameters of



76

individualized health care will add to the knowledge of pet and human health

interactions upon which nursing care can be based.

Nursing Research 

With respect to nursing research, this study is in keeping with the

recommendations of the Canadian Nurses Association (1991) regarding further

study into the value of natural support systems to promote mental health, the

identification of risk factors for mental illness, and the exploration into the

establishment of coping resources for individuals and families. The study

provides empirical validation of much of the previous anecdotal nursing literature.

The findings provide a base for further exploration into the relationship between

pets and the emotional health of urban adolescents. The first of further studies

could be a replication study using an alternate instrument to measure depression

in the adolescent population. Such an exercise would validate the findings of this

study and the use of this tool with such a culturally diverse adolescent population.

Qualitative studies could be undertaken to determine the meaning of pets

for adolescents, the specific role of pets as coping mediators, the role of pets in

families with adolescents, and the role of pets in first generation Canadian

families with adolescent members.

Other studies could involve pre-test, post-test control group designs of

families with adolescent members who had acquired a family pet for the first time.

This would help to determine causal relationships between pets and the

emotional health of adolescents and/or families.

Through the process of studying the prevalence of depression in urban

adolescents and pets as a potential coping mediator, this study has

demonstrated that the emotional relationship between humans and animals

which dates back 12,000 years is still active in regard to the mental health of



77

urban adolescents. The credence that Florence Nightingale gave to the benefit

of pets in the care of the sick over 100 years ago has relevance for the future

direction of mental health nursing. The relationship between people, pets, and

health can have a more central role in health care in the future.



7 8

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Prusoff, B.A., & Sholomskas, D. (1987). Children of depressed parents.
Increased psychopathology and early onset of major depression. Archives
of General Psychiatry, 44(10), 847-853.

Wille, R. (1984). Therapeutic use of companion pets for neurologically impaired
patients. Journal of Neurosurgical Nursing,1Q(6),  323-325.

Wilkinson, L. (1990). SYSTAT: The system for statistics. Evanston, IL: SYSTAT,
Inc..

Wolfe, J. (1977). The use of pets as transitional objects in adolescent
interpersonal functioning. Dissertation Abstracts International, 38, 2391 B.

Wyatt, V. (1988). Pets. An amazing investigation. Toronto: Greey de Pencier
Books.

Zar, J.H. (1984). Biostatistical analysis (2nd ed.). Toronto: Prentice-Hall Canada,
Inc.

Zasloff, R. (1992, July). Friends, confidants. and companion animals: A study of
social support characteristics and psychological well-being among pet
owners and non-owners. Paper presented at The 6th International
Conference On Human Animal Interactions: Animals and Us, Montreal,
Canada.



Appendix A

Adolescent and Pet Characteristics Questionnaire

89



90

Household Pets and Depression Among Urban Adolescents
Adolescent and Pet Characteristics Questionnaire

For the following questions please circle the best option or write your answer in the space
provided. DO NOT PUT YOUR NAME ON THIS FORM.

Personal Characteristics
Sex:^M^F
^

Age: ^

Average marks in school this year: A^B^C^D^F

Number of parents living with you: 1^2

Number of brothers^ & sisters ^ living with you.

Your position in the order of kids in your family (eg. oldest, youngest, second out of four, ninth
out of ten):

Country you were born in: ^

Country your mother was born in:^

Country your father was born in: ^

Number of years you have lived in Canada:^

Number of years you have lived in your current neighbourhood:^

Primary language spoken at home:^

Do you have any pets in your home? ^Yes ^ No. (if no, then stop here).

Pet Characteristics
Types of pets you currently have (and how many of each)

dog(s)^ cat(s)^bird(s)
fish^ reptile(s)^insect(s)
small mammal(s),(eg. hamster, gerbil, rabbit, rat) type:^
other(s), type:^

If you currently have more than one pet, for the following questions, answer in regard to your
favorite pet:

Type of pet: ^Name of pet:^

Main owner of the pet: ^ yourself ^ parent(s) ^ brother or sister^whole family

For what occasion did you or your family get this pet? (eg. birthday, other pet died, brother left
home, nothing special, other):

How long you have had this pet:^

Rate how close or emotionally attached you are to your favorite pet:

1^2
^

3^4^5
not attached^somewhat attached

^
attached^very attached extremely attached



Appendix B

Center for Epidemiologic Studies Depression Scale

91



92

Household Pets and Depression Among Urban Adolescents
Center for Epidemiological Studies Depression Scale

For the following statements, circle the number for each statement which best describes how
often you felt this way DURING THE PAST WEEK.

DURING THE PAST WEEK:

1. I was bothered by things that usually

Rarely or
none of
the time

Some or a
little of
the time

Occasionally^Most or
or a moderate all the
amt. of time^time

don't bother me. 0 1 2 3

2. I did not feel like eating;
my appetite was poor. 0 1 2 3

3.^I felt that I could not shake off the blues
even with help from my family or friends. 0 1 2 3

4.^I felt that I was just as good as
other people. 3 2 1 0

5.^I had trouble keeping my mind on what
I was doing. 0 1 2 3

6.^I felt depressed. 0 1 2 3

7.^I felt that everything I did was an effort. 0 1 2 3

8.^I felt hopeful about the future. 3 2 1 0

9.^I thought life had been a failure. 0 1 2 3

10.^I felt fearful. 0 1 2 3

11. My sleep was restless. 0 1 2 3

12. I was happy. 3 2 1 0

13. I talked less than usual. 0 1 2 3

14.^I felt lonely. 0 1 2 3

15. People were unfriendly. 0 1 2 3

16.^I enjoyed life. 3 2 1 0

17.^I had crying spells. 0 1 2 3

18.^I felt sad. 0 1 2 3

19. I felt that people disliked me. 0 1 2 3

20. I could not get "going". 0 1 2 3



Appendix C

Letter of School Consent and Consent Form

93



THE UNIVERSITY OF BRITISH COLUMBIA 94

School of Nursing
T. 206-2211 Wesbrook Mall
Vancouver, B.C. Canada V6T 2B5
Fax:(604) 822-7466

Household Pets and Depression Among Urban Adolescents

Dear

Your consent is requested to enable a sample of grade nine students from your school to
participate in a brief questionnaire survey to take place within school hours. This survey has
been approved by the Vancouver and Victoria School Boards. It addresses the important issue
of depression among our adolescent population. Depression is known to be associated with
increased risks of dropping out of school, substance abuse, delinquency, and suicide.

This survey will anonymously survey grade nine students in regard to certain
demographic characteristics (the presence of household pets being a major focus) in addition to
measuring their current level of depression (if any). The survey takes approximately 10 minutes
and would be ideally administered by myself in a pre-arranged portion of class time.
(Homeroom, physical education, or health classes are preferable to increase the likelihood of
student attendance.)

As the questionnaire is anonymous and will be collected by myself, student confidentiality
will be ensured. The analysis of this data may potentially reveal situations of a severely
depressed student(s). Should this be the case in your school, I will contact you with this
information as well as resource referrals for mental health education and consultation for your
students as a group.

The completion of this project will contribute greatly to the understanding of the incidence
and characteristics of adolescent depression among grade nine students in selected Vancouver
and Victoria high schools. I thank you in advance for your consideration and support in this
regard. Should you wish to give your consent, please sign the attached form and retain this page
for your records. I will contact you by telephone within the next couple of weeks to arrange a
time to meet with you and answer any questions you may have and pick up your consent form.
Please do not hesitate to call me at the University of British Columbia, School of Nursing (822-
7486). Thank you once again, I look forward to meeting you.

Respectfully,

Molly Nevin-Haas, R.N., B.S.N.
Graduate Student

Dr. Marilyn Willman, RN., Ph.D. & Gloria Joachim, R.N., M.S.N.
Faculty Advisors, School of Nursing
University of British Columbia (822-7417).^ page 1 of 2



THE UNIVERSITY OF BRITISH COLUMBIA 95

School of Nursing
T. 206-2211 Wesbrook Mall
Vancouver, B.C. Canada V6T 2B5
Fax: (604) 822-7466

Household Pets and Depression Among Urban Adolescents
A questionnaire survey by Molly Nevin-Haas

Signed School Consent

I have read the attached information sheet and hereby give / do not give ( please circle )

my consent to have the above study take place at

^ School. I understand that

individual student and parental consent will be obtained by the researcher prior to surveying the

students selected. I also understand that I may withdraw permission for this school to participate

in the study at any time before or during the course of the sampling without experiencing any

negative ramifications from the researcher.

Signed,

(print name)

(position)

(date)

page 2 of 2



Appendix D

Letter of Parental Informed Consent and Consent Form

96



THE UNIVERSITY OF BRITISH COLUMBIA g7

School of Nursing
T. 206-2211 Wesbrook Mall
Vancouver, B.C. Canada V6T 2B5
Fax: (604) 822-7466

Household Pets and Depression Among Urban Adolescents
Letter of Informed Consent

Dear Parent:

Your consent is requested in enabling your daughter or son to participate in a brief
questionnaire survey to take place at their high school.

This survey has been approved by the Vancouver and Victoria School Boards and
addresses the important topic of teenage depression. It will determine the level of this
occurrence among our young people as well as identify its relationship with a selection of
individual characteristics. The presence of pets in the home will be the main focus of this survey.
However, even if you have no pets in your household your child's opinion is important to this
study.

Please be aware that the questionnaire is completely anonymous. Your child's name
will not appear on the questionnaire. The entire survey will take no longer than 10 minutes
and will be completed during an allotted portion of school time. Should you choose not to allow
your child to participate in the questionnaire survey, there will be no impact on your child's
education or treatment in class. Should you give your permission for your son or daughter to
participate in the survey, your child will also be given an opportunity on the day of the survey to
consent to participate. Either decision you or your child makes will not affect his or her education
or treatment in class.

Please sign the attached consent and have your son / daughter return it to school.
Alternately send a note indicating your consent with your child to school. Retain this sheet for
your information. If you have any questions regarding this study, please do not hesitate to call
me at The School of Nursing, University of British Columbia, (822-7486).

Thank you for returning this signed form so promptly!

Sincerely,

Molly Nevin-Haas, R.N., B.S.N.
Graduate Student

Dr. M. Willman, R.N., Ph.D. & G. Joachim, R.N., M.S.N.
Faculty Advisors
U.B.C., School of Nursing (822-7417)

^
page 1 of 2



THE UNIVERSITY OF BRITISH COLUMBIA 98

School of Nursing
T. 206-2211 Wesbrook Mall
Vancouver, B.C. Canada V6T 2B5
Fax:(604) 822-7466

Household Pets and Depression Among Urban Adolescents
A questionnaire survey by Molly Nevin-Haas

Signed Parental Consent

I have read the attached information sheet describing this study. I give / do not

give (please circle your choice) permission for my child, ^  to

participate in the study, Household Pets and Depression Among Urban Adolescents. I

understand that all results of the study are entirely anonymous. I also understand that I may

withdraw consent for my child to participate in this study at any time before or during the course

of the survey without any negative consequences towards myself or my child.

Signed,

(Parent or Legal Guardian).

(date)

page 2 of 2



Appendix E

Information and Instructions for Questionnaire

99



THE UNIVERSITY OF BRITISH COLUMBIA no

School of Nursing
T. 206-2211 Wesbrook Mall
Vancouver, B.C. Canada V6T 2B5
Fax: (604) 822-7466

Household Pets and Depression Among Urban Adolescents

Information and Instructions for Questionnaire

This questionnaire is part of a survey to study the relationship between personal
characteristics (and for those with a pet, also pet characteristics) and teenage depression. By
filling out this questionnaire it is assumed that you are agreeing to have your answers used in our
study. If you do not wish to participate, do not fill out the questionnaire. Either choice you make
will not effect your school standing in any way.

DO NOT PUT YOUR NAME ON ANY OF THESE PAPERS. Please answer all the
questions as honestly as possible. There are no right or wrong answers. The questionnaire
consists of two pages. Please be sure to complete both of them. The questionnaire will take
approximately 10 minutes. When you are finished please fold your papers in half to conceal your
responses, and bring it to the envelope held by the researcher.

Thank you very much for agreeing to participate! Your information will greatly help add to
what is known about teenage depression.

Molly Nevin-Haas, R.N., B.S.N.
Graduate Student (822-7486)

Dr. Marilyn Willman, R.N., Ph.D. & Gloria Joachim, R.N., M.S.N.
Faculty Advisors
U.B.C. School of Nursing, (822-7417)



Appendix F

Density Distribution of CES-D Scores

101



P4 0.25 -

r=4 0.20 -

ra.4 0.15 -
0

0.10 -
r=4
° 0.05 -a
0

  

- 100

-80

- 60

102

      

- 40

       

- 20

             

35^70^105

CESD Scores
Density Distribution of Overall Raw CES -D Scores

0.20 -

       

- 70
- 60
- 50
- 40
- 30
- 20
- 10

              

r:4 0.15 -
aq

4

• 

0.10-
(

O 0.05 -A.(
0
Pq

     

0.0^0.5^1.0^1.5^2.0^2.5

CESD Scores Using Log 10 Transformation

Density Distribution of Overall CES-D Scores Using
Logarithmic 10 (x+1) Data Transformation


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