title: Depressive and anxiety symptom trajectories from school age through young adulthood in samples with autism spectrum disorder and developmental delay.
abstract: OBJECTIVE
  The objectives of this study were to model growth in anxiety and depressive symptoms from late school age through young adulthood in individuals with autism spectrum disorder (ASD) and controls with developmental delay (DD), and to assess relationships among internalizing growth patterns, participant characteristics, baseline predictors, and distal outcomes.
  
  
  METHODS
  Data were collected between ages 6 and 24 years in 165 participants (n = 109 with ASD; n = 56 with nonspectrum DD), most of whom received diagnostic evaluations in both childhood and early adulthood. Questionnaires were collected approximately every 3 to 6 months between ages 9 and 24 years. Parent-rated Child Behavior Checklist (CBCL), Adult Behavior Checklist (ABCL), and Developmental Behaviour Checklist anxiety- and depression-related subscale distributions were modeled with mixed-effects Poisson models, covarying diagnosis, age, verbal IQ (VIQ), gender, and significant 2- and 3-way interactions.
  
  
  RESULTS
  Anxiety was positively associated with VIQ, and controlling for VIQ, both anxiety and depressive symptoms were greater in ASD than nonspectrum participants. Female gender predicted greater increases over time in anxiety and depressive symptoms for both diagnostic groups. Lower maternal education was associated with increasing internalizing symptoms in a subset of less verbal individuals with ASD. In exploratory post hoc analyses, internalizing symptoms were associated with poorer emotional regulation in school age, and with lower life satisfaction and greater social difficulties in early adulthood.
  
  
  CONCLUSIONS
  Findings support previous claims that individuals with ASD are at particular risk for affect- and anxiety-specific problems. Although symptom levels in females increase at a faster rate throughout adolescence, males with ASD appear to have elevated levels of depressive symptoms in school age that are maintained into young adulthood.
authors.affiliation: Vanderbilt University School of Medicine, Nashville. Electronic address: katherine.gotham@vanderbilt.edu.
authors.forename: Katherine
authors.initials: K
authors.lastname: Gotham
authors.affiliation: Vanderbilt University Kennedy Center, Nashville.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Brunwasser
authors.affiliation: Center for Autism and the Developing Brain, Weill-Cornell Medical College, New York.
authors.forename: Catherine
authors.initials: C
authors.lastname: Lord
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000453:epidemiology*; D000067877:Autism Spectrum Disorder / Q000175:diagnosis* / Q000523:psychology; D000067290:Behavior Rating Scale; D002648:Child; D003863:Depression / Q000453:epidemiology*; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012574:Schools; D057566:Self Report; D055815:Young Adult
keywords: Child Behavior Checklist; anxiety; autism spectrum disorder; depression; growth curve