Fig. 1

Flow diagram of sampling and participation in the study. Shown is the purposive sampling strategy utilized to recruit youth with SLE/MCTD and their parents for participation in the interview study. Youth-parent dyads who had participated in a previous cross-sectional study, during which youth were screened for depression and anxiety, were invited to participate. Sixteen dyads accepted and underwent interviews and assessment of their interim mental health history. Of the 33 dyads declining to participate, 7 were not interested, 4 expressed interest but were not successfully scheduled for interview (all were followed at CHOP rheumatology but 3 were away at college), and 22 did not respond (7 were no longer followed at CHOP; 8 were followed at CHOP but were away at college). One dyad was deemed ineligible due to co-occurring developmental disorder