Bidirectional Influences of Anxiety and Depression in Young Children

Abstract

Anxiety and depression tend to co-occur in children. Studies indicate that higher levels of anxiety are associated with subsequent higher levels of depression, while depression may inhibit subsequent anxiety. It is important to increase our understanding of the temporal sequencing of these disorders and, particularly, to determine if suppression effects account for the inhibitory association. In addition, further information about these relationships in young children is needed. Participants were a diverse (20.4 % Hispanic, 16.7 % African American; 49.1 % boys) community sample of 796 children with data available at ages 4, 5, and 6–7 years. Anxiety and depression symptoms were assessed using the Child Symptom Inventory and symptom count measures from the Diagnostic Interview Schedule for Children-Parent Scale-Young Child version. The results indicated: (a) anxiety and depression were relatively stable over time; (b) anxiety at age 4 and 5 was a significant positive predictor of subsequent depression; (c) while an inhibitory effect of depression on subsequent anxiety was found, that inhibitory effect was due to negative suppression, and higher levels of depression were actually associated with subsequent anxiety; (e) consistent with a significant suppression effect, when depression was included as a predictor, the association between anxiety at ages 4 and 5 and anxiety one year later increases in magnitude. Both anxiety and depression are associated with higher levels of one another in the subsequent year. Implications for prevention are discussed.

Anxiety and Depression in Children of Depressed Parents: Dynamics of Change in a Preventive Intervention

“…Previous studies examining symptoms of anxiety and depression in interventions for youth have been limited to examining one set of symptoms or how comorbidity impacts treatment in one direction. Consistent with previous descriptive studies (e.g., Hale et al, 2009; Lavigne et al, 2015), the current study found evidence of bidirectional effects of symptoms of anxiety and depression, both for initial symptom levels and symptom changes over time, offering a more complete picture of how these symptoms are related over the course of a preventive intervention. Further, the study provides multi-informant reports of symptoms over time.…”

“…Although some studies have found that symptoms of anxiety developmentally precede symptoms of depression (e.g., Cole, Peeke, Martin, Truglio, & Seroczynski, 1998; Keenan, Feng, Hipwell, & Klostermann. 2009; Snyder et al, 2009), there is a growing record of evidence to support a bidirectional relationship between these symptoms across development (e.g., Hale, Raaijmakers, Muris, van Hoof, & Meeus, 2009; Lavigne, Hopkins, Gouze, & Bryant, 2015; Moffitt et al, 2007). For example, Hale et al (2009) found that in a sample of children and adolescents at-risk for anxiety, higher levels of anxiety symptoms positively predicted the slope of depressive symptoms over time and vice versa, such that initially high levels of symptoms predicted less reduction in the parallel symptom.…”

“…For example, Hale et al (2009) found that in a sample of children and adolescents at-risk for anxiety, higher levels of anxiety symptoms positively predicted the slope of depressive symptoms over time and vice versa, such that initially high levels of symptoms predicted less reduction in the parallel symptom. Lavigne et al (2015) built upon previous research examining the bidirectional relationship between anxiety and depression across three points in time (ages 4, 5, 6), assessing multiple indicators of the latent constructs of anxiety and depression. In this study, the authors found a bidirectional influence of anxiety and depressive symptoms on one another in a community sample of children, such that symptoms of anxiety and depression were associated with higher levels of one another one year later.…”

A hierarchical causal taxonomy of psychopathology across the life span.

“…There also is evidence that first-order dimensions (and diagnoses) in the distress domain significantly predict other dimensions or diagnoses in the fears domain (Copeland et al, 2009; Lavigne et al, 2015; Mathyssek, Olino, Verhulst, & van Oort, 2012; Ormel et al, 2015). The studies reviewed in this section did not consistently find that every fears dimension prospectively predicted every distress dimension and vice versa, perhaps due partly to insufficient statistical power.…”

Interactive Effects of Psychosocial Stress and Early Pubertal Timing on Youth Depression and Anxiety: Contextual Amplification in Family and Peer Environments

“…We examined both depressive and anxiety symptoms as these two outcomes have received differential attention (i.e., depressive symptoms have received more attention), have yielded inconsistent findings across studies (e.g., Blumenthal, Leen-Feldner, Trainor, Babson, & Bunaciu, 2009; Conley & Rudolph, 2009), and have generated different findings when examined in the same study (e.g., Hamlat, Stange, Abramson, & Alloy, 2013). Furthermore, it has been recommended that viewing depression and anxiety symptoms as separate but related constructs is ideal for both research and practice on emotional health problems in youth (Lavigne, Hopkins, Gouze, & Bryant, 2014; Snyder et al, 2009). We examine peer problems and harsh parenting as stressors as both could amplify early puberty timing; however, as there are no studies that have included both of these types of stressors, we do not offer differential predictions.…”