Depression, Anxiety, and Anhedonia as Correlates of Distinct Family Functioning Domains among Adolescents

Abstract

Abstract Background The bi-directional relationships between family dynamics and psychopathology have been documented, yet how aspects of family functioning relate to specific symptoms remains elusive. Such work is important in adolescence as it represents a vulnerable developmental period when psychiatric symptoms often emerge. Critically, most research on family functioning has focused on categorical clinical diagnoses and has not accounted for the inter-individual variability of symptom severity. Therefore, we aimed to study the associations between well-validated domains of family functioning and depression, anxiety, and anhedonia in youth using a dimensional approach. Methods We comprehensively evaluated 59 adolescents with diverse mood and anxiety symptoms and 17 controls with semi-structured diagnostic interviews and self-reported measures for depression, anxiety, and anticipatory and consummatory anhedonia. Adolescents’ perception of seven aspects of family life was assessed with the McMaster Family Assessment Device (FAD). Following bivariate assessments of associations between FAD subscales and symptom measures, linear regression models were employed to further investigate their relationships accounting for variations in age, sex, race, and ethnicity. Results were corrected for multiple comparisons. Results As hypothesized, more severe depression was implicated across most family domains, including Problem Solving, Communication, Roles, Affective Responsiveness, and General Functioning. Elevated anxiety was associated with worse family Problem Solving, Roles, and General Functioning. Interestingly, anhedonia showed no relationship with family domains following adjustment for multiple comparisons and depression severity, suggesting a different etiological pathway. Conclusions Our findings further support the intertwined relationships between family factors and adolescent mood processes and the need for specialized interventions addressing multiple family dimensions simultaneously.