Cited by 263Child and Adolescent Psychosocial and Emotional DevelopmentMental Health Treatment and AccessAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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Depression in Children and Adolescents

Garber, Judy·2006·American Journal of Preventive Medicine

DOI 10.1016/j.amepre.2006.07.007

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Abstract

The National Institute of Mental Health has called for translational research linking basic knowledge about vulnerabilities that underlie mood disorders to the development of effective preventive interventions. This paper highlights research about risk factors for depression in children and adolescents and links it to current knowledge about interventions aimed at preventing depression in youth. Basic epidemiologic and clinical research indicates that increased risk for depression is associated with being female; a family history of depression, particularly in a parent; subclinical depressive symptoms; anxiety; stressful life events; neurobiological dysregulation; temperament/personality (e.g., neuroticism); negative cognitions; problems in self-regulation and coping; and interpersonal dysfunction. These vulnerabilities both increase individuals' chances of encountering stress and decrease their ability to deal with the stress once it occurs. Although several existing depression-prevention studies have targeted one or more of these risk factors, the efficacy of these various prevention programs for youth with different combinations of these risk factors needs to be investigated further. Most existing depression-prevention programs in youth have used cognitive-behavioral techniques, with some success. Other depression-prevention strategies have included training in coping, social problem solving, social skills, communication skills, and parenting. A comprehensive prevention program is recommended that includes multiple intervention components, each of which addresses risk and protective factors across different domains and levels of analysis.

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The Relationship Between Parents’ Poor Emotional Health Status and Childhood Mood and Anxiety Disorder in Florida Children, National Survey of Children’s Health, 2011–2012
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“Also consistent with national findings [8–13], the odds of having a mood or anxiety disorder among Florida children were approximately five times greater for children living with a parent in poor emotional health compared to children living with a parent whose emotional health status was good.”
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Mittelfristige Effekte des Präventionsprogramms EFFEKT-E für emotional belastete Mütter und ihre Kinder unter besonderer Berücksichtigung psychosozialer Risikofaktoren
Kötter, C., Stemmler, M., Lösel, F. A., Bühler, A., & Jaursch, S. (2011) · Zeitschrift für Gesundheitspsychologie · doi:10.1026/0943-8149/a000043 · Cited by 15
How to Identify Students for School‐Based Depression Intervention: Can School Record Review Be Substituted for Universal Depression Screening?
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“A meta-analytic review conducted in 2006 determined that indicated depression interventions tend to be more effective than universal ones (Horowitz & Garber, 2006).”
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Parental Depression Confers Greater Prospective Depression Risk to Females than Males in Emerging Adulthood
Morris, B. H., McGrath, A. C., Goldman, M. S., & Rottenberg, J. A. (2013) · Child Psychiatry & Human Development · doi:10.1007/s10578-013-0379-5 · Cited by 15
“Recent commentaries on the future of depression risk research emphasize the importance of studying the interaction of risk factors, including gender [1, 3].”
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Parents' clinical depression and children's problem behaviors: A multi-level meta-analytic examination
Aaron, L., Kaplan, R. M., & Black, S. R. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.08.199 · Cited by 16
Depression and Anxiety Symptoms in Female Adolescents: Relations with Parental Psychopathology and Parenting Behavior
Rasing, S. P. A., Braam, M. W. G., Brunwasser, S. M., Janssens, J., Creemers, D. H. M., & Scholte, R. H. J. (2019) · Journal of Research on Adolescence · doi:10.1111/jora.12525 · Cited by 14
The Association of Pain and Depression in Preadolescent Girls: Moderation by Race and Pubertal Stage
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“depression (Garber, 2006), and it may be that these dimen-”
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Avatar-based counselling for psychological distress in secondary school pupils: pilot evaluation
Cooper, M., van Rijn, B., & Chryssafidou, E. (2018) · British Journal of Guidance and Counselling · doi:10.1080/03069885.2018.1506567 · Cited by 14
“This finding may also reflect gender differences in therapy preferences, with female clients valuing more the interpersonal relation and the expression of feelings, while, when dealing with negative emotions, male clients tend to prefer a logical, systematic, and structured approach (Garber, 2006).”
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Sub-syndromal depression in adolescents attending primary care: frequency, clinical features and 6 months outcome
Gledhill, J. A., & Garralda, M. E. (2012) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-012-0572-z · Cited by 14
A Retrospective Evaluation of a Wilderness-Based Leadership Development Programme
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“These findings suggest that the LP is developing participants’ intra- and interpersonal skills, and these have been shown to be protective against mental ill-health (Donald & Dower, 2002; Garber, 2006).”
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A systematic review of delivery modes in school‐based adolescent social–emotional learning programs—Current perspectives and future directions
Lynn, S., Carroll, A., Nankervis, K. L., & Antrobus, E. (2024) · Review of Education · doi:10.1002/rev3.70019 · Cited by 20
Mental health in Somali youth in the United States: the role of protective factors in preventing depressive symptoms, suicidality, and self-injury
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“Risk and protective factors for depression, suicidality, and self-injury among general samples of adolescents are well-described (Garber 2006; et al. 1993; Resnick et al. 1997).”
Background
Hippocampal subregion volume in high-risk offspring is associated with increases in depressive symptoms across the transition to adolescence
Hubachek, S. Q., Botdorf, M., Riggins, T., Leong, H.-C., Klein, D. N., & Dougherty, L. R. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.12.017 · Cited by 14
“A major focus of research is to understand the complex array of biological, genetic, and environmental mechanisms by which risk is transmitted from parents to offspring (Garber, 2006; Sullivan et al., 2000).”
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Next Steps for Research on Child and Adolescent Depression Prevention
Kovács, M. (2006) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2006.07.008 · Cited by 12
Using population attributable risk to help target preventive interventions for adolescent depression
Booth, K. V. P., Paunesku, D., Msall, M. E., Fogel, J., & Voorhees, B. W. V. (2008) · International Journal of Adolescent Medicine and Health · doi:10.1515/ijamh.2008.20.3.307 · Cited by 11
Maternal adherence to healthy lifestyle and risk of depressive symptoms in the offspring: mediation by offspring lifestyle
Wang, W.-C., Ding, M., Strohmaier, S., Schernhammer, E. S., Sun, Q., Chavarro, J. E., & Tiemeier, H. W. (2022) · Psychological Medicine · doi:10.1017/s0033291722003257 · Cited by 10
“Explanations for the occurrence of depressive disorders include biological and psychosocial risk factors (Bernaras, Jaureguizar, & Garaigordobil, 2019; Garber, 2006).”
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Can Basic Risk Research Help in the Prevention of Childhood and Adolescent Depression? Examining a Cognitive and Emotional Regulation Approach
Rice, F. J., & Rawal, A. (2010) · Depression Research and Treatment · doi:10.1155/2011/871245 · Cited by 13
“Children and adolescents with high levels of anxiety may be one such group given observations that anxiety often precedes depression and shows high levels of comorbidity with depression [17].”
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Prevention of Depression in Children and Adolescents
Sims, B. E., Nottelmann, E. D., Koretz, D. S., & Pearson, J. C. (2007) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2007.02.011 · Cited by 10
Evaluation of MyTeen – a SMS-based mobile intervention for parents of adolescents: a randomised controlled trial protocol
Chu, J. T. W., Whittaker, R., Jiang, Y., Wadham, A. K., Stasiak, K., Shepherd, M., & Bullen, C. (2018) · BMC Public Health · doi:10.1186/s12889-018-6132-z · Cited by 10
“The serious developmental consequences of adolescent depression, the associated treatment challenges and the high costs once it has developed, underscore the need for interventions aimed at prevention [8, 9].”
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Teenage Blues: Predictors of depression among adolescents in Nigeria
Nzeakah, C. W., Nzeakah, C., Onofa, L. E. U., DadeMatthews, O. D., & Ogundare, T. (2024) · PLoS ONE · doi:10.1371/journal.pone.0293995 · Cited by 18
Key Components and Content of Effective Evidence-Based Digital Prevention Programs for Anxiety and Depression in Children and Adolescents: A Systematic Umbrella Review
Reitegger, F., Peras, I., Wright, M., & Gasteiger‐Klicpera, B. (2024) · Adolescent Research Review · doi:10.1007/s40894-024-00237-z · Cited by 13
Prevention of familial transmission of depression through a family‐oriented programme targeting parenting as well as the child's social competence
Stemmler, M., Kötter, C., Bühler, A., Jaursch, S., Beelmann, A., & Lösel, F. A. (2013) · Journal of Children s Services · doi:10.1108/17466661311309754 · Cited by 9
Study protocol for a randomized controlled trial of a group cognitive-behavioral course for depressed adolescents
Idsøe, T., & Keleş, S. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0954-y · Cited by 9
“Depression is associated with a range of problems, like school dropout, school difficulties, health problems, increased substance abuse, suicide, as well as problems with peers and family [18–21].”
Background
Three-way interaction effects of early life stress, positive parenting and FKBP5 in the development of depressive symptoms in a general population
Keijser, R., Olofsdotter, S., Nilsson, K. W., & Åslund, C. (2021) · Journal of Neural Transmission · doi:10.1007/s00702-021-02405-0 · Cited by 9
“2013; Garber 2006; LeMoult et al.”
A Journey to Embodied Healing: Yoga as a Treatment for Post-Traumatic Stress Disorder
Jindani, F., & Khalsa, G. F. S. (2015) · Journal of Religion & Spirituality in Social Work Social Thought · doi:10.1080/15426432.2015.1082455 · Cited by 12
“Many of them identified yoga as a spiritual or embodied practice supportive of healing for PTSD. Heightened Energy/Renewal Heightened energy was one of the most widely reported experiences of embodied healing cited by program participants.”
BackgroundInfluential
Emotion Regulation in Elementary School-Aged Children with a Maternal History of Suicidal Behavior: A Pilot Study
Sheftall, A. H., Bergdoll, E. E., James, M., Bauer, C., Spector, E., Vakil, F., Armstrong, E., Allen, J. D., & Bridge, J. A. (2020) · Child Psychiatry & Human Development · doi:10.1007/s10578-020-01010-8 · Cited by 9
Adaptation of an evidence-based, preventive intervention to promote mental health in Hispanic adolescents: eHealth Familias Unidas Mental Health
Perrino, T., Lozano, A., Estrada, Y. A., Tapia, M. I., Brown, C. H., Horigian, V. E., Beardslee, W. R., & Prado, G. J. (2024) · Translational Behavioral Medicine · doi:10.1093/tbm/ibae056 · Cited by 9
Self‐Perceived Competence in Mainland China: A Multiwave Longitudinal Examination of Internalizing Symptoms in Chinese Adolescents
Cohen, J. R., Sheshko, D. M., Ames, A. M., Young, J. F., Hansford, A., Zhu, X., Yao, S., & Abela, J. R. Z. (2014) · Journal of Research on Adolescence · doi:10.1111/jora.12146 · Cited by 10
Depressive Symptomatology in Greek Preadolescents: The Role of Parenting Style Perceptions
Kleftaras, G., & Αλεξόπουλος, Δ. Α. (2015) · Marriage & Family Review · doi:10.1080/01494929.2015.1060286 · Cited by 9
“There is convincing evidence that the structure of depression is complex and multifactorial (Garber, 2006).”
Background
Development of the Self-Report Measures of Assessing Developmental Assets Among At-Risk Youth in Malaysia
Kadir, N. B. A., Rahim, S. A., Mutalib, M. H. A., Mahmud, W. A. W., Chong, S. T., & Subhi, N. (2012) · Child and Adolescent Social Work Journal · doi:10.1007/s10560-012-0267-z · Cited by 8
To be or not to be flexible: A hierarchical model of affective flexibility in typical development and internalizing problems
Mărcuș, O., Rusu, R., Mueller, S. C., & Visu‐Petra, L. (2024) · Acta Psychologica · doi:10.1016/j.actpsy.2024.104275 · Cited by 8
Planning Adolescent Mental Health Promotion Programming in Saskatoon
Cushon, J. A., Waldner, C., Scott, C., & Neudorf, C. (2016) · Journal of School Health · doi:10.1111/josh.12410 · Cited by 7
Parent depressive symptoms and offspring executive functioning
Craun, E. A., Lachance, K., Williams, C. L., & Wong, M. M.-H. (2018) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803395.2018.1504893 · Cited by 7
“…Department of Psychology, Idaho State University, 921 S 8th Ave, Stop 8112, Pocatello, ID 83209, USA © 2018 Informa UK Limited, trading as Taylor & Francis Group with a family history of depression are three to four times more likely to develop the disorder later on in life (Garber, 2006).”
Background
The Effect of Diaphragmatic Breathing as a Complementary Therapeutic Strategy in Stress of Children and Teenagers 6–18 Years Old
Tsakona, P., Kitsatis, I., Apostolou, T. S., Papadopoulou, O., & Hristara-Papadopoulou, A. (2025) · Children · doi:10.3390/children12010059 · Cited by 10
“The presence of anxiety appears to be related to gender, with girls showing higher rates of stress and depression than boys [19].”
Effect of parental competences on anxious-depressive symptoms and suicidal ideation in adolescents: Exploring the mediating role of mindfulness
Nieto-Casado, F. J., Suárez, L. A., Rodríguez‐Meirinhos, A., & Delgado, A. O. (2022) · Children and Youth Services Review · doi:10.1016/j.childyouth.2022.106526 · Cited by 6
RETRACTED ARTICLE: Randomized controlled trial for selective preventive transdiagnostic intervention for adolescents at risk for emotional disorders
Vivas-Fernández, M., López, L. J. G., Piqueras, J. A., Muela-Martínez, J. A., Canals, J., Fernández, L. E., Jiménez-Vázquez, D., Díaz-Castela, M. D. M., Morales‐Hidalgo, P., Rivera, M., et al. (2023) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-022-00550-2 · Cited by 7
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Trajectories of co-occurrence of depressive symptoms and deviant behaviors: The influences of perceived social support and personal characteristics
Chen, C.-Y., & Lien, Y. (2018) · Children and Youth Services Review · doi:10.1016/j.childyouth.2018.10.037 · Cited by 7
Mothers' and children's depression is linked through children's perceptions of attachment security
Hughes, J. L., Morrow, K. E., Spears, S. K., & Gentzler, A. L. (2020) · Infant and Child Development · doi:10.1002/icd.2208 · Cited by 6
Factor Structure and Expression of Depressive Symptoms in a Community Sample of African American Adolescents Living in Urban Public Housing
Nebbitt, V. E., Mapson, A. V., & Robinson, A. M. (2011) · Springer eBooks · doi:10.1007/978-1-4419-9616-9_8 · Cited by 6
“These risk factors include community risk factors (social isolation, poverty, and affiliation with antisocial peers), family risk factors (low levels of parental warmth and family dysfunction), and individual level factors (gender, temperament, and antisocial behavior) ( Garber, 2006; Levisohn et al., 1998).”
Background
Assessment and analysis of factors influencing suicidal ideation in young adults: a large cohort study using an elastic network logistic regression model
Guo, Z., Han, X., Kong, T., Wu, Y., Kang, Y., Liu, Y., & Wang, F. (2025) · BMC Psychiatry · doi:10.1186/s12888-024-06415-6 · Cited by 6
Structural Relations among Adolescents' Stress, Automatic Thoughts, Depression, Suicidal Ideation and a Path Analysis of Gender Differences
구경미, & Chung, H. (2012) · Korea Journal of Counseling · doi:10.15703/kjc.13.3.201206.1295 · Cited by 5
Cognitive‐behavioral therapy, behavioral therapy, and related treatments in children
Kendall, P. C., Peterman, J. S., & Cummings, C. M. (2015) · Wiley eBooks · doi:10.1002/9781118381953.ch38 · Cited by 6
Threat of war on cognitive development of refugee children
Yeter, Ö., Rabagliati, H., & Özge, D. (2022) · East European Journal of Psycholinguistics · doi:10.29038/eejpl.2022.9.2.yet · Cited by 6
Child’s Number of Activities as a Moderator of Depressive Symptoms
Ryan, P. M., Kaskas, M. M., Davis, T. E., NoackLeSage, F., Lilly, M. E., Castagna, P. J., & Shaheen, G. L. (2017) · Journal of Child and Family Studies · doi:10.1007/s10826-017-0853-y · Cited by 4
Directions for Expanding the Prevention of Depression in Children and Adolescents
Barrera, M. (2006) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2006.07.019 · Cited by 4
School based prevention programme may reduce depressive episodes in adolescents at risk
Voorhees, B. W. V. (2010) · Evidence-Based Mental Health · doi:10.1136/ebmh.13.1.15 · Cited by 4
The psychological functioning and experiences following placement in orphanages : an exploratory study of orphanhood in Accra, Ghana
Yendork, J. S. (2014) · SUNScholar (Stellenbosch University) · Cited by 4
An ecological exploration of Black adolescent psychopathology: Depression and suicidal ideation
Merchant, C. R. (2010) · Deep Blue (University of Michigan) · Cited by 4
Perceived parental rejection and gaming disorder among adolescents: the mediating role of subjective stress and depressive symptoms
Tkalić, R. G., Razum, J., & Milas, G. (2024) · Behaviour and Information Technology · doi:10.1080/0144929x.2024.2359043 · Cited by 3
“Depression in youth has been associated with high levels of rejection from members of their social domain (Garber 2006), especially parents (Hammen 2005; Roh-ner 2021; Wasif et al. 2015).”
Development and pilot evaluation of a universal intervention – Enhancing resilience in culturally and linguistically diverse primary school classrooms
Higgen, S., & Mösko, M. (2021) · International Journal of Educational Research · doi:10.1016/j.ijer.2021.101757 · Cited by 3
Self-Compassion as a Mediator of the Longitudinal Link Between Parent and Adolescent Depressive Symptoms
Cherpe, S., Cunha, M. I. V. A., Xavier, A., Matos, A. P., Arnarson, E. Ö., Craighead, W. E., & Pinto‐Gouveia, J. (2025) · Adolescents · doi:10.3390/adolescents5030045 · Cited by 3
“Family therapy and psychoeducation for parents may be effective in improving family dynamics and reducing the transmission of depressive symptoms from parents to children [24].”
The Change in Trait Resilience Predicts the Alleviation of Transdiagnostic Depressive Symptoms in Outpatient Adolescents: The Mediating Role of the Change in Psychological Inflexibility/Experiential Avoidance
Sarnola, K., Välitalo, H., Kraav, S., Therman, S., Kurkinen, K., Ruuska, S.-M., Kekkonen, V., Kivimäki, P., Lehto, S. M., & Tolmunen, T. (2026) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.70268 · Cited by 2
“On the population level, depressive symptoms increase between childhood and adolescence, especially among girls (Thapar et al. 2012), and exposure to psychological stress is one of the strongest risk factors for depression (Askeland et al. 2020; Garber 2006).”
Associations Between Children's Depressive Symptoms, Life Events, and Family Factors Among School‐Aged Children
Talja, T., Rantanen, A., Koivisto, A., Helenius, J., & Joronen, K. (2022) · Journal of School Health · doi:10.1111/josh.13271 · Cited by 2
Factors Influencing Depression among Middle-School Girls
Lee, H., Jung, H. Y., Yun, E., 엄화윤, & Jee, Y.-J. (2011) · Journal of Korean Academy of Nursing · doi:10.4040/jkan.2011.41.4.550 · Cited by 2
“스트레스에 대한 반응이 문제 중심적일 때 정서중심적일 때보다 우울경향이 낮으며, 자신이나 세 상, 미래에 대해 부정적인 믿음을 갖는 개인은 더 우울할 수 있고 (Garber, 2006), 효과적인 문제해결능력은 상황에 대한 대처능력과”
Factors Associated with Childhood Depression in Saskatoon Students: A Multilevel Analysis
Jin, S., Muhajarine, N., Cushon, J. A., & Lim, H. J. (2013) · Canadian Journal of Community Mental Health · doi:10.7870/cjcmh-2013-004 · Cited by 2
“also, since depression was more common among girls than boys in our study, a finding that has been validated in many other studies (afifi, enns, cox, & Martens, 2005; Garber, 2006; Mazza, fleming, abbott, haggerty, & catalano, 2010), gender considerations should also be a component of programming.”
Result
Internalizing problems in a sample of Romanian preschool children. Contributions of both child and maternal temperament along with family functioning
Fechete, G. L., Susa-Erdogan, G., & Bengà, O. (2016) · Early Child Development and Care · doi:10.1080/03004430.2016.1266485 · Cited by 2
“…(Mangelsdorf, Schoppe, & Buur, 2000; Parade & Leerkes, 2008; Rothbart & Bates, 2006); also, parents may acknowledge more accurately the intensity and the persistence of child internalizing symptoms over time, in a broad area of situations (Garber, 2006; Rapee, Schniering, & Hudson, 2009).”
Background
Risk Factors and Prevention Strategies for Depression in Childhood and Adolescence
Kim, J. W., & Kim, J.-W. (2017) · Springer eBooks · doi:10.1007/978-981-10-6580-4_22 · Cited by 2
Mood Dysregulation Disorders
Yearwood, E. L., & Meadows‐Oliver, M. (2012) · Wiley eBooks · doi:10.1002/9781118704660.ch9 · Cited by 2
Subclinical Depression and Anxiety in Adolescence:: Developmental Trajectories and Online Intervention
Hoek, N. W. (2012) · Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) · Cited by 2

Authors: Garber, J.
Affiliations: Vanderbilt University (US)
Corresponding author: Garber, Judy
ORCID: Garber, Judy
Venue: American Journal of Preventive Medicine
Publisher: Elsevier BV
Published: 2006-12
Volume: 31
Issue: 6
Pages: 104-125
ISSN: 0749-3797 (ISSN-L)
DOI: 10.1016/j.amepre.2006.07.007
OpenAlex: W2914498801
Cited by: 263
References: 203
Citations by year: 2026: 6 · 2025: 9 · 2024: 9 · 2023: 7 · 2022: 10 · 2021: 9 · 2020: 12 · 2019: 6 · 2018: 13 · 2017: 17 · 2016: 17 · 2015: 19 · 2014: 18 · 2013: 23 · 2012: 20
FWCI: 1.69
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: American Journal of Preventive Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Mental Health (K02MH066249, K02 MH 66249, R01MH64735, R01MH057822, R01 MH57822, R01MH064735)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (P30HD015052, P30 HD-15052)
Topics: Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: depression, children, adolescents, depression prevention, risk factors, mood disorders, family history of depression, anxiety, life events, neuroticism, negative thinking, coping, self-regulation, interpersonal problems, cognitive-behavioral intervention, parenting support, social skills training, social problem solving, protective factors
MeSH terms: Adolescent, Anxiety, Child, Depression, Female, Humans, Interpersonal Relations, Male, Personality, Risk Factors, Sex Factors, Stress, Psychological

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