Temporal dynamics and longitudinal co-occurrence of depression and different anxiety syndromes in youth: Evidence for reciprocal patterns in a 3-year prospective study
Open accessAbstract
Background Depression is highly comorbid with anxiety in youth. It is frequently reported that anxiety precedes depression; however, evidence surrounding the temporal precedence of anxiety over depression is mixed. Many studies of anxiety-depression co-occurrence lump distinct forms of anxiety, obscuring information regarding trajectories of specific anxiety syndromes. This study sought to more accurately describe the development of anxiety and depression over time by moving beyond the question of temporal precedence to investigate a developmentally dynamic model of anxiety-depression co-occurrence.Methods A community sample of 665 youth (M= 11.8, SD= 2.4; 55% female) completed repeated self-report measures of depression and anxiety (social, physical, and separation anxiety) over a 3-year longitudinal study. Prospective associations between distinct syndromes of anxiety with depression were analyzed using an autoregressive cross-lagged path model over four time points.Results Physical symptoms and depression symptoms reciprocally predicted each other, above and beyond the stability of either domain. Social anxiety and depression symptoms similarly predicted each other in a systematic pattern.Limitations Our study is limited in its generalizability to other forms of anxiety, like worry. Additional research is needed to determine whether similar patterns exist in clinical populations, and whether these processes maintain symptoms once they reach diagnostic levels.Conclusions The development of syndromes of depression, physical, and social anxiety during childhood and adolescence occurs in a predictable, systematic reciprocal pattern, rather than sequentially and unidirectionally (i.e., anxiety syndromes precede depression). Results are clinically useful for predicting risk for disorder, and demonstrate the necessity of tracking symptom levels across domains.
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The nature of the association between anxiety and depression remains unclear, despite their well-established co-occurrence, and there are significant unresolved questions about the longitudinal and temporal relationships between them.
“The nature of the association between anxiety and depression remains unclear, despite their well-established co-occurrence, and there are significant unresolved responses about the longitudinal and temporal relationships between them 38 .”
From Relationships between worry and depressive symptoms during two group therapies for generalized anxiety disorder (2022) · cites this paper as [38]
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The Prevalence of Depression, Anxiety and Stress and Their Associated Factors in College Students.
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“[40] suggest that there is a bidirectional, systematic pattern between the development of depressive and anxious syndromes in young adults.”
BackgroundMartins, D. S., Sampaio, T. P. D. A., & Lotufo Neto, F. (2022) · Jornal Brasileiro de Psiquiatria · doi:10.1590/0047-2085000000361
- Authors
- Long, E. E., Young, J. F., & Hankin, B. L.
- Affiliations
- University of Illinois Urbana-Champaign (US)
- Children's Hospital of Philadelphia (US)
- Corresponding author
- Long, Erin E.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2018-07
- Volume
- 234
- Pages
- 20-27
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC5895498
- OpenAlex
- W2791879732
- Cited by
- 51
- References
- 70
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 5 · 2023: 5 · 2022: 6 · 2021: 5 · 2020: 6 · 2019: 7
- FWCI
- 5.29
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Affective Disorders (acceptedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Illinois Digital Environment for Access to Learning and Scholarship (University of Illinois at Urbana-Champaign) (submittedVersion)
- Funders
- National Institute of Mental Health (MH077178, R21MH102210, R01MH105501, MH109662, R01MH077195)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- depression, anxiety disorders, social anxiety, somatic symptoms, separation anxiety, comorbid depression and anxiety, temporal precedence, childhood and adolescence, symptom trajectories, developmental psychopathology
- MeSH terms
- Adolescent, Anxiety Disorders, Anxiety, Separation, Child, Depression, Depressive Disorder, Female, Humans, Longitudinal Studies, Male, Prospective Studies, Syndrome, Comorbidity, Adolescent Development, Self Report
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