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Why do anxious children become depressed teenagers? The role of social evaluative threat and reward processing

Published online by Cambridge University Press:  17 February 2012

J. S. Silk ,
S. Davis ,
D. L. McMakin ,
R. E. Dahl  and
E. E. Forbes
J. S. Silk*
Affiliation:
University of Pittsburgh, Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA
S. Davis
Affiliation:
University of Pittsburgh, Department of Psychology, Pittsburgh, PA, USA
D. L. McMakin
Affiliation:
University of Pittsburgh, Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA
R. E. Dahl
Affiliation:
University of California, Berkeley, School of Public Health, Berkeley, CA, USA
E. E. Forbes
Affiliation:
University of Pittsburgh, Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA
*
*Address for correspondence: J. S. Silk, Ph.D., Western Psychiatric Institute and Clinic, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA. (Email: silkj@upmc.edu)
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Abstract

Background

Depression is a leading cause of worldwide disability. Adolescence represents a key developmental window in which rates of this disorder increase markedly. Children with an anxiety disorder show a particular risk of developing depression during adolescence.

Method

We present and review evidence for a developmental model that considers the intersection of two vulnerabilities relevant to the trajectory from anxiety to depression: difficulties in response to potential social evaluation and changes in reward processing at puberty.

Results

Evidence suggests that these vulnerabilities (a) have been associated with depression, (b) are likely to be problematic in many, but not all, anxious youth, and (c) may be exacerbated by maturational processes that occur around pubertal development in ways that can create a negative spiral into a depressive disorder.

Conclusions

We discuss the possibility that early intervention strategies targeting key aspects of these vulnerabilities could alter the trajectory away from depression for many anxious youth.

Keywords

Adolescenceanxietydepressionpubertyrewardthreat
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 10 , October 2012 , pp. 2095 - 2107
Copyright
Copyright © Cambridge University Press 2012

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