Contract grant sponsor: NIMH; Contract grant numbers: R01MH052239 and T32MH082719.
DOES RELATIONAL DYSFUNCTION MEDIATE THE ASSOCIATION BETWEEN ANXIETY DISORDERS AND LATER DEPRESSION? TESTING AN INTERPERSONAL MODEL OF COMORBIDITY
Article first published online: 26 AUG 2013
© 2013 Wiley Periodicals, Inc.
Depression and Anxiety
Focus on Prognosis and Risk Factors
Volume 31, Issue 1, pages 77–86, January 2014
How to Cite
Starr, L. R., Hammen, C., Connolly, N. P. and Brennan, P. A. (2014), DOES RELATIONAL DYSFUNCTION MEDIATE THE ASSOCIATION BETWEEN ANXIETY DISORDERS AND LATER DEPRESSION? TESTING AN INTERPERSONAL MODEL OF COMORBIDITY. Depress. Anxiety, 31: 77–86. doi: 10.1002/da.22172
- Issue published online: 2 JAN 2014
- Article first published online: 26 AUG 2013
- Manuscript Accepted: 31 JUL 2013
- Manuscript Revised: 26 JUL 2013
- Manuscript Received: 11 APR 2013
- NIMH. Grant Numbers: R01MH052239, T32MH082719
- social phobia;
- social anxiety disorder;
- generalized anxiety disorder;
- depressive disorder;
- interpersonal relations;
Anxiety disorders tend to precede onset of comorbid depression. Several researchers have suggested a causal role for anxiety in promoting depressive episodes, but few studies have identified specific mechanisms. The current study proposes an interpersonal model of comorbidity, where anxiety disorders disrupt interpersonal functioning, which in turn elevates risk for depression.
At age 15 (T1), 815 adolescents oversampled for maternal depression completed diagnostic interviews, social chronic stress interviews, and self-report measures. At age 20 (T2), participants repeated all measures and reported on self-perceived interpersonal problems. At approximately age 23 (T3), a subset of participants (n = 475) completed a self-report depressive symptoms measure.
Consistent with other samples, anxiety disorders largely preceded depressive disorders. Low sociability and interpersonal oversensitivity mediated the association between T1 social anxiety disorder and later depression (including T2 depressive diagnosis and T3 depressive symptoms), controlling for baseline. Interpersonal oversensitivity and social chronic stress similarly mediated the association between generalized anxiety disorder before age 15 and later depression.
Interpersonal dysfunction may be one mechanism through which anxiety disorders promote later depression, contributing to high comorbidity rates.