Distinguishing between Pediatric Anxiety and Depression: \ud The Experience of Emotion and Emotion Regulation\ud

Anxiety and depression, two common disorders in childhood and adolescence, are highly comorbid. However, while the majority of depressed youth have a past history or current diagnosis of anxiety, only one third of anxious youth have experienced depression. To elucidate the substantial, but incomplete overlap between these disorders, this study sought to determine whether youth with clinical diagnoses of depression and anxiety could be differentiated based on features of emotion and emotion regulation. To achieve this, this study utilized ecological momentary assessment (EMA) data to examine youth’s experience of and response to negative emotions in real-life. The sample included 165 nine to 14 year-olds: 27 with diagnoses of depression (DEP), 76 with diagnoses of Generalized Anxiety Disorder (ANX), and 62 healthy controls (CON). None of the participants in the ANX group had diagnoses of depression, while 37% of participants in the DEP group had secondary diagnoses of anxiety. Over a 5 day block, participants received phone calls in which they were asked to identify recent events that elicited negative emotions, provide ratings of negative emotions, and report on how they handled these emotions. Hypotheses were tested using both categorical groups (DEP, ANX, CON) and continuous indices of depressive and anxious symptoms to examine the contribution of depressive symptoms above and beyond anxious symptoms (and vice versa). Using either approach, findings indicated that depression was uniquely linked with greater peak sadness and higher levels of rumination, while anxiety was uniquely related to greater peak nervousness and higher levels of worry. While more tenuous, findings supported aspects of emotion regulation as shared features (e.g., higher rumination, lower effortful control, greater mean intensity of worry). In sum, this study lends support to anxiety and depression being different manifestations of similar underlying phenomena with respect to how youth experience and respond to negative emotions.\ud \u