Multi-domain Models of Internalizing Disorders: Risk Factors and Complex Pathways

This chapter describes findings about risk factors for the development and maintenance of depression and anxiety symptoms in young children by examining two different multidomain models for each symptom type. The first models for each symptom type included pathways from risk factors in different domains at age 4 to age 5 risk factors, and then to child symptoms at age 6. The second models, developed to examine risk factors associated with changes in depression and anxiety symptoms between ages 4 and 6, consisted of the same risk factors and pathways, but with the addition of symptom levels at each age. The first models for depression and anxiety revealed many similarities in risk factors and pathways leading to these two symptom types, including multiple pathways from risk factors at age 4 to factors in other domains at age 5, which, in turn, predicted child symptom levels at age 6. Effortful control and sensory regulation at age 5 mediated several of these pathways. The second models for each symptom type revealed that symptoms of each disorder were stable across ages 4–6, and only effortful control at age 5 had an effect on changes in symptom levels. The next part of the chapter describes reciprocal effects between parenting and child symptoms of depression and anxiety. A final section contributes to knowledge about the temporal sequencing of anxiety and depression symptoms in young children.