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Alterations in dynamic affective processes are associated with dysregulated affect and depression. Although depression is often associated with heightened inertia (i.e., greater moment-to-moment correlation) and variability (i.e., larger departures from typical levels) of affect in adults, less is known about whether altered affect dynamics are present in youth at risk for depression. This study investigated the association of clinical depression and depression risk with the inertia and variability of positive and negative affect in a sample of youth at varying risk for depression. Our sample included 147 adolescents aged 14 to 17, categorized into three groups: never-depressed lower-risk, never-depressed higher-risk (based on maternal history of depression), and currently depressed adolescents. Adolescents completed ecological momentary assessments of positive and negative affect up to seven times per day for a week. Multilevel models and ANOVAs were used to examine associations of affective inertia and variability with adolescent depression and risk based on maternal history, controlling for average affect. Depressed adolescents showed more inert and diminished positive affect, and more variable and elevated negative affect compared to lower- and higher-risk youth, though associations attenuated after controlling for average affect. No differences were identified between never-depressed higher-risk and lower-risk youth. Additional longitudinal studies are needed to evaluate whether altered affect dynamics in daily life precede depression onset to understand their utility for developing preventive interventions.
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Depressed individuals tend to use maladaptive emotion regulation strategies more frequently than non-depressed individuals while using adaptive strategies (e.g., reappraisal) less frequently. Objective neural markers of emotion regulation ability could aid in identifying youth at greatest risk for depression and functional impairment more broadly. We used electroencephalography to examine emotion regulation in adolescents (aged 14-17; N = 201) with current depression (n = 94) and without any history of depression (n = 107) at high (n = 54) and low (n = 53) risk for depression based on a maternal history of depression. Results revealed group differences in event-related potential markers of emotion regulation using multiple scoring approaches. Never-depressed adolescents had significant reductions in mean-activity and principal component analysis-identified late positive potential responses to dysphoric stimuli under reappraisal instructions compared to passive viewing. There was no significant difference in neural responses between conditions among depressed adolescents. The magnitude of the reappraisal effects appeared slightly stronger for low-risk adolescents relative to high-risk. Exploratory analyses further demonstrated that the association between neural markers of emotion regulation and overall functioning was moderated by age, such that impaired emotion regulation abilities predicted poorer functioning among older adolescents. Findings support the sensitivity of the late positive potential to emotion regulation impairments in depression and psychopathology more broadly.
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Social media use is common in adolescents, with implications for psychosocial development and the emergence of depression. Yet, little is known about the time-linked connections between social media use and adolescents' affective experiences and how they may differ between depressed and non-depressed youth. We leveraged ecological momentary assessment in adolescents oversampled for current depression to examine (1) associations between social media use and concurrent and later positive and negative affect and (2) sex and presence of a depressive disorder as moderators of these associations. Adolescents aged 14-17 with (n = 48) and without (n = 97) clinical depression, as indicated via clinical interview, reported momentary social media use and positive and negative affect seven times per day for one week. Multilevel modeling indicated that social media use was associated with reduced positive affect both concurrently and at the next assessment. Further, among clinically depressed youth only, social media use was associated with reduced negative affect at the next assessment. Results suggest that social media use may reduce both positive and negative affect, highlighting the nuanced relation between adolescent social media use and emotional health and laying the groundwork for future research to address several open questions.
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Afecto , Evaluación Ecológica Momentánea , Medios de Comunicación Sociales , Humanos , Medios de Comunicación Sociales/estadística & datos numéricos , Adolescente , Femenino , Masculino , Depresión/psicología , Trastorno Depresivo/psicología , Trastorno Depresivo/epidemiología , Conducta del Adolescente/psicologíaRESUMEN
Trauma exposure is associated with a heightened risk for depression and such risk is thought to vary based on the type of traumatic events (e.g., interpersonal, including abuse and domestic violence, or non-interpersonal, including accidents or natural disasters). Depression is often accompanied by altered emotional reactivity, and the late positive potential (LPP) serves as a reliable neurophysiological measure of sustained attention towards emotional stimuli, raising questions regarding the role of the LPP in moderating trauma effects on depression. We conducted a cross-sectional study of 201 adolescents aged 14-17 years (61.2% female) who were oversampled for current depression and elevated risk of depression based on maternal history. Clinical interviews were conducted to assess diagnoses and lifetime trauma exposure, and participants reported on current depressive symptoms. Electroencephalogram (EEG) was continuously recorded while participants completed a previously validated interpersonal emotional images task. Cumulative trauma (CT) and interpersonal trauma (IPT) were both associated with greater depressive symptoms, but non-interpersonal trauma (NIPT) was not significantly related to depressive symptoms. The association between IPT and depressive symptoms was moderated by the LPP to positive interpersonal images, such that IPT-exposed adolescents with blunted neural responses to such images showed the greatest symptoms. This result was specific to IPT, and the LPP to threatening interpersonal images did not significantly moderate the effects of IPT on depressive symptoms. These findings highlight the unique effects of interpersonal trauma on depressive symptoms and elucidate a potential vulnerability linking trauma exposure to depression risk among adolescents.
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Depresión , Violencia Doméstica , Humanos , Femenino , Adolescente , Masculino , Estudios Transversales , Emociones/fisiología , ElectroencefalografíaRESUMEN
Depression is a prevalent, debilitating, and costly disorder that often manifests in adolescence. There is an urgent need to understand core pathophysiological processes for depression to inform more targeted intervention efforts. The Research Domain Criteria (RDoC) Positive Valence Systems (PVS) and Negative Valence Systems (NVS) have both been implicated in depression symptomatology and vulnerability; however, the nature of NVS alterations is unclear across studies, and associations between single neural measures and symptoms are often small in magnitude and inconsistent. The present study advances characterization of depression in adolescence via an innovative data-driven approach to identifying subgroups of PVS and NVS function by integrating multiple neural measures (assessed by electroencephalogram [EEG]) relevant to depression in adolescents oversampled for clinical depression and depression risk based on maternal history (N = 129; 14-17 years old). Results of the k-means cluster analysis supported a two-cluster solution wherein one cluster was characterized by relatively attenuated reward and emotion responsiveness across valences and the other by relatively intact responsiveness. Youth in the attenuated responsiveness cluster reported significantly greater depressive symptoms and were more likely to have major depressive disorder diagnoses than youth in the intact responsiveness cluster. In contrast, associations of individual neural measures with depressive symptoms were non-significant. The present study highlights the importance of innovative neuroscience approaches to characterize emotional processing in depression across domains, which is imperative to advancing the clinical utility of RDoC-informed research.
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Introduction: Genomics has the potential to transform medicine by identifying genetic risk factors that predispose people to certain illnesses. Use of genetic screening is rapidly expanding and shifting towards screening all patients regardless of known risk factors, but research is limited on the success of broad population-level outreach for genetic testing and the effectiveness of different outreach methods across diverse populations. In this study, we tested the effectiveness of Digital Only (emailing and texting) and Brochure Plus Digital (mailed brochure, emailing, and texting) outreach to encourage a diverse patient population to participate in a large hospital system's whole genome sequencing program. Methods: Disproportionate stratified sampling was used to create a study population more demographically diverse than the eligible population and response rates were analyzed overall and by demographics to understand the effectiveness of different outreach strategies. Results: 7.5% of all eligible patients enrolled in the program. While approximately 70% of patients invited to complete genetic testing identified in their EHR as being Hispanic, Black or African America, Asian, or another non-White race, these patients generally enrolled at lower rates than the overall population. Other underrepresented groups had higher enrollment rates including people with Medicaid coverage (8.7%) and those residing in rural areas (10.6%). We found no significant difference in enrollment rates between our Digital-Only and our Brochure Plus Digital outreach approaches in the overall population, but enrollment rates were significantly higher for Asian patients and patients who resided in rural areas in the Brochure Plus Digital group. Across both outreach approaches, links provided in emails were most commonly used for enrollment. Discussion: Our study reveals expected enrollment rates for proactive outreach by a hospital system for genetic testing in a diverse population. As more hospital systems are adopting population-scale genetic testing, these findings can inform future outreach efforts to recruit patients for genetic testing including those patients traditionally underrepresented in genomics.
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Reduced activation of the Research Domain Criteria (RDoC) positive valence systems (PVS) is observed in high-risk (HR) children of depressed mothers and predictive of future psychopathologies. We developed a dyadic, neuroscience-informed preventive intervention, Family Promoting Positive Emotions (FPPE), designed to prevent psychopathology in HR children by targeting PVS processes. We evaluated the initial efficacy of FPPE compared to written information (WI) psychoeducation in engaging PVS-related targets and reducing perceived stress and emotional distress symptoms in HR youth. Participants included 74 children ages 8-12 years and their biological mothers reporting elevated depressive symptoms. Following random assignment, 55 dyads completed FPPE (n = 29) or WI (n = 26) and pre-post assessments of child clinical symptoms. Youth completed a reinforcement learning task and 10 days of positive affect ratings to assess PVS-related targets. Results revealed a small within-subjects increase in child daily positive affect in FPPE, but not WI. Further, FPPE resulted in reductions in mother-reported child perceived stress and symptoms of anger, anxiety, and depression with medium-to-large within-subjects effects. Intervention effects on reinforcement learning and child-rated clinical symptoms were not observed. This study suggests FPPE shows promise in enhancing positive affect and reducing the emergence of clinical symptoms in HR children. CLINICALTRIALS.GOV IDENTIFIER: NCT05223842.
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Depresión , Madres , Adolescente , Femenino , Humanos , Proyectos Piloto , Emociones , AnsiedadRESUMEN
Group cognitive behavioral therapy (CBT) is an effective treatment for adolescent depression, but outcomes vary. Our goal was to examine interpersonal factors that predict response to group CBT for adolescent depression using a broad range of outcomes, including depressive symptoms, session attendance, treatment completion, engagement, and improvement. Seventy adolescents (age 14-18) with depression completed self-report measures of social support and parental conflict and were offered an established 16-session group CBT program. Correlation and regression analyses were conducted for interpersonal predictors and CBT outcomes. Accounting for pre-treatment depressive symptoms, fewer social supports predicted lower likelihood of finishing treatment and less clinician-rated improvement. Greater pre-treatment parental conflict predicted fewer sessions attended, lower clinician-rated engagement, and less clinician-rated improvement. Results highlight the need to consider interpersonal difficulties in CBT, as they may present a barrier to treatment attendance, engagement, and improvement.
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Earlier depression onsets are associated with more debilitating courses and poorer life quality, highlighting the importance of effective early intervention. Many youths fail to improve with evidence-based treatments for depression, likely due in part to heterogeneity within the disorder. Multi-method assessment of individual differences in positive and negative emotion processing could improve predictions of treatment outcomes. The current study examined self-report and neurophysiological measures of reward responsiveness and emotion regulation as predictors of response to cognitive-behavioral therapy (CBT). Adolescents (14-18 years) with depression (N = 70) completed monetary reward and emotion regulation tasks while electroencephalogram (EEG) was recorded, and self-report measures of reward responsiveness, emotion regulation, and depressive symptoms at intake. Adolescents then completed a 16-session group CBT program, with depressive symptoms and clinician-rated improvement assessed across treatment. Lower reward positivity amplitudes, reflecting reduced neural reward responsiveness, predicted lower depressive symptoms with treatment. Larger late positive potential residuals during reappraisal, potentially reflecting difficulty with emotion regulation, predicted greater clinician-rated improvement. Self-report measures were not significant predictors. Results support the clinical utility of EEG measures, with impairments in positive and negative emotion processing predicting greater change with interventions that target these processes.
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Terapia Cognitivo-Conductual , Regulación Emocional , Humanos , Adolescente , Depresión , Emociones/fisiología , Terapia Cognitivo-Conductual/métodos , RecompensaRESUMEN
Increased rates of depression beginning in adolescence are thought to be attributed in part to marked developmental changes in reward systems and interpersonal relationships. Blunted reward response has been observed in depression and this may be shaped in part by social experiences, raising questions about the combined associations of parental conflict, depression, and reward response in both social and monetary domains. The present study used the reward positivity (RewP), an event-related potential that indexes both monetary and social reward processing, to examine the unique and combined associations of parental conflict and depressive symptoms on reward responsiveness in adolescents with clinical depression (N = 70) 14-18 years of age (M = 15.81, SD = 1.46; 65.7% female). Results indicated that depressive symptoms interacted with maternal conflict in characterizing the RewP to social, but not monetary, rewards. Specifically, higher levels of current depressive symptoms and potentiated maternal conflict together were associated with an attenuated RewP to social rewards in this clinical sample. We found no significant effects of paternal conflict. This investigation highlights maternal conflict as an important environmental factor for reward responsiveness and also emphasizes the utility of examining social reward responsiveness in depression in order to better understand the impacts of contextual factors.
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Depresión , Trastorno Depresivo Mayor , Masculino , Femenino , Humanos , Adolescente , Potenciales Evocados/fisiología , Padre , RecompensaRESUMEN
Self-injurious thoughts and behaviors (SITBs), which include suicidal ideation (SI), suicide attempts (SA), and nonsuicidal self-injury (NSSI), are prevalent and associated with impairments in functioning and elevated risk of suicide deaths. Preventing suicide is a complex problem, with numerous systems likely contributing to the onset and maintenance of SITBs, and there is a critical need to identify more precise predictors of risk. Positive valence systems (PVS) are an understudied domain with promise for improving understanding of risk processes underlying SITBs. In this systematic review, we evaluate the evidence for the potential role of altered PVS function in SI, SA, and/or NSSI, including alterations in reward responsiveness, learning, and valuation assessed through behavioral, physiological and circuit measures. Results provide preliminary support for associations between distinct aspects of PVS function and alterations in SITBs. Specifically, SI appears to be characterized by low reward responsiveness, whereas little research has examined reward responsiveness in SA, and NSSI has been characterized by hyper-responsiveness to rewards. Alterations in reward learning and valuation are commonly examined in SA, with some evidence that they may be more strongly associated with attempts than SI or NSSI. At the same time, the literature is limited in that some constructs are commonly examined in one form of SITBs but not others. Further, research is predominantly cross-sectional and focused on adults, raising questions about the role of PVS function in developmental pathways to SITBs. We conclude by integrating the research to date and highlighting promising directions for future research.
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Ideación Suicida , Intento de Suicidio , Humanos , Estudios TransversalesRESUMEN
Introduction: The COVID-19 pandemic has led to major stressors, increases in internalizing symptomatology, and greater reliance on online interactions. We examined associations between social media use, online social support, pandemic-related stress, and internalizing symptoms, and tested the moderating role of social media use on the relation between stress and symptom change across time. Methods: Emerging adults aged 18-25 (N=200) self-reported pandemic-related stress, internalizing symptoms, social media use, and online social support in May 2020, then repeated measures of internalizing symptoms in August 2020. Results: Greater social media use was cross-sectionally associated with greater stress and anxiety symptoms. High social media use in conjunction with high interpersonal stress was predictive of increases in depression, whereas low online social support and high total stress was predictive of increases in anxiety. Discussion: Findings suggest that general social media usage and online social support are differentially related to internalizing symptom change among emerging adults.
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BACKGROUND: Stressful events, such as those imposed by the COVID-19 pandemic, are associated with depression risk, raising questions about processes that make some people more susceptible to the effects of stress on mental health than others. Emotion regulation may be a key process, but methods for objectively measuring emotion regulation abilities in youth are limited. We leveraged event-related potential (ERP) measures and a longitudinal study of adolescents oversampled for depression and depression risk to examine emotion regulation difficulties as prospective predictors of depressive symptoms in response to pandemic-related stress. METHODS: Before the pandemic, adolescents with (n = 28) and without (n = 34) clinical depression (N = 62 total) completed an explicit emotion regulation task while ERP data were recorded and measures of depressive symptoms. Adolescents were re-contacted during the pandemic to report on COVID-19 related stressful events and depressive symptoms (n = 48). RESULTS: Adolescents who had never experienced a depressive episode showed an increase in depressive symptoms during the pandemic, but adolescents who were clinically depressed before the pandemic did not exhibit significant changes in symptoms. Neural markers of emotion regulation abilities interacted with pandemic-related stressful events to predict depressive symptoms during the pandemic, such that stressors predicted increases in depressive symptoms only for adolescents with greater difficulty modulating responses to negative images before the pandemic. CONCLUSIONS: Results provide insight into adolescent mental health during the COVID-19 pandemic and highlight the role of emotion regulatory brain function in risk and resilience for depression.
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COVID-19 , Regulación Emocional , Adolescente , Depresión/psicología , Emociones/fisiología , Humanos , Estudios Longitudinales , PandemiasRESUMEN
The COVID-19 pandemic imposed profound effects on health and daily life, with widespread stress exposure and increases in psychiatric symptoms. Despite these challenges, pandemic research provides unique insights into individual differences in emotion and cognition that predict responses to stress, with general implications for understanding stress vulnerability. We examined predictors of responses to COVID-19-related stress in an online sample of 450 emerging adults recruited in May 2020 to complete questionnaires assessing baseline stress and psychiatric symptoms, rumination, cognitive reappraisal use and intolerance of uncertainty. Stress and symptoms were re-assessed 3 months later (N = 200). Greater pandemic-related stressful events were associated with increases in symptoms of depression, anxiety and alcohol use severity. Additionally, individual differences in emotional and cognitive styles emerged as longitudinal predictors of stress responses. Specifically, greater rumination predicted increased depression. Reduced cognitive reappraisal use interacted with stress to predict increases in alcohol use. An unexpected pattern emerged for intolerance of uncertainty, such that stress was associated with increases in depression for those high in intolerance of uncertainty but increases in alcohol use at relatively low levels of intolerance of uncertainty. These results highlight unique vulnerabilities that predict specific outcomes following stress exposure and offer potential prevention targets.
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COVID-19 , Adulto , Ansiedad/psicología , Trastornos de Ansiedad/psicología , Depresión/epidemiología , Depresión/psicología , Humanos , PandemiasRESUMEN
Emotionally-salient stimuli receive selective attention and elicit complex neural responses that evolve considerably across development. Event-related potentials (ERPs) optimally capture the dynamics of emotion processing and regulation, with sensitivity to detect changes in magnitude, latency, and maximal location across development. In this selective qualitative review, we summarize evidence of developmental changes in neural reactivity to emotional stimuli and modulation of neural responses during emotion regulation indexed by ERPs across infancy, childhood, and adolescence. The cumulative ERP literature suggests the transition from childhood to adulthood is characterized by a gradual decrease in neural reactivity to emotional stimuli and increased efficiency in attentional allocation towards emotional stimuli. Some studies show sensitivity to emotional stimuli peaks in adolescence, but the evidence is mixed. While both early (<300 ms) and late (>300 ms) ERPs demonstrate sensitivity to emotional stimuli, emotional modulation is more consistently observed in relatively later ERPs across development. The literature additionally shows improvements in regulation abilities across development, though ERP research on developmental changes in emotion regulation is still relatively limited, highlighting a critical direction for future research. Finally, we briefly discuss changes in emotion-related ERPs relevant to the emergence of depression and anxiety. Findings from this review indicate that ERPs provide abundant information about the development of emotion processing and regulation, with potential clinical utility for detecting early-emerging vulnerabilities for internalizing forms of psychopathology.
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Electroencefalografía , Potenciales Evocados , Adolescente , Ansiedad , Atención , Niño , Emociones , Humanos , Adulto JovenRESUMEN
INTRODUCTION: Depression is associated with increased negative affect (NA) and low positive affect (PA), as well as interpersonal difficulties. Although most studies examine symptoms and affect at only one time point, ecological momentary assessment (EMA) captures data on affect and activity in real time and across contexts. The present study used EMA to explore the links between in-person and virtual social interactions, depressive symptoms, and momentary affect. METHODS: Emerging adults (N=86) completed a self-report measure of both general depression and dysphoria symptoms, followed by EMA surveys 8 times daily for one week, reporting momentary affect (PA and NA) and social context (in-person and virtual interactions with friends). RESULTS: In-person, but not virtual, presence of friends was associated with increased PA overall. Depressive symptoms were linked to less time with in-person friends and elevated NA. There was also a significant interaction between in-person presence of friends and dysphoria in predicting NA, such that presence of in-person friends was associated with lower NA only for those low in dysphoria. DISCUSSION: Findings suggest that time with in-person friends is associated with increased PA overall and decreased NA only for those lower in depressive symptoms, but these effects do not generalize to virtual interactions. Those with greater depressive symptoms may be less responsive to positive stimuli and experience less of an effect of friends' presence on affect. Alternatively, maladaptive social behaviors characteristic of depression may influence the effect of social interactions on affect.
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Affective neuroscience research using electrocortical event-related potentials has provided valuable insights on alterations in emotion processing in internalizing disorders. However, internalizing disorders are accompanied by additional impairments in social cognition and functioning, and most extant research examines neural responses to broad categories of emotional scenes or faces presented irrespective of context. Examining neural reactivity specifically to interpersonal emotional scenes may more precisely capture and disentangle processes involved in depression and social anxiety, two highly comorbid forms of psychopathology. The current study validated a novel set of positive and threatening interpersonal emotional stimuli in a sample of emerging adults (N = 114) who completed a modified emotional interrupt paradigm while electroencephalogram and behavioral data were recorded. Participant ratings of valence and arousal supported the validity of the emotional images. Consistent with prior research, sustained neurophysiological processing indexed by the late positive potential (LPP) was observed for interpersonal emotional images, especially positive, compared with neutral images. Elevated LPP reactivity to both positive and threatening interpersonal images moderated the effects of chronic interpersonal stress on social anxiety symptoms, such that enhanced LPP reactivity in conjunction with higher levels of chronic interpersonal stress was associated with elevated social anxiety symptoms. These results were unique to social anxiety symptoms and not symptoms of depression, suggesting sustained neural processing of interpersonal stimuli may differentiate social anxiety from depression. Future research on emotional reactivity specifically within the interpersonal domain is needed to inform our understanding of developmental pathways to internalizing psychopathology.
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Depresión , Emociones , Adulto , Ansiedad , Electroencefalografía , Potenciales Evocados , Miedo , HumanosRESUMEN
BACKGROUND: Exposure to stressful events related to the COVID-19 coronavirus pandemic has been associated with increases in the prevalence of depression and anxiety, raising questions about vulnerabilities that make some individuals more susceptible to internalizing symptoms following stress exposure. METHODS: This prospective study examined the effects of neurophysiological reactivity to positive and threatening interpersonal stimuli, indexed by the late positive potential (LPP) event-related potential, in conjunction with exposure to interpersonal pandemic-related stressors in the prediction of internalizing symptom changes from before to during the pandemic. Emerging adults (n= 75) initially completed measures of internalizing symptoms and an interpersonal emotional images task while an electroencephalogram was recorded pre-pandemic and were recontacted during the COVID-19 pandemic in May 2020 to complete measures of exposure to pandemic-related stressful events and current internalizing symptoms. RESULTS: Results indicated that emerging adults experienced numerous stressful events associated with the pandemic, as well as overall increases in symptoms of depression and traumatic intrusions during the pandemic. Furthermore, significant interactions between LPP reactivity to positive and threatening interpersonal stimuli and interpersonal stress exposure emerged in the prediction of internalizing symptoms, controlling for baseline symptoms. Under high exposure to interpersonal stressors, reduced positive LPPs predicted increases in depressive symptoms while enhanced threatening LPPs predicted increases in traumatic intrusions. CONCLUSIONS: These findings highlight the mental health impacts of the COVID-19 pandemic on emerging adults, and the role of individual differences in neurophysiological reactivity to emotional stimuli in vulnerability for depression and traumatic intrusions following stress exposure.
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COVID-19 , Pandemias , Adulto , Depresión , Humanos , Estudios Prospectivos , SARS-CoV-2RESUMEN
Exposure to adverse childhood experiences (ACEs) is prevalent and confers risk for psychopathology later in life. Approaches to understanding the impact of ACEs on development include the independent risk approach, the Dimensional Model of Adversity and Psychopathology (DMAP) distinguishing between threat and deprivation events, and the cumulative risk approach. The present research provides an empirical confirmation of DMAP and a comparison of these three approaches in predicting internalizing and externalizing symptoms in youth. In Study 1, mental health professionals (N = 57) rated ACEs as threat or deprivation events. These ratings were used to create composites to represent the DMAP approach in Study 2. With cross-sectional and longitudinal data from children and adolescents in state custody (N = 23,850), hierarchical linear regression analyses examined independent risk, DMAP, and cumulative risk models in predicting internalizing symptoms, disinhibited externalizing symptoms, and antagonistic externalizing symptoms. All three approaches produced significant models and revealed associations between exposure to ACEs and symptoms. Individual risk accounted for significantly more variance in symptoms than cumulative risk and DMAP. Cumulative risk masked differential associations between ACEs and psychological symptoms found in the individual risk and DMAP approaches. (PsycInfo Database Record (c) 2021 APA, all rights reserved).