Insecure Attachment, Dysfunctional Attitudes, and Low Self-Esteem Predicting Prospective Symptoms of Depression and Anxiety During Adolescence

Abstract

This study extends the existing adult literature on insecure attachment as a predictor of depression and anxiety by examining these pathways in a sample of adolescents. In addition, dysfunctional attitudes and low self-esteem were tested as mediators of the association between insecure attachment and symptoms of depression and anxiety. Youth (N =350; 6th-10th graders) completed self-report measures of attachment, dysfunctional attitudes, self-esteem, and symptoms of depression and anxiety in a 4-wave prospective study. Results indicate that anxious and avoidant attachment each predicted changes in both depression and anxiety (after controlling for initial symptom levels). The association between anxious attachment, but not avoidant attachment, and later internalizing symptoms was mediated by dysfunctional attitudes and low self-esteem. Effects remained even after controlling for initial co-occurring symptoms.Depression and anxiety are among the most common psychiatric disorders during adolescence (Costello, Egger, & Angold, 2005;Williamson, Forbes, Dahl, & Ryan, 2005), and prevalence rates of both major depressive disorder and anxiety disorders increase significantly during adolescence (Costello et al., 2005;). Point prevalence rates for depression range from 2% to 5%, and rates of recurrence are found to be approximately 70% within 5 years (Birmaher et al., 1996). Anxiety disorders have a point prevalence rate of approximately 20% and exhibit a significant degree of stability across the lifespan (Costello et al., 2005). In addition, adolescent depression and anxiety disorders co-occur highly with each other (Angold, Costello, & Erkanli, 1999), as well as with other psychiatric disorders. Given the high prevalence and recurrence rates, marked increase during adolescence, significant degree of co-occurrence, and continuity into adulthood, it is important to understand the mechanisms involved in the development of depression and anxiety in adolescents.Attempts to understand the development of depression in youth have utilized both cognitive and interpersonal approaches. Separately, each approach has contributed substantially to our understanding of the development of depression. Cognitive theories (e.g., Beck's Cognitive Theory of Depression;Beck, 1987) have provided evidence for the influence of negative cognitions in the development of depression, whereas interpersonal theories (e.g., Interactional Theory of Depression; Coyne, 1976) emphasize the role of interpersonal processes (e.g., relationships with family and peers) in depression. Using an integrated cognitive-interpersonal approach allows for an examination of the interplay between both intrapersonal and Correspondence should be addressed to Adabel Lee, Department of Psychology, University of Illinois at Chicago, 1007 West Harrison, Chicago, IL 60607. E-mail: adabel@uic.edu. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript interpersonal factors. Attachment theory is one such integrative theory that can be...

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