Interpersonal functioning and depressive symptoms in childhood: addressing the issues of specificity and comorbidity

Gender differences in the prevalence, correlated factors and comorbidity of depression in adolescents: a cross-sectional study in Shanghai, China

Background

Prior studies have reported gender differences in the prevalence, comorbidity rates and related factors of depression during adolescence. But the gender differences in depression vary across studies. Besides, the evidence from Chinese adolescent samples is limited. This study aimed to explore gender differences in the depression-related factors, the potential interactions of the associated factors and clinical features of comorbid depression and anxiety among Chinese adolescents.

Methods

A cross-sectional study involving 3,510 participants aged 11 to 16 years from schools (private and public) in Shanghai was conducted with an anonymous paper-and-pencil questionnaire. Children's Depression Inventory (CDI), Child Anxiety Related Emotional Disorders (SCARED), Strengths and Difficulties Questionnaire (SDQ) were used to evaluate depression, anxiety and behavioral and emotional difficulties, respectively. Logistic regression model was used to explore the possible correlated factors of adolescent depression and analyze the interactions of the risk factors.

Results

Our results showed that there was no gender difference in the prevalence rates of depression (χ 2 = 0.047, p = 0.83), but the prevalence of depression in females began to exceed that of males at the ages of 15 and 16. The factors associated with depression varied by gender. Private school was a risk factor for depression only in boys (adjusted OR = 1.842 [95% CI, 1.286-2.636]), whereas girls from nuclear families (adjusted OR = 1.631 [95% CI, 1.156-2.300]) and other family structures (adjusted OR = 2.682 [95% CI, 1.502-4.788]) were more likely to experience depression compared to their peers in extended family structures. Interaction analyses showed there was a negative interaction between abnormal peer problems and 7th grade among boys (adjusted OR = 0.288 [95% CI, 0.086-0.951]). Furthermore, comorbidity rates of depression and anxiety were higher in girls than that in boys (χ 2 = 14.457, p < 0.001). And girls with comorbidity showed increased SDQ peer problems scores (Z = -3.151, p = 0.002).

Conclusion

The findings indicate it is important to develop gender-specific interventions for adolescent depression. And for boys, evaluating peer relationships may be particularly crucial in lower grades. Moreover, recognizing the gender-specific clinical features of comorbid depression and anxiety is important for appropriate clinical diagnosis and targeted treatment.

From antidepressants and psychotherapy to oxytocin, vagus nerve stimulation, ketamine and psychedelics: how established and novel treatments can improve social functioning in major depression

Social cognitive deficits and social behavior impairments are common in major depressive disorder (MDD) and affect the quality of life and recovery of patients. This review summarizes the impact of standard and novel treatments on social functioning in MDD and highlights the potential of combining different approaches to enhance their effectiveness. Standard treatments, such as antidepressants, psychotherapies, and brain stimulation, have shown mixed results in improving social functioning, with some limitations and side effects. Newer treatments, such as intranasal oxytocin, mindfulness-based cognitive therapy, and psychedelic-assisted psychotherapy, have demonstrated positive effects on social cognition and behavior by modulating self-referential processing, empathy, and emotion regulation and through enhancement of neuroplasticity. Animal models have provided insights into the neurobiological mechanisms underlying these treatments, such as the role of neuroplasticity. Future research should explore the synergistic effects of combining different treatments and investigate the long-term outcomes and individual differences in response to these promising interventions.

Depression symptoms, communication and cooperation skills, and friendship: longitudinal associations in young Norwegian children

Introduction

Symptoms of depression in early childhood have been linked to interpersonal difficulties, whereas friendships serve a protective function.

Methods

In the present study, we examined depression symptoms in preschool age (4 years) in relation to social skills (communication and cooperation), and friendships into early school age (Grades 1 and 2) in a large subsample (n = 943) of Norwegian children.

Results

The results indicated that preschool depression symptoms negatively predicted Grade 1 communication skills, which in turn predicted Grade 2 depression symptoms. This pathway suggests that communication skills may be a maintenance factor for depression symptoms in young children. In addition, preschool depression symptoms predicted lower Grade 1 cooperation skills, which in turn predicted lower Grade 2 communication skills, suggesting that preschool depression symptoms may begin a cascade of social skill problems that affect cooperation and communication skills into early school years. Best friendships were negatively related to depression symptoms in preschool and Grade 2.

Discussion

Given that preschool depression symptoms impact the development of social skills and friendships, it is important to attend to depression symptoms in early childhood.

Social goals as predictors of children's in vivo emotional responses to social challenges

This study examined the role of social goals in shaping children's in vivo emotional responses during a challenging dyadic peer interaction. In all, 132 children (M_age  = 9.46 years, SD = 0.33; 50% girls; 72% White) participated in a dyadic social challenge (conflict-of-interest situation) and reported their social goals and emotions during the task, and observers coded child emotions and dyad negativity. Mastery goals predicted more positive emotions unless interactions were highly negative. Performance-avoidance goals predicted more negative emotions, particularly in the context of negative interactions and disappointing outcomes. Performance-approach goals predicted less negative displayed emotions but more negative self-reported emotions. Findings provide novel insights into how context-specific social goals contribute to affective social competence during peer interactions.

Mentoring and depressive symptoms of youth: Examining prospective and interactive associations with mentoring relationship quality

A significant body of research has demonstrated that mentoring relationships support positive youth development. The quality of the mentoring relationship has been identified as a predictor of positive youth outcomes. However, limited research has examined how engagement in a mentoring program may be related to youth depressive symptoms specifically. The current study utilized a sample of 2003 youth participating in mentoring programs across the country (M_age  = 12.32, SD = 1.42, 55.1% female) from diverse racial and ethnic backgrounds (39.1% Black, 23.6% White, 22.1% Hispanic, 3.3% Native American or Alaskan Native, .4% Asian or Pacific Islander, 1.8% other, and 9.7% Multi-Ethnic) to investigate associations between youth depressive symptoms and mentoring relationship quality. Results revealed that: (1) mean depressive symptoms decreased after participation in a mentoring program; (2) several, but not all, relationship quality indicators predicted change in depressive symptoms; (3) baseline levels of depressive symptoms negatively predicted indicators of relationship quality; and (4) associations between several relationship quality indicators and follow-up depressive symptoms differed by baseline levels of depressive symptoms. These findings highlight the potential benefits of mentoring programs to youth and the need to provide mentors with support around building relationships with youth, especially those experiencing depressive symptoms.

Family alliance as a developmental antecedent of depressive and anxiety symptoms in early adolescence: Friendship quality as a mediating factor

Family interactions constitute a critical context in which children can learn the basic relational skills that they need to make friends. In turn, friendship quality is a robust predictor of child socioemotional functioning. Therefore, friendship is likely to act as a bridge in a socioemotional developmental cascade linking early family interactions to child subsequent socioemotional adjustment. This study aimed to examine a mediation model linking family alliance (the degree of mother-father-child engagement and coordination in joint activities) in kindergarten to anxiety and depressive symptoms in early adolescence through the mediating role of friendship quality in middle childhood. The family alliance of 87 mother-father-child triads was assessed when children were aged 6 years based on a 15-min videotaped interaction. Children reported on the quality of their relationship with their best friend at age 10 and on their anxiety and depressive symptoms at both 12 and 13 years (averaged). Results showed that children who experienced better family alliance at 6 years had higher relationship quality with their best friend at 10 years which in turn, predicted less anxiety (but not depressive) symptoms in early adolescence. There was a significant indirect effect of family alliance on anxiety through friendship quality. Findings suggest that family alliance may play a central role in shaping children's capacity to develop high-quality friendships, with implications for their subsequent socioemotional functioning. Further longitudinal studies are needed to examine the reciprocal influences unfolding over time that are likely to characterize developmental cascades among family systems, children's developing friendships, and their socioemotional functioning.

The longitudinal role of early family risks and early social-emotional problems for friendship quality in preadolescence-A regression model

The quality of a best friendship provides information about how developmentally beneficial it is. However, little is known about possible early risk factors that influence later friendship quality. The present study examined the role of family risks and social-emotional problems (behavioral problems, peer problems, anxious, and depressive symptoms) in early childhood for positive (i.e., support and help) and negative (i.e., conflicts and betrayal) dimensions of friendship quality with their best friend in preadolescence. 293 children (47.9% female) aged 2–4, their parents and teachers participated in the study with three measurement occasions (T1; M_age = 2.81, T2; M_age = 3.76, T3; M_age = 9.69). The last measurement occasion was at the age of 9–11 years. Results of the longitudinal regression model showed that depressive symptoms in early childhood were associated with a lower positive dimension of friendship quality in preadolescence. In contrast, early anxious symptoms were related to a higher positive dimension of friendship quality six years later. Neither family risks, nor behavioral problems and peer problems in early childhood were linked to the positive dimension of friendship quality in preadolescence. No early predictors were found for the negative dimension of friendship quality. Possible reasons for the lack of associations are discussed. Findings suggest that children with early depressive symptoms at 3–5 years of age should be the targets of potential interventions to form high quality friendships in preadolescence. Possible interventions are mentioned.

Associations between cognitive and affective empathy and internalizing symptoms in late childhood

BACKGROUND

Empathy is a multidimensional construct, which includes cognitive and affective components. Studies in adults have demonstrated that both cognitive and affective empathy are associated with anxious and depressive symptoms. The aim of this study was to examine these associations in childhood.

METHODS

Participants were 127 9- and 10-year-old children, recruited from the community. Self-report measures of cognitive and affective empathy, and internalizing symptoms were administered, as well as a task-based measure of cognitive empathy.

RESULTS

Canonical correlation analysis demonstrated that components of affective empathy, specifically affective sharing and empathic distress, were associated with internalizing (particularly social anxiety) symptoms (R_c = 0.63, non-parametric p < .001). Cognitive empathy was not associated with internalizing symptoms.

LIMITATIONS

Most of our findings were based around self-report measures of empathy, which may not accurately reflect empathy ability.

CONCLUSIONS

Findings suggests that children who share each other's emotions strongly are more likely to experience anxiety, particularly of a social nature.

The Relationship between Positive Youth Development and Depressive Symptoms among Chinese Early Adolescents: A Three-Year Cross-Lagged Analysis

Based on the development assets theory and the scar model, the present study examined the relationship between positive youth development (PYD) and depressive symptoms among Chinese early adolescents using a three-year longitudinal study design. Data from three waves were collected from 1301 students (Mean age = 12.46, SD = 0.63 years and 51.2% boys at wave 1) across the junior high school period (Grades 7-9). All participants completed a questionnaire that included the Center for Epidemiologic Studies Depression Scale (CES-D) and the Chinese Positive Youth Development Scale (CPYD) once a year over three years. After controlling for age and gender, this study found that PYD significantly predicted subsequent depressive symptoms. However, depressive symptoms did not significantly predict subsequent PYD. The results indicated a unidirectional relationship between PYD and depressive symptoms, where a reduction in PYD may increase subsequent depressive symptoms, though not vice versa. Besides, the negative cross-sectional correlation between PYD and depressive symptoms remains significant and stable from first year (T1) to third year (T3). These findings suggest that promoting PYD may be a promising approach to preventing/reducing adolescent depressive symptoms.

Adolescent Internalizing Symptoms and the "Tightknittedness" of Friendship Groups

Adolescents with depression have lower peer status overall, but tend to befriend each other. We examined the "tightknittedness" of their friendship groups by testing whether adolescent friendship groups' average levels of or variability in internalizing symptoms predict group cohesiveness. We used four waves (9th-12th grades) of survey and social network data on 3,013 friendship groups from the PROmoting School-Community-University Partnerships to Enhance Resilience study. Friendship groups with higher average depressive symptoms were less cohesive; groups with higher average anxiety symptoms had greater reciprocity. Groups with greater variability in depressive symptoms had greater density; variability in anxiety symptoms was not consistently associated with cohesion. The friendship groups of depressed adolescents appear less cohesive than the "typical" adolescent friendship group.

[Frequency and type of offences committed by men with severe mental disorders by age of antisocial behaviors onset]

OBJECTIVE

There are important differences in frequency and type of offence committed by individuals with severe mental disorders (SMD), depending on whether their antisocial behaviors began at an early age or as adults. However, individuals having shown early antisocial behaviors do not form an homogenous group. This study's objective is to test if the antisocial behaviors earliness could explain this heterogeneity.

METHOD

137 men with SMD under 3 separate legal status were recruited. They were distributed in 3 groups according to the antisocial behaviors earliness.

RESULTS

The participants in the childhood group commit more violent offences and more of them present a substance use disorder compared with those in the adult group. A more frequent alcohol use disorder separates the youth group from the adult group. There is no significant difference between the childhood and the youth group, but there are more reported offences in the childhood group.

CONCLUSIONS

Our results suggest that the age of antisocial behaviors onset should be considered in evaluating risk and managing individuals with SMD.

Developmental Trajectories of Anxiety and Depression Symptoms from Early to Middle Childhood: a Population-Based Cohort Study in the Netherlands

Developmental patterns of anxiety and depression symptoms in early childhood have previously been related to anxiety and mood disorders in middle childhood. In the current study, trajectories of anxiety and depression symptoms (1.5-10 years) were related to children's broader psychosocial and school-related functioning at 10 years. We included a population-based sample of 7499 children, for whom primary caregivers reported anxiety and depression symptoms on the Child Behavior Checklist, at children's ages of 1.5, 3, 6, and 10. Growth Mixture Modeling identified four distinct, gender-invariant, trajectories of anxiety and depression symptoms: low (82.4%), increasing (7.4%), decreasing (6.0%), and increasing symptoms up to age 6 followed by a decrease to age 10 (preschool-limited, 4.2%). Children with a non-Dutch ethnicity had lower odds to be in the increasing trajectory and higher odds to be in the decreasing and pre-school limited trajectory. Also, low maternal education predicted the decreasing and pre-school limited trajectory. Higher levels of psychopathology during pregnancy for both mothers and fathers predicted the increasing, decreasing, and preschool-limited trajectory, compared to the low trajectory. At age 10, children in the increasing and preschool-limited trajectory had diminished psychosocial outcomes (friendship-quality and self-esteem) and worse school-related outcomes (school performance and school problems). This study adds to current knowledge by demonstrating that developmental patterns of anxiety and depression symptoms in early childhood are related to broader negative outcomes in middle childhood. Child and family factors could guide monitoring of anxiety and depression symptoms in the general population and provide targets for prevention programs.

Birds of a Feather Want to Talk Together: The Impact of Depressive Symptoms on Initial Stages of Friendship Formation in Older Adolescence

Introduction: Peer relationships play a vital role in adolescents’ lives and are considered to be especially critical for youth who experience elevated depressive symptoms. Unfortunately, depressed youth tend to have difficulties with existing friendships (e.g., fewer and lower quality friendships), which may exacerbate their symptoms. Little is known, however, about how depressed youth approach the initial stages of friendship formation, which may have implications for the types of social support they can access.

Method: Using a conversation task designed to build intimacy, older adolescents (N = 228, M age = 19.54 years) with and without elevated depressive symptoms interacted with a previously unknown, same-gender partner.

Results: Results suggested that adolescents with elevated symptoms experienced interactions differently (e.g., speculated more about their conversation partner and thought their partner was speculating more about them, experienced more negative affect) than nondepressed peers. The depression status of the potential friend also mattered, as participants paired with partners of similar emotional adjustment status wanted to talk more and felt closer to one another than did mismatched partners.

Discussion: Findings underscore that depressive symptoms impact even the earliest stages of friendship formation. From the perspective of interpersonal theories of depression, implications for bolstering depressed adolescents’ relationships are discussed.

Efficacy of the Aussie Optimism Program: Promoting Pro-social Behavior and Preventing Suicidality in Primary School Students. A Randomised-Controlled Trial

The efficacy of an enhanced version of the Aussie Optimism Program (AOP) was investigated in a cluster randomized controlled trial. Grade 6 students aged 10-11 years of age (N = 2288) from 63 government primary schools in Perth, Western Australia, participated in the pre, post, and follow-up study. Schools were randomly assigned to one of three conditions: Aussie Optimism with teacher training, Aussie Optimism with teacher training plus coaching, or a usual care condition that received the regular Western Australian Health Education Curriculum. Students in the Aussie Optimism conditions received 20, 1-h lessons relating to social and interpersonal skills and optimistic thinking skills over the last 2 years of primary school. Parents in the active conditions received a parent information booklet each year, plus a self-directed program in Grade 7. Students and parents completed the Extended Strengths and Difficulties Questionnaire. Students who scored in the clinical range on the Emotional Symptoms Scale were given The Diagnostic Interview for Children and Adolescents IV, to assess suicidal ideation and behavior, and depressive and anxiety disorders. Results indicated that Aussie Optimism with teacher training plus coaching was associated with the best outcomes: a significant increase in student-reported pro-social behavior from pre-test to post-test 1 (maintained at post-test 2) and significantly lower incidence rates from suicidal ideation at post-test 2 and follow-up. No significant intervention effects on anxiety and depressive disorders, and total difficulties were reported. These findings suggest that the AOP with teacher training along with coaching may have the potential to positively impact on suicidality and pro-social behavior in the pre-adolescent years.

Testing the Direction of Longitudinal Paths between Victimization, Peer Rejection, and Different Types of Internalizing Problems in Adolescence

The transition to secondary school is accompanied by the fragmentation of peer groups, while adolescents are also confronted with heightened incidents of bullying and increased levels of internalizing problems. Victimization, peer rejection, and internalizing problems are known to be interrelated, but how they influence each other over time remains unclear. We tested the direction of these associations by applying a cross-lagged path model among a large sample of Finnish adolescents (N = 5645; 49.1 % boys; M age at T1 = 14.0 years) after they transitioned to secondary school (grades 7-9). Self-reported depression, anxiety, and victimization and peer-reported rejection were measured 3 times over the course of 1 year. Results showed that depression was predictive of subsequent victimization for both boys and girls, in line with a symptoms-driven model; for girls, anxiety was reciprocally related to victimization, in line with a transactional model; for boys, victimization was related to subsequent anxiety, in line with an interpersonal risk model. Peer rejection was not directly related to depression or anxiety, but among girls peer rejection was bi-directionally related to victimization. Overall, our results suggest that associations between internalizing problems and peer relations differ between depression and anxiety and between genders. Implications for practice and directions for future research are discussed.

Testing the Direction of Longitudinal Paths between Victimization, Peer Rejection, and Different Types of Internalizing Problems in Adolescence

The transition to secondary school is accompanied by the fragmentation of peer groups, while adolescents are also confronted with heightened incidents of bullying and increased levels of internalizing problems. Victimization, peer rejection, and internalizing problems are known to be interrelated, but how they influence each other over time remains unclear. We tested the direction of these associations by applying a cross-lagged path model among a large sample of Finnish adolescents (N = 5645; 49.1 % boys; M age at T1 = 14.0 years) after they transitioned to secondary school (grades 7-9). Self-reported depression, anxiety, and victimization and peer-reported rejection were measured 3 times over the course of 1 year. Results showed that depression was predictive of subsequent victimization for both boys and girls, in line with a symptoms-driven model; for girls, anxiety was reciprocally related to victimization, in line with a transactional model; for boys, victimization was related to subsequent anxiety, in line with an interpersonal risk model. Peer rejection was not directly related to depression or anxiety, but among girls peer rejection was bi-directionally related to victimization. Overall, our results suggest that associations between internalizing problems and peer relations differ between depression and anxiety and between genders. Implications for practice and directions for future research are discussed.

Depressive symptoms, friend distress, and self-blame: Risk factors for adolescent peer victimization

Past research indicates that depressed adolescents experience increased risk for peer victimization. Less is known about the conditions under which depressive symptoms predict social vulnerability and the mechanism underlying such links. The current study considers a) characterological self-blaming attributions as a social cognitive mechanism accounting for links between depressive symptoms and victimization across the first two years of middle school and b) the potential moderating role of friends' level of depressive symptoms. Relying on an ethnically diverse sample of 5,374 adolescents, multilevel moderated mediation analyses indicated that maladaptive attributions accounted for links between 6^th grade depressive symptoms and increases in 7^th grade victimization. Moreover, this mediational pathway was strongest for students whose friends also experienced heightened depressive symptoms at the beginning of middle school. These results highlight the roles of both intra- and inter-personal risk factors in predicting social cognitive biases and future victimization risk during the middle school years.

The Temporal Sequence of Social Anxiety and Depressive Symptoms Following Interpersonal Stressors During Adolescence

Social anxiety and depressive symptoms dramatically increase and frequently co-occur during adolescence. Although research indicates that general interpersonal stressors, peer victimization, and familial emotional maltreatment predict symptoms of social anxiety and depression, it remains unclear how these stressors contribute to the sequential development of these internalizing symptoms. Thus, the present study examined the sequential development of social anxiety and depressive symptoms following the occurrence of interpersonal stressors, peer victimization, and familial emotional maltreatment. Participants included 410 early adolescents (53% female; 51% African American; Mean age =12.84 years) who completed measures of social anxiety and depressive symptoms at three time points (Times 1-3), as well as measures of general interpersonal stressors, peer victimization, and emotional maltreatment at Time 2. Path analyses revealed that interpersonal stressors, peer victimization, and emotional maltreatment predicted both depressive and social anxiety symptoms concurrently. However, depressive symptoms significantly mediated the pathway from interpersonal stressors, peer victimization, and familial emotional maltreatment to subsequent levels of social anxiety symptoms. In contrast, social anxiety did not mediate the relationship between these stressors and subsequent depressive symptoms. There was no evidence of sex or racial differences in these mediational pathways. Findings suggest that interpersonal stressors, including the particularly detrimental stressors of peer victimization and familial emotional maltreatment, may predict both depressive and social anxiety symptoms; however, adolescents who have more immediate depressogenic reactions may be at greater risk for later development of symptoms of social anxiety.

Sleep and behavioural problems associate with low mood in Finnish children aged 4-12 years: an epidemiological study

BACKGROUND

Few studies have examined the associations between sleep, mood and behaviour in young children in the early stages of developing psychopathology. The purpose here was to examine the association of emotional problems, especially mood, with family and child characteristics, sleep and behavioural problems in 4-12 year-old children.

METHODS

The sample was population-based and included 1714 children. Parents filled in the Strengths and Difficulties Questionnaire and a background questionnaire on child and family characteristics. The associations between (a) emotional symptoms/mood and background variables, (b) emotional problems and conduct problems/hyperactivity and (c) mood and conduct problems/hyperactivity were examined with ordinal regression in univariate and multivariate models.

RESULTS

Of the background variables, child's sleeping problems had the most powerful association with emotional symptoms and mood. Abnormal emotional problems score and emotional symptoms were associated with abnormal conduct problems and hyperactivity scores. Of the emotional symptoms, low mood was the one associated most strongly with conduct problems and hyperactivity after controlling for all significant background variables and other emotional symptoms.

CONCLUSIONS

We conclude that in young children sleep problems associate with low mood. Low mood associates with behavioural problems. When a child presents with low mood or behavioural problems, a comprehensive assessment of their psychiatric symptoms, as well as their sleep problems, is recommended.

Co-occurrence of depressive moods and delinquency in early adolescence: The role of failure expectations, manipulativeness, and social contexts

This study examined the co-occurrence of depression and delinquency in early adolescents, focusing on longitudinal associations with failure expectations and manipulativeness, and on perceptions of relationships with parents, school and teachers, and peers. Data were used from 1,059 Swedish adolescents aged 13 to 15, who participated in 2 waves (T1–1998; T2–2000) of an ongoing longitudinal research. Results showed that depression and delinquency co-occurred in about 9% of respondents, and that depression and delinquency followed separate developments throughout early adolescence. Development of co-occurring depression and delinquency was positively linked to a later constellation of high failure expectations and manipulativeness across a 2-year period. Additionally, the development of combined failure expectations and manipulativeness was positively linked to a later co-occurrence of depression and delinquency across a 2-year period. Further, the cooccurrence of depression and delinquency was predicted by lower-quality relationships with parents and negative attitudes towards school and teachers, whereas a constellation of high failure expectations and manipulativeness was linked to earlier negative interactions with parents and feeling isolated from peers.

Gender Differences in the Developmental Links Between Conduct Problems and Depression Across Early Adolescence

Various developmental models have attempted to explain the relationship between antisocial behavior and depressive symptoms in youth, often proposing intermediary processes such as social and academic functioning. However, few studies have tested these developmental models fully, particularly in mixed gender samples. The current study strives to fill this gap in the literature, examining these processes in an early adolescent sample. Results indicated both direct and indirect paths between antisocial behavior and depression. In addition, potentially important gender differences were found. These results underscore the importance of examining direct and indirect links between symptoms of depression and anti-social behavior, and suggest that there may be important developmental differences between girls and boys in the relationship between these symptoms.

Differentiating Anxiety and Depression in Relation to the Social Functioning of Young Adolescents With ADHD

The present study examined anxiety and depressive symptoms in relation to the social functioning of young adolescents with attention-deficit/hyperactivity disorder (ADHD) and builds upon prior work by incorporating youths' self-reports of internalizing symptoms and examining distinct anxiety and depression dimensions to increase specificity. Participants were 310 young adolescents (ages 10-14; 71% male, 78% Caucasian) diagnosed with ADHD. Youth provided ratings of anxiety/depression, and parents provided ratings of their own depression. Parents and youth both reported on youths' social skills and perceived social acceptance. Path analyses indicated that above and beyond child demographics, ADHD and oppositional defiant disorder symptom severity, and parents' own depression, self-reported social anxiety and anhedonia were both associated with lower youth-reported social skills and both parent- and youth-reported social acceptance. Negative self-evaluation was associated with poorer parent-reported social skills. Finally, harm avoidance was positively associated with both youth- and parent-reported social skills. A path analysis using comorbid diagnoses (rather than symptom dimensions) indicated that that having a comorbid disruptive behavior disorder or depression diagnosis (but not a comorbid anxiety diagnosis) was associated with poorer parent-reported social functioning. Results demonstrate that the relation between internalizing symptoms and social functioning among young adolescents with ADHD is nuanced, with social anxiety and anhedonia symptoms associated with lower social skills and social acceptance in contrast to harm avoidance being associated with higher ratings of social skills (and unrelated to social acceptance). In terms of comorbid diagnoses, depression is more clearly related than anxiety to poorer social functioning among young adolescents with ADHD. These results point to the importance of attending to specific facets of anxiety and depression in clinical care and future research.

High impulsivity as a risk factor for the development of internalizing disorders in detained juvenile offenders

BACKGROUND

Whilst impulsivity is most commonly linked to the development of internalizing disorders, high levels of impulsivity, anxiety, and depression have been found in detained juvenile offenders. We therefore sought to determine whether impulsivity is associated with the development of self-reported anxiety or depression in a sample of detained juvenile offenders.

METHODS

323 male juvenile offenders and 86 typically developing controls, aged 15-17 were assessed. The Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (SADS-PL) was used to assess psychiatric diagnoses, the Barratt Impulsivity Scale (BIS-11) was used to measure impulsivity, and the Screen for Child Anxiety Related Emotional Disorders (SCARED) and the Birleson Depression Self-Rating Scale (DSRS) were used to assess self-reported anxiety and depression respectively.

RESULTS

Compared to controls, juvenile offenders had significantly higher scores on the BIS-11 total, as well as on the motor and nonplanning subscales (all p values <0.001), as well as higher DSRS (p<0.001) and SCARED (p<0.05) scores. Within the juvenile offender group, scores on the SCARED correlated positively with BIS-11 total, attention subscale, motor subscale, and total DSRS (all p values <0.01). DSRS scores correlated positively with BIS-11 total, attention subscale, nonplanning subscale, and total SCARED scores (all p values <0.01). Participants were then categorized low, middle or high impulsivity according to scores on the BIS-11. One-way ANOVAs demonstrated a significant difference between these tertiles on DSRS [F(2,320)=4.862, p<0.05] and SCARED total scores [F(2,320)=3.581, p<0.05]. Specifically, post-hoc analyses found that the high impulsivity tertile scored significant higher than the remaining tertiles on both DSRS (16.1 ± 0.3 vs. 14.0 ± 0.6, p<0.05) and SCARED (23.3 ± 0.9 vs. 18.4 ± 1.4, p<0.05) scores. Using multiple linear regression, BIS-11 attention scores, number of months served in custody, age, and BIS-11 nonplanning scores predicted higher levels of anxiety, whilst only BIS-11 attention and nonplanning scores predicted higher levels of depression.

CONCLUSIONS

In detained juvenile offenders, high impulsivity may be an important risk factor not only for the externalizing disorders, but also for anxiety and depression. Results of this study, therefore, suggest that specific facets of impulsivity may represent one mechanism underlying the emergence of anxiety and depression in this population.

Comorbidity of anxiety and depression in children and adolescents: 20 years after

Brady and Kendall (1992) concluded that although anxiety and depression in youths are meaningfully linked, there are important distinctions, and additional research is needed. Since then, studies of anxiety-depression comorbidity in youths have increased exponentially. Following a discussion of comorbidity, we review existing conceptual models and propose a multiple pathways model to anxiety-depression comorbidity. Pathway 1 describes youths with a diathesis for anxiety, with subsequent comorbid depression resulting from anxiety-related impairment. Pathway 2 refers to youths with a shared diathesis for anxiety and depression, who may experience both disorders simultaneously. Pathway 3 describes youths with a diathesis for depression, with subsequent comorbid anxiety resulting from depression-related impairment. Additionally, shared and stratified risk factors contribute to the development of the comorbid disorder, either by interacting with disorder-related impairment or by predicting the simultaneous development of the disorders. Our review addresses descriptive and developmental factors, gender differences, suicidality, assessments, and treatment-outcome research as they relate to comorbid anxiety and depression and to our proposed pathways. Research since 1992 indicates that comorbidity varies depending on the specific anxiety disorder, with Pathway 1 describing youths with either social phobia or separation anxiety disorder and subsequent depression, Pathway 2 applying to youths with coprimary generalized anxiety disorder and depression, and Pathway 3 including depressed youths with subsequent social phobia. The need to test the proposed multiple pathways model and to examine (a) developmental change and (b) specific anxiety disorders is highlighted.

Interpersonal problem areas and alexithymia in adolescent girls with loss of control eating

This study investigated the links among interpersonal problem areas, depression, and alexithymia in adolescent girls at high risk for excessive weight gain and binge eating disorder. Participants were 56 girls (Mage = 14.30, SD = 1.56; 53% non-Hispanic White) with a body mass index (BMI, kg/m(2)) between the 75th and 97th percentiles (MBMI z = 1.57, SD = 0.32). By design, all participants reported loss of control eating patterns in the past month. Adolescents were individually interviewed prior to participating in a group interpersonal psychotherapy obesity and eating disorder prevention program, termed IPT for the prevention of excessive weight gain (IPT-WG). Participants' interpersonal problem areas were coded by trained raters. Participants also completed questionnaires assessing depression and alexithymia. Primary interpersonal problem areas were categorized as interpersonal deficits [as defined in the eating disorders (ED) literature] (n = 29), role disputes (n = 22), or role transitions (n = 5). Girls with interpersonal deficits-ED had greater depressive symptoms and alexithymia than girls with role disputes (p's ≤ 0.01). However, girls with role transitions did not differ from girls with interpersonal deficits-ED or role disputes. Interpersonal problem area had an indirect association with depression via alexithymia; interpersonal deficits-ED were related to greater alexithymia, which in turn, was related to greater depressive symptoms (p = 0.01). Among girls at risk for excess weight gain and eating disorders, those with interpersonal deficits-ED appear to have greater distress as compared to girls with role disputes or role transitions. Future research is required to elucidate the impact of interpersonal problem areas on psychotherapy outcomes.

Internalizing symptoms and rumination: the prospective prediction of familial and peer emotional victimization experiences during adolescence

Adolescence is marked by increases in stressful life events. Although research has demonstrated that depressed individuals generate stress, few studies investigate the generation of emotional victimization. The current study examined the effects of rumination and internalizing symptoms on experiences of peer victimization and familial emotional abuse. Participants were 216 adolescents (M = 14-years-old; 58% female; 47% African-American) who completed two assessments. Results showed that rumination predicted peer victimization and emotional abuse. The effect of rumination on emotional victimization is heightened for those who have higher levels of depression symptoms. That is, individuals who ruminate and who have depression symptoms experience increases in both peer emotional victimization and parental emotional abuse. This study builds upon prior research and indicates that rumination may be a stronger predictor of emotional victimization than symptoms of depression or anxiety. Identifying underlying mechanisms may yield targets for interventions aimed at addressing the chronic nature of depression.

Personality dimensions as common and broadband-specific features for internalizing and externalizing disorders

Several researchers have suggested that the nature of the covariation between internalizing and externalizing disorders may be understood better by examining the associations between temperament or personality and these disorders. The present study examined neuroticism as a potential common feature underlying both internalizing and externalizing disorders and novelty seeking as a potential broad-band specific feature influencing externalizing disorders alone. Participants were 12- to 18-year-old twin pairs (635 monozygotic twin pairs and 691 dizygotic twin pairs; 48 % male and 52 % female) recruited from the Colorado Center for Antisocial Drug Dependence. Genetic and nonshared environmental influences shared in common with neuroticism influenced the covariation among distinct internalizing disorders, the covariation among distinct externalizing disorders, and the covariation between internalizing and externalizing disorders. Genetic influences shared in common with novelty seeking influenced the covariation among externalizing disorders and the covariation between major depressive disorder and externalizing disorders, but not the covariation among internalizing disorders or between anxiety disorders and externalizing disorders. Also, after accounting for genetic and environmental influences shared in common with neuroticism and novelty seeking, there were no significant common genetic or environmental influences among the disorders examined, suggesting that the covariance among the disorders is sufficiently explained by neuroticism and novelty seeking. We conclude that neuroticism is a heritable common feature of both internalizing disorders and externalizing disorders, and that novelty seeking is a heritable broad-band specific factor that distinguishes anxiety disorders from externalizing disorders.

Pathways from depressive symptoms to low social status

This research examined two pathways through which depressive symptoms contribute to low social status (i.e., neglect and rejection) within the peer group over time: (a) depressive symptoms promote socially helpless behavior and consequent neglect by peers; and (b) depressive symptoms promote aggressive behavior and consequent rejection by peers. These pathways were investigated in independent samples of youth at two developmental stages: middle childhood (2nd-4th grade) and early adolescence (5th-7th grade). In both Study 1 (M age = 7.97, SD = 0.37; 338 girls, 298 boys) and Study 2 (M age = 11.74, SD = 0.68; 305 girls, 300 boys), youth and their teachers completed questionnaires at three waves. Multi-group comparison path analyses were conducted to examine sex differences in the models. Consistent with expectations, two pathways emerged through which depressive symptoms undermined subsequent social status. Support was not found for the reverse direction of effect nor for developmental or sex differences in the pathways with one exception: In early adolescence, neglect directly predicted depressive symptoms. These findings suggest specificity but also heterogeneity in the effects of depressive symptoms on social status, and identify behaviors that may be targeted for preventing the persistence of depression and its interpersonal consequences.

Recalled peer relationship experiences and current levels of self-criticism and self-reassurance

OBJECTIVES

Numerous studies have shown that personality factors may increase or decrease individuals' vulnerability to depression, but little research has examined the role of peer relationships in the development of these factors. Accordingly, this study examined the role of recalled parenting and peer experiences in the development of self-criticism and self-reassurance. It was hypothesized that, controlling for recalled parenting behaviours, specific recalled experiences of peer relationships would be related to current levels of specific forms of self-criticism and self-reassurance.

DESIGN

Hypotheses were tested using a retrospective design in which participants were asked to recall experiences of parenting and peer relationships during early adolescence. This age was chosen as early adolescence has been shown to be a critical time for the development of vulnerability to depression.

METHODS

A total of 103 female and 97 male young adults completed measures of recalled parenting, overt and relational victimization and prosocial behaviour by peers, and current levels of self-criticism and self-reassurance.

RESULTS

Hierarchical regression analyses showed that parents and peers independently contributed to the development of self-criticism and self-reassurance. Specifically, controlling for parental care and control, overt victimization predicted self-hating self-criticism, relational victimization predicted inadequacy self-criticism, and prosocial behaviour predicted self-reassurance. As well, prosocial behaviour buffered the effect of overt victimization on self-reassurance.

CONCLUSIONS

Findings highlight the importance of peers in the development of personality risk and resiliency factors for depression, and suggest avenues for interventions to prevent the development of depressive vulnerabilities in youth.

PRACTITIONER POINTS

The nature of a patient's personality vulnerability to depression may be better understood through a consideration of the patient's relationships with their peers as well as with parents during adolescence. An understanding of adult patients' past peer relationships may further the therapist's understanding of the client's core schemas and dysfunctional attitudes, as well as potential transference reactions during therapy. Identifying and helping youth to better cope with peer victimization may help prevent the development of a vulnerable personality style in adulthood. Fostering positive peer relationships in adolescence may buffer the effects of other more negative relationships with peers.

Interpersonal Psychotherapy-Adolescent Skills Training: Effects on School and Social Functioning

This paper reports on school and social functioning outcomes in a randomized depression prevention study that compared Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) with usual school counseling (SC). Outcome analyses were performed utilizing hierarchical linear models and mixed model analysis of variance. IPT-AST adolescents had significantly greater improvements than SC adolescents in total social functioning and friend functioning during the intervention. IPT-AST adolescents also demonstrated improvements in school, dating, and family functioning and emotional engagement in school, although these improvements were not significantly greater than seen in SC adolescents. Finally, in the 18 months following the intervention, IPT-AST adolescents were less likely than SC adolescents to be asked to leave school for academic or behavioral reasons. These findings extend the potential range of impact of depression prevention programs such as IPT-AST and provide preliminary evidence of the benefits of these programs on school and social functioning.

Biased self-perceptions, peer rejection, and aggression in children

This study examined whether children's biased self-perceptions of peer acceptance are associated in a linear or curvilinear fashion with aggression, whether associations are moderated by peer rejection status, and whether associations apply uniquely to reactive aggression. Children in the 4th through 7th grades completed a self-report measure on their social functioning (SPPC; Harter 1982), and teachers reported on children's social functioning and aggression. Self-perceptual bias was operationalized as the standardized residual difference between children's self-perceptions and their teachers' perceptions of their peer acceptance. Rejected status moderated associations between biased self-perceptions and reactive aggression. Among non-rejected children, biased perceptions were not significantly associated with reactive aggression. In contrast, among peer-rejected children, reactive aggression was elevated in those who greatly underestimated as well as in those who even modestly overestimated their peer acceptance. This pattern was observed whether or not proactive aggression was statistically controlled. In contrast, biased self-perceptions were not associated with proactive aggression for rejected or nonrejected children. Implications are discussed with regard to future research and potential interventions for aggressive children.

Transactional associations between youths' responses to peer stress and depression: the moderating roles of sex and stress exposure

This study examined transactional associations between responses to peer stress and depression in youth. Specifically, it tested the hypotheses that (a) depression would predict fewer effortful responses and more involuntary, dysregulated responses to peer stress over time; and (b) fewer adaptive and more maladaptive responses would predict subsequent depression. Youth (M age = 12.41; SD = 1.19; 86 girls, 81 boys) and their maternal caregivers completed semi-structured interviews and questionnaires at three annual waves. Multi-group comparison path analyses were conducted to examine sex and stress-level differences in the proposed reciprocal-influence model. In girls and in youth exposed to high levels of peer stress, maladaptive stress responses predicted more depressive symptoms and adaptive stress responses predicted fewer depressive symptoms at each wave. These findings suggest the utility of preventive interventions for depression designed to enhance the quality of girls' stress responses. In boys, depression predicted less adaptive and more maladaptive stress responses, but only at the second wave. These findings suggest that interventions designed to reduce boys' depressive symptoms may help them develop more adaptive stress responses.

Depressive symptoms and romantic relationship qualities from adolescence through emerging adulthood: a longitudinal examination of influences

Research has consistently demonstrated the negative consequences of depression on adolescents' functioning in peer and family relationships, but little work has examined how depressive symptoms affect the quality of adolescents' and emerging adults' romantic relationships. Five waves of data on depressive symptoms, romantic relationship conflict, and use of positive problem solving were collected from 188 boys and girls during middle adolescence to emerging adulthood. Latent growth curve models indicated that having more depressive symptoms when 15 years old was associated with both more increase in relationship conflict and less increase in positive problem solving as compared to adolescents with fewer depressive symptoms. These results suggest that depression in middle adolescence may impair subsequent romantic relationship qualities into late adolescence and emerging adulthood.

Peer contagion and adolescent depression: the role of failure anticipation

The current study investigated the mechanisms underlying peer contagion of depressive symptoms in adolescence. Five annual measurements of data were gathered from a large (N = 842) community-based network of adolescents (M = 14.3 years at first measurement). Results showed that, after controlling for selection and deselection of friends on the basis of depressive symptoms, peers' depressive symptoms predicted increases in adolescents' depressive symptoms over time. Failure anticipation mediated effects of peers' depressive symptoms on adolescents' depressive symptoms, particularly for girls. Thus, results suggest that peers' depressive symptoms place adolescents at risk of developing depressive symptoms through increasing in failure anticipation.

Subgenual anterior cingulate responses to peer rejection: a marker of adolescents' risk for depression

Extensive developmental research has linked peer rejection during adolescence with a host of psychopathological outcomes, including depression. Moreover, recent neuroimaging research has suggested that increased activity in the subgenual region of the anterior cingulate cortex (subACC), which has been consistently linked with depression, is related to heightened sensitivity to peer rejection among adolescents. The goal of the current study was to directly test the hypothesis that adolescents' subACC responses are predictive of their risk for future depression, by examining the relationship between subACC activity during peer rejection and increases in depressive symptoms during the following year. During a functional magnetic resonance imaging scan, 20 13-year-olds were ostensibly excluded by peers during an online social interaction. Participants' depressive symptoms were assessed via parental reports at the time of the scan and 1 year later. Region of interest and whole-brain analyses indicated that greater subACC activity during exclusion was associated with increases in parent-reported depressive symptoms during the following year. These findings suggest that subACC responsivity to social exclusion may serve as a neural marker of adolescents' risk for future depression and have implications for understanding the relationship between sensitivity to peer rejection and the increased risk of depression that occurs during adolescence.

Relationship quality and depressive symptoms among adolescents: a short-term multiwave investigation of longitudinal, reciprocal associations

This study used a multiwave design to examine the short-term longitudinal and bidirectional associations between depressive symptoms and peer relationship qualities among a sample of early to middle adolescents (N = 350, 6th-10th graders). Youth completed self-report measures of relationship quality and depressive symptoms at three time points spaced about 5 weeks apart. Results indicated that depressive symptoms predicted increases in negative qualities and decreases in positive qualities. However, neither positive nor negative relationship qualities predicted increases in depressive symptoms. Findings inform a developmentally based interpersonal model of depression by advancing knowledge on the longitudinal direction of effects between depressive symptoms and relationship quality in adolescence.

Depressive symptoms and psychosocial functioning in preadolescent children

The current study was designed to determine the percentage of children "at-risk" of depression or evidencing clinical levels of depression. In addition, the study examined how the "at-risk" and the clinical groups differed from children who demonstrated no depressive symptoms on positive and negative affect, four aspects of self-concept, and peer ratings of popularity. Respondents were 510 children (270 boys 240 girls) who ranged in age from 7 to 13 years (mean = 9.39). The results demonstrated that 23% of children were either in the "at-risk" or clinical range of depression. Children in both the clinical and the "at-risk" range demonstrated higher negative affect but lower positive affect and lower self-concepts than children in the normal range. However, children's peers only differentiated between the "clinical" and "normal" groups. It is harder for peers, and other informants such as teachers and parents, to detect the problems of children with elevated depressive symptoms but who do not meet the diagnostic criteria. It is important to implement intervention programs for children who evidence depression symptoms, as well as "at-risk" children. "At-risk" children with elevated levels of depressive symptoms may be more disadvantaged, as their problems are less likely to be detected and treated.

The Latent Structure of Youth Responses to Peer Provocation

This study examined whether the three categories often applied to children’s behavior—aggressive, avoidant, and assertive—actually capture the structure of a naturalistic sample of youth behavior coded at a more micro level. A sample of lower-income youth (N = 392; M age = 12.69, SD = 0.95) completed a new multiple-choice measure asking them to select responses to scenarios depicting physical, verbal, and relational provocation by a peer. Youth responses to the vignettes showed the expected associations with self-reported aggression and regulation of anger, providing preliminary evidence for the convergent validity of the measure. Factor analysis confirmed that responses loaded on three factors: aggression, avoidance, and assertion. Model fit was adequate (RMSEA = .028) and cross-validated in a second sample (RMSEA = .039). Several types of responses loaded on two factors suggesting that some strategies that youth use to manage provocation are not “pure” examples of these broadband categories. Implications for conceptualization and measurement of youth social behavior are discussed.

The Contribution of Deficits in Emotional Clarity to Stress Responses and Depression

This research investigated the contribution of deficits in emotional clarity to children's socioemotional adjustment. Specifically, this study examined the proposal that deficits in emotional clarity are associated with maladaptive interpersonal stress responses, and that maladaptive interpersonal stress responses act as a mechanism linking deficits in emotional clarity to childhood depressive symptoms. Participants included 345 3(rd) graders (M age = 8.89, SD = .34) assessed at two waves, approximately one year apart; youth completed self-report measures of emotional clarity, responses to interpersonal stress, and depressive symptoms. Results supported the hypothesized process model linking deficits in emotional clarity, maladaptive interpersonal stress responses, and depressive symptoms, adjusting for prior depressive symptoms. Findings have implications for theories of emotional competence and for depression-intervention efforts aimed at fostering emotional understanding and adaptive interpersonal stress responses.

A Prospective Test of the Hopelessness Theory of Depression in Children

Providing a developmental extension of the cognitive theories of depression, researchers and theorists have suggested that during early to middle childhood, attributional styles may mediate rather than moderate the association between negative life events and the development of depression. Within the context of the hopelessness theory of depression, we tested this hypothesis in a 6-month longitudinal study of 4th- and 5th-grade children. Using path analysis, we found support for the mediating role of attributional styles among both 4th and 5th graders. Supporting recent refinements in the hopelessness theory, the best fitting mediation model was one in which depressive symptoms exhibited reciprocal relations with the other variables. Specifically, attributional styles partially mediated the link between verbal victimization and residual change in depressive symptoms. In addition, initial depressive symptoms predicted negative changes in children's attributional styles and increases in verbal victimization across the follow-up. Contrary to our hypothesis, we also found support for the moderating role of attributional styles, although this was significant only among 5th graders.

Identifying trajectories of adolescents' depressive phenomena: an examination of early risk factors

Few studies have examined risk factors of childhood and early adolescent depressive symptomatology trajectories. This study examined self-report depressive symptomatology across a 6-year time period from 2nd to 8th grade to identify latent groups of individuals with similar patterns of depressive phenomena in a sample of 951 children (440 girls, 511 boys). Analyses, using semiparametric group modeling (SGM), identified 5 trajectory groups for girls and boys: low depressed stables, low depressed risers, mildly depressed stables, moderately depressed changers, and moderately depressed risers. Individual risk factors, with the exception of shy/withdrawn behavior, were significantly different across trajectory group membership for boys and girls, as was low-income status for boys. Boys in the low depressed and mildly depressed stable trajectory groups had significantly higher levels of antisocial behavior, attention problems, and lower social competency compared to girls in similar groups. These results suggest that universal prevention programs implemented in early elementary school that target selected risk factors may be helpful in reducing future adolescent mental health problems, specifically depressive symptomatology.

Conversational Self-Focus in Adolescent Friendships: Observational Assessment of an Interpersonal Process and Relations with Internalizing Symptoms and Friendship Quality

Although youth with internalizing symptoms experience friendship difficulties, surprisingly little is known about their problematic interpersonal behaviors. The current observational study identifies a new construct, conversational self-focus, defined as the tendency to direct the focus of conversations to the self and away from others. Results indicated that youth with internalizing symptoms were especially likely to engage in self-focus when discussing problems with friends and that doing so was related to their friends perceiving the relationship as lower in quality, particularly helping. Content analyses further indicated that self-focused youth talked about themselves in ways that were distracting from their friends' problems and that they changed the subject abruptly. Last, conversational self-focus was not redundant with related constructs of rumination and self-disclosure. This research highlights the importance of intervention efforts aimed at teaching self-focused youth ways to cope with distress that are more effective and will not damage their friendships.