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Within-Person Changes in Individual Symptoms of Depression Predict Subsequent Depressive Episodes in Adolescents: a Prospective Study

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Abstract

The current longitudinal study examined which individual symptoms of depression uniquely predicted a subsequent Major Depressive Episode (MDE) in adolescents, and whether these relations differed by sex. Adolescents (N = 240) were first interviewed in grade 6 (M = 11.86 years old; SD = 0.56; 54 % female; 81.5 % Caucasian) and then annually through grade 12 regarding their individual symptoms of depression as well as the occurrence of MDEs. Individual symptoms of depression were assessed with the Children’s Depression Rating Scale-Revised (CDRS-R) and depressive episodes were assessed with the Longitudinal Interval Follow-up Evaluation (LIFE). Results showed that within-person changes in sleep problems and low self-esteem/excessive guilt positively predicted an increased likelihood of an MDE for both boys and girls. Significant sex differences also were found. Within-person changes in anhedonia predicted an increased likelihood of a subsequent MDE among boys, whereas irritability predicted a decreased likelihood of a future MDE among boys, and concentration difficulties predicted a decreased likelihood of an MDE in girls. These results identified individual depressive symptoms that predicted subsequent depressive episodes in male and female adolescents, and may be used to guide the early detection, treatment, and prevention of depressive disorders in youth.

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References

  • Alfano, C. A., Zakem, A. H., Costa, N. M., Taylor, L. K., & Weems, C. F. (2009). Sleep problems and their relation to cognitive factors, anxiety, and depressive symptoms in children and adolescents. Depression and Anxiety, 26, 503–512.

    PubMed  Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: APA.

    Google Scholar 

  • Avenevoli, S., Swendsen, J., He, J.-P., Burstein, M., & Merikangas, K. R. (2015). Major depression in the National Comorbidity Survey- Adolescent Supplement: prevalence, correlates, and treatment. Journal of the American Academy of Child and Adolescent Psychiatry, 54, 37–44.

    Article  PubMed  PubMed Central  Google Scholar 

  • Baron, P., & Campbell, T. L. (1993). Gender differences in the expression of depressive symptoms in middle adolescents: an extension of earlier findings. Adolescence, 28, 903–911.

    PubMed  Google Scholar 

  • Bennett, D. S., Ambrosini, P. J., Kudes, D., Metz, C., & Rabinovich, H. (2005). Gender differences in adolescent depression: do symptoms differ for boys and girls? Journal of Affective Disorders, 89, 35–44.

    Article  PubMed  Google Scholar 

  • Bertha, E. A., & Balàz, J. (2013). Subthreshold depression in adolescence: a systematic review. European Child and Adolescent Psychiatry, 22, 589–603.

    Article  PubMed  Google Scholar 

  • Birmaher, B., Ryan, N. D., Williamson, D. E., & Brent, D. A. (1996). Childhood and adolescent depression: a review of the past 10 year, Part I. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 1575–1583.

    Article  PubMed  Google Scholar 

  • Bolger, N., & Laurenceau, J.-P. (2013). Intensive longitudinal methods: An introduction to diary and experience sampling methods. New York: Guildford Press.

    Google Scholar 

  • Buysse, D. J., Reynolds, C. F., Hoch, C. C., Houck, P. R., Kupfer, D. J., Mazumdar, S., & Frank, E. (1996). Longitudinal effects of nortriptyline on EEG sleep and the likelihood of recurrence in elderly depressed patients. Neuropsychopharmacology, 14, 243–252.

    Article  PubMed  Google Scholar 

  • Chorpita, B. F., Plummer, C. M., & Moffitt, C. E. (2000). Relations of tripartite dimensions of emotion to childhood anxiety and mood disorders. Journal of Abnormal Child Psychology, 28, 299–310.

    Article  PubMed  Google Scholar 

  • Clarke, G., & Harvey, A. G. (2012). The complex role of sleep in adolescent depression. Child and Adolescent Psychiatric Clinics of North America, 21, 385–400.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cole, D. A., Cai, L., Martin, N. C., Findling, R. L., Youngstrom, E. A., Garber, J., … Forehand, R. (2011). Psychological Assessment, 23, 819–833.

  • Dahl, R. E., & Harvey, A. G. (2007). Sleep in children and adolescents with behavioral and emotional disorders. Sleep Medicine Clinics, 2, 501–511.

    Article  Google Scholar 

  • Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M., … Jacobson, N. S. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74, 658–670.

  • Dombrovski, A. Y., Cyranowski, J. M., Mulsant, B. H., Houck, P. R., Buysse, D. J., Andreescu, C., … Frank, E. (2008). Which symptoms predict recurrence of depression in women treated with maintenance interpersonal psychotherapy? Depression and anxiety, 12, 1060–1066.

  • Dwyer, S. B., Nicholson, J. M., & Battistutta, D. (2006). Parent and teacher identification of children at risk of developing internalizing and externalizing mental health problems: a comparison of screening methods. Prevention Science, 7, 343–357.

    Article  PubMed  Google Scholar 

  • Eaton, W. W., Badawi, M., & Melton, B. (1995). Prodromes and precursors: epidemiologic data for primary prevention of disorders with slow onset. The American Journal of Psychiatry, 152, 967–971.

    Article  PubMed  Google Scholar 

  • Fergusson, D. M., Horwood, L. J., Ridder, E. M., & Beautrais, A. L. (2005). Subthreshold depression in adolescence and mental health outcomes in adulthood. Archives of General Psychiatry, 62, 66–72.

    Article  PubMed  Google Scholar 

  • Fonseca-Pedrero, E., Wells, C., Paino, M., Lemos-Giráldez, S., Villazón-García, Ú., Sierra, S., González, M. P. G., Bobes, J., & Muñiz, J. (2010). Measurement invariance of the Reynolds Depression Adolescent Scale across gender and age. International Journal of Testing, 10, 133–148.

    Article  Google Scholar 

  • Ford, D. E., & Cooper-Patrick, L. (2001). Sleep disturbances and mood disorders: an epidemiological perspective. Depression and Anxiety, 14, 3–6.

    Article  PubMed  Google Scholar 

  • Fried, E. I., Nesse, R. M., Zivin, K., Guille, C., & Sen, S. (2014). Depression is more than the sum score of its parts: individual DSM symptoms have different risk factors. Psychological Medicine, 44, 2067–2076.

    Article  PubMed  PubMed Central  Google Scholar 

  • Georgiades, K., Lewinsohn, P. M., Monroe, S. M., & Seeley, J. R. (2006). Major depressive disorder in adolescence: the role of subthreshold symptoms. Journal of the American Academy for Child and Adolescent Psychiatry, 45, 936–944.

    Article  Google Scholar 

  • Gordon, W. R., & Caltabiano, M. L. (1996). Urban–rural differences in adolescent self-esteem, leisure boredom, and sensation seeking as predictors of leisure-time usage and satisfaction. Adolescence, 31, 883–901.

    PubMed  Google Scholar 

  • Gregory, A. M., Rijsdijk, F. V., Lau, J. Y., Dahl, R. E., & Eley, T. C. (2009). The direction of longitudinal associations between sleep problems and depression symptoms: a study of twins aged 8 and 10 years. Sleep, 32, 189–199.

    PubMed  PubMed Central  Google Scholar 

  • Haarasilta, L., Marttunen, M., Kaprio, J., & Aro, H. (2001). The 12-month prevalence and characteristics of major depressive episode in a representative sample of adolescents and young adults. Psychological Medicine, 31, 1169–1179.

    Article  PubMed  Google Scholar 

  • Hammen, C., & Rudolph, K. D. (1996). Childhood depression. In E. J. Mash & R. A. Barkley (Eds.), Child psychopathology (pp. 153–195). New York: Guildford Press.

    Google Scholar 

  • Hankin, B. L., & Abramson, L. Y. (2001). Development of gender differences in depression: an elaborated cognitive vulnerability-transactional stress theory. Psychological Bulletin, 127, 773–796.

    Article  PubMed  Google Scholar 

  • Hankin, B. L., Abramson, L. Y., Moffitt, T. E., Silva, P. A., McGee, R., & Angell, K. E. (1998). Development of depression from preschool to young adulthood: emerging gender differences in a 10-year longitudinal study. Journal of Abnormal Psychology, 107, 128–140.

    Article  PubMed  Google Scholar 

  • Hollingshead, A. B. (1975). Four factor index of social status. New Haven: Yale University. Unpublished manuscript.

    Google Scholar 

  • Horowitz, J. L., & Garber, J. (2003). Relation of intelligence and religiosity to depressive disorders in offspring of depressed and nondepressed mothers. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 578–586.

    Article  PubMed  Google Scholar 

  • Iacoviello, B. M., Alloy, L. B., Abramson, L. Y., & Choi, J. Y. (2010). The early course of depression: a longitudinal investigation of prodromal symptoms and their relation to the symptomatic course of depressive episodes. Journal of Abnormal Psychology, 119, 459–467.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jain, S., Carmody, T. J., Trivedi, M. H., Hughes, C., Bernstein, Morris, D. W., … Rush, A. J. (2007). A psychometric evaluation of the CDRS and MADRS in assessing depressive symptoms in children. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 1204–1212.

  • Johnson, J. G., Cohen, P., & Kasen, S. (2004). Minor depression during adolescence and mental health outcomes during adulthood. The British Journal of Psychiatry, 195, 264–265.

    Article  Google Scholar 

  • Keenan, K., Hipwell, A. E., Feng, X., Babinski, D., Hinze, A., Rischall, M., & Hennenberger, A. (2008). Subthreshold symptoms of depression in preadolescent girls are stable and predictive of depressive disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 1433–1442.

    Article  PubMed  PubMed Central  Google Scholar 

  • Keller, M. B., Lavori, P. W., Friedman, B., Nielson, E., Endicott, J., … Andreasen, N.C. (1987). The longitudinal interval follow-up evaluation: a comprehensive method for assessing outcome in prospective longitudinal studies. Archives of General Psychiatry, 44, 540–548.

  • Khan, A. A., Gardner, C. O., Prescott, C. A., & Kendler, K. S. (2002). Gender differences in the symptoms of major depression in opposite-sex dizygotic twin pairs. American Journal of Psychiatry, 159, 1427–1429.

    Article  PubMed  Google Scholar 

  • Kovacs, M. (1981). Rating scales to assess depression in school-aged children. Acta Paedopsychiatrica: International Journal of Child and Adolescent Psychiatry, 46, 305–315.

    Google Scholar 

  • Kovacs, M. (2001). Gender and the course of major depressive disorder through adolescence in clinical referred youngsters. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1079–1085.

    Article  PubMed  Google Scholar 

  • Kovacs, M., & Lopez-Duran, N. (2010). Prodromal symptoms and atypical affectivity as predictors of major depression in juveniles: implications for prevention. Journal of Child Psychology and Psychiatry, 4, 472–496.

    Article  Google Scholar 

  • Kupfer, D. J., Frank, E., McEachran, A. B., & Grochocinski, V. J. (1990). Delta sleep ratio: a biological correlate of early recurrence in unipolar affective disorder. Archives of General Psychiatry, 47, 1100–1105.

    Article  PubMed  Google Scholar 

  • Leckman, J. F., & Yazgan, M. Y. (2010). Editorial: developmental transitions to psychopathology: from genomics and epigenomics to social policy. Journal of Child Psychology and Psychiatry, 51, 333–340.

    Article  PubMed  Google Scholar 

  • Letcher, P., Smart, D., Sanson, A., & Toumbourou, J. W. (2008). Psychosocial precursors and correlates of differing internalizing trajectories from 3 to 15 years. Social Development, 18, 618–646.

    Article  Google Scholar 

  • Lonigan, C. J., Carey, M. P., & Finch, A. J. (1994). Anxiety and depression in children and adolescents: negative affectivity and the utility of self-reports. Journal of Consulting and Clinical Psychology, 62, 1000–1008.

    Article  PubMed  Google Scholar 

  • Mayes, T. L., Bernstein, I. H., Haley, C. L., Kennard, B. D., & Emslie, J. (2010). Psychometric properties of the Children’s Depression Rating Scale-Revised in Adolescents. Journal of Child and Adolescent Psychopharmacology, 20, 513–516.

    Article  PubMed  PubMed Central  Google Scholar 

  • McKenzie, D. P., Toumbourou, J. W., Forbes, A. B., Mackinnon, A. J., McMorris, B. J., Catalano, R. F., & Patton, G. C. (2011). Predicting future depression in adolescents using the Short Mood and Feelings Questionnaire: a two-nation study. Journal of Affective Disorders, 134, 151–159.

    Article  PubMed  PubMed Central  Google Scholar 

  • McMakin, D. L., Olino, T. M., Porta, G., Dietz, L. J., Emslie, G., Clarke, G., Wagner, K. D., Asarnoq, J. R., Ryan, N. D., Birmaher, B., Shamseddeen, W., Mayes, T., Kennard, B., Spirito, A., Keller, M., Lynch, F. L., Dickerson, J. F., & Brent, D. A. (2012). Anhedonia predicts poorer recovery among youth with selective serotonin reuptake inhibitor treatment-resistant depression. Journal of the American Academy of Child and Adolescent Psychiatry, 51, 404–411.

    Article  PubMed  PubMed Central  Google Scholar 

  • Merikangas, D. R., He, J., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., … & Swendsen, J. (2010). Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Study-Adolescent Supplement. Journal of the American Academy of Child and Adolescent Psychiatry, 49, 980–989.

  • Merry, S. N., Hetrick, S. E., Cox, G. R., Brudevold-Iverson, T., Birr, J. J. & McDowell, H. (2012). Psychological and educational interventions for preventing depression in children and adolescescnets (Review). Evidence-based Child Health: A Cochrane Review Literature, 7, 1409–1685.

  • Pine, D. S., Cohen, E., Cohen, P., & Brooks, J. (1999). Adolescent depressive symptoms as predictors of adult depression: moodiness or mood disorder? American Journal of Psychiatry, 156, 133–135.

    Article  PubMed  Google Scholar 

  • Poznanski, E., Mokros, H. B., Grossman, J., & Freeman, L. N. (1985). Diagnostic criteria in childhood depression. The American Journal of Psychiatry, 142, 1168–1173.

    Article  PubMed  Google Scholar 

  • Raudenbush, S. W., & Bryk, A. S. (2002). Hierarchical linear models: Applications and data analysis methods (2nd ed.). Thousand Oaks: Sage Publications.

    Google Scholar 

  • Roberts, R. E., Lewinsohn, P. M., & Seeley, J. R. (1995). Symptoms of DSM-III-R major depression in adolescence: evidence from an epidemiological survey. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 1608–1617.

    Article  PubMed  Google Scholar 

  • Rohde, P., Beevers, C. G., Stice, E., & O’Neil, K. (2009). Major and minor depression in female adolescents: onset, course, symptom presentation, and demographic associations. Journal of Clinical Psychology, 65, 1339–1349.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sandler, R., Wolchik, S. A., Cruden, G., Mahrer, N. E., Ahn, S., Brincks, A., & Brown, C. H. (2014). Overview of meta-analyses of the prevention of mental health, substance use, and conduct problems. Annual Review of Clinical Psychology, 10, 25.1–25.31.

    Article  Google Scholar 

  • Shankman, S. A., Lewinsohn, P. M., Klein, D. N., Small, J. W., Seeley, J. R., & Altman, S. E. (2009). Subthreshold conditions as precursors for full syndrome disorders: a 15-year longitudinal study of multiple diagnostic classes. Journal of Child Psychology and Psychiatry, 50, 1485–1494.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sihvola, E., Keski-Rahkonen, A., Dick, D. M., Pulkkinen, L., Rose, R. J., Marttunen, M., & Kaprio, J. (2007). Minor depression in adolescence: phenomenology and clinical correlates. Journal of Affective Disorders, 97, 211–218.

    Article  PubMed  PubMed Central  Google Scholar 

  • Shochat, T., Cohen-Zion, M., & Tzischinsky, O. (2014). Functional consequences of inadequate sleep in adolescents: a systematic review. Sleep Medicine Reviews, 18, 75–87.

    Article  PubMed  Google Scholar 

  • Signoretta, S., Maremmani, I., Liguori, A., Perugi, G., & Akiskal, H. S. (2005). Affective temperament traits measured by TEMPS-I and emotional-behavioral problems in clinically-well children, adolescents, and young adults. Journal of Affective Disorders, 85, 169–180.

    Article  PubMed  Google Scholar 

  • Sijtsema, J. J., Verboom, C. E., Pennix, B. W. J. H., Verhulst, F. C., & Ormel, J. (2014). Psychopathology and academic performance, social well-being, and social preference at school: the TRAILS study. Child Psychiatry and Human Development, 45, 273–284.

    Article  PubMed  Google Scholar 

  • Smith, D. J., Kyle, S., Forty, L., Cooper, C., Walters, J., Russell, E., … Craddock, N. (2007). Differences in depressive symptom profile between males and females. Journal of Affective Disorders, 108, 279–284.

  • Soutullo, C. A., Escamilla-Canales, I., Wozniak, J., Gamazo-Garran, P., Figueroa-Quintana, A., & Biederman, J. (2009). Pediatric bipolar disorder in a Spanish sample: features before and at the time of diagnosis. Journal of Affective Disorders, 118, 39–47.

    Article  PubMed  Google Scholar 

  • Spitzer, R. L., Williams, J. B., Gibbon, M., & First, M. B. (1990). The Structured Clinical Interview for DSM-III-R (SCID): history, rationale, and description. Archives of General Psychiatry, 49, 624–629.

    Article  Google Scholar 

  • Stringaris, A. (2011). Irritability in children and adolescents: a challenge for DSM-5. European Child and Adolescent Psychiatry, 20, 61–66.

    Article  PubMed  Google Scholar 

  • Stringaris, A., Cohen, P., Pine, D. S., & Leibenluft, E. (2009). Adult outcomes of youth irritability: a 20-year prospective community-based study. American Journal of Psychiatry, 166, 1048–1054.

    Article  PubMed  PubMed Central  Google Scholar 

  • Stringaris, A., Maughan, B., Copeland, W. S., Costello, E. J., & Angold, A. (2013). Irritable mood as a symptom of depression in youth: prevalence, developmental, and clinical correlates in the Great Smoky Mountains Study. Journal of the American Academy of Child and Adolescent Psychiatry, 52, 831–840.

    Article  PubMed  PubMed Central  Google Scholar 

  • Whelan, Y. M., Leibenluft, E., Stringaris, A., & Barker, E. D. (2015). Pathways from maternal depressive symptoms to adolescent depressive symptoms: the unique contribution of irritability symptoms. Journal of Child Psychology and Psychiatry. doi:10.1111/jcpp.12395.

  • Whitcomb-Smith, S., Sigmon, S. T., Martison, A., Young, M., Craner, J., & Boulard, N. (2014). The temporal development of mood, cognitive, and vegetative symptoms in recurrent SAD episodes: a test of the dual vulnerability hypothesis. Cognitive Therapy Research, 38, 43–54.

    Article  Google Scholar 

  • Wolitzky-Taylor, K., Dour, H., Zinbarg, R., Mineka, S., Vrshek-Schallhorn, S., Epstein, A., … & Craske, M. G. (2014). Experiencing core symptoms of anxiety and unipolar mood disorders in late adolescence predicts disorder onset in early adulthood. Depression and Anxiety, 31, 207–213.

  • van Lang, N. D. J., Ferdinand, R. F., & Verhulst, F. C. (2007). Predictors of future depression in early and late adolescence. Journal of Affective Disorders, 97, 137–144.

    Article  PubMed  Google Scholar 

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Acknowledgements

This work was supported in part by grants from the National Institute of Mental Health (R29 MH454580; K02 MH66249), NICHD Grant P30HD15052, and a Faculty Scholar Award (1214-88) and grant (173096) from the William T. Grant Foundation awarded to Garber. Kouros (2008-2011) and Morris (2006-2008) are former trainees on NIMH training grant T32-MH18921. We appreciate the cooperation of the Nashville Metropolitan School District, Drs. Binkley and Crouch, and we especially thank the parents and children who participated in the project.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Psychology, Southern Methodist University, P.O. Box 750442, Dallas, TX, 75275, USA

    Chrystyna D. Kouros

  2. Department of Family and Community Medicine, Meharry Medical College, Nashville, TN, USA

    Matthew C. Morris

  3. Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA

    Judy Garber

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  1. Chrystyna D. Kouros
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Correspondence to Chrystyna D. Kouros.

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Kouros, C.D., Morris, M.C. & Garber, J. Within-Person Changes in Individual Symptoms of Depression Predict Subsequent Depressive Episodes in Adolescents: a Prospective Study. J Abnorm Child Psychol 44, 483–494 (2016). https://doi.org/10.1007/s10802-015-0046-3

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