University of Pittsburgh, Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213, USA.
Psychol Med. 2012 Oct;42(10):2095-107. doi: 10.1017/S0033291712000207. Epub 2012 Feb 17.
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.
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.
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.
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.
抑郁症是全球残疾的主要原因。青春期是这种疾病发病率显著增加的关键发育窗口。患有焦虑症的儿童在青春期特别容易发展为抑郁症。
我们提出并回顾了一个发展模型的证据，该模型考虑了与从焦虑到抑郁的轨迹相关的两个脆弱性的交叉点：对潜在社会评价的反应困难和青春期奖励处理的变化。
有证据表明，这些脆弱性(a)与抑郁症有关，(b)可能在许多但不是所有焦虑的年轻人中出现问题，(c)可能会因青春期发育周围发生的成熟过程而加剧，从而导致进入抑郁障碍的负面螺旋。
我们讨论了针对这些脆弱性关键方面的早期干预策略是否有可能改变许多焦虑青年的抑郁轨迹。
