Category: Transdiagnostic

Symposium

Developmental Cascades in Anxiety and Depression Co-Occurrence During Childhood and Adolescence

Sunday, November 19
10:15 AM - 11:45 AM
Location: Indigo Ballroom A, Level 2, Indigo Level

Keywords: Longitudinal | Comorbidity
Presentation Type: Symposium

It is well-established that depression is highly comorbid with anxiety in youth, and it is commonly believed that anxiety precedes depression. However, evidence surrounding the temporal precedence of anxiety over depression is mixed. Additionally, many studies of the co-occurrence of anxiety and depression lump distinct forms of anxiety, obscuring information regarding the trajectories of specific syndromes of anxiety. This study sought to advance knowledge on the development of anxiety and depression over time by moving beyond the question of temporal precedence to investigate a developmentally dynamic model of anxiety-depression co-occurrence. A community sample of 610 youth (M=11.8; SD=2.4) completed self-report measures of depression (CDI) and anxiety (MASC; social, physical, and separation anxiety) every 3 months over a 3-year longitudinal study. Prospective associations between distinct syndromes of anxiety with depression symptoms were analyzed using an autoregressive cross-lagged path model (ARCL) over four time points. This allowed for the test of a developmental cascade model, in which escalations in one domain spill over to other domains, resulting in elevated symptom levels across domains over time. SEM, via MPlus, was used to examined the model. Model fit was good (SRMR=.07, CFI=.93, c2=.4765, df=55). Physical symptoms (PH) and depression symptoms (DEP) predicted each other in cascades over a three-year prospective period, above and beyond the stability of either domain (PH T1 to DEP T2 b=.09, p=.06; DEP T2 to PH T3 b=.08, p=.05; PH T3 to DEP T4 b=.13, p=.003). Social anxiety symptoms and depression symptoms similarly formed transactional cascades (SA T1 to DEP T2 b=.093, p=.036; DEP T2 to SA T3 b=.080, p=.055). This is the first study we are aware of investigating the temporal dynamics relating the unique contributions of multiple and specific anxiety syndromes with depression over time. Results suggest that, rather than framing the development of co-occurring anxiety and depression as a question of “which came first”, it is more informative to conceptualize the development of these syndromes as occurring in a series of cascades over time.

Erin Long

Graduate Student
University of Illinois - Urbana-Champaign

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