Youth Depressive Symptoms Research Articles

The relationship between familial factors and youth mental health outcomes in Korean American families: The mediation effects of youth's negative emotionality.

Depressive symptoms are one of the mental health problems among Korean American (KA) youth. Although several studies examined mental distress among KA youth, few have examined the associations between different familial factors, negative emotionality, and depressive symptoms among them, especially using longitudinal data. Drawing on the Triadic Model of Family Process (TMFP), this study examined the longitudinal associations between Korean-specific aspects of familial factors and depressive symptoms among KA youth and the mediation role of negative emotionality in the relationships. Using KA youth and parent data from the Midwest Longitudinal Study of Asian American Families (MLSAAF) project, path analyses revealed that family enmeshment and youth-reported intergenerational conflict were associated with youth depressive symptoms, with negative emotionality serving as a mediator. The findings suggest that interventions aimed at reducing negative emotionality and improving parent-youth relationship quality and family boundaries could be helpful in reducing youth depressive symptoms.

Within-Person Effects of Executive Functioning on Anxiety and Depressive Symptoms in Youth with Neurodevelopmental Disorders: A Longitudinal Study

Abstract Objectives The objective was to disentangle the role of between- and within-person variation in executive functioning (EF) in the development of anxiety and depressive symptoms among youth with neurodevelopmental disorders. Methods We assessed 85 youth with ADHD, 38 youth with autism spectrum disorder (ASD), and 50 typically developing (TD) youth at baseline (Mage = 11.7 years, 64% males), 2-year follow-up, and 10-year follow-up with neuropsychological tests of EF and anxiety and depressive symptoms scales. Results Across groups, depressive symptoms increased with age, whereas anxiety symptoms were stable. Greater within-person improvement in overall EF from baseline to 2-year follow-up predicted reduced anxiety symptoms. Greater within-person improvement in cognitive flexibility predicted reduced depressive symptoms from baseline to 2-year follow-up. Conclusions We conclude that improvement in EF skills in youth may lessen the severity of anxiety and depressive symptoms over time. Thus, EF could be an intervention target to prevent anxiety and depressive symptoms.

Psychometric Validation of the Slovenian Version of the Revised Child Anxiety and Depression Scale - Child and Parent Versions (RCADS and RCADS-P)

Abstract Objective Anxiety and depression are common disorders in children and adolescents and can have a negative impact on their lives. The Revised Child Anxiety and Depression Scale – Child and Parent versions (RCADS and RCADS-P) are widely used standardized measurement tools, but the Slovenian versions have not yet been validated. The aim of the present study was to examine the psychometric properties of the Slovenian version of RCADS and RCADS-P in a representative Slovenian school sample. Methods We examined the psychometric properties (factor structure, internal reliability, short-term stability, inter-rater agreement and convergent validity) of the Slovenian version of the RCADS and the RCADS-P in 754 primary and secondary school students and parents of 485 students. The short-term stability of anxiety and depressive symptoms in youth was assessed in a subsample of 117 children and adolescents. Results Confirmatory factor analysis showed an acceptable fit of the 6-factor model with CFI=0.92, TLI=0.92 and RMSEA=0.056 for RCADS and with CFI=0.93, TLI=0.92 and RMSEA=0.047 for RCADS-P. Cronbach's α and McDonald's ω ranged from 0.70 to 0.95 for the total scale and the six subscales. The subscales correlated significantly positively with the total Child Anxiety Life Interference Scale score. Conclusion The results affirm the good psychometric properties of the Slovenian versions of RCADS and RCADS-P within a school-based sample. There is a need in the future to examine psychometric properties in clinical samples and to provide normative data.

Reactivity to Peer Rejection Moderates the Effect of Victimization on Adolescent Girls' Depressive Symptoms: A Prospective Study.

Peer victimization and bullying behaviors are prevalent during adolescence and have been linked to depression. This study examined whether peer rejection reactivity, defined as physiological responses to peer exclusion, moderated the associations of victimization and bullying behaviors with depressive symptoms 12 months later in a sample of female youths (N = 79, Mage = 13.37 ± 2.31). Participants underwent the Yale Interpersonal Stressor-Child, during which systolic and diastolic blood pressure and heart rate were continuously measured. Parent and youth reports of the youth's depressive symptoms were utilized. Our results demonstrate that peer rejection reactivity moderates the relationship between victimization and subsequent depressive symptoms but does not moderate the relationship between bullying behaviors and subsequent depressive symptoms. Higher victimization was associated with increased youth-reported depressive symptoms among girls with high reactivity but decreased depressive symptoms among girls with low reactivity. Future research can explore whether reducing emotional and physiological reactivity to peer rejection, as well as increasing interpersonal effectiveness in peer relationships, can reduce depressive symptoms in adolescent girls experiencing victimization.

Depressive symptoms during the transition to adolescence: Left hippocampal volume as a marker of social context sensitivity

The transition to adolescence is a critical period for mental health development. Socio-experiential environments play an important role in the emergence of depressive symptoms with some adolescents showing more sensitivity to social contexts than others. Drawing on recent developmental neuroscience advances, we examined whether hippocampal volume amplifies social context effects in the transition to adolescence. We analyzed 2-y longitudinal data from the Adolescent Brain Cognitive Development (ABCD®) study in a diverse sample of 11,832 youth (mean age: 9.914 y; range: 8.917 to 11.083 y; 47.8% girls) from 21 sites across the United States. Socio-experiential environments (i.e., family conflict, primary caregiver's depressive symptoms, parental warmth, peer victimization, and prosocial school environment), hippocampal volume, and a wide range of demographic characteristics were measured at baseline. Youth's symptoms of major depressive disorder were assessed at both baseline and 2 y later. Multilevel mixed-effects linear regression analyses showed that negative social environments (i.e., family conflict, primary caregiver's depressive symptoms, and peer victimization) and the absence of positive social environments (i.e., parental warmth and prosocial school environment) predicted greater increases in youth's depressive symptoms over 2 y. Importantly, left hippocampal volume amplified social context effects such that youth with larger left hippocampal volume experienced greater increases in depressive symptoms in more negative and less positive social environments. Consistent with brain-environment interaction models of mental health, these findings underscore the importance of families, peers, and schools in the development of depression during the transition to adolescence and show how neural structure amplifies social context sensitivity.

Latent structure and measurement invariance of the Depression Self-Rating Scale for Children across sex and age.

Measurement tools from which valid interpretations can be made are critical for assessing early emerging depressive symptoms, as depressive symptoms in childhood are associated with increased risk for early-onset depressive disorder, recurrence, suicidality, and other psychopathology. The Depression Self-Rating Scale for Children (DSRS) is a widely used self-report scale assessing youth depressive symptoms. The relatively few studies investigating the DSRS' latent structure have yielded mixed results, and measurement invariance (MI) based on sex and age has not been examined. We examined the factor structure and MI of the DSRS across sex and age in a community sample of 6-9-year-olds (N = 352; Mage = 7.57 years, SD = .70). Consistent with the largest prior structural study of the DSRS, a two-factor structure, with factors reflecting elevated negative affect (NA) and low positive affect (PA), showed strong model fit. Although this structure was consistent across sex and age (i.e., configural invariance), loadings of DSRS items varied across sex and age (i.e., metric noninvariance). Allowing the loadings of items contributing to noninvariance to vary across groups improved model fit. Implications for the clinical and research utility of the DSRS and suggestions for future research are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Social Failure Model: Do Classroom Norms Play a Role in the Development of Antisocial Behavior and Depressive Symptoms?

This study examined the moderating role of descriptive and status norms in the stability of youth's antisocial behavior, and the link between initial antisocial behavior and the development of depressive symptoms over the course of one academic year, while controlling for initial depression levels. A total of 1081 students (51.06% girls; grades 4 through 6) in schools in low to average socio-economic status neighborhoods completed self-reports and a peer nomination inventory in the fall (T1) and spring (T2) of one year. Descriptive norms were operationalized as the classroom- and sex-specific mean level of antisocial behavior. Status norms were operationalized as the classroom- and sex-specific correlation between antisocial behavior and social preference. Descriptive norms moderated the link between T1 and T2 antisocial behavior, such that youth exhibiting high levels of antisocial behavior showed a greater increase in antisocial behavior in classrooms where descriptive norms strongly favored such behavior (i.e., + 1 SD) than in classrooms with neutral or weak descriptive norms (i.e., - 1 SD). Status norms moderated the association between T1 antisocial behavior and T2 depressive symptoms, such that youth with high levels of antisocial behavior had higher depressive symptoms in classrooms where status norms disfavored antisocial behavior than in classrooms with neutral or favorable norms. No moderating effects of sex or grade were observed. These results suggest that both descriptive norms and status norms play important, albeit distinct, roles in exacerbating youth's depressive symptoms and antisocial behavior, but they may also mitigate these same outcomes in favorable contexts.

Amygdala volume and depression symptoms in young adolescents who use cannabis

IntroductionBoth cannabis use and depressive symptomology increase in prevalence throughout adolescence. Concurrently, the brain is undergoing neurodevelopment in important limbic regions, such as the amygdala. Prior research indicates the amygdala may also be related to cannabis use and depressive symptoms. We aimed to investigate the effects of adolescent cannabis use on amygdala volumes as well as the interaction of cannabis use and amygdala morphometry on depressive symptoms in youth. MethodTwo-hundred-twenty-four participants (ages 12–15), balanced by sex assigned at birth, were selected from a sub-sample of the Adolescent Brain Cognitive Development (ABCD) Study based on hair toxicology and self-report measures of cannabis use. Participants positive for cannabinoids in hair and/or self-reported cannabis use were demographically matched to youth with no self-reported or confirmed cannabis use. The guardians of these youth reported depression symptoms on the Child Behavioral Checklist. Linear mixed effect models were run investigating cannabis use group on amygdala volumes bilaterally, controlling for whole brain volume and random effects of scanner type. Additional analyses examined cannabis group status and bilateral amygdala volume on depression symptoms. ResultsCannabis use was not significantly associated with amygdala volume but was associated with increased depressive symptoms (p<0.01). Cannabis group interacted with amygdala volume, such that individuals with smaller volumes had increased depressive symptoms within the cannabis group (p’s<0.01–0.02). ConclusionAberrations in amygdala volume based on cannabis use were not found in early adolescence; however, more depressive symptoms were related to cannabis group. Youth who use cannabis and have smaller amygdala volumes were at increased risk for depressive symptomology, suggesting potential neurovulnerabilities to cannabis use.

Investigating physiological symptoms associated with mental health symptoms in youth with cerebral palsy: An observational study

Over 50 % of children and youth with cerebral palsy (CP) experience mental health challenges, with anxiety and depression most common. Youth with CP also experience several physiological symptoms such as fatigue, pain, sedentary lifestyle, and sleep disturbances that impact their daily living; however, little is known about the impact of these symptoms on mental health outcomes in these youth. This study addressed this gap and examined the individual and cumulative impacts of physiological symptoms on anxiety and depression symptoms in youth with CP. Forty youth with CP aged 8 to 18 years, and their caregiver, participated in this cross-sectional observational study. Pain, fatigue, anxiety, and depressive symptoms were measured using caregiver- and self-reported questionnaires and participants wore accelerometers for seven consecutive days, providing non-invasive physical activity and sleep pattern data. Youth with CP experienced substantial physiological symptoms and elevated anxiety and depression symptoms. Linear regression models determined that all physiological factors were predictive of caregiver-reported youth anxiety (R2 = 0.23) and youth depressive symptoms (R2 = 0.48). Fatigue, pain severity, sleep efficiency, and physical activity outcomes individually and cumulatively contributed to caregiver-reported youth anxiety and depression symptoms. These findings highlight the important role of physiological symptoms as potential risk factors and potential targets for intervention for mental health issues for in youth with CP.

Results from a Pilot Randomized Controlled Trial of a Single-Session Growth-Mindset Intervention for Internalizing Symptoms in Autistic Youth.

Autistic youth experience elevated rates of co-occurring internalizing symptoms. Interventions to treat internalizing symptoms in autistic youth are almost uniformly costly and time-intensive, blunting dissemination of intervention and highlighting the need for scalable solutions. One promising option is a relatively new class of evidence-based treatments, single-session interventions (SSIs), however, no study has examined SSIs for depression symptoms in autistic youth. Participants included 40 autistic adolescents ranging in age from 11 to 16 (Mage = 14.22, Nmale = 32). Eligible youth who agreed to participate were randomized to either the active intervention (Project Personality), or an active control designed to mimic supportive therapy. Participants and their caregiver completed questionnaires immediately before, after, and three months post intervention. All participants completed the intervention independently and largely reported enjoying it. The intervention was delivered with 100% fidelity. Findings demonstrated improvements in perceived primary control, malleability of personality, and social competence relative to the active control group immediately post-intervention. Further, results revealed improvements in self-reported depression symptoms and parent reported emotional regulation at 3-month follow up. This study was the first to assess a GM-SSI designed to treat depression symptoms in autistic adolescents. Results indicated improvements in perceived control immediately post-intervention and downstream improvements in depression. Nonetheless, we did not find improvements in symptoms of anxiety, suggesting that autistic adolescents may require modifications to the intervention to maximize benefit. Findings demonstrate the utility of GM-SSI for internalizing symptoms for autistic youth and hold considerable promise as a low-intensity and scalable intervention.

Physical activity and depressive symptoms in youth

Physical activity and depressive symptoms in youth

Tracking Studies on the Effects of Qi Gong Fitness on Stress, Anxiety, and Depression Among Underprivileged Working Youth.

This study aimed to evaluate the effectiveness of Qi Gong fitness in alleviating stress, anxiety, and depression among underprivileged working youth with a follow-up study. Eighty subjects were randomly assigned to normal groups (NG) and treatment groups (TG), with 40 participants in each group. The Perceived Stress Scale (PSS), Generalized Anxiety Disorder 7 (GAD-7), and 24-Item Hamilton Rating Scale for Depression (HAMD-24) were used to evaluate the effect of Qi Gong fitness on alleviating stress, anxiety, and depression symptoms in underprivileged working youth. There was no significant difference in demographic outcome indicators between NG and TG. The main analytic results showed significant differences (P < .05) in the intra- and inter-group comparisons of NG and TG in stress, anxiety, and depression before and after intervention. When compared with prior intervention, NG and TG after intervention showed more favorable scores in PSS, GAD-7, and HAMD-24, among which PSS (NG: 51.61 ± 4.32 vs. 29.80 ± 3.08; TG: 55.21 ± 5.41 vs. 15.85 ± 2.25; P < .01), GAD-7 (NG: 10.83 ± 2.45 vs. 9.85 ± 2.52; TG: 12.23 ± 1.90 vs. 7.84 ± 1.57; P < .01), and HAMD-24 (NG: 10.83 ± 2.45 vs. 9.85 ± 2.52; TG: 25.63 ± 3.94 vs. 11.40 ± 3.82; P < .01); These results indicate that NG and TG have significant effects on alleviating occupational stress, anxiety, and depression in young underprivileged people. The study indicates that Qi Gong fitness had a positive effect on reducing and alleviating stress, anxiety, and depression among young underprivileged professionals. This highlights the potential benefits of incorporating Qi Gong fitness into treatment plans.

Feasibility and preliminary efficacy of behavioral activation for treatment of depression in autistic adolescents.

Depression is common among autistic youth and has a significant negative impact on quality of life and day-to-day functioning. Despite great need for efficacious treatments, there are currently limited research-supported interventions for depression symptoms in autistic young people. This study tested a novel, behavior-based approach or psychotherapy for treatment of depression symptoms in autistic adolescents without intellectual disability (i.e. Behavioral Activation for Autistic Adolescents, BA-A) with 15 youth (11-16 years old). BA-A is an individually delivered 12-session therapy that was developed for and to meet the needs of autistic youth with depression. Results found that autistic youth and their caregivers were able to participate in BA-A therapy sessions, and clinicians were able to deliver BA-A in accordance with the treatment manual. Notably, results demonstrated that autistic youth depression symptoms significantly improved after participating in BA-A. Furthermore, anxiety symptoms and social skills significantly improved following BA-A.

Specificity and valence of adolescents’ turning point memory narratives: Relationships with depressive symptoms over time

Although recent research suggests that, for community youth, greater specific (episodic) detail in self-relevant turning point memory narratives predicts depressive symptoms over time, no research has investigated whether the narratives’ specificity similarly predicts depression. Therefore, we investigated whether recalling a specific (unique, 24-hour or less) turning point narrative predicted youth depressive symptoms concurrently and across 6 months (Study 1), and, for a subset of participants, three years (Study 2). We also examined whether the valence of the implication of the experience for self (the resolution) explained additional variance and interacted with memory specificity. For Study 1 (N = 320, M = 16.9 years, 81% female), a specific (rather than a non-specific) turning point predicted greater depressive symptoms concurrently but not longitudinally, whereas a negative resolution predicted both concurrent and longitudinal depressive symptoms. The moderation result showed that a specific turning point predicted escalating depressive symptoms across six months when the resolution was negative. Study 2 (N = 68) additionally showed that a specific turning point predicted increased depressive symptoms three years later. These findings contrast with research suggesting that specific memories are related to better mental health and highlight the complexity of the role of memory in emerging youth depression.

Associations between perceived parenting, brain activity and connectivity, and depression symptoms in Brazilian adolescents

ABSTRACT In adolescence, parental care is associated with lower depression symptoms whereas parental overprotection is associated with greater depression symptoms, effects which may be mediated by adolescent brain activity and connectivity. The present study examined associations between perceived parenting, brain activity and connectivity, and depression symptoms in adolescents from Brazil, a middle-income country (MIC). Analyses included 100 adolescents who underwent functional magnetic resonance imaging scanning while completing a face matching task. Parental care and overprotection were associated with adolescent depression symptoms in expected directions. We also found that parental care and overprotection were associated with amygdala connectivity with several brain regions; however, amygdala activity was not associated with parenting and neither activity or connectivity mediated the association between parenting and depression symptoms. Results identify how parenting influences brain function and depression symptoms in youth from a MIC.

Comparing Symptoms of Major Depression in Youth with Confirmed Versus Suspected Bipolar Disorder.

Background: While numerous studies have compared symptoms of major depressive episodes (MDEs) associated with bipolar disorder (BD; i.e., bipolar depression) versus major depressive disorder (MDD; i.e., unipolar depression), little is known about this topic in youth. We compared MDE symptoms in youth with BD with youth with suspected BD who have similar clinical and familial characteristics aside from having BD. Methods: MDE symptoms based on Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS) Depression Rating Scale items for the most severe past episode were compared in youth, ages 13-21 years, with BD (n = 208) versus suspected BD (n = 165). Diagnoses were confirmed via semistructured interviews. Symptoms with between-group differences (p < 0.05) in univariate analyses were evaluated in a multivariate forward stepwise regression. All analyses controlled for age and sex. Results: Youth with BD had significantly higher (more severe) ratings on depressed mood (p = 0.001, η2 = 0.05), irritability (p = 0.037, η2 = 0.02), anhedonia (p = 0.004, η2 = 0.04), negative self-image (p < 0.001, η2 = 0.07), hopelessness (p = 0.04, η2 = 0.02), fatigue (p = 0.001, η2 = 0.05), hypersomnia (p = 0.001, η2 = 0.05), suicidal ideation (p = 0.04, η2 = 0.02), and recurrent thoughts of death (p < 0.001, η2 = 0.05). In regression analyses, the only symptom that remained significant in the BD group was depressed mood (p = 0.002). Conclusions: These findings demonstrate greater severity of depressive symptoms in youth with BD versus MDD across mood, and cognitive and neurovegetative symptom domains. These differences are especially noteworthy given that the MDD group was highly similar to the BD group, aside from BD diagnosis. Present findings emphasize the need for novel treatment approaches to bipolar depression in youth, and for studies examining potential mechanisms underlying the increased severity of bipolar depression.

Indirect associations between immigration-related stressors and latine adolescents' depressive symptoms: The moderating roles of familism, nativity, and gender.

This study examined the indirect relationship between immigration-related stressors and depressive symptoms via family conflict and whether familism values moderated this relationship in a sample of U.S. Latine youth. We also explored nativity and gender differences in the predictive model. Participants were 306 Midwestern Latine youth (Mage = 15.50, 46.2% girls, 79.9% Mexican origin) and their primary caregivers who completed measures of study constructs. A series of path models examined the potential mediating role of family conflict and the moderating effects of familism values, gender, and nativity. For the overall sample, parental exposure to immigration-related stressors was related to higher youth depressive symptoms through higher levels of family conflict. However, multigroup models revealed significant differences by nativity and gender. The indirect effect through family conflict was only significant for non-U.S.-born youth with low to average levels of familism-support and average to high levels of familism-obligation; it was not significant for U.S.-born youth. Furthermore, the indirect association was only significant for boys with average to high levels of familism-obligation; no significant indirect effects were found for girls. The results indicate that the indirect pathway linking immigration-related stressors to depressive symptoms via family conflict depends on youth familism values, nativity status, and gender. Findings highlight the distinct effects of familism-support and obligation and the need to consider sociodemographic diversity within Latine communities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Feasibility of a physical activity intervention for children and adolescents with anxiety and depression

BackgroundPhysical activity is identified as a key modifiable factor towards good short- and long-term mental health and has shown positive effects on anxiety and depression in children and adolescents. However, physical activity-based interventions are not a part of standard mental health care and evidence on the effect of such interventions is still lacking. A transdiagnostic, physical activity-based intervention was developed as a supplement to routine clinical care for youth in specialized child and adolescent mental health services.Methods/design.The feasibility of the physical activity intervention (Confident, Active, and Happy Youth) was evaluated in an open-label study by assessing the recruitment process, acceptability, intervention suitability, contentment, and preliminary intervention effects in the form of youth and parent-rated anxiety and depressive symptoms. Physical activity levels were objectively measured using Actigraph™ physical activity sensors, and progression to a definitive study was evaluated in accordance with a priori criteria.ResultsIn total 21 of 25 eligible youth consented to participate, two dropped out of the intervention and 19 completed (76% of eligible participants). The retention rate among consenting participants was 89% and mean attendance to sessions was 83%. The suitability of the intervention was rated as good by the youth and their parents, and intervention contentment was rated high. Changes in youth and parent-rated symptom measures following the intervention were negligible, except for parent-rated anxiety symptoms assessed at 10-month follow-up. Accelerometer data indicated lower levels of moderate to vigorous activity during sessions than intended. No adverse effects were noted.ConclusionThis feasibility study met the pre-determined progression criteria to a definitive study. Thus, a larger trial with longer follow-up should be conducted to explore the effect of the intervention.Trial registrationClnicalTrials.gov, NCT05049759. Retrospectively registered, 20.09.2021.

Investigating the Effects of Transdiagnostic Processes on Anxiety and Depression Symptoms in Autistic Young People: the Mediating Role of Emotion Dysregulation.

Internalising symptoms are elevated in autism compared to the general population. Few studies have investigated emotional dysregulation (ED) as a potential mediator between specific transdiagnostic processes and anxiety and depression symptoms in autistic youth. In a sample of 94 autistic young people aged 5-18years referred to a specialist clinic for an autism evaluation, we tested the effects of ED as a mediator between cognitive inflexibility (CI), intolerance of uncertainty (IU) and alexithymia with anxiety and depression symptoms, using structural equation modelling. Effect sizes were compared to a non-autistic comparison group (n = 84). CI and alexithymia did not significantly predict depression symptoms in autistic young people, directly nor via ED. Relationships between CI/alexithymia and depression were fully mediated by ED in the non-autistic sample. There was a direct effect of CI on anxiety in the non-autistic group but not in those with a diagnosis. IU predicted depression symptoms in the autism group; and ED mediated this relationship only in those who did not receive a diagnosis. IU directly predicted anxiety in both groups and this relationship did not occur via ED. The finding of a direct pathway from IU to anxiety and depression in autistic youth is consistent with the literature. The finding that CI did not predict anxiety or depression in those with autism is novel, as was the finding that ED mediated relationships between alexithymia and anxiety/depression symptoms in both samples. The findings may have important implications for the delivery of psychological interventions for autistic youth.

Diabetes distress in urban Black youth with type 1 diabetes and their caregivers: associations with glycemic control, depression, and health behaviors.

Adolescents with type 1 diabetes (T1D) and their caregivers endorse high diabetes distress (DD). Limited studies have documented the impact of DD on Black youth. The aims of the present study were to (1) describe DD among a sample of Black adolescents with T1D and their caregivers, (2) compare their DD levels with published normative samples, and (3) determine how DD relates to glycemic outcomes, diabetes self-management, parental monitoring of diabetes, and youth depressive symptoms. Baseline data from a multicenter clinical trial were used. Participants (N = 155) were recruited from 7 Midwestern pediatric diabetes clinics. Hemoglobin A1c (HbA1c) and measures of DD, parental monitoring of diabetes care, youth depression and diabetes management behaviors were obtained. The sample was split into (1) adolescents (ages 13-14; N = 95) and (2) preadolescents (ages 10-12; N = 60). Analyses utilized Cohen's d effect sizes, Pearson correlations, t-tests, and multiple regression. DD levels in youth and caregivers were high, with 45%-58% exceeding either clinical cutoff scores or validation study sample means. Higher DD in youth and caregivers was associated with higher HbA1c, lower diabetes self-management, and elevated depressive symptoms, but not with parental monitoring of diabetes management. Screening for DD in Black youth with T1D and caregivers is recommended, as are culturally informed interventions that can reduce distress levels and lead to improved health outcomes. More research is needed on how systemic inequities contribute to higher DD in Black youth and the strategies/policy changes needed to reduce these inequities.