CoChat
Sign Up
Cited by 93Child and Adolescent Psychosocial and Emotional DevelopmentAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Research Topics

Subthreshold Symptoms of Depression in Preadolescent Girls Are Stable and Predictive of Depressive Disorders

Open access
Keenan, Kate, Hipwell, Alison, Feng, Xin, Babinski, Dara, Hinze, Amanda, Rischall, Michal, Henneberger, Angela·2008·Journal of the American Academy of Child & Adolescent Psychiatry
DOI 10.1097/chi.0b013e3181886eabPMC PMC2694956
Open this paper in CoChat — free account

Abstract

Objective Given the risk for adolescent depression in girls to lead to a chronic course of mental illness, prevention of initial onset could have a large impact on reducing chronicity. If symptoms of depression that emerge during childhood were stable and predictive of later depressive disorders and impairment, then secondary prevention of initial onset of depressive disorders would be possible.Method Drawing from the Pittsburgh Girls Study, an existing longitudinal study, 232 nine-year-old girls were recruited for the present study, half of whom screened high on a measure of depression at age 8 years. Girls were interviewed about depressive symptoms using a diagnostic interview at ages 9, 10, and 11 years. Caregivers and interviewers rated impairment in each year.Results The stability coefficients for DSM-IV symptom counts for a 1- to 2-year interval were in the moderate range (i.e., intraclass coefficients of 0.40-0.59 for continuous symptom counts and Kendall tau-b coefficients of 0.34-0.39 for symptom level stability). Depressive disorders were also relatively stable at this age. Poverty moderated the stability, but race and pubertal stage did not. Among the girls who did not meet criteria for a depressive disorder at age 9 years, the odds of meeting criteria for depressive disorders and for demonstrating impairment at age 10 or 11 years increased by 1.9 and 1.7, respectively, for every increase in the number of depression symptoms.Conclusions Early-emerging symptoms of depression in girls are stable and predictive of depressive disorders and impairment. The results suggest that secondary prevention of depression in girls may be accomplished by targeting subthreshold symptoms manifest during childhood.

Integrity signals

Registry

Crossref · 10.1097/chi.0b013e3181886eab

Cites

51 of 51 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 56 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Pubertal stage did not moderate the stability of depressive symptoms from ages 9 to 11.

    “In testing the moderating effect of pubertal stage, stability did not differ between prepuberty to beginning and middle to advanced puberty groups from ages 9 to 10 years (β = .44 and .44, p values < .001) or from ages 10 to 11 years (β = .37 and .48, p values < .001).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Depressive disorders were relatively stable during ages 9 to 11.

    “Depressive disorders were also relatively stable at this age.”
    Quote in the paperSubstantial claim
  • Findingown data

    Among girls who did not meet criteria for a depressive disorder at age 9, the odds of meeting criteria for depressive disorders at age 10 or 11 increased by 1.9 for each additional depression symptom.

    “Among the girls who did not meet criteria for a depressive disorder at age 9 years, the odds of meeting criteria for depressive disorders and for demonstrating impairment at age 10 or 11 years increased by 1.9 and 1.7, respectively, for every increase in the number of depression symptoms.”
    Quote in the paperSubstantial claim
  • Findingown data

    Race did not moderate the stability of depressive symptoms.

    “Poverty moderated the stability, but race and pubertal stage did not.”
    • Also stated in: § Moderation of the Stability of Depressive Symptoms · plain
      “Race did not moderate the stability of depressive symptoms, as evidenced by similar stability coefficients for African American and European American girls from ages 9 to 10 years (β= .42 and 0.54, p values < .001) and from ages 10 to 11 years (β = .44 and .42, p values < .001).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Among girls who did not meet criteria for a depressive disorder at age 9, the odds of demonstrating impairment at age 10 or 11 increased by 1.7 for each additional depression symptom.

    “Among the girls who did not meet criteria for a depressive disorder at age 9 years, the odds of meeting criteria for depressive disorders and for demonstrating impairment at age 10 or 11 years increased by 1.9 and 1.7, respectively, for every increase in the number of depression symptoms.”
    Quote in the paperSubstantial claim
  • May combine two claims. 31
  • Classified as probably not a substantial claim. 24

  • May combine two claims.

    Findingown data

    At age 9, 36.2% of girls reported no symptoms, 38.8% reported 1 to 2 symptoms, and 25.0% reported 3 or more symptoms.

    “At age 9 years, 84 girls (36.2%) reported no symptoms, 90 (38.8%) reported 1 to 2 symptoms, and 58 (25.0%) reported 3 or more symptoms.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Depressive symptoms were moderately stable across ages 9 to 11, with ICCs of 0.45 for 9 to 10, 0.40 for 10 to 11, and 0.59 for 9 to 11.

    “Symptoms were moderately stable from ages 9 to 10 years (ICC = 0.45, p < .001), 10 to 11 years (ICC = 0.40, p < .001), and 9 to 11 years (ICC = 0.59, p < .001).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    At age 9 years, the endorsement rates of individual depressive symptoms in the sample ranged from 6.9% for anhedonia to 33.6% for concentration disturbance.

    “Symptoms of depression at age 9 years were endorsed at the following rate: disturbance in concentration, 33.6%; appetite disturbance, 32.3%; sleep disturbance, 26.3%; feelings of worthlessness or guilt, 18.5%; motor disturbance, 15.5%; suicidal ideation or behavior, 10.3%; fatigue, 10.3%; mood disturbance, 9.5%; and anhedonia, 6.9%.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    For DSM-IV depressive symptom counts over a 1- to 2-year interval, stability was moderate, with intraclass coefficients of 0.40 to 0.59 for continuous symptom counts and Kendall tau-b coefficients of 0.34 to 0.39 for symptom level stability.

    “The stability coefficients for DSM-IV symptom counts for a 1- to 2-year interval were in the moderate range (i.e., intraclass coefficients of 0.40–0.59 for continuous symptom counts and Kendall τ-b coefficients of 0.34–0.39 for symptom level stability).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Receipt of public assistance moderated the stability of depressive symptoms from ages 10 to 11, with greater stability for girls whose families received public assistance (β = .59) than for those who did not (β = .22); stability from 9 to 10 did not differ between poverty and nonpoverty groups.

    “Receipt of public assistance was a significant moderator. Stability of depressive symptoms from ages 10 and 11 years was greater for girls whose families received public assistance (β = .59, p < .001) than girls whose families did not (β = .22, p < .01). The stability coefficients between ages 9 and 10 years did not differ between poverty and nonpoverty groups (β = .35 and .22, p < .001).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    At age 9, the rate of minor depression (6.0%) was equal to that of major depression; at age 10, major depression (2.2%) was about a third of minor depression (6.0%); at age 11, rates were similar but lower (3.0% major, 4.3% minor).

    “At age 9 years, the rate of minor depression (6.0%) is equal to that of major depression. At age 10 years, the rate of major depression (2.2%) is about a third of the rate of minor depression (6.0%). By age 11 years, the rates are again similar but lower than that observed in the first year (3.0% for major depression and 4.3% for minor depression).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    More than 80% of girls who reported 3 or more symptoms at age 9 continued to report symptoms at age 10, and symptom level stability from 9 to 11 was similar (Kendall τ-b = 0.34, p < .0001).

    “As shown in Figure 1, more than 80% of girls who reported 3 or more symptoms at age 9 years continued to report symptoms at age 10 years (Kendall τ−b = 0.39, p < .0001). Similar results were observed for the stability of symptom level from ages 9 to 11 years (Kendall τ−b = 0.34, p < .0001) (Fig. 2).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Pubertal stage at age 9 was not associated with the stability of depressive symptoms from ages 9 to 11 or with the predictive validity of depressive symptoms to later disorders and impairment.

    “Pubertal stage of development at age 9 years was not associated with the stability of depressive symptoms from ages 9 to 11 years or the predictive validity of depressive symptoms to later disorders and impairment.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the present study, the level of impairment among girls meeting criteria for minor depression was significantly different from girls without a depressive diagnosis and did not differ from girls with major depression.

    “Moreover, further evidence of the validity of minor depression was provided in the present study; the level of impairment among the girls who met the criteria for minor depression was significantly different from the girls without a depressive diagnosis and did not differ from the girls with a diagnosis of major depression.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingnone given

    Poverty, but not race, was associated with stability of depressive symptoms from ages 10 to 11.

    “Poverty, but not race, was associated with stability of depressive symptoms from ages 10 to 11 years.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In three of four ANOVA models, average impairment ratings among girls with minor depression were significantly lower (greater impairment) than girls with no depressive disorders and not different from girls with major depression.

    “Post hoc comparisons revealed that, in three of the four analysis of variance models, the average impairment ratings among girls diagnosed with minor depression was significantly lower, reflecting greater impairment, than girls with no depressive disorders and not different from girls diagnosed with major depression.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Race, poverty, and pubertal development at age 9 were not associated with later depressive disorders, nor did they interact with depressive disorders at age 9 to increase stability of depressive disorders.

    “Race, poverty, and pubertal development at age 9 years were not associated with later depressive disorders, nor did these covariates interact with depressive disorders at age 9 years to increase the stability of depressive disorders.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Initial episodes of depression are more severe and longer for girls than boys.

    “Initial episodes of depression are more severe and longer in duration for girls than for boys,5”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5] McCauley, 1993, Depression in young people: Initial presentation and clinical course, J Am Acad Child Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Girls primarily account for the increase in adolescent depression, with a 2:1 sex difference continuing through reproductive years.

    “It is primarily girls who account for the increase in adolescence,2,3 evidencing a 2:1 sex difference in depression that continues throughout the reproductive years.4”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [2] Hankin, 1998, Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study, J Abnorm Psychol source

      Not checked in the free run.

    • cites [3] Wichstrom, 1999, The emergence of gender difference in depressed mood during adolescence: the role of intensified gender socialization, Dev Psychol source

      Not checked in the free run.

    • cites [4] Kessler, 1993, Sex and depression in the National Comorbidity Survey, I: lifetime prevalence, chronicity and recurrence, J Affect Dis source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Premisereasoning

    For preventive purposes, the predictive validity of symptoms to disorders needs to be tested in addition to the predictive validity of disorders.

    “Moreover, for preventive purposes, the predictive validity of symptoms to disorders needs to be tested in addition to the predictive validity of disorders.”
    Quote in the paperNot a substantial claim
    • The authors state this as an assumption: The best predictor of later psychopathology, including depression, is earlier psychopathology.

  • May combine two claims.

    Interpretationown data

    Early-emerging symptoms of depression in girls are stable and predictive of depressive disorders and impairment.

    “Early-emerging symptoms of depression in girls are stable and predictive of depressive disorders and impairment.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    In most studies, nondiagnostic questionnaires were used, and children scoring in the clinically significant range were underrepresented.

    “In most studies, however, nondiagnostic questionnaires were used, and in most samples, children scoring in the clinically significant range were underrepresented.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [10] Tram, 2006, A multimethod examination of the stability of depressive symptoms in childhood and adolescence, J Abnorm Psychol source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Both race and poverty are associated with heightened risk for depression.

    “Both race and poverty, which are often confounded within studies, are associated with heightened risk for depression.22–24”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [22] Gilman, 2003, Socio-economic status, family disruption and residential stability in childhood: relation to onset, recurrence and remission of major depression, Psychol Med source

      Not checked in the free run.

    • cites [23] Leech, 2006, Predictors and correlates of high levels of depression and anxiety symptoms among children at age 10, J Am Acad Child Psychiatry source

      Not checked in the free run.

    • cites [24] Sen, 2004, Adolescent propensity for depressed mood and help seeking: race and gender differences, J Ment Health Policy Econ

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisecitation

    There is a need for replication in nonclinical samples with sufficient levels of depression and with methods that include diagnostic measures.

    “Thus, there is a need for replication in nonclinical samples with sufficient levels of depression and with methods that include diagnostic measures to complement existing studies.10”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] Tram, 2006, A multimethod examination of the stability of depressive symptoms in childhood and adolescence, J Abnorm Psychol source

      Not checked in the free run.

    • The authors state this as an assumption: The best predictor of later psychopathology, including depression, is earlier psychopathology.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Children's scores on depression-screening questionnaires are moderately or highly stable across time frames of 1 to 72 months and across sexes, with somewhat higher stability for girls than boys in a number of studies.

    “A recent review revealed that children’s scores on depression-screening questionnaires are moderately or highly stable across time frames (e.g., 1–72 months) and across sexes, although stability coefficients were somewhat higher for girls than for boys in a number of studies.10”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [10] Tram, 2006, A multimethod examination of the stability of depressive symptoms in childhood and adolescence, J Abnorm Psychol source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In the Great Smoky Mountains Study, the risk for girls was significantly greater than for boys, whose odds ratio was 5.2.

    “This risk was significantly greater than that observed for boys, for whom the odds ratio was 5.2.8”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [8] Costello, 2003, Prevalence and development of psychiatric disorders in childhood and adolescence, Arch Gen Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Interrater agreement for K-SADS-PL symptom counts and minor/major depressive disorder diagnoses was high across years, with ICCs of 0.92 to 0.97 and kappas of 0.77 to 1.00.

    “Intraclass correlation coefficients (ICCs) for total number of symptoms were 0.92, 0.96, and 0.97 for Years 01, 02, and 03, respectively. Kappa coefficients for minor/major depressive disorders were 0.77, 1.00, and 0.79 for Years 01, 02, and 03, respectively.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    The rates of depressive disorders in this sample are higher than those reported in population-based samples of children, reflecting the success of screening to increase the base rate.

    “These rates are higher than those reported in population-based samples of children,1 reflecting the success of the screening to increase the base rate of depressive disorders.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] Birmaher, 1996, Childhood and adolescent depression: a review of the past 10 years, Part I, J Am Acad Child Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    If childhood symptoms of depression in girls are predictive of disorders and impairment, then treatment of symptoms and subsyndromal forms in preadolescence may be one of the few options for reducing chronicity.

    “If childhood symptoms of depression in girls are predictive of disorders and impairment, then treatment of symptoms and subsyndromal forms of depression in preadolescence may be one of the few options for reducing the chronicity of depression.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Interrater agreement on interviewer-generated CGAS ratings was very high, with an ICC of 0.91.

    “Interrater agreement on 42 cases of interviewer-generated CGAS ratings after the child K-SADS was very high: ICC = 0.91.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Three differences between the Dunedin and Great Smoky Mountains studies may explain their discrepant results: structured versus unstructured assessment, symptom counts versus depressive disorders, and a single age versus an extended age range.

    “Three significant differences between these two studies may explain the discrepant results: the use of a structured versus an unstructured assessment of DSM-based depressive symptoms, the use of symptom counts versus depressive disorders, and the use of a single (i.e., 9 years old) versus an extended age range (i.e., 9–13 years old).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Retention across the three waves was high, with 97.8% completing at wave 2 and 97.0% at wave 3.

    “Retention across the three waves was high. At wave 2, 227 (97.8%) completed the assessment, 4 (1.7%) declined to participate, and 1 (0.4%) could not be scheduled. At wave 3, 225 (97.0%) completed the assessment, 5 (2.2%) declined to participate, and 2 (1.3%) could not be scheduled.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing).

    Premisecitation

    High stability of depression scores in these contexts cannot be equated with stability or predictive validity of childhood symptoms of depression, given low rates of depression in most samples.

    “The possibility that high stability of depression scores in these contexts cannot be equated with stability or predictive validity of childhood symptoms of depression, given the low rates of depression in most samples, has been raised.10”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] Tram, 2006, A multimethod examination of the stability of depressive symptoms in childhood and adolescence, J Abnorm Psychol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Maternal report of pubertal development is more closely associated with physical examination results than child self-report.

    “Maternal report of pubertal development in comparison with child self-report has been shown to be more closely associated with results from a physical examination.33”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [33] Dorn, 2006, Defining the boundaries of early adolescence: a user's guide to assessing pubertal status and pubertal timing in research with adolescents, Appl Dev Sci source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    The role of pubertal development in the onset of depression in girls remains unclear.

    “The role of pubertal development in the onset of depression in girls still remains unclear.”
    Quote in the paperSubstantial claim0 of 5 sources checked
    • cites [17] Angold, 1992, Effects of age and pubertal status on depression in a large clinical sample, Dev Psychopathol source

      Not checked in the free run.

    • cites [18] Laitinen-Krispijn, 1999, The role of pubertal progress in the development of depression in early adolescence, J Affect Dis source

      Not checked in the free run.

    • cites [19] Ge, 1996, Coming of age too early: pubertal influences on girls' vulnerability to psychological distress, Child Dev source

      Not checked in the free run.

    • cites [20] Stice, 2001, Relation of early menarche to depression, eating disorders, substance abuse, and comorbid psychopathology among adolescent girls, Dev Psychol source

      Not checked in the free run.

    • cites [21] Ge, 2001, Pubertal transition, stressful life events, and the emergence of gender differences in adolescent depressive symptoms, Dev Psychol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Premisereasoning

    Both pubertal development and depression may be associated with a shared factor, such as race or living in an economically stressed environment.

    “The level of complexity in the puberty–depression literature is further increased by the possibility that both pubertal development and depression may be associated with a shared factor, such as race or living in an economically stressed environment.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The association between early developing puberty and higher depression scores is complex, with differences emerging over time rather than at pubertal onset.

    “Even in this literature, however, the association between early developing puberty and higher depression scores is complex, with differences in depression scores emerging over time, not at the time of pubertal onset (often operationalized as age at menarche).21”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] Ge, 2001, Pubertal transition, stressful life events, and the emergence of gender differences in adolescent depressive symptoms, Dev Psychol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Childhood-onset depression recurs in adolescence in 40% to 60% of clinically referred cases.

    “Kovacs and coworkers have shown that childhood-onset depression is likely to recur in adolescence in 40% to 60% of clinically referred cases.9”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9] Kovacs, 2003, Developmental changes in the phenomenology of depression in girls compared to boys from childhood onward, J Affect Dis source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    A structured method of assessment may be a requirement for reliably assessing depressive symptoms in children.

    “A structured method of assessment, which was not used in the Dunedin Study, may be a requirement for reliably assessing depressive symptoms in children.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The Dunedin Study did not use a structured method of assessment.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The sample size in the present study is more than sufficient to provide stable results given the relations modeled and minimal missing data.

    “The sample size in the present study is more than sufficient to provide stable results, given the relations modeled in each analysis and the minimal amount of missing data.35”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [35] Muthén, 2007

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing).

    Premisecitation

    Some investigators have argued and provided evidence that minor and major depression fall along a continuum of a single clinical disorder.

    “Some investigators have argued and provided evidence for the contention that minor and major depression fall along a continuum of a single clinical disorder.37”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [37] Judd, 1998, A prospective 12-year study of subsyndromal and syndromal depressive symptoms in unipolar major depressive disorders, Arch Gen Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    The narrow window of assessment may have led to incorrectly classifying some girls as not depressed who had in fact experienced depression during the past year, making this a fairly conservative test of the hypothesis that childhood depressive symptoms and disorders demonstrate predictive validity.

    “The disadvantage is that the narrow window of assessment may have led to incorrectly classifying some girls as not depressed who had in fact experienced depression during the past year. Therefore, this is a fairly conservative test of the hypothesis that childhood depressive symptoms and disorders demonstrate predictive validity.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Symptoms of depression that emerge during preadolescence are not benign; they are predictive of depressive disorders and impairment in the following 2 years.

    “The results also demonstrate that symptoms of depression that emerge during this period are not benign. They are predictive of depressive disorders and impairment in the following 2 years.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The role of environmental factors such as poverty in the etiology versus the stability of symptoms and disorders may vary depending on the type of disorder.

    “It is interesting to note that the role of environmental factors, such as poverty, in the etiology versus the stability of symptoms and disorders may vary, depending on the type of disorder.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [40] Steinhausen, 1993, Abnormal psychosocial situations and ICD-10 diagnoses in children and adolescents attending a psychiatric service, J Child Psychol Psychiatry source

      Not checked in the free run.

    • cites [41] Lahey, 1995, Four-year longitudinal study of conduct disorder in boys: patterns and predictors of persistence, J Abnorm Psychol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In a study of adolescent-onset depression, depressed mood explained unique variance in the prediction of later depression.

    “In a study of adolescent-onset depression, depressed mood explained unique variance in the prediction of later depression.45”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [45] Georgiades, 2006, Major depressive disorder in adolescence: the role of subthreshold symptoms, J Am Acad Child Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    There is evidence from studies of adults that anhedonia is predictive of depressive disorders.

    “There is evidence from studies of adults that anhedonia is predictive of depressive disorders.44”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [44] Roberts, 2000, Sleep complaints and depression in an aging cohort: a prospective perspective, Am J Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    If the association between poverty and depressive symptom stability continued over time, it could lead to a higher incidence of depression among females living in poverty as they continue to experience recurrence, whereas those not living in poverty may be more likely to remit.

    “If this pattern of association with depressive symptoms continued over time, it could lead to a higher incidence of depression among females living in poverty as they continue to experience recurrence, whereas those not living in poverty may be more likely to remit.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Minor depression seems equivalent to major depression in prognosis regarding impairment, use of mental health services, future major depressive episodes, and suicidality.

    “Although still under consideration for DSM-V, minor depression seems to be equivalent to major depression in terms of prognosis regarding impairment, use of mental health services, future major depressive episodes, and suicidality.14,15”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [14] Gonzalez-Tejera, 2005, Examining minor and major depression in adolescents, J Child Psychol Psychiatry source

      Not checked in the free run.

    • cites [15] Fergusson, 2005, Subthreshold depression in adolescence and mental health outcomes in adulthood, Arch Gen Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    Because socioeconomic factors such as poverty have biological consequences, they may differentially impact disorders at different points in the developmental trajectory.

    “Because socioeconomic factors such as poverty have biological consequences,42 it is plausible that they may differentially have an impact on disorders at different points in the developmental trajectory.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [42] Kristenson, 2004, Psychobiological mechanisms of socioeconomic differences in health, Soc Sci Med source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Early-emerging symptoms of depression in girls are stable and predictive of meeting criteria for major and minor depressive disorders and impairment.

    “In summary, early-emerging symptoms of depression in girls are stable and predictive of meeting the criteria for major and minor depressive disorders and impairment.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Reliability of symptoms could influence the predictive validity of those symptoms, leading to an underestimate in the Dunedin Study.

    “Reliability of symptoms obviously could influence the predictive validity of those symptoms leading to an underestimate in the Dunedin Study.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The Dunedin Study did not use a structured method of assessment.

  • May combine two claims.

    Premisecitation

    Recall for past episodes of depression is poor among young adults, as is recall for key symptoms such as depressed mood.

    “Recall for past episodes of depression is poor among young adults, as is recall for key symptoms of depression such as depressed mood.38”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [38] Wells, 2004, How accurate is recall of key symptoms of depression? A comparison of recall and longitudinal reports, Psychol Med source

      Not checked in the free run.

47 of 47

  • The authors state this as an assumption.

    The best predictor of later psychopathology, including depression, is earlier psychopathology.

    “In keeping with the assumption that the best predictor of later psychopathology is earlier psychopathology, the predictive validity of symptoms of depression during childhood to depressive disorders would be a logical hypothesis to test.”

  • The paper relies on this without support.

    Defining the developmental phenomenology of depression is critical to successful prevention of depression.

    “Critical to the successful prevention of depression is defining the developmental phenomenology of the disorder.”

  • The paper relies on this without support.

    The Dunedin Study did not use a structured method of assessment.

    “A structured method of assessment, which was not used in the Dunedin Study, may be a requirement for reliably assessing depressive symptoms in children.”

  • The paper relies on this without support.

    The prevalence of depressive disorders at ages 9 to 10 years in the Great Smoky Mountains Study was less than 1%.

    “The prevalence of depressive disorders at ages 9 to 10 years, however, was less than 1%.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

  • Eligible families percentages are not based on the stated denominator

    Major

    The counts 232, 25, and 6 sum to 263, but the percentages reported (88.2%, 8.3%, 2.3%) do not all correspond to a denominator of 263. With 263 as the denominator, 25 is 9.5% and 6 is 2.3%, so the refusal percentage is inconsistent.

    Reported 8.3 · recomputed 9.505703

  • Wave 3 completion counts and percentages do not match

    Major

    The wave 3 counts sum to 232, but the stated percentages are based on 225 participants (97.0%, 2.2%, 1.3%). Using 232 as the denominator gives 97.0%, 2.2%, and 0.9%, so the percentage for those who could not be scheduled is inconsistent with the counts shown.

    Reported 1.3 · recomputed 0.862069

  • Refusal percentage uses the wrong denominator

    Minor

    Of 263 eligible families, 25 refusals represent 9.5%, not 8.3%.

    Reported 8.3 · recomputed 9.505703

3 of 3

Cites

Flagged first, then by citations

5 of the 56 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Murray, 1996, 1, 117

Cited by

Sorted by citations

Related

Authors
Keenan, K., Hipwell, A., Feng, X., Babinski, D., Hinze, A., Rischall, M., & Henneberger, A.
Affiliations
University of Pittsburgh (US)
Corresponding author
Keenan, Kate
ORCID
Venue
Journal of the American Academy of Child & Adolescent Psychiatry
Publisher
Elsevier BV
Published
2008-12
Volume
47
Issue
12
Pages
1433-1442
ISSN
0890-8567 (ISSN-L)
DOI
10.1097/chi.0b013e3181886eab
PMC
PMC2694956
OpenAlex
W2060569432
Cited by
93
References
56
Citations by year
2026: 4 · 2025: 2 · 2024: 1 · 2023: 3 · 2022: 4 · 2021: 7 · 2020: 6 · 2019: 4 · 2018: 7 · 2017: 3 · 2016: 6 · 2015: 8 · 2014: 8 · 2013: 5 · 2012: 3
FWCI
8.15
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (R01 MH66167, R01MH066167, K01MH071790)
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
subthreshold depression, depressive symptoms, preadolescent girls, symptom stability, poverty, secondary prevention, chronic depression, Pittsburgh Girls Study
MeSH terms
Adolescent, Age Factors, Child, Child, Preschool, Chronic Disease, Depression, Major Depressive Disorder, Depressive Disorder, Female, Humans, Longitudinal Studies, Mass Screening, Personality Assessment, Poverty, Puberty, Risk Factors

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read under definition version 3 (extract-v3) on 2026-09-28.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review