Effects of personalized depression prevention on anxiety through 18-month follow-up: A randomized controlled trial.

Depression and anxiety frequently co-occur and share several risk factors. There is some evidence for transdiagnostic effects of prevention programs on depression and anxiety. In the Personalized Depression Prevention (PDP) study, youth (n = 98, Mage = 13.94 years, SD = 1.67) were classified as high or low on cognitive and interpersonal risk factors and randomized to either a cognitive-behavioral or an interpersonal prevention program. Some participants received a match between risk and prevention, others received a mismatch. Our initial work found evidence for the benefits of personalization on depression outcomes. In this paper, we focus on secondary anxiety outcomes through 18-months post-intervention. We found evidence for the benefits of personalized prevention on anxiety symptoms during the 18-month follow-up period, but not during the intervention. From post-intervention to 18-month follow-up matched youth showed a decrease in anxiety symptoms whereas mismatched youth showed a significant increase in symptoms (d = 0.87, p = .001). The rates of anxiety disorders were equivalent across the groups (p = 1.00). Given the comorbidity of depression and anxiety, interventions that have effects on both may be an efficient and cost-effective approach to reducing the burden associated with these conditions. A risk-informed personalization approach to prevention may be one way to enhance the transdiagnostic effects of depression prevention.

Internalizing symptoms and chronotype in youth: A longitudinal assessment of anxiety, depression and tripartite model.

Biological rhythm theories highlight the reciprocal relations between dysregulated circadian patterns and internalizing psychopathology. Chronotype characterizes individuals' diurnal preference, as some exhibit more morningness or eveningness. Previous research suggests that eveningness prospectively predicts depression in adolescence. Anxiety often co-occurs with depression, but little is known about longitudinal, reciprocal associations between chronotype and anxiety, and whether this relationship remains after controlling for depression. We assessed different forms of anxiety (social, panic, separation), positive/negative affect, anxious arousal (from tripartite theory), and depression, in relation to chronotype to better understand the specificity and directionality of associations between chronotype and internalizing problems in adolescence. Community youth participated in three assessment time points: T1, T2 (18-months post-T1), and T3 (30-months post-T1) as part of a larger longitudinal study. Youth completed self-report measures of anxiety, depression, positive and negative affect, and chronotype. Regression analyses showed that eveningness: (1) concurrently associated with decreased separation anxiety, elevated symptoms of depression and low levels of positive affect, (2) was prospectively predicted by elevated depression, (3) did not predict later symptoms of anxiety. The reciprocal, prospective relationship between chronotype and internalizing psychopathology is specific to depression during adolescence.

The relationship between depression and chronotype: A longitudinal assessment during childhood and adolescence.

BACKGROUND/OBJECTIVE: During adolescence, chronotype shifts toward "eveningness." "Eveningness" is related to negative physical and mental health outcomes. Little is known about what influences the shift in chronotype beyond pubertal status. The current study examined the influence of earlier depression predicting later individual differences in adolescent chronotype, accounting for pubertal status, and the prospective prediction of later increases in depression from earlier chronotype. METHODS: Youth (age M = 12.06, SD = 2.35; 56.5% girls) from the community completed repeated assessments of depression, including both self-reports (14 assessments) and diagnostic interviews (eight assessments), over a 48-month period. At the 36-month timepoint, participants completed chronotype and pubertal development measures. Regression and ANOVA analyses examined: (1) the influence of earlier depression levels (baseline to 36 months) upon chronotype, and (2) chronotype (at 36 months) upon later depression (48 months). RESULTS: Youth with higher earlier depression symptoms (ß = -0.347, P < .001) and history of depression diagnosis (ß = -0.13, P = .045) showed a greater eveningness preference controlling for pubertal status, age, and gender. Further, depression diagnosis history interacted with pubertal status to predict chronotype: (F(1,243) = 4.171, P = .045) such that the influence of depression on chronotype was greatest among postpubertal youth (t = 3.271, P = .002). Chronotype (greater eveningness preference) predicted prospective increases in depression symptoms (ß = -0.16, P = .03) and onset of depressive episode (b = -0.085, OR = 0.92, P = .03) 1 year later. CONCLUSION: Depression, experienced earlier in life, predicts greater preference for eveningness, especially among postpubertal youth. In turn, later depression is predicted by evening preference. These findings suggest the reciprocal interplay between mood and biological rhythms, especially depression and chronotype, during adolescence.