Youth Depressive Symptoms Research Articles

Efficacy and Safety of Lurasidone in a Younger Population With Bipolar Depression: Pooled Post-hoc Analysis of Two Placebo-controlled Studies

AbstractIntroductionEarly onset of bipolar disorder is associated with high rates of psychiatric comorbidity (e.g., anxiety disorders, ADHD, PTSD), high rates of recurrence, and marked impairment in functioning and quality of life. The aim of this analysis was to evaluate the efficacy and safety of lurasidone in bipolar depression in youth and young adult patients (10–30 years old).MethodsData from two 6-week, double-blind, placebo-controlled studies of lurasidone monotherapy for bipolar I depression were pooled for this analysis. In the 1st study, patients 10–17 years old were evaluated using the Children’s Depression Rating Scale–Revised (CDRS-R) and the Clinical Global Impression-Bipolar Severity (CGI-BP-S) depression scale; in the 2nd study, a subgroup of adult patients (18–30 years old) were evaluated by CGI-BP-A, and the MADRS, with the latter being converted to a CDRS-R scores using a validated conversion algorithm.ResultsThe safety population consisted of 465 patients (mean age, 17.1 years; mean age of onset, 14.1; mean CDRS-R total score, 60.8). 400 patients (85.7%) completed the study. For lurasidone vs. placebo, LS mean Week 6 change was -21.4 vs. -15.3 for the CDRS-R total score (P<0.0001; ES, 0.46); and -1.6 vs. -1.1 for the CGI-BP-S score (P<0.0001; ES, 0.50). Adverse events (≥5%) on lurasidone vs. placebo were nausea (15.9% vs. 5.2%), headache (15.1% vs. 13.1%), somnolence (7.9% vs. 3.8%), vomiting (5.2% vs. 3.3%), and weight increase (5.2% vs. 2.3%). No clinically meaningful changes were observed in weight, metabolic parameters, or prolactin.ConclusionsIn this post-hoc analysis of two placebo-controlled trials, lurasidone demonstrated clinically meaningful improvement of depressive symptoms in youth and young adults with bipolar depression. Lurasidone was generally safe, well-tolerated, and associated with minimal effects on weight, metabolic parameters, and prolactin.FundingServier Laboratories (Aust.) Pty. Ltd., and Sunovion Pharmaceuticals Inc.

Negative affect and loss-of-control eating in relation to adiposity among non-Hispanic youth identifying as black or white

Negative affect and loss-of-control (LOC)-eating are consistently linked and prevalent among youth identifying as non-Hispanic Black (NHB) and non-Hispanic White (NHW), particularly those with high weight. Given health disparities in high weight and associated cardiometabolic health concerns among NHB youth, elucidating how the association of negative affect with adiposity may vary by racial/ethnic group, and whether that relationship is impacted by LOC-eating, is warranted. Social inequities and related stressors are associated with negative affect among NHB youth, which may place this group at increased risk for excess weight gain. Across multiple aggregated protocols, 651 youth (13.0 ± 2.7 y; 65.9 % girls, 40.7 % NHB; 1.0 ± 1.1 BMIz; 37.6 % LOC-eating) self-reported trait anxiety and depressive symptoms as facets of negative affect. LOC-eating was assessed by interview and adiposity was measured objectively. Cross-sectional moderated mediation models predicted adiposity from ethno-racial identification (NHB, NHW) through the pathway of anxiety or depressive symptoms and examined whether LOC-eating influenced the strength of the pathway, adjusting for SES, age, height, and sex. The association between ethno-racial identity and adiposity was partially mediated by both anxiety (95 % CI = [0.01, 0.05]) and depressive symptoms (95 % CI = [0.02, 0.08]), but the mediation was not moderated by LOC-eating for either anxiety (95 % CI = [−0.04, 0.003]) or depressive symptoms (95 % CI = [−0.07, 0.03]). Mechanisms underlying the link between negative affect and adiposity among NHB youth, such as stress from discrimination and stress-related inflammation, should be explored. These data highlight the need to study impacts of social inequities on psychosocial and health outcomes.

An Integrative Data Analysis of Main and Moderated Crossover Effects of Parent-Mediated Interventions on Depression and Anxiety Symptoms in Youth in Foster Care.

Without preventative intervention, youth with a history of foster care (FC) involvement have a high likelihood of developing depression and anxiety (DA) symptoms. The current study used integrative data analysis to harmonize data across four foster and kinship parent-mediated interventions (and seven randomized control trials) designed to reduce youth externalizing and other problem behaviors to determine if, and for how long, these interventions may have crossover effects on youth DA symptoms. Moderation of intervention effects by youth biological sex, developmental period, number of prior placements, and race/ethnicity was also examined. Youth (N = 1891; 59% female; ages 4 to 18years) behaviors were assessed via the Child Behavior Checklist, Parent Daily Report, and Eyberg Child Behavior Inventory at baseline, the end of the interventions (4-6months post baseline), and two follow-up assessments (9-12months and 18-24months post baseline), yielding 4830 total youth-by-time assessments. The interventions were effective at reducing DA symptoms at the end of the interventions; however, effects were only sustained for one program at the follow-up assessments. No moderation effects were found. The current study indicates that parent-mediated interventions implemented during childhood or adolescence aimed at reducing externalizing and other problem behaviors had crossover effects on youth DA symptoms at the end of the interventions. Such intervention effects were sustained 12 and 24months later only for the most at-risk youth involved in the most intensive intervention.

Updated Psychosocial Surveys With Continuous Glucose Monitoring Items for Youth With Type 1 Diabetes and Their Caregivers.

We added items relevant to continuous glucose monitoring (CGM) to the Diabetes Family Conflict Scale (DFC), Diabetes Family Responsibility Questionnaire (DFR), and Blood Glucose Monitoring Communication Questionnaire (GMC) and evaluated the psychometric properties of the updated surveys. Youth with type 1 diabetes who recently started CGM and their parents completed the updated surveys and additional psychosocial surveys. Medical data were collected from self-reports and review of the medical record. Youth (N = 114, 49% adolescent girls) were aged 13.3 ± 2.7 years and had mean glycated hemoglobin (HbA1c) 7.9 ± 0.9%; 87% of them used pump therapy. The updated surveys demonstrated high internal consistency (DFC youth: α = .91, parent: α = .81; DFR youth: α = .88, parent: α = .93; and GMC youth: α = .88, parent: α = .86). Higher youth and parent DFC scores (more diabetes-specific family conflict) and GMC scores (more negative affect related to glucose monitoring) were associated with more youth and parent depressive symptoms (r = 0.28-0.60, P ≤ .003), more diabetes burden (r = 0.31-0.71, P ≤ .0009), more state anxiety (r = 0.24 to r = 0.46, P ≤ .01), and lower youth quality of life (r = -0.29 to -0.50, P ≤ .002). Higher youth and parent DFR scores (more parent involvement in diabetes management) were associated with younger youth age (youth: r = -0.76, P < .0001; parent: r = -0.81, P < .0001) and more frequent blood glucose monitoring (youth: r = 0.27, P = .003; parent: r = 0.35, P = .0002). The updated DFC, DFR, and GMC surveys maintain good psychometric properties. The addition of CGM items expands the relevance of these surveys for youth with type 1 diabetes who are using CGM and other diabetes technologies.

Perceived parental social support and psychological control predict depressive symptoms for lesbian, gay, bisexual, transgender, queer, or questioning youth in the United States.

Salient practices in the parenting literature-support and control-have seldom been applied to understanding lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ) youth mental health. We examine associations among perceived parental social support, psychological control, and depressive symptoms for LGBTQ youth in the United States (n= 536; Mage = 18.98; 48.1% women; 25.2% Black or African American; 37.1% Hispanic or Latino/a/x). Data were collected in 2011-2012. Results indicated joint effects of social support and psychological control predicting youth depressive symptoms. Multiple group analysis yielded a significant interaction of parenting practices for youth whose parent(s) did not know their LGBTQ identity. Findings support further consideration of parental support and control in relation to LGBTQ youth well-being.

Developmental pathways of depressive symptoms via parenting, self-evaluation and peer relationships in young people from 3 to 17 years old: evidence from ALSPAC

PurposeSelf-evaluation and interpersonal factors are theoretically and empirically linked to depression in young people. An improved understanding of the multifactorial developmental pathways that explain how these factors predict depression could inform intervention strategies.MethodsUsing structural equation modeling, this study explored whether self-evaluation and interpersonal factors were associated with adolescent depressive symptoms in a population-based sample (n = 11,921; Avon Longitudinal Study of Parents and Children, ALSPAC), across four development stages: early and late childhood plus early and middle adolescence from 3 to 17 years old.ResultsEarly good parenting practices predicted self-esteem, fewer peer difficulties, good friendships and fewer depressive symptoms in late childhood development outcomes. Higher self-esteem and less negative self-concept mediated the effect of early good parenting practice on reduced depressive symptoms in middle adolescence. The hypothesized erosion pathway from depressive symptoms in late childhood via higher levels of negative self-concept in early adolescence to depressive symptoms in middle adolescence was also confirmed. Additionally, peer difficulties played a mediation role in developing depressive symptoms. Contrary to the hypothesis, poor friendships predicted fewer depressive symptoms. The analysis supported a developmental pathway in which good parenting practices in early childhood led to fewer peer difficulties in late childhood and to less negative self-concept in early adolescence, which in turn predicted fewer depressive symptoms in middle adolescence.ConclusionThe social-developmental origin of youth depressive symptoms was supported via the effect of peer relationships in late childhood on self-evaluation in early adolescence.

Children's Mental Health in a Pandemic-Altered World: Technology's Evolving Role

Children's Mental Health in a Pandemic-Altered World: Technology's Evolving Role

Disrupting Maternal Transmission of Depression: Using Integrative Data Analysis (IDA) to Examine Indirect Effects of the Family Check-Up (FCU) Across Three Randomized Trials.

Maternal depression is a well-established risk factor for the development of depression in offspring. As such, reducing maternal depression may be key to effective prevention efforts to reduce offspring's depression. Based on the broad risk represented by maternal depression, examining cross-over effects of parent-focused interventions on maternal depression is important. The present study examined improvements in maternal depression as a mediator of the long-term effects of the Family Check-Up (FCU) prevention program on youth depression across three randomized controlled trials. The FCU is a family-focused intervention originally designed to reduce youth problem behaviors, particularly conduct problems and substance use, but has also been found to have cross-over effects on other youth problem behaviors, including internalizing symptoms. We utilized integrative data analysis that allows for powerful tests of prevention effects across trials, specifically moderated nonlinear factor analysis, to integrate data across three trials: one trial initiated in early childhood and two in early adolescence. Using a latent growth modeling approach, we first examined direct effects of the FCU on changes in maternal depression. Then we examined the mediating effect of maternal depression on changes in both parent and youth reports of youth depression. A significant intervention effect on maternal depression was observed across the three trials, with the FCU predicting improvements in maternal depression. In turn, such improvements predicted a reduction in the growth in both parent and youth reports of youth depressive symptoms across 10years post baseline. These results demonstrate the utility in addressing cross-over effects of family-focused interventions in reducing the long-term development of depression in youth through mediating pathways.

The Importance of Sibling Relationships in Buffering Against Depressive Symptoms of Youth in Foster Care

Sibling relationships are among the most influential relationships of one’s life. For youth in foster care, sibling relationships may be particularly important. Using National Survey of Child and Adolescent Well-Being (NSCAW) II data, this study tested if higher sibling relationship quality was associated with lower depressive symptoms among youth in foster care, and the interactive effects of relationships with siblings and biological mothers on youth depressive symptoms. Results indicated higher sibling and mother relationship quality were associated with lower depressive symptoms. Regarding interactive associations, the protective effects of sibling relationships on youth depressive symptoms were stronger when youth reported lower levels of relationship quality with biological mothers, highlighting the importance of good sibling relationships, especially in the absence of a positive relationship with biological mothers.

Word usage in spontaneous speech as a predictor of depressive symptoms among youth at high risk for mood disorders

BackgroundWe examined whether digital phenotyping of spontaneous speech, such as the use of specific word categories during speech samples, was associated with depressive symptoms in youth who were at familial and clinical risk for mood disorders. MethodsParticipants (ages 13–19) had active mood symptoms, mood instability, and at least one parent with bipolar or major depressive disorder. During a randomized trial of family-focused therapy, participants were instructed to make weekly calls to a central voice server and leave speech samples in response to automated prompts. We coded youths' speech samples with the Linguistic Inquiry and Word Count system and used machine learning to identify the combination of speech features that were most closely associated with the course of depressive symptoms over 18 weeks. ResultsA total of 253 speech samples were collected from 44 adolescents (mean age = 15.8 years; SD = 1.6) over 18 weeks. Speech containing affective processes, social processes, drives toward risk or reward, nonfluencies, and time orientation words were correlated with depressive symptoms at concurrent time periods (ps < 0.01). Machine learning analyses revealed that affective processes, nonfluencies, drives and risk words combined to most strongly predict changes in depressive symptoms over 18 weeks of treatment. LimitationsStudy results were limited by the small sample and the exclusion of paralinguistic or contextual variables in analyzing speech samples. ConclusionsIn youth at high risk for mood disorders, knowledge of speech patterns may inform prognoses during outpatient psychosocial treatment.

Self-Compassion Correlates of Anxiety and Depression Symptoms in Youth: A Comparison of Two Self-Compassion Measures.

Self-compassion is considered as a protective psychological construct that would shield against the development of emotional problems. The aim of the present study was to compare the 'protective nature' of two measures of self-compassion: the Self-Compassion Scale for Youth (SCS-Y) and the Sussex-Oxford Compassion for the Self Scale (SOCS-S). Eighty-seven adolescents aged 12 to 18 years completed both self-compassion measures as well as scales of anxiety and depression symptoms. SCS-Y and SOCS-S scores were positively correlated, and for both measures it was generally found that higher levels of self-compassion were associated with lower levels of emotional symptoms. However, the uncompassionate self-responding scales of the SCS-Y correlated positively with anxiety and depression symptoms and hence can better be seen as indices of vulnerability. Regression analyses suggested that a positive attitude toward oneself, as measured by the self-kindness scale of the SCS or its SOCS-S equivalent 'feeling for the person suffering' is particularly relevant as a buffer against emotional problems. The protective nature of self-compassion can be established by both measures. Caution is advised with the use of the uncompassionate self-responding scales included in the SCS-Y as they appear to measure vulnerability rather than protection.

Cerebral Blood Flow and Core Mood Symptoms in Youth Bipolar Disorder: Evidence for Region-Symptom Specificity.

Building on prior findings in adults, this study investigated regional cerebral blood flow (CBF) in relation to DSM-5 criterion A symptoms of depression and mania in youth with bipolar disorder (BD). The study recruited 81 youths with BD and 75 healthy controls 13-20 years old. CBF was ascertained using pseudocontinuous arterial spin labeling magnetic resonance imaging. Region-of-interest analyses examined the amygdala, anterior cingulate cortex (ACC), middle frontal gyrus, and global gray matter CBF. The association of criterion A depression and mania symptoms with CBF was examined dimensionally in youth with BD in regression analyses with continuous symptom severity scores. Age and sex were included as covariates. False discovery rate (FDR) was used to correct for 28 tests (4 regions by 7 symptoms; α< .0017). CBF for BD and healthy control groups was compared to give context for findings. In youth with BD, depressed mood inversely correlated with ACC (β=-0.31, puncorrected= .004, pFDR= .056) and global (β=-0.27, puncorrected= .013, pFDR= .09) CBF. The same pattern was observed for anhedonia (ACC CBF: β=-0.33, puncorrected= .004, pFDR= .056; global CBF: β=-0.29, puncorrected= .008, pFDR= .07). There were no significant findings for manic symptoms or in BD vs healthy control contrasts. The present findings, while not significant after correction for multiple testing, highlight the potential value of focusing on ACC in relation to depressed mood and anhedonia, and demonstrate that CBF is sensitive to depression symptom severity in youth. Lack of findings regarding manic symptoms may relate to the exclusion of fully manic participants in this outpatient sample.

Effects of the Big Brothers Big Sisters of America Community-Based Mentoring Program on social-emotional, behavioral, and academic outcomes of participating youth: A randomized controlled trial

This research is a randomized controlled trial of effects of the Big Brothers Big Sisters of America (BBBSA) Community-Based Mentoring Program on the social-emotional, behavioral, and academic outcomes of participating youth over a 13-month period. Seven hundred sixty-four youth between 9 and 14 years old were enrolled in the study through two BBBSA agencies that served predominantly urban areas on the West Coast. Each participating youth was randomly assigned either to be immediately eligible for being matched with a mentor (treatment group; n = 379) or to remain on the program waitlist for 13 months (control group; n = 385). Analyses for the present study are based on 654 youth for whom outcome data were able to be obtained at a 13-month follow-up (87.0% of the treatment group and 84.2% of the control group). Outcome measures were completed by youth (depressive symptoms, prosocial behavior, social acceptance, parent–child relationship quality, misconduct, self-perception of academic ability, skipping school, and academic performance) and primary caregivers (Strengths and Difficulties Questionnaire [SDQ]) at baseline and at the 13-month follow-up. Composite indices reflecting the average of youth- and/or parent-reported outcome measures were also examined. Findings indicated effects of mentoring (i.e., being offered a mentor) that reached statistical significance, all favoring the treatment group, for youth-reported depressive symptoms, parent-reported emotional symptoms, peer problems, conduct problems and the total difficulties score on the SDQ, and the parent-report and combined youth- and parent-report composite indices at the 13-month assessment (Cohen’s d ranging from 0.138 to 0.253).

Factor analysis of the stigma scale-child in pediatric inflammatory bowel disease

ObjectiveIllness stigma, or perceived stigma related to a chronic health condition, is pervasive among youth with inflammatory bowel disease (IBD). However, no studies exist examining the psychometric properties of illness stigma measures in this population. Using a modified version of the Child Stigma Scale originally developed for youth with epilepsy, the current study investigated the factor structure and validity of this adapted measure (i.e., Stigma Scale - Child; SS-C) in youth with IBD. MethodsFactor analyses were conducted to determine the most parsimonious factor structure for the adapted 8-item Stigma Scale – Child in a sample of 180 youth with IBD. Correlations were conducted to assess convergent validity, and a multiple regression was conducted to further evaluate the measure's predictive validity of child depressive symptoms. ResultsThe most parsimonious model for the SS-C is a one-factor solution with an error covariance between the two items assessing concealment/disclosure of IBD diagnosis. ConclusionsThe SS-C is a psychometrically sound illness stigma measure in pediatric IBD that demonstrates strong convergent validity with psychosocial adjustment factors such as thwarted belongingness, illness uncertainty, and illness intrusiveness, as well as strong predictive validity with youth depressive symptoms. The SS-C is a viable option for use as a brief screener in youth with IBD across clinical and research settings.

Dissociable neural mechanisms of cognition and well-being in youth versus healthy aging.

Mental health, cognition, and their underlying neural processes in healthy aging are rarely studied simultaneously. Here, in a sample of healthy younger (n = 62) and older (n = 54) adults, we compared subjective mental health as well as objective global cognition across several core cognitive domains with simultaneous electroencephalography (EEG). We found significantly greater symptoms of anxiety, depression, and loneliness in youth and in contrast, greater mental well-being in older adults. Yet, global performance across core cognitive domains was significantly worse in older adults. EEG-based source imaging of global cognitive task-evoked processing showed reduced suppression of activity in the anterior medial prefrontal default mode network (DMN) region in older adults relative to youth. Global cognitive performance efficiency was predicted by greater activity in the right dorsolateral prefrontal cortex in younger adults and in contrast, by greater activity in right inferior frontal cortex in older adults. Furthermore, greater mental well-being in older adults related to lesser global task-evoked activity in the posterior DMN. Overall, these results suggest dissociated neural mechanisms underlying global cognition and mental well-being in youth versus healthy aging. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

3.128 Impact of Sleep on Anxiety and Depression Symptoms Before and During COVID-19

Previous research has shown that sleep difficulties are associated with symptoms of depression and anxiety in youth. During the peaks of COVID-19, many children were homebound and faced interruptions to their academic and social development as well as their sleep schedules. Thus, there was likely an exacerbation of sleep problems for youth during COVID-19. Using data collected from youth in a partial hospitalization program (PHP), we investigated if enrollment in the program before vs during COVID-19 moderated the associations of sleep difficulties with symptoms of depression and anxiety.

A transactional mediation model of risk for the intergenerational transmission of depression: The role of maternal criticism.

In this study, we sought to combine two lines of research to better understand risk for the intergenerational transmission of depression. The first focuses on the role of maternal criticism as a potential mechanism of risk for depression in youth while the second builds from interpersonal and stress generation models regarding the potential impact of youth depression on future escalations in maternal criticism. Specifically, we examined the role of maternal criticism within a transactional mediation model using data from a multi-wave study. Participants were 251 mother-offspring pairs consisting of mothers with (n = 129) and without (n = 122) a history of major depressive disorder (MDD) during their child's lifetime who completed assessments every 6 months for 2 years. We found support for the hypothesized transactional mediational model in which maternal expressed emotion-criticism (EE-Crit) mediated the link between maternal history of MDD and residual change in youth's depressive symptoms over the previous 6 months and, reciprocally, youth depressive symptoms mediated the relation between maternal MDD history and residual change in EE-Crit 6 months later. These results indicate that maternal criticism and offspring depressive symptoms may contribute to a vicious cycle of depression risk, which should be considered for interventions targeted toward youth at risk of developing MDD.

Informant Discrepancies in Suicidality Screening Tools Among School Age Youth.

As the rate of death by suicide in youth ages 6 to 12 rises, it is imperative to better understand informant discrepancies when screening for suicidality. Accordingly, this study investigated associations among youth-, caregiver-, and clinician-reports of youth's suicidality and their associations with youth- and caregiver-reports of youth's depressive symptoms. Participants were 161 6- to 12-year-old youth presenting for outpatient psychological services at a Midwest training clinic between 2014 and 2019. More than 1 in 4 youth had at least one informant report some suicidal concerns. Results indicated that all informants' reports of suicidality were correlated with one another, with youth- and clinician-report being most strongly linked and caregiver- and clinician-report having the weakest correlation. Clinician- and youth-reports of suicidality were associated with youth-report, (but not caregiver-report) of depressive symptoms. Caregiver-report of suicidality was not associated with youth- or caregiver-report of depressive symptoms. When youth-report of depressive symptoms was regressed on sex, age, and youth-, caregiver-, and clinician-reports of suicidality, there was a trend that youth-report of suicidality was positively associated with youth-report of depressive symptoms. No informant's report of suicidality was uniquely associated with caregiver-report of depressive symptoms. Findings indicate that youth- and clinician-reports at intake are more strongly linked with one another than with caregiver-reports. Further, youth-reports on suicidality screening tools are more strongly associated with depressive symptoms than caregiver-report, suggesting that caregiver-reports are insufficient to assess concerns of suicidality at intake among school age youth.

Bullying victimization and depressive symptoms in Chinese adolescents: the roles of belief in a just world and classroom-level victimization.

Studies have demonstrated that bullying victimization is a risk factor for depressive symptoms; however, little is known about the underlying processes that may mediate or moderate this relationship. To address this research gap, this study examined the mediating effects of personal and general belief in a just world (BJW) and the moderating effect of classroom-level victimization on the relationship between bullying victimization and depressive symptoms. Using a short-term longitudinal design, two-wave data were obtained from 2,551 Chinese adolescents (initial age = 12.99 ± 0.61, 52.2% boys) from 47 classes over 6months. The results indicated that Time 1 personal BJW mediated the relationship between Time 1 bullying victimization and Time 2 depressive symptoms. Furthermore, the mediating effect of Time 1 personal BJW was moderated by Time 1 classroom-level victimization; this effect was stronger for adolescents in classrooms with low levels of victimization. These findings contribute to our understanding of how and when bullying victimization impacts youth depressive symptoms. Education practitioners should pay special attention to personal BJW in victimized adolescents, especially when classroom-level victimization is low.

Illness stigma, body image dissatisfaction, thwarted belongingness and depressive symptoms in youth with inflammatory bowel disease.

Elevated depressive symptoms are observed in a significant number of youth with inflammatory bowel disease (IBD) and have been linked to illness stigma and social isolation. Body image dissatisfaction is an understudied variable in the pediatric IBD literature that may be related to both stigma and social difficulties. It is suspected that, due to the stigmatizing nature of IBD, some youth may feel self-conscious about their body image, which contributes to decreased feelings of social belongingness and ultimately depressive symptoms. The current study tested an illness stigma→ body image dissatisfaction→ thwarted belongingness→ depressive symptoms serial mediation model, in which IBD stigma was hypothesized to indirectly influence youth depressive symptoms through the sequential effects of stigma on body image dissatisfaction and thwarted social belongingness. Youth with IBD (N = 75) between 10 and 18 years old were recruited from a pediatric gastroenterology clinic and completed psychosocial measures. Disease severity was assessed by a physician global assessment. Current medications and BMI data were collected. Analyses revealed significant direct effects among the modeled variables and a significant serial indirect path for illness stigma→ body image dissatisfaction→ thwarted belongingness→ depressive symptoms, controlling for sex, BMI and prednisone medication. Youth who perceive greater IBD stigma are more likely to experience increased body image dissatisfaction due to their IBD, which may engender feelings of social estrangement and ultimately elevated depressive symptoms. Depressive symptoms and the psychosocial challenges faced by youth should be routinely monitored as part of comprehensive IBD management.