Research Review

The internalizing paradox – youth anxiety and depression symptoms, psychotherapy outcomes, and implications for research and practice

Dados Bibliográficos

ID21344207
AutoresJohn R Weisz (0000-0002-5560-6814, Department of Psychology Harvard University Cambridge MA USA, autor correspondente), Olivia M Fitzpatrick (0000-0001-8868-6702, Department of Psychology Harvard University Cambridge MA USA), Katherine E Venturo-Conerly (0000-0003-3559-2491, Harvard University), Katherine E Venturo‐Conerly (Department of Psychology Harvard University Cambridge MA USA), Ariel Sternberg (0000-0003-1111-1307, Department of Psychology Harvard University Cambridge MA USA), Joshua S Steinberg (0000-0002-8920-3415, Department of Psychology Harvard University Cambridge MA USA), Mei-Yee Ng (0000-0002-1399-0133, Department of Psychology Florida International University Miami FL USA), Mei Yi Ng (Department of Psychology Florida International University Miami FL USA)
Ano2023
Volume64
Fascículo12
Páginas1720-1734
Data de publicação2023-12-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoJournal of Child Psychology and Psychiatry (JOURNAL)
Identificadores do periódicoISSN: 0021-9630 • E-ISSN: 1469-7610
EditoraWiley (PUBLISHER • GB)
DOI10.1111/jcpp.13820
PMID37222162
OpenAlexW4377940778
IdiomaEN
Citações recebidas3
Referências citadas114

BACKGROUND: Youth anxiety and depression have long been combined within the empirically derived internalizing syndrome. The two conditions show substantial comorbidity, symptom co-occurrence, and overlap in treatment procedures, but paradoxically diverge in psychotherapy outcomes: strong, positive effects for anxiety and weak effects for depression. METHODS: Drawing on recent research, we examine candidate explanations for this paradox to help identify strategies for addressing it by improving outcomes for youth depression. RESULTS: Candidate explanations include that youth depression, compared with youth anxiety, has more varied comorbidities and more heterogeneous symptom combinations, has greater uncertainty regarding mediators and mechanisms of change, is treated with more complex and potentially confusing protocols, and has characteristics that may impede client engagement. Candidate strategies for shrinking the psychotherapy effectiveness gap include personalizing through transdiagnostic modular treatment, simplifying therapy by focusing on empirically supported principles of change, developing effective strategies for engaging family members as intervention allies, using shared decision-making to inform clinical decisions and boost client engagement, capitalizing on youth-friendly technological advances, and shortening and digitizing treatments to enhance their accessibility and appeal. CONCLUSIONS: Recent advances suggest explanations for the internalizing paradox, which in turn suggest strategies for shrinking the youth anxiety-depression psychotherapy outcome gap; these form an agenda for a promising new era of research

Anxiety · Appeal · Comorbidity · Conceptualization · Depression (economics) · Intervention (counseling) · Political science · Psychiatry · Psychotherapist · Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes · Child and Adolescent Psychosocial and Emotional Development · Clinical Psychology · Digital Mental Health Interventions · Psychology