JAACAP Open. 2024 Sep 26;3(3):793-804. doi: 10.1016/j.jaacop.2024.09.002. eCollection 2025 Sep.
ABSTRACT
OBJECTIVE: The bidirectional relationships between family functioning and adolescent depressive and anxiety disorders have been documented. However, categorical diagnostic criteria for these disorders often mask the high variability of symptom severity across individuals sharing the same diagnoses. Accounting for such heterogeneity, this study examined the associations between domains of family functioning and depression, anxiety, and anhedonia symptoms from the adolescent perspective using a dimensional approach.
METHOD: Semistructured diagnostic interviews and self-reported measures for depression, anxiety, and anticipatory and consummatory anhedonia were used to evaluate adolescents. Participants’ perception of 7 aspects of family life was assessed with the Family Assessment Device. Bivariate assessments of associations between family subscales and symptom severity scores were conducted. Subsequently, regression models were employed to investigate these relationships while adjusting for age, sex, race, ethnicity, and multiple comparisons.
RESULTS: Data from 79 adolescents (15.0 ± 1.84 years old; 61.8% biologically female) were analyzed, including 59 participants with psychopathology and 19 control participants. Adolescents with psychiatric symptoms perceived lower levels of family Problem Solving, Communication, and General Functioning relative to control participants. Depression severity was associated with Problem Solving, Communication, Roles, Affective Responsiveness, and General Functioning. Anxiety was associated with Problem Solving, Roles, and General Functioning. These relationships remained significant following adjustments for covariates and multiple comparisons correction. Anhedonia subconstructs and perceived family functioning associations were not as robust, suggesting a different etiological pathway.
CONCLUSION: These findings support the intertwined relationships between adolescent mood and anxiety processes and perceived family functioning factors. Future studies should examine larger samples and incorporate parents’ perspectives.
DIVERSITY & INCLUSION STATEMENT: We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.
PMID:40922792 | PMC:PMC12414323 | DOI:10.1016/j.jaacop.2024.09.002
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