Longitudinal Associations Between Anxiety and Depression in Transition From Childhood to Adolescence

Abstract

Background The transition from childhood to adolescence is often accompanied by an increase in internalizing problems, particularly anxiety and depression. Although anxiety and depression are conceptually distinct, they also frequently co‐occur. Some evidence suggests that anxiety may precede depression; however, the longitudinal dynamics between the two remain unclear. In the current study, we used a random intercept cross‐lagged panel model (RI‐CLPM) to disentangle between‐person stability from within‐person fluctuations. This approach allows us to examine how changes in anxiety and depression predict each other over time during the transition from childhood to adolescence. Methods Participating children (n = 1499; 47.8% girls) from the All Our Families (AOF) cohort reported on their anxiety and depression using the Behavior Assessment System for Children – Third Edition (BASC‐3) four times between 2020 and 2023 (mean age at Time 1 = 9.66 years; SD = 0.81). Results At the between‐person level, which captures stability in the levels of anxiety and depression, there was a strong positive correlation. At the within‐person level, which captures within‐person variations over time, concurrent associations were significant at most time points. However, cross‐lagged effects were unidirectional, with depression predicting anxiety, but not vice versa. These effects were significant from Time 2 to Time 3 and from Time 3 to Time 4 and were consistent across sexes. Conclusions The findings underscore the significance of the timing of child‐specific effects between anxiety and depression, indicating that depression, rather than anxiety, may serve as the primary driving factor in the longitudinal association between the two symptom clusters.