Longitudinal associations among dimensional symptoms of depression and anxiety and first onset suicidal ideation in adolescents.

INTRODUCTION: Depression and anxiety are implicated in suicide risk, but the contributionof specific symptom dimensions within these disorders is not well understood. The present study examined longitudinal associations of transdiagnostic symptoms (General Distress[GD]) and unique symptom dimensions (Anhedonia-Apprehension [AA], Fears, and Narrow Depression [ND]) of depression and anxiety and suicidal ideation (SI). METHODS: Data from 551 adolescents oversampled on high neuroticism were examined in a series of discrete-time survival analyses to predict first SI onset over an 8-year period. RESULTS: Results indicate that GD, AA, and ND were independent predictors of increased likelihood of SI onset and remained significant when controlling for effects of fears. Furthermore, AA and GD remained significant when controlling for one another. ND effects reduced by 24% when adjusting for AA and 74% when adjusting for GD. Fears did not significantly predict SI onset. CONCLUSION: Results suggest that broad levels of distress across depression and anxiety, deficits in positive affect, and elevated negative affect specific to depression increase the likelihood of suicidal thoughts. As such, attention to broader distress and a lack of pleasure, interest, and motivation-potentially more so than negative affect characterizing depression-are particularly important for addressing suicide risk in adolescents.

Early-life adversity and risk for depression and anxiety: The role of interpersonal support.

Early-life adversity is a major risk factor for psychopathology, but not all who experience adversity develop psychopathology. The current study evaluated whether the links between child and adolescent adversity and depression and anxiety were described by general benefits and/or buffering effects of interpersonal support. Data from 456 adolescents oversampled on neuroticism over a 5-year period were examined in a series of discrete-time survival analyses to predict subsequent disorder onsets. Models examined linear, quadratic, and interactive effects of interpersonal support over time, as measured by chronic interpersonal stress interview ratings. Results did not support buffering effects of interpersonal support against either child or adolescent adversity in predicting depression or anxiety. However, there was support for the general benefits model of interpersonal support as evidenced by follow-up analyses of significant quadratic effects of interpersonal support, demonstrating that higher interpersonal support led to decreased likelihood of depression and anxiety onsets. Secondary analyses demonstrated that effects of interpersonal support remained after accounting for baseline depression and anxiety diagnoses. Further, quadratic effects were driven by social domains as opposed to familial domains when considering child adversity. Implications for interventions and randomized controlled prevention trials regarding interpersonal relationships are discussed.

Experiences of adversity in childhood and adolescence and cortisol in late adolescence.

Early life adversity influences the diurnal cortisol rhythm, yet the relative influence of different characteristics of adversity remains unknown. In this study, we examine how developmental timing (childhood vs. adolescence), severity (major vs. minor), and domain of early life adversity relate to diurnal cortisol rhythms in late adolescence. We assessed adversity retrospectively in early adulthood in a subsample of 236 participants from a longitudinal study of a diverse community sample of suburban adolescents oversampled for high neuroticism. We used multilevel modeling to assess associations between our adversity measures and the diurnal cortisol rhythm (waking and bedtime cortisol, awakening response, slope, and average cortisol). Major childhood adversities were associated with flatter daily slope, and minor adolescent adversities were associated with greater average daily cortisol. Examining domains of childhood adversities, major neglect and sexual abuse were associated with flatter slope and lower waking cortisol, with sexual abuse also associated with higher cortisol awakening response. Major physical abuse was associated with higher waking cortisol. Among adolescent adversities domains, minor neglect, emotional abuse, and witnessing violence were associated with greater average cortisol. These results suggest severity, developmental timing, and domain of adversity influence the association of early life adversity with stress response system functioning.

Fear-potentiated startle predicts longitudinal change in transdiagnostic symptom dimensions of anxiety and depression.

BACKGROUND: Elevated defensive responding, through startle reflex (SR) and skin conductance response (SCR), may contribute to onset and maintenance of depression and anxiety. Most work examining SR and SCR has predicted psychiatric diagnoses. There is a paucity of research examining links between SR or SCR and dimensional measures of psychopathology. METHODS: We used latent growth curve modeling to predict longitudinal change in three symptom factors (i.e., General Distress, Fears, Anhedonia-Apprehension) from SR and SCR measured during a fear-potentiated startle paradigm among adolescents oversampled for neuroticism (N = 129). RESULTS: Elevated SCR in danger phases before and after an unpleasant muscle contraction predicted increasing Fears over time. Elevated SR in safe phases post-contraction also predicted increasing Fears over time. Attenuated SR in safe phases post-contraction predicted elevated General Distress longitudinally. Attenuated SCR pre-contraction in danger phases predicted elevated Anhedonia-Apprehension over time. LIMITATIONS: Our non-clinical sample may limit generalizability of results. Additionally, we did not assess change in SR and SCR over time. CONCLUSIONS: The present study demonstrates that SR and SCR during a fear-potentiated startle paradigm predict longitudinal change in dimensional anxiety and depression symptom factors and relatedly, that SR and SCR may represent risk factors for the exacerbation of symptomatology.

Examining the dimensionality of anxiety and depression: A latent profile approach to modeling transdiagnostic features.

Depression and anxiety are highly prevalent psychological disorders; our understanding of these conditions remains limited. Efforts to explain anxiety and depression have been constrained in part by binary classification systems. Dimensional approaches to understanding psychopathology may be more effective. The present study used latent profile analysis (LPA) to assess whether unique subgroups exist within a tri-level model of anxiety and depression. Participants (N=627) completed self-report questionnaires from which tri-level model factors were derived. LPA was conducted on those factors. A 4-profile model offered optimal fit to the data at baseline. This model was replicated at a second time point. Models derived included profiles labelled 'Mixed Fears,' 'Anxious Arousal,' 'Low Mood/Anhedonia,' and 'Sub-Clinical.' Profiles were validated at Time 1 using diagnostic status and clinical severity ratings associated with mood and anxiety presentations. Profiles demonstrated flexibility in accommodating breadth in clinical presentations and common comorbidities. Latent variable models may offer more ecologically valid approaches to understanding psychopathology.

A Current Learning Theory Approach to the Etiology and Course of Anxiety and Related Disorders.

The authors describe how contemporary learning theory and research provide the basis for models of the etiology and maintenance of anxiety and related disorders. They argue that contemporary learning theory accounts for much of the complexity associated with individual differences in the development and course of these disorders. These insights from modern research on learning overcome the limitations of earlier behavioral approaches, which were overly simplistic and have been justifiably criticized. The authors show how considerations of early learning histories and temperamental vulnerabilities affect the short- and long-term likelihood that experiences with stressful events will lead to the development of anxiety disorders. They also discuss how contextual variables during and after stressful learning experiences influence the maintenance of anxiety disorder symptoms. Thus, contemporary learning models provide a rich and nuanced understanding of the etiology and course of anxiety and related disorders.

Rumination and worry as putative mediators explaining the association between emotional disorders and alcohol use disorder in a longitudinal study.

INTRODUCTION: The high rate of comorbidity between alcohol use and emotional disorders is well demonstrated, but the mechanisms underlying their relationship remain largely unidentified. One possibility is maladaptive responding to negative affect, such as worry and rumination. The present study sought to examine worry and rumination as putative mediators explaining the link between emotional disorders and alcohol use disorders. Methods Mediational analyses were conducted using a sample (n = 232) derived from a larger late adolescence/early adulthood longitudinal dataset (Youth Emotion Project; Zinbarg et al., 2010). Results A significant indirect effect was observed for emotional disorder severity on alcohol use disorder severity via rumination, but not via worry or the shared variance between worry and rumination. Conclusions These findings suggest that rumination may specifically confer risk for the development of alcohol use disorder for individuals with emotional disorders. Further, ruminative thinking may serve as a specific treatment target to reduce vulnerability to alcohol use disorder.

Reciprocal effects of neuroticism and life stress in adolescence.

BACKGROUND: Stressful life experiences and personality can influence one another. Personality may contribute to the amount and type of stress individuals experience, which is referred to as a selection effect. Life stress may also impact one's personality, which is referred to as a socialization effect. It was hypothesized that neuroticism would predict increased chronic and episodic stress (selection effect) and that chronic and episodic stress would predict increased neuroticism (socialization effect). METHODS: The current study investigated selection and socialization effects of neuroticism and life stress over a three-year period in 627 adolescents. Life stress data were examined in terms of duration (chronic versus episodic) and type (interpersonal versus non-interpersonal). Episodic stress data were examined as dependent or independent. RESULTS: The results from ten cross-lagged panel models provided some evidence for significant selection and socialization effects depending on stress type. Over three years, we observed that neuroticism increases interpersonal chronic stress and non-interpersonal stressful events (selection effects) and that dependent non-interpersonal stressful events and chronic stress increase neuroticism (socialization effects). LIMITATIONS: Study limitations include a lack of a lifespan perspective and a statistical approach that does not differentiate between- from within-person variance. CONCLUSIONS: Findings suggest the value of attending to stress response as well as targeting neuroticism in prevention and intervention approaches in adolescents.

Reciprocal effects of personality and general distress: Neuroticism vulnerability is stronger than scarring.

Internalizing (anxiety and depressive) disorders, and the symptoms that comprise them, are known for being chronic and recurrent. Neuroticism, reflecting dispositional tendencies toward negative affect, is a personality trait that bears durable cross-sectional and prospective associations with internalizing symptoms. There are also indications that extraversion, consisting of tendencies such as the heightened experience of positive emotion, is associated with these symptoms. Some investigators have posited that the experience of internalizing symptoms leaves residual effects, or scars, on personality traits, with the effect of raising risk of symptom reexacerbation. In the present study, we compare vulnerability and scar effects in a sample of older adolescents (N = 606) at risk for the development of internalizing disorders. Anxiety and depressive symptoms were assessed annually, as were neuroticism, extraversion, and other trait-like cognitive vulnerabilities. Cross-lagged panel models compared the relative strength of vulnerability and scar effects, revealing support for vulnerability effects but little evidence of scar effects. The results also showed that whatever scar effects might be present are weaker than vulnerability effects in the case of neuroticism. These findings underscore the importance of personality vulnerability for internalizing symptom risk by suggesting that neuroticism vulnerability is stronger than any lasting scars the experience of internalizing symptoms produce. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Neuroticism and the longitudinal trajectories of anxiety and depressive symptoms in older adolescents.

Adolescence is a developmental period characterized by remarkable volatility and comorbidity in internalizing disorders. Delineating internalizing symptom change in a manner that accounts for symptoms' shared versus distinctive features is imperative to an understanding of their development. An additional question concerns how vulnerabilities for internalizing disorders relate to development of internalizing symptoms. Cross-sectional and prospective associations between neuroticism and internalizing psychopathology are well-established, yet conclusive evidence on neuroticism's relation to the progression of symptom dimensions relevant to internalizing disorders remains absent. In this investigation, we used latent growth curve modeling to characterize the trajectories of tri-level model internalizing dimensions (General Distress, Anhedonia-Apprehension, Fears, Anxious Arousal, Fears of Specific Stimuli, Social Fears, Narrow Depression, Interoceptive/Agoraphobic Fears) and examined whether a general neuroticism factor predicted their growth. We used anxiety and depressive symptom data spanning 6 years, collected from 606 high school juniors mostly vulnerable for internalizing disorders. We observed a pattern of results that varied by symptom dimension. Only Anhedonia-Apprehension showed a distinct increasing trend, on average. Neuroticism predicted an adverse symptom course for the dimension of General Distress. Our results reinforce the notion that neuroticism confers substantial risk for internalizing symptom maintenance and extend past findings by demonstrating that neuroticism forecasts a poor symptom course for General Distress but not narrower dimensions of internalizing. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Extraversion and interpersonal support as risk, resource, and protective factors in the prediction of unipolar mood and anxiety disorders.

Whereas there is extensive research on factors that contribute to vulnerability for depression and anxiety, research on how to promote mental health or offset risk effects in individuals likely to develop these disorders is lacking. Resilience models focus on risk, resource, and protective factors and their relationships. The current longitudinal study evaluated whether extraversion and interpersonal support functioned in resource or protective roles in relation to unipolar mood disorder (UMD), anxiety disorder (AD), and comorbid diagnoses. Data from 534 adolescents over a 3-year period were examined in a series of survival analyses to predict future disorder onset. The linear effect of extraversion significantly interacted with neuroticism predicting UMD diagnoses with extraversion conferring protection and introversion conferring risk at high levels of neuroticism. The quadratic effect of extraversion significantly interacted with neuroticism predicting AD and comorbid diagnoses such that extraversion escalated risk for diagnoses at high levels of neuroticism. The quadratic effect of extraversion was significant in comorbidity models, demonstrating increased risk as one progresses from slight extraversion to extreme introversion, independent of neuroticism. Interpersonal support significantly predicted UMD, AD, and comorbid diagnoses in an approximately linear fashion. Specificity tests indicated that these effects remained when including the other diagnosis in each model. Findings suggest the value of attending to extraverted traits and encouraging social connection regardless of risk status in prevention and treatment approaches. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Neuroticism and interpretive bias as risk factors for anxiety and depression.

Neuroticism has been associated with depression and anxiety both cross-sectionally and longitudinally. Interpretive bias has been associated with depression and anxiety, primarily in cross-sectional and bias induction studies. The purpose of the current study was to examine the role of interpretive bias as a prospective risk factor and a mediator of the relation between neuroticism and depressive and anxious symptoms in young adults assessed longitudinally. Neuroticism significantly predicted a broad general distress dimension, but not intermediate fears and anhedonia-apprehension dimensions, nor a narrow social fears dimension. Neuroticism also significantly predicted negative interpretive bias for social scenarios. Negative interpretive bias for social scenarios did not significantly predict dimension scores, nor did it mediate the relation between neuroticism and general distress or social fears. These results suggest that although neuroticism relates to negative interpretive bias, its risk for symptoms of depression and anxiety is at most weakly conferred through negative interpretive bias.

Five-year prospective neuroticism-stress effects on major depressive episodes: Primarily additive effects of the general neuroticism factor and stress.

The past decades of research on predictors of depression have frequently emphasized interactive diathesis-stress questions: What kinds of vulnerabilities under stressful circumstances increase risk of developing depression? This study addresses 3 theoretically important gaps in our knowledge regarding diathesis-stress models of depression: the role of temperament (neuroticism), interactive versus additive effects of neuroticism-stress relationships, and effects of stressor characteristics (acute vs. chronic, major vs. minor events, interpersonal vs. noninterpersonal content). We addressed these gaps in the prediction of major depressive episodes (MDEs) in a sample of high schoolers (n = 559) oversampled for high neuroticism and assessed for presence of MDEs annually for 5 years. Survival analyses provided relatively consistent support for the main effects of the broad vulnerability factor of the general neuroticism factor, acute stressors, and chronic stressors in the prediction of MDEs. In contrast, the majority of our analyses failed to support interactive neuroticism-stress accounts of MDE risk. Integrating our results with the extant literature reinforces the notion that both the general neuroticism factor and stress prospectively predict depressive disorders and highlight that their main effects are significantly larger than their interaction. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Positive Affect as a Buffer between Chronic Stress and Symptom Severity of Emotional Disorders.

Research has demonstrated that stressors play a critical role in the development of generalized anxiety disorder (GAD), social anxiety disorder (SAD), and major depressive disorder (MDD). Separately, deficits in positive affect (PA) have been identified in GAD, SAD, and MDD. While previous research has linked the buffering effects of PA in chronic illness, such effects have yet to be investigated for chronic stressors and emotional disorder-related symptom severity. The purpose of the present study was to examine PA as a moderator of chronic interpersonal and non-interpersonal stress on GAD, SAD, and MDD symptom severity. Using a multilevel statistical approach with a sample of adolescents and young adults (N=463), PA was found to significantly moderate the relationship between chronic interpersonal stress and symptom severity for MDD and SAD. Findings suggest that in times of chronic interpersonal stress, higher PA may serve as a buffer from development of SAD and MDD symptoms.

Reduced autobiographical memory specificity affects general distress through poor social support.

Sharing specific autobiographical events is likely to influence the support people give us; a person who shares little detail of their lives may be unlikely to attract social support and this may in turn contribute towards anxious and depressive symptoms. Participants (N = 142) reported memories evoked by negative and positive cue words and these memories were coded for whether or not they referred to a specific event lasting less than 24 h. At this time (T1) and one year later (T2), participants also completed the UCLA Life Stress Interview (LSI), which includes a measure of social support, and measures of depression and anxiety comprising a general distress latent construct. The tendency to recall fewer specific memories was associated with lower social support given by friends and romantic partners and this was in turn associated with elevated general distress at T2, even when accounting for T1 social support and general distress. Our findings contribute to the literature regarding the social function of memory and suggest another route via which reduced specificity contributes to emotional disorders.

Cortisol awakening response and additive serotonergic genetic risk interactively predict depression in two samples: The 2019 Donald F. Klein Early Career Investigator Award Paper.

BACKGROUND: The serotonin system and hypothalamic pituitary-adrenal (HPA)-axis are each implicated in the pathway to depression; human and animal research support these systems' cross-talk. Our work implicates a 5-variant additive serotoninergic multilocus genetic profile score (MGPS) and separately the cortisol awakening response (CAR) in the prospective prediction of depression; other work has shown that the serotonin transporter polymorphism 5HTTLPR predicts CAR and interacts with the CAR to predict depression. METHODS: We tested the hypothesis that a 6-variant MGPS (original plus 5HTTLPR) would interact with CAR to predict prospective depressive episode onsets in 201 emerging adults using four annual follow-up interviews. We also tested whether MGPS predicted CAR. We attempted replication of significant findings in a sample of 77 early adolescents predicting depression symptoms. RESULTS: In sample 1, MGPS did not significantly predict CAR. MGPS interacted with CAR to predict depressive episodes; CAR slopes for depression steepened as MGPS increased, for risk or protection. No single variant accounted for results, though CAR's interactions with 5HTTLPR and the original MGPS were both significant. In sample 2, the 6-variant MGPS significantly interacted with CAR to predict depression symptoms. CONCLUSIONS: Higher serotonergic MGPS appears to sensitize individuals to CAR level-for better and worse-in predicting depression.

Emotion Regulation Regulates More than Emotion: Associations of Momentary Emotion Regulation with Diurnal Cortisol in Current and Past Depression and Anxiety.

Maladaptive emotion regulation and dysregulated hypothalamic-pituitary-adrenal (HPA) axis functioning are characteristic of depression and anxiety. However, little research examines whether and how emotion regulation affects HPA axis functioning. We utilized an experience sampling methodology to examine associations between three emotion regulation strategies (problem solving, disengagement, and emotional expression/support seeking) and diurnal cortisol rhythms and reactivity in everyday life. Participants were young adults with current, past, or no history of internalizing disorders (depression or anxiety; N = 182). Across participants, problem solving was associated with an elevated cortisol awakening response (CAR) while disengagement was associated with a steeper cortisol slope. Only for individuals with internalizing disorders was momentary problem solving and emotional expression/support seeking associated with higher cortisol reactivity and emotional expression/support seeking associated with a flatter diurnal slope and blunted CAR. Results provide insight into associations between emotion regulation and day-to-day HPA-axis functioning.

Core dimensions of anxiety and depression change independently during adolescence.

The developmental trajectories of emotional disorder symptoms during adolescence remain elusive, owing in part to a shortage of intensive longitudinal data. In the present study, we charted the temporal course of the tripartite model of anxiety and depression-which posits an overarching negative affect dimension and specific anhedonia and anxious arousal dimensions-over adolescence and emerging adulthood to construct a developmental map of the core dimensions of emotional disorders. We recruited 604 high school juniors, overselecting those at high risk for emotional disorders, and assessed the tripartite symptom domains 5 times annually. Latent curve modeling revealed that negative affect and anxious arousal declined over follow up, whereas anhedonia did not. Moreover, the correlation in rate of change varied across pairs of symptom domains. Change in negative affect was moderately correlated with change in anxious arousal, but change in anhedonia was not significantly related to change in any other domain. Symptom trajectories, and the pattern of covariation among trajectories, were equivalent across gender and comorbidity status. We discuss implications of these findings for developmental models of anxiety and depression, as well as transdiagnostic frameworks for emotional disorders. (PsycINFO Database Record

The Effects of Childhood and Adolescent Adversity on Substance Use Disorders and Poor Health in Early Adulthood.

Childhood and adolescent adversity have been shown to predict later mental and physical health outcomes. Understanding which aspects and developmental timings of adversity are important, and the mechanisms by which they have their impact may help guide intervention approaches. A large subset of adolescents (N = 457; Female 68.9 %) from the 10-year longitudinal Youth Emotion Project was examined to better understand the associations among childhood/adolescent adversity, substance use disorder, and later health quality. Adolescent (but not childhood) adversities were associated with poorer health in late adolescence/early adulthood, adolescent adversities were associated with subsequent onset of substance use disorder, and adolescent adversities continued to be associated with poorer health in late adolescence/early adulthood after accounting for the variance explained by substance use disorder onset. These associations were observed after statistically accounting for emotional disorders and socioeconomic status. Specific domains of adversity uniquely predicted substance use disorder and poorer health outcomes. In contrast with current recent research, our findings suggest the association between childhood/adolescent adversity and poorer health outcomes in late adolescence and emerging adulthood are not entirely accounted for by substance use disorder, suggesting efforts to curtail family-based adolescent adversity may have downstream health benefits.

Interaction of CD38 Variant and Chronic Interpersonal Stress Prospectively Predicts Social Anxiety and Depression Symptoms Over Six Years.

Variation in the CD38 gene, which regulates secretion of the neuropeptide oxytocin, has been associated with several social phenotypes. Specifically, rs3796863 A allele carriers have demonstrated increased social sensitivity. In 400 older adolescents, we used trait-state-occasion modeling to investigate how rs3796863 genotype, baseline ratings of chronic interpersonal stress, and their gene-environment (GxE) interaction predicted trait social anxiety and depression symptoms over six years. We found significant GxE effects for CD38 A-carrier genotypes and chronic interpersonal stress at baseline predicting greater social anxiety and depression symptoms. A significant GxE effect of smaller magnitude was also found for C/C genotype and chronic interpersonal stress predicting greater depression; however, this effect was small compared to the main effect of chronic interpersonal stress. Thus, in the context of chronic interpersonal stress, heightened social sensitivity associated with the rs3796863 A allele may prospectively predict risk for social anxiety and (to a lesser extent) depression.