Childhood Maltreatment as a Predictor of Depression-Anxiety Coupling Strength

Abstract

Major depressive disorder (MDD) and anxiety disorders are among the most common psychiatric conditions, with their co-occurrence associated with increased severity, functional impairment, and relapse risk. However, not all individuals with depressive symptoms experience co-occurring anxiety symptoms, highlighting the need to identify mechanisms that explain this variability. Childhood maltreatment, including emotional, physical, and sexual abuse and neglect, is a well-established transdiagnostic risk factor for internalizing psychopathology, yet its role in shaping dynamic co-occurrence of symptoms and disorders remains poorly understood. This study will examine childhood maltreatment as a predictor of Depression-Anxiety Coupling Strength (DACS), a construct reflecting the extent to which fluctuations in anxiety and depressive symptoms co-vary over time. Archival data (N=250) will be drawn from the LAUREL cohort in the Mood Research Laboratory at Queen’s University. Participants completed the Childhood Experience of Care and Abuse (CECA) interview at baseline and the Mood and Anxiety Symptom Questionnaire (MASQ-D30) at two follow-ups over eight months. Multilevel modeling (MLM) will estimate within-person DACS and test whether childhood maltreatment severity and subtype predict stronger coupling and more persistent symptom trajectories. I hypothesize that individuals with greater childhood maltreatment severity, particularly severity of emotional abuse and neglect, will exhibit stronger DACS, reflecting greater temporal coupling between depression and anxiety symptoms. Clarifying how early adversity shapes these dynamic processes may enhance prediction of illness trajectories and inform more precise interventions for individuals who experience comorbidity.