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.

Trajectories of positive and negative affect across adolescence: Maternal history of depression and adolescent sex as predictors.

BACKGROUND: Trajectories of affect vary across development, with normative increases in positive affect occurring during childhood and declines in positive affect appearing across adolescence. Little is known, however, about predictors of the trajectories of affect across adolescence. The present study examined associations between changes in adolescent affect across adolescence and maternal history of depression and child sex. METHODS: Participants were 240 adolescents and their mothers; 185 mothers had a history of depression (i.e., high risk) and 55 mothers did not (i.e., low risk). Youth were assessed annually from 6th grade (meanage = 11.86 years, SD = 0.57, 54.2 % female, 82 % White) through 12th grade. Latent growth models tested the relation of maternal depression history and adolescent sex with trajectories of adolescent affect. RESULTS: High-risk adolescents exhibited lower levels of PA as compared to low-risk youth (coefficient = -3.51, p = .008, 95 % CI [-6.11, -0.91]). Girls experienced earlier increases in negative affect (NA) as compared to boys, with more positive linear (coefficient = 2.07, p = .002, 95 % CI [0.774, 3.368]) and quadratic (coefficient = -0.29, p = .025, 95 % CI [-0.55, -0.04]) slopes. LIMITATIONS: Use of self-report measures and limited generalizability. CONCLUSION: Maternal depression significantly predicted decreases in offspring PA and distinct trajectories of NA in girls and boys. Interventions aimed at reducing risk in adolescent offspring of depressed parents may benefit from targeting PA and supporting girls in early adolescence.

Relationships between attention to emotion and anxiety among a community sample of adolescents.

BACKGROUND: Attentional bias to threat has been implicated as a cognitive mechanism in anxiety disorders for youth. Yet, prior studies documenting this bias have largely relied on a method with questionable reliability (i.e. dot-probe task) and small samples, few of which included adolescents. The current study sought to address such limitations by examining relations between anxiety - both clinically diagnosed and dimensionally rated - and attentional bias to threat. METHODS: The study included a community sample of adolescents and employed eye-tracking methodology intended to capture possible biases across the full range of both automatic (i.e. vigilance bias) and controlled attentional processes (i.e. avoidance bias, maintenance bias). We examined both dimensional anxiety (across the full sample; n = 215) and categorical anxiety in a subset case-control analysis (n = 100) as predictors of biases. RESULTS: Findings indicated that participants with an anxiety disorder oriented more slowly to angry faces than matched controls. Results did not suggest a greater likelihood of initial orienting to angry faces among our participants with anxiety disorders or those with higher dimensional ratings of anxiety. Greater anxiety severity was associated with greater dwell time to neutral faces. CONCLUSIONS: This is the largest study to date examining eye-tracking metrics of attention to threat among healthy and anxious youth. Findings did not support the notion that anxiety is characterized by heightened vigilance or avoidance/maintenance of attention to threat. All effects detected were extremely small. Links between attention to threat and anxiety among adolescents may be subtle and highly dependent on experimental task dimensions.

Experiences of Discrimination and Depression Trajectories over Pregnancy.

INTRODUCTION: Research on risk factors for prenatal depression is critical to improve the understanding, prevention, and treatment of women's psychopathology. The current study examines the relation between experiences of racial discrimination and trajectories of depression symptoms over the course of pregnancy. METHOD: Participants completed standardized measures regarding symptoms of depression at four timepoints during pregnancy and reported on experiences of racial discrimination at one timepoint. Latent growth curve modeling was used to examine the relation between discrimination and initial levels (intercept) and trajectories (slope) of depression symptoms over pregnancy. RESULTS: Participants were 129 pregnant individuals recruited from obstetric clinics and oversampled for elevated depression symptoms. Thirty-six percent of the participants were living at or below 200% of the federal poverty line. Fifty-four percent of the sample identified as non-Latinx White, 26% as Latinx, and 13% as non-Latinx Black. An unconditional latent growth curve modeling revealed a negative quadratic trajectory of depression symptoms during pregnancy. When women's report of discrimination was added as a predictor of depression trajectories, discrimination predicted the initial value (intercept) of depression symptoms, but not change over the course of pregnancy (slope). Specifically, higher levels of experiences of discrimination were associated with higher levels of depression symptoms. When sociodemographic and contextual covariates were included in the model, a low family income-to-needs ratio was also related to higher levels of depression symptoms. CONCLUSIONS: These findings provide evidence that women's experiences of racial discrimination and family financial strain are risk factors for prenatal depression, with implications for screening, treatment, and policy.

Affective Development from Middle Childhood to Late Adolescence: Trajectories of Mean-Level Change in Negative and Positive Affect.

Adolescence has long been purported to be a period of emotional upheaval, yet relatively little is known regarding normative patterns of change in youth positive and negative affect across the adolescent transition. This study addressed this gap by examining normative patterns of mean-level change in youth positive and negative affect from middle childhood through late adolescence, encompassing the full span of adolescent development. Participants included 665 youth recruited in 3rd, 6th, and 9th grade cohorts (55.0% female; age 9-16 at baseline) who provided self-report ratings of positive and negative affect every 18 months for a period of three years in an accelerated longitudinal cohort design. Multi-level growth curve models revealed that adolescence is characterized by declines in positive affect and non-linear patterns of alternating decreases and increases in negative affect. Patterns of change differed across boys and girls. The findings from this study indicate that adolescence is characterized by normative reductions in positive affect in the context of labile negative affect, with implications for understanding processes of risk and resilience across the adolescent transition.

Longitudinal patterning of depression repeatedly assessed across time among youth: Different trajectories in self-report questionnaires and diagnostic interviews.

Developmental epidemiological work shows that rates of depression as assessed by diagnostic interviews increase from childhood through early adulthood. It could be assumed that the trajectory of depression as assessed by self-report questionnaire measures would be characterized by a similar pattern. We aimed to evaluate this assumption and more clearly establish the longitudinal trajectory of depression in youth, when repeatedly assessed over time with a self-report questionnaire and with a diagnostic interview. Participants were 679 youth ages 7-16 years at baseline (Mage = 11.8, SD = 2.4, 56% girls). They completed the Children's Depression Inventory (CDI) every 3 months for 3 years (13 time points) and were interviewed every 6 months using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) to ascertain onset of depression diagnosis. A series of growth curve models was fit to the CDI and K-SADS data. A piecewise model characterized growth in depression as assessed by the CDI, with an initial negative linear slope (b = -0.64) spanning the first 3 assessments, and a positive quadratic second slope (b = 0.015; linear component: b = -0.22) spanning the remaining 10 assessments. Depression, as assessed by the K-SADS, grew continuously over time (a positive linear slope, b = 0.23). Findings illustrate differences between longitudinal trajectories of depression when assessed repeatedly by self-report questionnaire and diagnostic interview. Implications for research designed to study longitudinal depression trajectories are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Subjective Executive Function Weaknesses Are Linked to Elevated Internalizing Symptoms Among Community Adolescents.

Adolescence is a period of high risk for the emergence of problems with anxiety and depression. Theory and research suggest that executive function deficits accompany internalizing and externalizing problems, although more evidence is required to understand these relationships. This study employed a commonly used rating scale of executive function, the Brief Rating Inventory of Executive Function, and examined relationships with self- and parent-reported internalizing and externalizing problems among a community sample of 299 adolescents. The sample was 56.2% female, with a mean age of 16.22 years (SD = 2.36 years). Analyses revealed strong associations between poorer self- and parent-reported executive function skills and the severity of anxiety and depression symptoms. Problems with executive function were also associated with externalizing symptoms. These results indicate that subjective ratings of executive function capture important aspects of cognitive problems that are highly relevant to adolescent psychopathology in a transdiagnostic fashion.

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.

A Preliminary Multimethod Comparison of Sleep Among Adolescents With and Without Generalized Anxiety Disorder.

Previous studies suggest that youth with anxiety disorders experience their sleep as more disrupted and unsatisfying than their healthy peers. However, it is unclear whether these subjective complaints align with objective measures of sleep quantity and quality. The purpose of this preliminary study was to assess subjective and objective sleep parameters, and their relationships with anxiety symptomatology, among adolescents (62.8% female, 81.4% Caucasian), ages 12 to 18 (M = 15.29 years), with generalized anxiety disorder (n = 26) and controls without any psychopathology (n = 17). We measured sleep over 7 nights using sleep diaries and actigraphy and collected self- and parent-report questionnaires pertaining to sleep, anxiety, and depression. Repeated-measures mixed models were used to examine relationships between nightly sleep duration and morning anxiety. We found a number of differences in sleep between our anxious and healthy participants. Via sleep diary, our anxious participants had longer sleep onset latencies and lower satisfaction with sleep relative to controls, whereas via actigraphy we found longer sleep onset latencies but greater overall sleep duration among anxious versus control participants. Actigraphic measures of sleep disturbance were associated with parent-report of anxiety and depression. Our mixed-model analyses revealed that decreases in nightly sleep duration were associated with increased morning anxiety, but only among our participants with generalized anxiety disorder. Findings suggest that sleep disturbance among anxious adolescents can be detected using both subjective and objective measures and that, for these individuals, fluctuations in sleep duration may have real consequences for daytime anxiety.