Richard Roxanne, Marcotte Diane
Université du Québec à Montréal.
Sante Ment Que. 2013 Autumn;38(2):257-75. doi: 10.7202/1023999ar.
Depression and anxiety are among the most prevalent disorders in the adolescent population. An increase of the prevalence of these disorders is taking place during adolescence, this developmental period being experienced in synchronicity with the high school transition. Also, some studies suggested the existence of a developmental trend between the onset of anxiety and depression. This longitudinal study explored the temporal relationship between anxiety and depression during the transition from primary to high school.
first, this study examined whether the presence of anxiety in grade 6 (Time 1) increases the risk of depression in grade 8 (Time 2). Then a subgroup of comorbid students, who presented anxiety and depression, was compared with a subgroup of anxious ones on the presence of cognitive distortions. It was assessed whether cognitive distortions in the anxious group in Time 1 influenced the development of comorbidity between anxiety and depression in Time 2.
146 students from 12 public schools, 62 girls and 84 boys (mean = 11.22 years) participated in this study. This sub sample was drowned from a larger sample of 499 students, in a 9 years longitudinal study (2003-2012). Participants completed the questionnaire and were met for an interview at the beginning of each school year. Parents consent was obtained. In Time 1, students were divided into two subgroups, anxious and non-anxious students. At time 2, two subgroups of students were constituted, either anxious or comorbid anxious and depressed students. Depression was controlled at time 1.The Dominic Interactive for Adolescents (Valla, 2000) was used to measure the presence of anxiety and depression. The correlation (.34 to .62) between the three anxiety scales (separation anxiety, generalized anxiety and phobia) allowed to create an unique anxiety score. Cognitive distortions (related to dependence, achievement and self control) were measured by the Dysfunctional Attitudes Scale (Weisseman & Beck, 1978).
The hierarchical log linear analyse revealed a tendency between the presence of anxiety in Time 1 and the development of depression in Time 2, only for girls (p=.08), so that 25% of anxious girls at Time 1 became depressive at Time 2, compare to 0% of non anxious girls. For boys, whether anxiety is present or not, the two subgroups presented the same risk to develop depression. Then, results of a Manova analysis revealed that anxious students at time 1 already adopted cognitive distortions related to dependency and to achievement, usually associated with depression. At time 2, the result of the Manova revealed that comorbid students presented more cognitive distortions related to dependency then the anxious students. However, non significant results were found for the longitudinal analyse, which did not supported the existence of a predicting link between the presence of depressogenous cognitive distortions at Time 1 in the anxious subgroup of students and the emergence of comorbidity at Time 2.
The results of the present study testified the importance to prevent depression, especially for anxious school girls. Anxiety seems to have a different role for girls and boys. A trend was observed between the presence of an anxiety disorder in Grade 6 and the development of a depressive disorder 2 years later, among girls only. This result raises the importance to understand the role of anxiety in girls to reduce their risk to develop a depressive disorder. Our results also showed that anxious students in grade 6, already presented cognitive distortions related to dependency and achievement which are associated with depression while comorbid students in the second year of high school presented more cognitive distortions related to dependency only, when they were compared with the anxious group.
抑郁和焦虑是青少年群体中最普遍的疾病。这些疾病的患病率在青春期呈上升趋势，这一发育阶段与初中过渡阶段同步经历。此外，一些研究表明焦虑和抑郁的发病之间存在发展趋势。这项纵向研究探讨了小学到初中过渡期间焦虑和抑郁之间的时间关系。
首先，本研究考察六年级（时间1）时焦虑的存在是否会增加八年级（时间2）时抑郁的风险。然后，将同时患有焦虑和抑郁的共病学生亚组与焦虑学生亚组在认知扭曲的存在方面进行比较。评估时间1时焦虑组中的认知扭曲是否会影响时间2时焦虑和抑郁共病的发展。
来自12所公立学校的146名学生（62名女生和84名男生，平均年龄 = 11.22岁）参与了本研究。该子样本是从499名学生的更大样本中抽取的，这是一项为期9年的纵向研究（2003 - 2012年）。参与者在每个学年开始时完成问卷并接受访谈。获得了家长的同意。在时间1，学生被分为两个亚组，焦虑学生和非焦虑学生。在时间2，组成了两个学生亚组，即焦虑学生或同时患有焦虑和抑郁的共病学生。在时间1对抑郁进行了控制。使用青少年多米尼克互动量表（瓦拉，2000）来测量焦虑和抑郁的存在。三个焦虑量表（分离焦虑、广泛性焦虑和恐惧症）之间的相关性（0.34至0.62）使得能够创建一个独特的焦虑得分。认知扭曲（与依赖、成就和自我控制相关）通过功能失调态度量表（魏斯曼和贝克，1978）进行测量。
分层对数线性分析显示，仅在女孩中，时间1时焦虑的存在与时间2时抑郁的发展之间存在一种趋势（p = 0.08），因此时间1时25%的焦虑女孩在时间2时变得抑郁，而非焦虑女孩为0%。对于男孩，无论是否存在焦虑，两个亚组患抑郁的风险相同。然后，多变量方差分析的结果显示，时间1时焦虑的学生已经表现出与依赖和成就相关的认知扭曲，这些通常与抑郁相关。在时间2，多变量方差分析的结果显示，共病学生比焦虑学生表现出更多与依赖相关的认知扭曲。然而，纵向分析未发现显著结果，这并不支持在时间1学生焦虑亚组中存在的抑郁性认知扭曲与时间2中共病的出现之间存在预测联系。
本研究结果证明了预防抑郁的重要性，特别是对于焦虑的女学生。焦虑对女孩和男孩似乎有不同的作用。仅在女孩中观察到六年级时存在焦虑症与两年后抑郁症的发展之间存在一种趋势。这一结果凸显了了解焦虑在女孩中的作用以降低她们患抑郁症风险的重要性。我们的结果还表明，六年级时焦虑的学生已经表现出与依赖和成就相关的认知扭曲，这些与抑郁相关，而高中二年级的共病学生与焦虑组相比，仅表现出更多与依赖相关的认知扭曲。
