Abstract
The present study sought to clarify the trajectory (i.e., continuous vs. discontinuous) and expression (i.e., homotypic vs. heterotypic) of anxiety and depressive symptoms across childhood and adolescence. We utilized a state-of-the-science analytic approach to simultaneously test theoretical models that describe the development of internalizing symptoms in youth. In a sample of 636 children (53% female; M age = 7.04; SD age = 0.35) self-report measures of anxiety and depression were completed annually by youth through their freshman year of high school. For both anxiety and depression, a piecewise growth curve model provided the best fit for the data, with symptoms decreasing until age 12 (the “developmental knot”) and then increasing into early adolescence. The trajectory of anxiety symptoms was best described by a discontinuous homotypic pattern in which childhood anxiety predicted adolescent anxiety. For depression, two distinct pathways were discovered: A discontinuous homotypic pathway in which childhood depression predicted adolescent depression and a discontinuous heterotypic pathway in which childhood anxiety predicted adolescent depression. Analytical, methodological, and clinical implications of these findings are discussed.
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Notes
We note the terms heterotypic and homotypic continuity have been used to describe both manifest behaviors and latent internalizing processes over time (Cicchetti et al. 1994; Lahey et al. 2014). As a major aim of our study was the translational importance of distinguishing between continuous and discontinuous models of psychopathology for assessment purposes, we focus our discussion of heterotypic and homotypic continuity on symptom manifestations.
Grade-based models for both anxiety and depression suggested that piecewise models provided the best fit, with the knot being placed at grades 6 or 7 (when the majority of participants would be age 12). Specifically, for anxiety models, the knot fit equally well in 6th and 7th grade (ΔCFI < 0.01, Δχ2/df = 0.20, ΔRMSEA < 0.01, ΔSRMR = 0.01). For depression models, the knot fit best when placed at grades 6 or 7, with slightly better fit for grade 7 (ΔCFI = 0.02, Δχ2/df = 1.12, ΔRMSEA = 0.01, ΔSRMR < 0.01).
The secondary intercept can be removed in alternate arrangements for piecewise growth functions. We selected this arrangement with a second intercept because of our interest in predicting average symptoms at the beginning of the second growth period, adolescence. Alternate piecewise growth functions with a single intercept per symptom were also examined. Both single-intercept models also fit well and produced similar findings.
Specific manifestations of anxiety (e.g., panic disorder), however, may have different trajectories during adolescence (Nelemans et al. 2014). This issue is discussed further in the limitations section.
References
Andersen, S. L., & Teicher, M. H. (2008). Stress, sensitive periods and maturational events in adolescent depression. Trends in Neurosciences, 31(4), 183–191.
Angold, A., Costello, E. J., Messer, S. C., & Pickles, A. (1995). Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. International Journal of Methods in Psychiatric Research, 5(4), 237–249.
Aune, T., & Stiles, T. C. (2009). The effects of depression and stressful life events on the development and maintenance of syndromal social anxiety: Sex and age differences. Journal of Clinical Child & Adolescent Psychology, 38(4), 501–512. https://doi.org/10.1080/15374410902976304.
Bittner, A., Egger, H. L., Erkanli, A., Costello, E. J., Foley, D. L., & Angold, A. (2007). What do childhood anxiety disorders predict? Journal of Child Psychology and Psychiatry, 48(12), 1174–1183. https://doi.org/10.1111/j.1469-7610.2007.01812.x.
Bollen, K. A., & Curran, P. J. (2004). Autoregressive latent trajectory (ALT) models a synthesis of two traditions. Sociological Methods & Research, 32(3), 336–383. https://doi.org/10.1177/0049124103260222.
Cheong, J., MacKinnon, D. P., & Khoo, S. T. (2003). Investigation of mediational processes using parallel process latent growth curve modeling. Structural Equation Modeling, 10(2), 238–262. https://doi.org/10.1207/S15328007SEM1002_5.
Chou, C. P., Yang, D., Pentz, M. A., & Hser, Y. I. (2004). Piecewise growth curve modeling approach for longitudinal prevention study. Computational Statistics and Data Analysis, 46(2), 213–225. https://doi.org/10.1016/S0167-9473(03)00149-X.
Cicchetti, D., & Toth, S. L. (1998). The development of depression in children and adolescents. American Psychologist, 53(2), 221–241. https://doi.org/10.1037/0003-066X.53.2.221.
Cicchetti, D., Rogosch, F. A., & Toth, S. L. (1994). A developmental psychopathology perspective on depression in children and adolescents. In W. M. Reynolds & H. F. Johnston (Eds.), Handbook of depression in children and adolescents (pp. 123–141). USA: Springer. https://doi.org/10.1007/978-1-4899-1510-8_7.
Cohen, J. R., Young, J. F., Gibb, B. E., Hankin, B. L., & Abela, J. R. (2014). Why are anxiety and depressive symptoms comorbid in youth? A multi-wave, longitudinal examination of competing etiological models. Journal of Affective Disorders, 161, 21–29. https://doi.org/10.1016/j.jad.2014.02.042.
Cole, D. A., Peeke, L. G., Martin, J. M., Truglio, R., & Seroczynski, A. D. (1998). A longitudinal look at the relation between depression and anxiety in children and adolescents. Journal of Consulting and Clinical Psychology, 66(3), 451–460.
Cole, D. A., Tram, J. M., Martin, J. M., Hoffman, K. B., Ruiz, M. D., Jacquez, F. M., & Maschman, T. L. (2002). Individual differences in the emergence of depressive symptoms in children and adolescents: a longitudinal investigation of parent and child reports. Journal of Abnormal Psychology, 111(1), 156–165. https://doi.org/10.1037/0021-843X.111.1.156.
Costello, E. J., Mustillo, S., Erkanli, A., Keeler, G., & Angold, A. (2003). Prevalence and development of psychiatric disorders in childhood and adolescence. Archives of General Psychiatry, 60(8), 837–844. https://doi.org/10.1001/archpsyc.60.8.837.
Cummings, C. M., Caporino, N. E., & Kendall, P. C. (2014). Comorbidity of anxiety and depression in children and adolescents: 20 years after. Psychological Bulletin, 140(3), 816–845. https://doi.org/10.1037/a0034733.
De Los Reyes, A., Augenstein, T. M., Wang, M., Thomas, S. A., Drabick, D. A., Burgers, D. E., & Rabinowitz, J. (2015). The validity of the multi-informant approach to assessing child and adolescent mental health. Psychological Bulletin, 141(4), 858–900. https://doi.org/10.1037/a0038498.
Duncan, T. E., Duncan, S. C., & Strycker, L. A. (2013). An introduction to latent variable growth curve modeling: concepts, issues, and application. New York: Routledge.
Enders, C. K., & Bandalos, D. L. (2001). The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Structural Equation Modeling, 8(3), 430–457. https://doi.org/10.1207/S15328007SEM0803_5.
Flannery-Schroeder, E. C. (2006). Reducing anxiety to prevent depression. American Journal of Preventive Medicine, 31(6), 136–142. https://doi.org/10.1016/j.amepre.2006.07.006.
Garber, J., & Horowitz, J. L. (2002). Depression in Children. In I. H. Gotlib & C. L. Hammen (Eds.), Handbook of depression (pp. 510–540). New York: Guilford.
Graber, J. A., & Brooks-Gunn, J. (1996). Transitions and turning points: navigating the passage from childhood through adolescence. Developmental Psychology, 32(4), 768–776. https://doi.org/10.1037/0012-1649.32.4.768.
Hale III, W. W., Raaijmakers, Q., Muris, P., & Meeus, W. (2008). Developmental trajectories of adolescent anxiety disorder symptoms: a 5-year prospective community study. Journal of the American Academy of Child & Adolescent Psychiatry, 47(5), 556–564. https://doi.org/10.1097/CHI.0b013e3181676583.
Hale III, W. W., Raaijmakers, Q. A., Muris, P., Van Hoof, A., & Meeus, W. H. (2009). One factor or two parallel processes? Comorbidity and development of adolescent anxiety and depressive disorder symptoms. Journal of Child Psychology and Psychiatry, 50(10), 1218–1226. https://doi.org/10.1111/j.1469-7610.2009.02115.x.
Hankin, B. L., & Abramson, L. Y. (2001). Development of gender differences in depression: An elaborated cognitive vulnerability–transactional stress theory. Psychological Bulletin, 127(6), 773–796. https://doi.org/10.1037/0033-2909.127.6.773.
Hankin, B. L., Abramson, L. Y., Moffitt, T. E., Silva, P. A., McGee, R., & Angell, K. E. (1998). Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study. Journal of Abnormal Psychology, 107(1), 128–140. https://doi.org/10.1037/0021-843X.107.1.128.
Hankin, B. L., Snyder, H. R., Gulley, L. D., Schweizer, T. H., Bijttebier, P., et al. (2016). Understanding comorbidity among internalizing problems: integrating latent structural of models of psychopathology and risk mechanisms. Development and Psychopathology, 28, 987–1012. https://doi.org/10.1017/S0954579416000663.
Harrington, R., Rutter, M., & Fombonne, E. (1996). Developmental pathways in depression: multiple meanings, antecedents, and endpoints. Development and Psychopathology, 8(04), 601–616.
Hu, L. T., & Bentler, P. M. (1998). Fit indices in covariance structure modeling: sensitivity to underparameterized model misspecification. Psychological Methods, 3(4), 424–453. https://doi.org/10.1037/1082-989X.3.4.424.
Hyde, J. S., Mezulis, A. H., & Abramson, L. Y. (2008). The ABCs of depression: integrating affective, biological, and cognitive models to explain the emergence of the gender difference in depression. Psychological Review, 115(2), 291–313. https://doi.org/10.1037/0033-295X.115.2.291.
Ingram, R. E., & Siegle, G. J. (2009). Methodological issues in the study of depression. In I. H. Gotlib & C. L. Hammen (Eds.), Handbook of depression (pp. 69–92). New York: Guilford.
Keenan, K., Feng, X., Hipwell, A., & Klostermann, S. (2009). Depression begets depression: Comparing the predictive utility of depression and anxiety symptoms to later depression. Journal of Child Psychology and Psychiatry, 50(9), 1167–1175. https://doi.org/10.1111/j.1469-7610.2009.02080.x.
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593–602. https://doi.org/10.1001/archpsyc.62.6.593.
Klimes-Dougan, B., Long, J. D., Lee, C.-Y. S., Ronsaville, D. S., Gold, P. W., & Martinez, P. E. (2010). Continuity and cascade in offspring of bipolar parents: a longitudinal study of externalizing, internalizing, and thought problems. Development and Psychopathology, 22(4), 849–866. https://doi.org/10.1017/S0954579410000507.
Kohli, N., Hughes, J., Wang, C., Zopluoglu, C., & Davison, M. L. (2015). Fitting a linear–linear piecewise growth mixture model with unknown knots: a comparison of two common approaches to inference. Psychological Methods, 20(2), 259–275. https://doi.org/10.1037/met0000034.
Lahey, B. B., Zald, D. H., Hakes, J. K., Krueger, R. F., & Rathouz, P. J. (2014). Patterns of heterotypic continuity associated with the cross-sectional correlational structure of prevalent mental disorders in adults. JAMA Psychiatry, 71(9), 989–996.
Lau, J. Y., & Eley, T. C. (2008). Attributional style as a risk marker of genetic effects for adolescent depressive symptoms. Journal of Abnormal Psychology, 117(4), 849–859. https://doi.org/10.1037/a0013943.
Laursen, B., & Collins, W. A. (2009). Parent-child relationships during adolescence. In R. M. Lerner & L. Steinberg (Eds.), Handbook of adolescent psychology (pp. 3–42). New York: Wiley.
Leadbeater, B., Thompson, K., & Gruppuso, V. (2012). Co-occurring trajectories of symptoms of anxiety, depression, and oppositional defiance from adolescence to young adulthood. Journal of Clinical Child & Adolescent Psychology, 41(6), 719–730. https://doi.org/10.1080/15374416.2012.694608.
Lewinsohn, P. M., & Essau, C. A. (2002). Depression in adolescents. In I. H. Gotlib & C. L. Hammen (Eds.), Handbook of depression (pp. 510–540). New York: Guilford.
Lewinsohn, P. M., Gotlib, I. H., Lewinsohn, M., Seeley, J. R., & Allen, N. B. (1998). Gender differences in anxiety disorders and anxiety symptoms in adolescents. Journal of Abnormal Psychology, 107(1), 109–117. https://doi.org/10.1037/0021-843X.107.1.109.
Mamey, M. R., Barbosa-Leiker, C., McPherson, S., Burns, G. L., Parks, C., & Roll, J. (2015). An application of analyzing the trajectories of two disorders: a parallel piecewise growth model of substance use and attention-deficit/hyperactivity disorder. Experimental and Clinical Psychopharmacology, 23(6), 422–427. https://doi.org/10.1037/pha0000047.
McLaughlin, K. A., & King, K. (2015). Developmental trajectories of anxiety and depression in early adolescence. Journal of Abnormal Child Psychology, 43(2), 311–323. https://doi.org/10.1007/s10802-014-9898-1.
Nelemans, S. A., Hale, W. W., Branje, S. J., Raaijmakers, Q. A., Frijns, T., van Lier, P. A., & Meeus, W. H. (2014). Heterogeneity in development of adolescent anxiety disorder symptoms in an 8-year longitudinal community study. Development and Psychopathology, 26(01), 181–202. https://doi.org/10.1017/S0954579413000503.
Olatunji, B. O., & Cole, D. A. (2009). The longitudinal structure of general and specific anxiety dimensions in children: testing a latent trait–state–occasion model. Psychological Assessment, 21(3), 412–424. https://doi.org/10.1037/a0016206.
Rapee, R. M., Schniering, C. A., & Hudson, J. L. (2009). Anxiety disorders during childhood and adolescence: origins and treatment. Annual Review of Clinical Psychology, 5, 311–341. https://doi.org/10.1146/annurev.clinpsy.032408.153628.
Reinke, W. M., & Ostrander, R. (2008). Heterotypic and homotypic continuity: the moderating effects of age and gender. Journal of Abnormal Child Psychology, 36(7), 1109–1121. https://doi.org/10.1007/s10802-008-9236-6.
Reynolds, C. R., & Richmond, B. O. (1978). What I think and feel: a revised measure of children's manifest anxiety. Journal of Abnormal Child Psychology, 6(2), 271–280. https://doi.org/10.1007/BF00919131.
Reynolds, C. R., & Richmond, B. O. (1985). Revised children's manifest anxiety scale. Los Angeles: Western Psychological Services.
Rudolph, K. D. (2014). Puberty as a developmental context of risk for psychopathology. In M. Lewis & K. D. Rudolph (Eds.), Handbook of developmental psychopathology (pp. 331–354). New York: Springer. https://doi.org/10.1007/978-1-4614-9608-3_17.
Rudolph, K. D., Lansford, J. L., & Rodkin, P. C. (2016). Interpersonal theories of developmental psychopathology. In D. Cichetti (Ed.), Developmental psychopathology. New York: Wiley.
Rutter, M., Kim-Cohen, J., & Maughan, B. (2006). Continuities and discontinuities in psychopathology between childhood and adult life. Journal of Child Psychology and Psychiatry, 47(3–4), 276–295. https://doi.org/10.1111/j.1469-7610.2006.01614.x.
Schulenberg, J. E., Maggs, J. L., & O’Malley, P. M. (2003). How and why the understanding of developmental continuity and discontinuity is important. In J. T. Mortimer & M. J. Shanahan (Eds.), Handbook of the life course (pp. 413–436). New York: Springer. https://doi.org/10.1007/978-0-306-48247-2_19.
Seligman, L. D., Ollendick, T. H., Langley, A. K., & Baldacci, H. B. (2004). The utility of measures of child and adolescent anxiety: a meta-analytic review of the Revised Children’s Manifest Anxiety Scale, the State–Trait Anxiety Inventory for Children, and the Child Behavior Checklist. Journal of Clinical Child and Adolescent Psychology, 33(3), 557–565. https://doi.org/10.1207/s15374424jccp3303_13.
Sterba, S. K., Prinstein, M. J., & Cox, M. J. (2007). Trajectories of internalizing problems across childhood: heterogeneity, external validity, and gender differences. Development and Psychopathology, 19(02), 345–366. https://doi.org/10.1017/S0954579407070174.
Thapar, A., & McGuffin, P. (1998). Validity of the shortened Mood and Feelings Questionnaire in a community sample of children and adolescents: a preliminary research note. Psychiatry Research, 81(2), 259–268. https://doi.org/10.1016/S0165-1781(98)00073-0.
United States Preventative Task Force (USPTF) (2016) Depression in adults: screening, depression in children and adolescents: screening. Retrieved from www.uspreventiveservicestaskforce.org. Accessed 24 Feb 2016.
Van Oort, F. V. A., Greaves-Lord, K., Verhulst, F. C., Ormel, J., & Huizink, A. C. (2009). The developmental course of anxiety symptoms during adolescence: the TRAILS study. Journal of Child Psychology and Psychiatry, 50(10), 1209–1217. https://doi.org/10.1111/j.1469-7610.2009.02092.x.
Van Oort, F. V. A., Greaves-Lord, K., Ormel, J., Verhulst, F. C., & Huizink, A. C. (2011). Risk indicators of anxiety throughout adolescence: the TRAILS study. Depression and Anxiety, 28(6), 485–494. https://doi.org/10.1002/da.20818.
Weems, C. F. (2008). Developmental trajectories of childhood anxiety: identifying continuity and change in anxious emotion. Developmental Review, 28(4), 488–502. https://doi.org/10.1016/j.dr.2008.01.001.
Weissman, M. M., Wolk, S., Goldstein, R. B., Moreau, D., Adams, P., Greenwald, S., et al. (1999). Depressed adolescents grown up. JAMA, 281(18), 1707–1713.
Wisniewski, J. J., Genshaft, J. L., Mulick, J. A., & Coury, D. L. (1987). Test-retest reliability of the Revised Children's Manifest Anxiety Scale. Perceptual and Motor Skills, 65(1), 67–70. https://doi.org/10.2466/pms.1987.65.1.67.
Acknowledgements
We would like to thank the families and schools who participated in this study. We are grateful to Jamie Abaied, Monica Agoston, Hannah Banagale, Megan Flynn, Ellie Hessel, Nicole Llewellyn, Michelle Miernicki, Jo Pauly, Jennifer Monti, and Niwako Sugimura for their assistance in data collection and management. This research was funded by a University of Illinois Arnold O. Beckman Award and National Institute of Mental Health Grant MH68444 awarded to Karen D. Rudolph.
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Cohen, J.R., Andrews, A.R., Davis, M.M. et al. Anxiety and Depression During Childhood and Adolescence: Testing Theoretical Models of Continuity and Discontinuity. J Abnorm Child Psychol 46, 1295–1308 (2018). https://doi.org/10.1007/s10802-017-0370-x
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DOI: https://doi.org/10.1007/s10802-017-0370-x