Developmental trajectories of co-occurring depressive, eating, antisocial, and substance abuse problems in female adolescents

Growth trajectories of co-occurring symptomatology were examined in a community sample of 493 female adolescents who were followed annually from early to late adolescence. On average, depression, eating disorder, and substance abuse symptoms increased over time, whereas antisocial behavior decreased. Increases in each symptom domain were associated with relative increases in all other domains. Initial depressive and antisocial behavior symptoms predicted future increases in the other; substance abuse and antisocial behavior symptoms also showed prospective reciprocal relations. Initial depression predicted increases in eating disorder and substance abuse symptoms. Initial eating disorder symptoms predicted increases in substance abuse problems. Finally, the results suggest that the developmental covariation between depressive and eating disorder symptoms and between antisocial behavior and substance abuse symptoms was accounted for by distinct but related 2nd-order growth parameters.     

A multimethod examination of the stability of depressive symptoms in childhood and adolescence

In an 8-wave, 2-cohort longitudinal study, children and adolescents were followed from the fall of 5th grade to the spring of 8th grade. Participants (N = 1,269), their parents, and peers completed reports of depressive symptoms at 6-month intervals. The use of a 2-group latent variable autoregressive model to examine the stability of depressive symptomatology revealed several trends. First, the 6-month stability of depressive symptoms was high for boys and girls. Second, the stability of depressive symptomatology was lower between the spring of 6th grade and the fall of 7th grade than during any other point in the study. Finally, the stability of depressive symptoms did not differ with respect to gender.     

Pubertal transition, stressful life events, and the emergence of gender differences in adolescent depressive symptoms

This study examined the role of both pubertal and social transitions in the emergence of gender differences in depressive symptoms during adolescence. This study generated the following findings: (a) Gender differences in depressive symptoms emerged during 8th grade and remained significant through 12th grade. (b) Pubertal status in 7th grade was related to adolescent depressive symptoms over time. (c) Early-maturing girls represented the group with the highest rate of depressive symptoms. (d) Depressive symptoms measured in 7th grade predicted subsequent symptom levels throughout the secondary school years. (e) Recent stressful life events were associated with increased depressive symptoms. (f) Early-maturing girls with higher levels of initial symptoms and more recent stressful life events were most likely to be depressed subsequently. The findings demonstrate the importance of the interaction between the pubertal transition and psychosocial factors in increasing adolescent vulnerability to depressive experiences.     

Joint Trajectories of Symptoms of Disruptive Behavior Problems and Depressive Symptoms During Early Adolescence and Adjustment Problems During Emerging Adulthood

The joint, longitudinal trajectories of symptoms of disruptive behavior problems and of depression were examined in a community sample drawn from neighborhoods with elevated rates of delinquency. Growth mixture modeling was applied to a 6?year transition period from childhood to adolescence, age 10 to 16?years, to identify latent classes of trajectories for each symptom type. Several classes emerged for the two types of symptoms, namely a group of youth with high levels of disruptive behavior, a group with increasing levels, and a group with low levels, as well as a group with increasing levels of depression, a group with high levels, a group with decreasing levels, and a group with low levels. Within each symptom type, membership in either the high or in the increasing classes was related to a variety of problematic outcomes during emerging adulthood. The co-occurrence of the disruptive behavior and depression classes was then evaluated using parallel process analysis. Youth exhibiting high depressive symptoms were at increased risk for disruptive behavior problems, and youth with increasing disruptive behavior problems were at risk for depressive symptoms. However, only a very small number of youth had both a high depression trajectory and a high disruptive behavior trajectory. Implications of the findings for the design of prevention and treatment programs are discussed.     

Emotion Regulation Mediates the Relationship between ADHD and Depressive Symptoms in Youth

A significant literature suggests that youth diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) are at increased risk for later depression relative to youth without ADHD. Youth with co-occurring ADHD and depression experience more serious impairments and worse developmental outcomes than those with either disorder alone, including increased rates of suicidal ideation and suicide completion. Despite these very serious outcomes, few studies have examined the mechanisms underlying the relationship between ADHD and depression in youth. The present study examined emotion regulation (ER) as a mediator of the relationship between ADHD and depressive symptoms in 69 youth between the ages of 10 and 14, with (n?=?37) and without (n?=?32) ADHD. Parent and youth ratings of depressive symptoms and ER were collected. Youth with ADHD reported significantly more depressive symptoms and poorer ER ability relative to youth without ADHD. ER fully mediated the relationship between ADHD and depressive symptoms. Limitations and clinical implications are discussed.     

Maternal Depression and Youth Internalizing and Externalizing Symptomatology: Severity and Chronicity of Past Maternal Depression and Current Maternal Depressive Symptoms

Maternal depression is a well-documented risk factor for youth depression, and taking into account its severity and chronicity may provide important insight into the degree of risk conferred. This study explored the degree to which the severity/chronicity of maternal depression history explained variance in youth internalizing and externalizing symptoms above and beyond current maternal depressive symptoms among 171 youth (58 % male) ages 8 to 12 over a span of 3 years. Severity and chronicity of past maternal depression and current maternal depressive symptoms were examined as predictors of parent-reported youth internalizing and externalizing symptomatology, as well as youth self-reported depressive symptoms. Severity and chronicity of past maternal depression did not account for additional variance in youth internalizing and externalizing symptoms at Time 1 beyond what was accounted for by maternal depressive symptoms at Time 1. Longitudinal growth curve modeling indicated that prior severity/chronicity of maternal depression predicted levels of youth internalizing and externalizing symptoms at each time point when controlling for current maternal depressive symptoms at each time point. Chronicity of maternal depression, apart from severity, also predicted rate of change in youth externalizing symptoms over time. These findings highlight the importance of screening and assessing for current maternal depressive symptoms, as well as the nature of past depressive episodes. Possible mechanisms underlying the association between severity/chronicity of maternal depression and youth outcomes, such as residual effects from depressive history on mother–child interactions, are discussed.     

"Learning to live with what you can't rise above": control beliefs, symptom control, and adjustment to tinnitus.

The relations between 3 types of perceived control, symptom severity, and 2 adaptational outcomes, depressive symptoms and psychological well-being, were examined in a sample of 319 people with tinnitus. Consistent with previous studies of control and adjustment to chronic health conditions, general health and symptom control were associated with better psychological adjustment, and retrospective control was associated with worse psychological adjustment. Only symptom control emerged as a significant moderator in the symptom severity-adjustment relationship, such that stronger beliefs in one's ability to control symptoms were most strongly associated with better adjustment among those with more severe tinnitus symptoms. These findings were consistent with coping perspectives and cognitive adaptation theory and suggest that symptom-related perceptions of control may be an effective coping resource to nurture in chronic health contexts with severe symptoms.     

Risk for suicidal ideation and suicide attempts associated with co-occurring depression and conduct problems in early adolescence

This study investigates the early manifestation of co-occurring depression and conduct problems as a predictor of heightened risk for later suicidal ideation and behavior in a community sample of 521 adolescents. Self-reported symptoms of depression and conduct problems were evaluated in early 6th grade. Suicidal thoughts and behaviors were tracked through multiple assessments carried out over the middle school years. Compared to adolescents with depression symptoms only, conduct problem symptoms only, or low psychopathology, those with co-occurring depression and conduct problem symptoms had the highest risk for subsequent suicidal ideation, recurrent suicidal behaviors, and suicide attempts.     

Reducing depression among at-risk early adolescents: three-year effects of a family-centered intervention embedded within schools

The Adolescent Transitions Program (ATP) is a family-focused multilevel prevention program designed for delivery within public middle schools to target parenting factors related to the development of behavior problems in early adolescence. The current study examines the effects of the ATP on the development of youth depressive symptoms across early adolescence in a sample of 106 high-risk youths. Youths were recruited in 6th grade, and selected as high risk based on teacher and parent reports of behavioral or emotional problems. Depression symptoms were based on youth and mother reports in 7th, 8th, and 9th grades. Receipt of the family-centered intervention inhibited growth in depressive symptoms in high-risk youths over the 3 yearly assessments compared with symptoms in high-risk youths in the control group. Results support the notion that parental engagement in a program designed to improve parent management practices and parent-adolescent relationships can result in collateral benefits to the youths' depressive symptoms at a critical transition period of social and emotional development.     

Specific Phobia in Youth: Phenomenology and Psychological Characteristics

Sociodemographic and psychological characteristics of 62 youth with animal and natural environment types of specific phobia were examined in a treatment-seeking sample. Differences due to age, sex, ethnicity, family structure, and family socioeconomic status were not found between youth with the two types of specific phobia. Moreover, differences were not obtained between the two groups in the clinical severity of their phobias, the perceived dangerousness of the feared outcomes associated with their phobias, the perceived levels of coping with their phobias, or overall fearfulness. However, differences between youth with the two types of specific phobias were found on somatic/anxious symptoms, depressive symptoms, and life satisfaction. In addition, differences were noted on withdrawn, somatic complaints, anxious/depressed symptoms, and social problems as reported by the mothers of these youngsters. Finally, differences in the percent of co-occurring anxiety disorders between youth with the two types of specific phobia were found. On all of the domains in which differences were found, youth with the natural environment type fared more poorly than those with the animal type. These findings converge with those obtained in treatment studies which indicate that youth with the natural environment type are more difficult to treat than youth with the animal type.     

Maternal Depression and Children’s Cognitive and Socio-Emotional Development at First Grade: The Moderating Role of Classroom Emotional Climate

This study examined whether a warm and positive classroom emotional climate would buffer the detrimental effects of maternal depression on children’s cognitive and socioemotional adjustment at first grade. Based on 1364 dyads, four waves of data spanning 6 months to first grade were used to examine paths between mothers’ early cumulative depressive symptoms and five first-grade outcomes (internalizing and externalizing behavior problems, social competence, academic functioning, and relationship with teachers). Classroom emotional climate was observed at first grade. Multiple group modeling revealed that children who were placed in a classroom that was characterized by a warm and positive emotional climate were shown to be less severely, or not, affected by mothers’ depressive symptoms in terms of the development of externalizing problems, social skills, cognitive performance, and relational functioning. Guided by the bioecological perspective, the current study showed synergic effects of intra-familial and extra-familial elements on an array of children’s developmental outcomes over time.     

Depressive Symptoms and Conversational Self-Focus in Adolescents’ Friendships

This multi-method, longitudinal study considered the interplay among depressive symptoms, aversive interpersonal behavior, and interpersonal rejection in early and middle adolescents’ friendships. In particular, the study examined a newly identified interpersonal process, conversational self-focus (i.e., the tendency to redirect conversations about problems to focus on the self). Traditional interpersonal theories of depression suggest that individuals with depressive symptoms engage in aversive behaviors (such as conversational self-focus) and are rejected by others. However, in the current study, not all adolescents with depressive symptoms engaged in conversational self-focus and were rejected by friends. Instead, conversational self-focus moderated prospective relations of depressive symptoms and later friendship problems such that only adolescents with depressive symptoms who engaged in conversational self-focus were rejected by friends. These findings are consistent with current conceptualizations of the development of psychopathology that highlight heterogeneity among youth who share similar symptoms and the possibility of multifinality of outcomes.     

Prospective Associations Between Peer Victimization and Internalizing Symptoms in Adolescence: The Protective Role of Hope

Youth who experience aggression at the hands of peers are at an increased risk for a variety of adjustment difficulties, including depressive and anxiety symptoms and lower self-esteem. The links between peer victimization and internalizing problems are robust, but less work has been done to identify individual-level protective factors that might mitigate these outcomes. The current study investigated whether hope served as a moderator of the prospective links from peer victimization to depressive and anxiety symptoms and self-esteem during adolescence. Participants included 166 high school students (64% female; 88% Black/African American). Youth completed self-report measures at three different time points across the Spring semester of an academic year. As predicted, hope interacted with peer victimization to predict changes in depressive and anxiety symptoms over the course of the semester. That is, for youth with low levels of hope, peer victimization predicted more stable patterns of depressive and anxiety symptoms. For adolescents with average levels of hope, however, peer victimization did not influence anxiety and depressive symptoms over time. Finally, for adolescents with high levels of hope, peer victimization predicted greater decreases in anxiety symptoms over time. Hope did not interact with peer victimization to predict self-esteem. Rather, hope uniquely predicted higher levels of self-esteem, whereas peer victimization uniquely predicted lower levels of self-esteem. The current study provides initial support for the notion that hope can serve as a protective factor among youth who are victims of peer aggression.

     

A Longitudinal Examination of Correlates of Depressive Symptoms Among Inner-City African-American Children and Adolescents

We longitudinally examined across four years the presence and correlates of depressive symptoms in a sample of inner-city African-American children, an ethnic minority population which is understudied regarding child depressive symptoms. Results, based on mother- and child-report, did not indicate gender differences in depressive symptoms at the onset of adolescence. However, depressive symptoms did significantly predict future child adjustment problems. Implications for the understanding and future study of depressive symptoms in ethnic minority youth are discussed.     

Adjustment following sexual abuse discovery: the role of shame and attributional style.

This study examined adjustment following sexual abuse as a function of shame and attributional style. One hundred forty-seven participants (83 children and 64 adolescents) were seen at the time of abuse discovery and again 1 year later. Once adjustment at abuse discovery was accounted for, shame and attribution style explained additional variation in subsequent adjustment, whereas abuse severity did not. A pessimistic attribution style at abuse discovery moderated the relation between severity of abuse and subsequent depressive symptoms and self-esteem. The relations between abuse severity and these outcomes were significant only at high levels of pessimistic attribution style. Of note, patterns of change in shame and attribution predicted which children remained at risk or improved in adjustment. In addition, age and gender differences were found in adjustment over time.     

Choosing or Being Chosen by Aggressive–Disruptive Peers: Do They Contribute to Children's Externalizing and Internalizing Problems?

The goal of this study was to investigate the extent to which aggressive-disruptive peers contribute to the development of externalizing and internalizing problems in children, while controlling for children's own behavior. We examined 2 sets of peers: (1) those that the child nominated as friends, and (2) those that nominated the child as a friend. The participants were 236 boys and girls attending 3rd to 5th grade at the beginning of the study, who were followed over a period of 2 years. Results showed that choosing more aggressive peers on the nomination procedure was associated with more externalizing problems and self-reported depressive symptomatology over time. On the other hand, being liked by more aggressive children generally was not associated with elevated externalizing or internalizing problems.     

Examining Anxiety and Depression as Moderators of the Associations Between ADHD Symptoms and Academic and Social Problems in Hispanic Adolescents

The effects of attention-deficit/hyperactivity disorder (ADHD) symptoms on the psychosocial functioning of Hispanic youth have been understudied. It also remains unclear if the well-established associations between ADHD symptoms and academic and social impairment are exacerbated by co-occurring internalizing symptoms. The purposes of the present study were to (1) examine whether ADHD symptoms would be associated with academic and social problems while also controlling for oppositional defiant disorder (ODD) symptoms, and (2) test the hypothesis that anxious and depressive symptoms would moderate the relations between ADHD symptoms and academic and social problems. Participants were 142 at-risk Hispanic adolescents (54 % male, ages 14–19) who reported on their anxious and depressive symptoms, as well as their teachers who reported on adolescents’ ADHD symptoms, ODD symptoms, academic problems, and social problems. When the psychopathology variables were included simultaneously in a path model, ADHD was the only domain significantly positively associated with academic problems. In contrast, ODD and depressive symptoms were the only domains significantly positively associated with social problems when all of the psychopathology variables were included in the path model. No moderation effects were found in relation to academic problems, although a significant ADHD × depression interaction was found in relation to social problems. Specifically, ADHD symptoms were not associated with social problems among adolescents who reported low levels of depressive symptoms, but the association between ADHD symptoms and social problems was significant at higher levels of depression. In addition to targeting oppositionality, attending to the combined presence of ADHD and depressive symptoms will be important for reducing the social impairments among Hispanic adolescents.     

Peer victimization and suicidal ideation: The role of gender and depression in a school-based sample

The current study investigated the relations among traditional and cyber victimization, depressive symptoms, suicidal ideation, and gender in a school-based sample of 403 9th grade (13 to 16-year-old) adolescents. Path analyses indicated that both traditional victimization and cyber victimization were associated with suicidal ideation indirectly through depressive symptoms. Although there was little evidence of gender differences in the associations among peer victimization and depressive symptoms and suicidal ideation, the relation between depressive symptoms and suicidal ideation was found to be significantly stronger for girls than boys. The current investigation confirms the complexity of the association between peer victimization and suicidal ideation and that depressive symptoms, as well as gender, may play a role in this complex relation. Future research should continue to explore the associations among victimization, depressive symptoms, and suicidal ideation within a social ecological framework.     

Linkages between depressive symptomatology and Internet harassment among young regular Internet users.

Recent reports indicate 97% of youth are connected to the Internet. As more young people have access to online communication, it is integrally important to identify youth who may be more vulnerable to negative experiences. Based upon accounts of traditional bullying, youth with depressive symptomatology may be especially likely to be the target of Internet harassment. The current investigation will examine the cross-sectional relationship between depressive symptomatology and Internet harassment, as well as underlying factors that may help explain the observed association. Youth between the ages of 10 and 17 (N = 1,501) participated in a telephone survey about their Internet behaviors and experiences. Subjects were required to have used the Internet at least six times in the previous 6 months to ensure a minimum level of exposure. The caregiver self-identified as most knowledgeable about the young person's Internet behaviors was also interviewed. The odds of reporting an Internet harassment experience in the previous year were more than three times higher (OR: 3.38, CI: 1.78, 6.45) for youth who reported major depressive symptomatology compared to mild/absent symptomatology. When female and male respondents were assessed separately, the adjusted odds of reporting Internet harassment for males who also reported DSM IV symptoms of major depression were more than three times greater (OR: 3.64, CI: 1.16, 11.39) than for males who indicated mild or no symptoms of depression. No significant association was observed among otherwise similar females. Instead, the association was largely explained by differences in Internet usage characteristics and other psychosocial challenges. Internet harassment is an important public mental health issue affecting youth today. Among young, regular Internet users, those who report DSM IV-like depressive symptomatology are significantly more likely to also report being the target of Internet harassment. Future studies should focus on establishing the temporality of events, that is, whether young people report depressive symptoms in response to the negative Internet experience, or whether symptomatology confers risks for later negative online incidents. Based on these cross-sectional results, gender differences in the odds of reporting an unwanted Internet experience are suggested, and deserve special attention in future studies.     

Early Adolescent Growth in Depression and Conduct Problem Symptoms as Predictors of Later Substance Use Impairment

Most studies of adolescent substance use and psychological comorbidity have examined the contributions of conduct problems and depressive symptoms measured only at particular points-in-time. Yet, during adolescence, risk factors such as conduct problems and depression exist within a developmental context, and vary over time. Though internalizing and comorbid pathways to substance use have been theorized (Hussong et al. Psychology of Addictive Behaviors 25:390-404, 2011), the degree to which developmental increases in depressive symptoms and conduct problems elevate risk for substance use impairment among adolescents, in either an additive or potentially a synergistic fashion, is unclear. Using a school-based sample of 521 adolescents, we tested additive and synergistic influences of changes in depressive symptoms and conduct problems from 6th to 9th grade using parallel process growth curve modeling with latent interactions in the prediction of late adolescent (12th grade) substance use impairment, while examining gender as a moderator. We found that the interaction between growth in depression and conduct disorder symptoms uniquely predicted later substance use problems, in addition to main effects of each, across boys and girls. Results indicated that adolescents whose parents reported increases in both depression and conduct disorder symptoms from 6th to 9th grade reported the most substance use-related impairment in 12th grade. The current study demonstrates that patterns of depression and conduct problems (e.g., growth vs. decreasing) are likely more important than the static levels at any particular point-in-time in relation to substance use risk.