title: Pathways to anxiety-depression comorbidity: A longitudinal examination of childhood anxiety disorders.
abstract: Anxiety disorders are prevalent in youth and associated with later depressive disorders. A recent model posits three distinct anxiety-depression pathways. Pathway 1 represents youth with a diathesis to anxiety that increases risk for depressive disorders; Pathway 2 describes youth with a shared anxiety-depression diathesis; and Pathway 3 consists of youth with a diathesis for depression who develop anxiety as a consequence of depression impairment. This is the first partial test of this model following cognitive-behavioral treatment (CBT) for child anxiety.
  
  
  
  The present study included individuals (N = 66; M age = 27.23 years, SD = 3.54) treated with CBT for childhood anxiety disorders 7-19 years (M = 16.24; SD = 3.56) earlier. Information regarding anxiety (i.e., social phobia (SoP), separation anxiety disorder (SAD), generalized anxiety disorder (GAD)) and mood disorders (i.e., major depressive disorder (MDD) and dysthymic disorders) was obtained at pretreatment, posttreatment, and one or more follow-up intervals via interviews and self-reports.
  
  
  
  Evidence of pathways from SoP, SAD, and GAD to later depressive disorders was not observed. Treatment responders evidenced reduced GAD and SoP over time, although SoP was observed to have a more chronic and enduring pattern.
  
  
  
  Evidence for typically observed pathways from childhood anxiety disorders was not observed. Future research should prospectively examine if CBT treatment response disrupts commonly observed pathways.
authors.affiliation: Center for Mental Health Policy and Services Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. cbenja@upenn.edu.
authors.forename: Courtney Benjamin
authors.initials: CB
authors.lastname: Wolk
authors.affiliation: Department of Psychology, Temple University, Philadelphia, PA, USA.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Carper
authors.affiliation: Department of Psychology, Temple University, Philadelphia, PA, USA.
authors.forename: Philip C
authors.initials: PC
authors.lastname: Kendall
authors.affiliation: Department of Psychology, Temple University, Philadelphia, PA, USA.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Olino
authors.affiliation: School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Marcus
authors.affiliation: Center for Mental Health Policy and Services Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Rinad S
authors.initials: RS
authors.lastname: Beidas
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D002648:Child; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012008:Recurrence; D012306:Risk; D016896:Treatment Outcome; D055815:Young Adult
keywords: anxiety; cognitive-behavioral therapy; comorbidity; depression; evidence-based treatment