Anxiety-Disordered Adolescents With and Without a Comorbid Depressive Disorder

Abstract

There is a high degree of comorbidity between anxiety and depressive disorders among treatment-seeking adolescents. Comorbid youth often present with greater diagnostic severity, worse social functioning, and more severe anxiety and depressive symptoms, compared with anxiety-disordered youth without depression. However, the degree to which these populations may differ in underlying affect and emotion regulation (ER) is largely unknown. This study compared 44 anxietydisordered adolescents (ages 12-18 years) with a comorbid depressive disorder (ANX + DEP) and 32 anxiety-disordered adolescents without a comorbid depressive disorder (ANX) on several clinical and emotion-related variables. Results indicated that ANX + DEP adolescents were assigned higher clinician-rated diagnostic severity ratings, and reported greater functional impairment and more severe social anxiety and depressive symptoms, compared with ANX adolescents. In addition, ANX + DEP adolescents demonstrated higher levels of negative affect, lower levels of positive affect, and poorer self-reported and parent-reported ER. Implications for assessment and treatment, as well as directions for future research, are discussed.

Emotion Regulation Among Adolescents With Pediatric Depression As a Function of Anxiety Comorbidity

“…We found that anxiety comorbidity in youngsters with lifetime depression was associated with dysfunctional ER, as children with comorbidity used maladaptive ER responses more frequently than non-comorbid peers. Our results are in line with findings from previous studies that showed more frequent use of maladaptive ER strategies in youths with comorbid depression and anxiety symptoms (11, 15, 36, 37, 47). It has been reported that the treatment of depression is more difficult in the presence of anxiety: comorbidity lengthens the duration of treatment and decreases the response to interventions (49, 50).…”

“…In fact, there is scant information about how anxiety as a comorbid condition affects the habitual use of different ER strategies in depressed youngsters. Queen and Ehrenreich-May (47) found that adolescents with anxiety and depression had poorer emotional awareness, greater emotional suppression, greater reluctance to express negative emotions, and greater inhibition of sadness than are patients with anxiety disorder. Research by Burklund et al (48) in adults revealed altered ER in patients with comorbid social phobia and depression.…”

Confirmatory Factor Analytic Structure and Measurement Invariance of the Emotion Regulation Questionnaire for Children and Adolescents in a Longitudinal Sample of Adolescents

“…The ERQ-CA has been used with clinical and school samples of U.S. adolescents (Ben-Eliyahu & Linnenbrink-Garcia, 2015;Queen & Ehrenreich-May, 2014;Tsao, Jacob, Seidman, Lewis, & Zeltzer, 2014). However, no study (to the authors' knowledge) has verified the factor structure of the ERQ-CA using samples from U.S. adolescent population.…”

Temporal dynamics and longitudinal co-occurrence of depression and different anxiety syndromes in youth: Evidence for reciprocal patterns in a 3-year prospective study

“…Estimates suggest that half of depressed individuals have a comorbid anxiety disorder (Kessler et al, 2003). Comorbidity is associated with greater symptom and diagnostic severity, and worse social functioning (Queen & Ehrenreich-May, 2014). It has been frequently reported that anxiety precedes depression (e.g., Cole, Peeke, Martin, Truglio, & Seroczynski, 1998; Keenan, Feng, Hipwell, & Klostermann, 2009; Avenevoli, Stolar, Li, Dierker, & Merikangas, 2001).…”