title: Stressful life events in anxious and depressed children.
abstract: OBJECTIVE
  The aim of this study was to examine the occurrence of stressful life events in anxious and depressed children.
  
  
  METHODS
  Children (6-12 years of age) with an anxiety disorder (n = 20), depression (n = 45), and normal controls (n = 11) were assessed using the Life Events Record. Cortisol was assessed from plasma samples collected every 20 minutes from an indwelling catheter in the one and two hour window around sleep onset.
  
  
  RESULTS
  Depressed children had significantly more events and events that were most likely independent of the child's behavior, compared to both the anxious and normal control children. Independent loss events were significantly more prevalent among the depressed children in the preceding year, compared to anxious children, with a trend toward more loss events compared to the normal controls. For both overall events and independent events, depressed females were significantly more likely to be exposed to stressful environments compared to anxious and normal control females. There were no effects of stress on cortisol secretion around sleep onset.
  
  
  CONCLUSIONS
  The results of this study suggest that stressful life events are significantly more likely to occur in depressed children, particularly females, compared to anxious children, and that these events are predominantly characterized by independent events outside of the child's control. The results also suggest that loss events may be specific for depression in children. Interestingly, stress does not appear to impact the HPA axis in children, which is true for anxious, depressed, and normal control children. The temporal occurrence and severity, as well as the type of stressful life events as they relate to the onset and maintenance of anxiety and depression in children, need to be more fully explored.
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania 15213, USA. Williamson DE@upmc.edu
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Williamson
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Dahl
authors.forename: Neal D
authors.initials: ND
authors.lastname: Ryan
mesh_terms: D001008:Anxiety Disorders / Q000097:blood / Q000523:psychology*; D002648:Child; D003866:Depressive Disorder / Q000097:blood / Q000523:psychology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008016:Life Change Events; D008297:Male; D011569:Psychiatric Status Rating Scales; D012890:Sleep / Q000502:physiology
chemical_list: D006854:Hydrocortisone