title: Why are anxiety and depressive symptoms comorbid in youth? A multi-wave, longitudinal examination of competing etiological models.
abstract: BACKGROUND
  The present study sought to clarify the development of comorbid emotional distress by comparing different explanations for how youth develop anxiety and depressive symptoms. Specifically, we introduced the diathesis-anxiety approach (whether cognitive vulnerabilities interact with anxiety symptoms), and compared it to a causal model (anxiety symptoms predicting depressive symptoms), and a correlated liabilities model (whether cognitive vulnerabilities interacted with stressors to predict both anxiety and depressive symptoms) to examine which model best explained the relation between depressive and anxiety symptoms in youth.
  
  
  METHODS
  678 3rd (n=208), 6th (n=245), and 9th (n=225) grade girls (n=380) and boys (n=298) completed self-report measures at baseline assessing cognitive vulnerabilities (rumination and self-criticism), stressors, depressive and anxiety symptoms. Every 3 months over the next 18 months, youth completed follow-up measures of symptoms and stressors.
  
  
  RESULTS
  While limited support was found for a causal (p>0.10) or correlated-liability model (p>0.05) for comorbidity, findings did support a diathesis-anxiety approach for both self-criticism (t(2494)=3.36, p<0.001) and rumination (t(2505)=2.40, p<0.05).
  
  
  CONCLUSIONS
  The present study׳s findings are based on self-report measure and makes inferences concerning comorbidity with a community sample.
  
  
  CONCLUSIONS
  These results may help clarify past research concerning comorbidity by introducing a diathesis-anxiety approach as a viable model to understand which youth are most at-risk for developing comorbid emotional distress.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, MSC 861, 2nd Fl. IOP South Building, Charleston, SC 29425, USA; Department of Psychology, Rutgers University, USA. Electronic address: cohej@musc.edu.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Cohen
authors.affiliation: Department of Psychology, Rutgers University, USA; Graduate School of Applied and Professional Psychology, Rutgers University, USA.
authors.forename: Jami F
authors.initials: JF
authors.lastname: Young
authors.affiliation: Department of Psychology, Binghamton University, USA.
authors.forename: Brandon E
authors.initials: BE
authors.lastname: Gibb
authors.affiliation: Department of Psychology, University of Denver, USA.
authors.forename: Benjamin L
authors.initials: BL
authors.lastname: Hankin
authors.affiliation: Department of Psychology, Rutgers University, USA.
authors.forename: John R Z
authors.initials: JR
authors.lastname: Abela
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000150:complications*; D002648:Child; D015897:Comorbidity; D003863:Depression / Q000150:complications*; D004644:Emotions; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008960:Models, Psychological; D011795:Surveys and Questionnaires
keywords: Anxiety; Comorbidity; Depression; Developmental psychopathology; Youth
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