OBJECTIVE Children who are fearful and anxious are at heightened risk for developing depression in adolescence. Treating anxiety disorders in pre-/early adolescence may be one mechanism through which depressive symptoms later in adolescence can be prevented. We hypothesized that anxious youth who responded positively to cognitive-behavioral therapy (CBT) for anxiety would show reduced onset of depressive symptoms 2 years later compared to treatment nonresponders, and that this effect would be specific to youth treated with CBT compared to an active supportive comparison treatment. METHOD Participants were 80 adolescents ages 11 to 17 years who had previously completed a randomized trial comparing predictors of treatment response to CBT and child-centered therapy (CCT). Youth met DSM-IV criteria for generalized, separation, and/or social anxiety disorder at the time of treatment. The present study was a prospective naturalistic 2-year follow-up examining trajectories toward depression, in which participants were reassessed for depressive symptoms 2 years after anxiety treatment. Treatment response was defined as a 35% reduction in independent evaluator-rated anxiety severity on the Pediatric Anxiety Rating Scale after treatment. RESULTS As hypothesized, lower levels of depressive symptoms were observed in anxious youth who responded to CBT for anxiety (β = -0.807, p = .004) but not CCT (β = 0.254, p = .505). Sensitivity analyses showed that the effects were driven by girls. CONCLUSION Findings suggest that CBT for anxiety is a promising approach to preventing adolescent depressive symptomatology, especially among girls. The results highlight the need for better early screening for anxiety and better dissemination of CBT programs targeting anxiety in youth.

中文翻译：

---

纵向随访研究，检查青少年抑郁症状与先前焦虑治疗的关系。

目的恐惧和焦虑的孩子在青春期患抑郁症的风险更高。在青春期前/青春期治疗焦虑症可能是一种可以预防青春期后的抑郁症状的机制。我们假设，对焦虑的认知行为疗法（CBT）产生积极反应的焦虑青年与治疗后无反应者相比，在2年后会显示出抑郁症状发作的减少，并且与积极支持疗法相比，这种效应仅针对接受CBT治疗的年轻人比较治疗。方法参与者为80位11至17岁的青少年，他们之前已经完成了一项随机试验，比较了对CBT和以儿童为中心的治疗（CCT）的治疗反应的预测指标。青年符合DSM-IV的概括，分离，和/或治疗时的社交焦虑症。本研究是一项对抑郁症的前瞻性，自然主义的两年随访研究，其中对焦虑治疗后2年的参与者进行了抑郁症状的重新评估。治疗反应定义为治疗后小儿焦虑评分量表上独立评估者的焦虑严重程度降低35％。结果如所假设的，在对CBT焦虑有反应的焦虑青年中观察到较低的抑郁症状水平（β= -0.807，p = .004），而对CCT无反应（β= 0.254，p = .505）。敏感性分析表明，这种影响是由女孩驱动的。结论研究结果表明，针对焦虑症的CBT是一种预防青春期抑郁症状的有前途的方法，尤其是在女孩中。