nhiều khả năng để phát triển một rối loạn tiếp theo. Trong OADP, dự đoán tốt nhất của phát triển một rối loạn trầm cảm trong thời gian 1 năm đã có triệu chứng cao (ví dụ, ghi được hơn một cắt một Screener) đánh giá đầu tiên (Gotlib, Lewinsohn, Seeley, 1995). Như vậy, ở cuối của quang phổ của các triệu chứng này, | Epidemiology of Anxiety and Depression in Adolescence 595 most likely to develop a subsequent disorder. In the OADP the best predictor of developing a depressive disorder over a 1-year period was having elevated symptomatology . scoring over a cutoff on a screener at the first assessment Gotlib Lewinsohn Seeley 1995 . Thus at this end of the spectrum of symptoms there seems to be greater continuity of symptomatology than for individuals with mid- or low-level symptoms. Moreover for depressive symptoms Gotlib et al. 1995 and other problems . eating problems and disorders Graber Tyrka Brooks-Gunn 2002 individuals with elevated symptoms or problems but not disorder tend to have impairment in functioning that is similar to that seen among youth who meet criteria for disorder. Factors that predict disorder or predict progression on this type of pathway to internalizing disorders are central to the discussion of internalizing problems in adolescence. Factors that influence perturbations or minor changes in emotion or symptoms may hold promise for future investigation but alternatively may not be important in understanding who is at risk for serious dysfunction or who may need treatment. Comorbidity or Co-occurrence of Anxiety and Depression As studies of adolescent development incorporated or focused specifically on internalizing disorders and problems it became clear that internalizing problems do not occur in isolation of other disorders and problems. Single-problem or single-disorder studies had previously failed to account for this phenomenon. With the utilization and development of comprehensive diagnostic interviews that assess multiple disorders for use in research protocols see McClellan Werry 2000 for a special issue on these protocols rates of co-occurrence or comorbidity of disorders were also assessed. Comorbidity or occurrence of a second disorder in an individual with an existing disorder poses a special concern in the study of adolescent .
