Background
Anxiety and depression are commonly comorbid with each other, with anxiety often temporally preceding the development of depression. Although increasingly research has begun to investigate ...the role of sleep problems in depression, no study has examined insomnia as a mediator in the longitudinal relationship between anxiety and subsequent depression.
Methods
The current study utilizes data from Waves I, II, and IV of the National Longitudinal Study of Adolescent to Adult Health, a nationally representative prospective study conducted over a 14‐year period (n = 20,745, 50.5% female, M age at Wave I = 16.20). Participants completed portions of the Center for Epidemiologic Studies Depression Scale at Waves I and IV to assess depressive symptoms, a six‐item anxiety measure at Wave I, and three items assessing insomnia, sleep quality, and sleep duration at Wave II.
Results
Structural equation modeling indicated that insomnia and unrestful sleep significantly mediated the relationship between anxiety and subsequent depression. The relationship between anxiety and depression was not significantly mediated by sleep duration.
Conclusions
Findings suggest that anxiety may increase risk for the development of later depression through insomnia.
Research on psychosocial correlates of depression and social anxiety often has not accounted for their comorbidity. Differentiating correlates of depression and social anxiety may inform the ...development of comorbidity models. Building on research linking both disorders to interpersonal dysfunction, this study examined interpersonal correlates of depressive symptoms and social anxiety in nonreferred early adolescent (M age = 13.46) girls (n = 83), controlling for comorbid symptoms. Although both showed significant bivariate correlations with peer and family variables, partial correlations revealed that social anxiety (controlling for depressive symptoms) was more strongly related to peer variables (e.g., social competence and trust and communication in friendships), whereas depressive symptoms (controlling for social anxiety) were more strongly related to family variables (e.g., lower trust and greater alienation and conflict). Comorbid girls showed heightened peer and family alienation compared to purely dysphoric or anxious girls. Implications for casual models of comorbidity and for understanding poorer outcomes associated with comorbidity and discussed.
The stress generation hypothesis suggests that some individuals contribute more than others to the occurrence of dependent (self-generated), but not independent (fateful), stressful life events. This ...phenomenon is commonly studied in relation to psychiatric disorders, but effects are also driven by underlying psychological processes that extend beyond the boundaries of DSM-defined entities. This meta-analytic review of modifiable risk and protective factors for stress generation synthesizes findings from 70 studies with 39,693 participants (483 total effect sizes) from over 30 years of research. Findings revealed a range of risk factors that prospectively predict dependent stress with small-to-moderate meta-analytic effects (rs = 0.10–0.26). Negligible to small effects were found for independent stress (rs = 0.03–0.12), and, in a critical test for stress generation, most effects were significantly stronger for dependent compared to independent stress (βs = 0.04–0.15). Moderation analyses suggest effects of maladaptive interpersonal emotion regulation behaviors and repetitive negative thinking are stronger for interpersonal (versus non-interpersonal) stress; effects of repetitive negative thinking and excessive standards for self may be inflated by overreliance on self-report measures that fail to isolate psychological distress from objective experience. Findings have key implications for advancing stress generation theory and informing targets for intervention.
•Presents a meta-analytic review of risk and protective factors for stress generation.•Small-to-moderate effects on dependent stress were found for a range of risk factors.•Most meta-analytic effects were stronger for dependent versus independent stress.•Effects of some risk factors are especially potent for interpersonal dependent stress.•Effects of some risk factors may be inflated by reliance on life stress checklists.
Negative emotion differentiation (NED) is the ability to precisely discern negatively-valenced emotional states. Low NED has been linked to numerous negative outcomes. However, little is known about ...the conditions under which individual differences in NED emerge, particularly during adolescence, a potentially important developmental stage. We examined associations between NED (assessed using intraclass correlations between negative emotion NE ratings collected via intensive longitudinal methods), parental variables, and age. Adolescents (N = 233, Mage = 15.90, 53% female) and their parents completed interview measures of depression and self-report questionnaires; adolescents then completed a seven-day ecological momentary assessment. Lower NED was associated with greater parental depression, greater authoritarian parenting style, and lower parental attachment security. Age was negatively and linearly associated with NED. Results held controlling for mean NE and adolescent depression, although authoritarian parenting was non-significant controlling for other developmental variables. Findings suggest healthy parent-child relationships may relate to adolescents' ability to perceive NEs with nuance.
Maladaptive emotion regulation (ER) strategies are important predictors of stress generation—the process by which individuals with certain traits are likely to experience higher levels of dependent ...(self-generated), but not independent (fateful), stressful life events. Positive affect (PA) dampening, the tendency to downregulate positive moods by reducing their intensity and duration, may weaken interpersonal ties and therefore increase vulnerability to stress generation, particularly in the interpersonal domain. The present study examined longitudinal associations between PA dampening and stress generation in an adolescent sample (
N
= 241,
M
age
= 15.9, 51.8% female) assessed at baseline and at follow-up 1.5 years later. Dampening was assessed with a self-report questionnaire and stress exposure was assessed using contextual threat-based interview methods. Preregistered analyses revealed that PA dampening did not prospectively predict episodic interpersonal or non-interpersonal dependent stress; instead, dampening was associated with greater episodic independent stress, inconsistent with the stress generation model. Higher dampening at baseline also predicted increases in chronic stress in both interpersonal and non-interpersonal domains over follow-up. Findings suggest that PA regulation strategies may contribute to sustained stressful contexts, rather than discrete life events.
Studies support a link between adolescent romantic involvement and depression. Adolescent romantic relationships may increase depression risk by introducing chronic stress, and genetic vulnerability ...to stress reactivity/emotion dysregulation may moderate these associations. We tested genetic moderation of longitudinal associations between adolescent romantic involvement and later depressive symptoms by a polymorphism in the serotonin transporter linked polymorphic region gene (5-HTTLPR) and examined contributory roles of chronic stress and family discord. Three hundred eighty-one youth participated at ages 15 and 20. The results indicated that 5-HTTLPR moderated the association between age 15 romantic involvement and age 20 depressive symptoms, with strongest effects for short homozygotes. Conditional process analysis revealed that chronic stress functioned as a moderated mediator of this association, fully accounting for the romantic involvement-depression link among short/short genotypes. Also, romantic involvement predicted later depressive symptoms most strongly among short-allele carriers with high family discord. The results have important implications for understanding the romantic involvement-depression link and the behavioral and emotional correlates of the 5-HTTLPR genotype.
Background
Anxiety disorders tend to precede onset of comorbid depression. Several researchers have suggested a causal role for anxiety in promoting depressive episodes, but few studies have ...identified specific mechanisms. The current study proposes an interpersonal model of comorbidity, where anxiety disorders disrupt interpersonal functioning, which in turn elevates risk for depression.
Methods
At age 15 (T1), 815 adolescents oversampled for maternal depression completed diagnostic interviews, social chronic stress interviews, and self‐report measures. At age 20 (T2), participants repeated all measures and reported on self‐perceived interpersonal problems. At approximately age 23 (T3), a subset of participants (n = 475) completed a self‐report depressive symptoms measure.
Results
Consistent with other samples, anxiety disorders largely preceded depressive disorders. Low sociability and interpersonal oversensitivity mediated the association between T1 social anxiety disorder and later depression (including T2 depressive diagnosis and T3 depressive symptoms), controlling for baseline. Interpersonal oversensitivity and social chronic stress similarly mediated the association between generalized anxiety disorder before age 15 and later depression.
Conclusions
Interpersonal dysfunction may be one mechanism through which anxiety disorders promote later depression, contributing to high comorbidity rates.
Stress generation theory initially posited that depression elevates risk for some stressful events (i.e., dependent events) but not others (i.e., independent events). This preregistered meta-analytic ...review examined whether stress generation occurs transdiagnostically by examining 95 longitudinal studies with 38,228 participants (537 total effect sizes) from over 30 years of research. Our multilevel meta-analyses found evidence of stress generation across a broad range of psychopathology, as evidenced by significantly larger prospective effects for dependent (overall psychopathology: r = .23) than independent (overall psychopathology: r = .10) stress. We also identified unique patterns of effects across specific types of psychopathology. For example, effects were larger for depression than anxiety. Furthermore, effects were sometimes larger in studies with younger participants, shorter time lags between assessments, checklist measures of stress, and for interpersonal stressors. Finally, a multilevel meta-analytic structural equation model suggested that dependent stress exacerbates psychopathology symptoms over time (β = .04), possibly contributing to chronicity. Interventions targeting the prevention of stress generation may mitigate chronic psychopathology. Conclusions of this study are limited by the predominance of depression effect sizes in the literature and our review of only English language articles. On the other hand, the findings are strengthened by rigorous inclusion criteria, lack of publication bias, and absence of moderating effects by publication year. The latter underscores the replicability of the stress generation effect over the last 30 years. Taken together, the review provides robust evidence that stress generation is a cross-diagnostic phenomenon that contributes to a vicious cycle of increasing stress and psychopathology.
Public Significance Statement
Stress generation theory originally showed that people with depression can create their own stress. This meta-analysis indicates that stress generation is a cross-diagnostic phenomenon that contributes to the chronicity of symptoms of psychopathology. Findings imply that interventions aimed at preventing stress generation may mitigate chronic psychopathology. Stress generation also varied in nuanced ways across various types of psychopathology, thereby indicating for whom and under what conditions stress generation is most prominent. Importantly, a lack of publication bias and absence of moderating effects by publication year and by most demographic variables underscores the replicability of the stress generation effect over time and its universality across groups.
Anxiety and depression co-occur, both at the disorder and symptom levels, and within anxiety disorders, fluctuations in daily anxious mood correspond temporally to fluctuations in depressed mood. ...However, little is known about the factors or conditions under which anxiety and depressive symptoms are most likely to co-occur. The current study investigated the role of cognitive factors (daily rumination and cognitive attributions about anxiety symptoms) and interpersonal functioning (daily perceived rejection, support, criticism, and interpersonal problems) as moderators of the daily association between anxious and depressed moods. Fifty-five individuals with generalized anxiety disorder completed a 21-day diary assessing daily mood and cognitive and interpersonal functioning. Ratings of anxious and depressed mood were more closely associated on days when participants ruminated about their anxiety or viewed anxiety symptoms more negatively. Furthermore, anxious mood predicted later depressed mood on days when participants reported greater interpersonal problems and more perceived rejection. Results suggest that cognitive and interpersonal factors may elevate the likelihood of anxiety-depression co-occurrence.
Sexual minority (e.g., gay, lesbian, bisexual) people are at increased risk for suicidal thoughts and behaviors compared to their heterosexual peers. The interpersonal theory of suicide proposes that ...perceived burdensomeness and thwarted belongingness are central to the desire to die, and both are associated with suicidal ideation in sexual minority samples. The Interpersonal Needs Questionnaire (INQ) was developed to measure these risk factors and has become the most commonly used measure. However, it is unknown whether the INQ demonstrates similar measurement properties across subgroups of sexual minority people. Therefore, the goal of this study was to examine whether the 15-item version of the INQ exhibited measurement invariance (MI) across sexual orientation (gay/lesbian vs. bi+), gender identity (cisgender men vs. cisgender women vs. transgender/gender diverse individuals), and race/ethnicity (non-Latinx White individuals vs. people of color) in a sample of 792 sexual minority young adults (ages 18-29). A series of multigroup measurement invariance models indicated that the INQ-15 met strict invariance (i.e., equal factor loadings, item intercepts, and residual variances) across all three dimensions of identity. This indicates that it can be used and compared across diverse samples of sexual minority young adults. Results also indicated that perceived burdensomeness was greater for transgender/gender diverse individuals than for cisgender men and women, and that perceived burdensomeness and thwarted belongingness were greater for people of color than for non-Latinx White individuals. In contrast, gay/lesbian and bi+ individuals did not differ. Additional research is needed to understand the factors that account for these group differences.
Public Significance Statement
This study demonstrated that the psychometric properties of the Interpersonal Needs Questionnaire (INQ-15) do not differ across sexual orientation, gender identity, and race/ethnicity groups in a sample of sexual minority young adults. Therefore, the INQ-15 can be used with confidence with diverse samples of sexual minority young adults.
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