The link between adolescent girls' interpersonal emotion regulation with parents and peers and depressive symptoms: A real-time investigation.

Adolescents often experience heightened socioemotional sensitivity warranting their use of regulatory strategies. Yet, little is known about how key socializing agents help regulate teens' negative emotions in daily life and implications for long-term adjustment. We examined adolescent girls' interpersonal emotion regulation (IER) with parents and peers in response to negative social interactions, defined as parent and peer involvement in the teen's enactment of emotion regulation strategies. We also tested associations between rates of daily parental and peer IER and depressive symptoms, concurrently and one year later. Adolescent girls (N = 112; Mage = 12.39) at temperamental risk for depressive disorders completed a 16-day ecological momentary assessment protocol measuring reactivity to negative social interactions, parental and peer IER, and current negative affect. Results indicated that adolescents used more adaptive strategies with peers and more maladaptive strategies with parents in daily life. Both parental and peer IER down-regulated negative affect, reflected by girls' decreased likelihood of experiencing continued negative affect. Higher proportions of parental adaptive IER predicted reduced depressive symptoms one year later. Findings suggest that both parents and peers effectively help adolescent girls down-regulate everyday negative emotions; however, parents may offer more enduring benefits for long-term adjustment.

'Professor Moms' & 'Hidden Service' in Pandemic Times: Students Report Women Faculty more Supportive & Accommodating amid U.S. COVID Crisis Onset.

Emerging data suggests the COVID-19 crisis exacerbated preexisting, long-documented gender inequities among U.S. faculty in higher education. During the initial Spring 2020 'lockdown' in the U.S., 80 students conveyed their experiences with faculty across 362 courses. We evaluated whether students' reports of faculty supportiveness, accommodations granted, and pandemic-impacted, anticipated grade outcomes differed according to faculty gender via mixed linear models (data on 362 courses were nested within 80 student reporters). Students perceived their women instructors as more supportive, accommodating, and anticipated lesser course grade decreases across the semester than in courses taught by men. Accordingly, we interpret that amidst the 'lockdown' crisis, women faculty earned higher perceived supportiveness and positive student outcomes than their male counterparts. Further, the data likely reflects women faculty's greater conscription into demonstrated care work, despite the coding of such labor as "feminine," thereby rendering such work devalued. To reframe, to the degree that students expect more 'intensive pedagogies,' which invites faculty and administrators to gender disparate demands, such pressures likely translate to 'hidden service' burdens, and correspondingly, less time for career-advancing activities (such as research). Broader implications are discussed, alongside women faculty's documented experiences of acceleration in career and work/family pressures in pandemic-times, which combine to exacerbate long-standing, yet now-amplified penalties, potentially driving a widening, gendered chasm in academic career outcomes. We conclude by offering constructive suggestions to mitigate any discriminatory impacts imposed by students' gendered assessment inputs and expectations.

Adolescent girls' intrapersonal and interpersonal parasympathetic regulation during peer support is moderated by trait and state co-rumination.

Effective emotion regulation (ER) is integral to adolescents' mental well-being and socioemotional development. During adolescence, peer interactions have an increasingly salient influence on the development of effective ER, but not all supportive peer interactions support adaptive ER. Co-rumination reflects the tendency to seek ER support by engaging with peers in negatively focused discussion of ongoing problems. We examined associations between co-rumination (state and trait) with measures of individual's autonomic (i.e., respiratory sinus arrhythmia, RSA) and affective regulation (self-report) among 30 female close-friend dyads (ages 11-17; 74% White) while engaged in a support-seeking discussion in the laboratory. We found that trait co-rumination corresponded with RSA withdrawal during peer support, suggesting a potential mechanism by which co-rumination contributes to dysregulated ER. We also examined dyadic patterns of physiological regulation via prospective change actor partner interdependence models (APIM). Partner effects were moderated by behaviorally coded state co-rumination. Dyads with high state co-rumination displayed coupled RSA movement in opposite directions, while dyads with low state co-rumination exhibited coupled RSA movement in the same direction. These findings are consistent with similar physiologic linkages in close relationships observed in other developmental periods. Results highlight the importance of multimodal assessment for characterizing social ER processes across development.

Adolescents' perceptions of maternal response to negative affect predict emotional reactivity during mother-daughter interaction: A multi-modal assessment.

Parental socialization of emotion consists of parental behaviors that scaffold child emotional reactivity and regulation. The current study examined whether adolescents' perceptions of their mothers' supportive versus non-supportive responses to negative emotions could predict adolescent emotional reactivity. Thirty adolescent girls (Mage  = 14.41 [1.55]) reported on how their mothers typically respond to their negative emotions and then completed a laboratory-based mother-adolescent interaction task. A multi-modal assessment of adolescent emotional reactivity during the interaction included adolescents' skin conductance levels (SCLs) and state anxiety, and mother-daughter interactions were behaviorally coded to assess how often dyads engaged in both negative and positive escalation (i.e., a pattern of negative or positive behavior of one partner being reciprocated by the other). Adolescents who reported that their mothers used more non-supportive responses to their negative emotion tended to exhibit higher SCL and engage in more negative escalation with their mothers during the interaction task. Furthermore, adolescents' SCL was positively correlated with both their state anxiety levels and negative escalation during the task. Together, these findings suggest that adolescents who perceive their mothers as less supportive of negative emotions are more likely to exhibit greater negative emotionality during parent-adolescent interaction, which may relate to risk for emotional disorders.

Linking Maternal Socialization of Emotion Regulation to Adolescents' Co-rumination With Peers.

Mounting research supports that co-rumination, the tendency to seek peer support by engaging in extensive negatively focused discussion, is a risk factor for adolescent psychopathology. It is unclear, though, how this interpersonal tendency develops. Parental responses to adolescents' negative affect likely shape how youth utilize peer relationships to regulate distress, as they shift to reliance on peer support during this developmental stage. For example, nonsupportive parental responses may fail to instill healthy regulation strategies, resulting in ineffective forms of peer support, such as co-rumination. Conversely, high levels of supportive parental responses to adolescents' negative affect may motivate youth to also express more negative affect with peers, leading to co-rumination. Eighty-nine healthy adolescents (9-17) and their mothers completed surveys and a support-seeking interaction. Only supportive maternal responses, including maternal affection, were associated with adolescents' co-rumination. These analyses indicate that some forms of parental support are associated with adolescents' tendency to co-ruminate.

Depressed Adolescents' Pupillary Response to Peer Acceptance and Rejection: The Role of Rumination.

Heightened emotional reactivity to peer feedback is predictive of adolescents' depression risk. Examining variation in emotional reactivity within currently depressed adolescents may identify subgroups that struggle the most with these daily interactions. We tested whether trait rumination, which amplifies emotional reactions, explained variance in depressed adolescents' physiological reactivity to peer feedback, hypothesizing that rumination would be associated with greater pupillary response to peer rejection and diminished response to peer acceptance. Twenty currently depressed adolescents (12-17) completed a virtual peer interaction paradigm where they received fictitious rejection and acceptance feedback. Pupillary response provided a time-sensitive index of physiological arousal. Rumination was associated with greater initial pupil dilation to both peer rejection and acceptance, and diminished late pupillary response to peer acceptance trials only. Results indicate that depressed adolescents high on trait rumination are more reactive to social feedback regardless of valence, but fail to sustain cognitive-affective load on positive feedback.

Brief report: preliminary evidence that co-rumination fosters adolescents' depression risk by increasing rumination.

Mounting research shows that the tendency to co-ruminate with peers regarding ongoing problems increases adolescents' depression risk; however, the means by which this interpersonal process fosters risk has not been identified. This said, theorists have proposed that co-rumination increases depression risk, in part, by increasing one's tendency to ruminate when alone. We tested this hypothesis in a study of 201 high-school freshmen who completed two assessments, six months apart. Supporting the proposed model, co-rumination predicted prospective increases in rumination and rumination predicted increases in depressive symptoms. The direct effect of co-rumination on depressive symptom change was not significant. Results indicate that co-rumination with friends may serve to increase rumination, which in turn increases depression risk.

Peer victimization and prospective changes in children's inferential styles.

There is evidence that the cognitive vulnerabilities featured in the hopelessness theory of depression-inferential styles for the causes, consequences, and self-worth implications of negative events-increase risk for depression. Given this, it is important to understand how these inferential styles develop. In this study, we examined the impact of overt and relational peer victimization in a multiwave prospective study of 100 children (8-12 years of age) with peer victimization and inferential styles assessed every 2 months for 6 months (4 assessments total). Overt victimization uniquely predicted prospective changes in children's inferential styles for consequences and relational victimization uniquely predicted changes in inferential styles for self-characteristics. It is important to note that these relations were maintained even after controlling for the impact of concurrent depressive symptoms. These results add to a growing body of research suggesting that peer victimization may increase risk for the development of cognitive vulnerability to depression in children.

Expressed emotion-criticism and risk of depression onset in children.

The primary goal of the current study was to examine the impact of maternal criticism (expressed emotion-criticism; EE-Crit) on the prospective development of depressive episodes in children. In addition to examining baseline levels of EE-Crit, we also sought to determine whether distinct subgroups (latent classes) of mothers could be identified based on the levels of EE-Crit they exhibited over a multiwave assessment and whether that latent class membership would predict depression onset in children. Finally, we examined whether EE-Crit and maternal depression would independently predict children's depression risk or whether EE-Crit would moderate the link between maternal depression and children's depression onset. Children of mothers with or without a history of major depression (N = 100) were assessed 5 times over 20 months. Children completed the Children's Depression Inventory and mothers completed the Five Minute Speech Sample and the Beck Depression Inventory at the baseline assessment, and at 2-, 4-, and 6-month follow-up assessments. Children and mothers completed diagnostic interviews assessing children's onsets of depressive episodes at the 20-month follow-up. Latent class analysis of the 4 waves of EE-Crit assessments revealed two distinct groups, exhibiting relatively lower versus higher levels of EE-Crit across the first 6 months of follow-up. EE-Crit latent class membership predicted children's depression onset over the subsequent 14 months. This finding was maintained after controlling for mother's and children's depressive symptoms during the initial 6 months of follow-up. Finally, maternal depression did not moderate the link between EE-Crit and childhood depression onset. Continued exposure to maternal criticism appears to be an important risk factor for depression in children, risk that is at least partially independent of the risk conveyed by maternal depression. These results highlight the importance of a modifiable risk factor for depression-repeated exposure to maternal criticism.

Stop talking about it already! Co-ruminating and social media focused on COVID-19 was associated with heightened state anxiety, depressive symptoms, and perceived changes in health anxiety during Spring 2020.

BACKGROUND: Social distancing presents a significant obstacle for relationships and threatens mental health. Identifying maladaptive, voluntary coping strategies may inform how to maintain interpersonal relationships and mental health during quarantine. Co-ruminating with peers on negative events, moods and fears has adjustment trade-offs of increasing depression and anxiety risk while also enhancing friendship quality. Similarly, social media use is associated with social benefits and risk to mental health. We extend prior research by examining whether co-ruminating on COVID-19, social media use, and social media use focused on COVID-19 during social isolation was associated with heightened depression and anxiety symptoms but also lower loneliness and higher social support during initial lockdown measures in the USA. METHODS: Adults were recruited through social media (n = 345) to complete self-report surveys on co-rumination, social media use, social distancing, social support from March-May 2020. During this cross-sectional assessment, in addition to completing surveys on current depressive symptoms and state and health anxiety, participants also provided retrospective report of their perceived health anxiety levels six months prior. RESULTS: Co-ruminating on COVID-19 with peers and greater time on social media focused on COVID-19 predicted perceived increases in health anxiety and were also associated with higher depressive symptoms and state anxiety, even after controlling for significant demographic predictors. Further, in the context of social distancing, both interaction strategies failed to confer social benefits. CONCLUSIONS: Results have direct implications for maintaining psychosocial health during social distancing restrictions. Adults may modify how they engage with peers by limiting COVID-19 content on social media and COVID-19 discussion.

Co-rumination and lifetime history of depressive disorders in children.

Co-rumination, the social process of frequently discussing and rehashing problems with peers, is hypothesized to increase risk for depression, particularly for girls. Although there is growing evidence for a relation between co-rumination and depressive symptoms in youth, it remains unclear whether these results generalize to diagnosable episodes of depression. Using a retrospective behavioral high-risk design with 81 children aged 9 to 14 years, we tested the hypothesis that children currently exhibiting high levels of co-rumination would be more likely to have a history of depressive diagnoses than children with low levels of co-rumination. The results supported this hypothesis. In addition, the link between co-rumination and history of depressive diagnoses was maintained even when we excluded children with current diagnoses and statistically controlled for children's current depressive symptoms, suggesting that the relation is not due simply to current levels of depression.

Cross system autonomic balance and regulation: Associations with depression and anxiety symptoms.

The autonomic nervous system (ANS) has demonstrated utility for identifying alterations in emotion processing associated with common psychopathology, including depression and anxiety. To date though the majority of this ANS research has several limitations. Most studies have examined parasympathetic and sympathetic branches separately, requiring activity in the other branch be inferred. This is problematic as each branch may function independently. Composite indices such as cardiac autonomic balance (CAB) and cardiac autonomic regulation (CAR) which examine the relative input between respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP) should provide more comprehensive measures of autonomic functioning and thus stronger predictors of psychopathology. However, the sympathetic branch is driven by multiple neurotransmitter systems, thus PEP does not necessarily reflect overall SNS arousal. We propose two new metrics for assessing ANS functioning associated with psychopathology: parasympathetic effects on cardiac control (RSA) relative to sympathetic effects on the eccrine system (electrodermal activity, EDA), which we term cross-system autonomic balance (CSAB) and regulation (CSAR). Eighty-five women (18-37) completed a baseline physiological assessment with parasympathetic (RSA) and sympathetic indices (PEP, EDA), along with self-reported depressive and anxiety symptoms. Lower CSAB, indicating sympathetic dominance driven by cholinergic neurotransmission, was associated with higher depressive and anxiety symptoms. Lower CAB indicating sympathetic dominance driven by beta-adrenergic neurotransmission was associated specifically with depressive symptoms. CSAB was a more robust index than RSA. Results support the utility of assessing multiple composite ANS indices for identifying physiological substrates of alterations in emotion regulation associated with internalizing disorders.

The autonomic correlates of dysphoric rumination and post-rumination savoring.

Trait dysphoric rumination is a transdiagnostic factor associated with depression and anxiety that has also been linked with blunted respiratory sinus arrhythmia (RSA), an index of reduced emotion regulation capacity. However, the autonomic correlates of state dysphoric rumination remain unclear. We examined the physiological correlates of state dysphoric rumination and the potential repairing effects of savoring on autonomic functioning. To provide a comprehensive assessment of autonomic correlates, we examined changes in parasympathetic (RSA) and sympathetic (cardiac pre-ejection period, PEP; and electrodermal activity, EDA) arousal independently, as well as autonomic coordination among indices. Eighty-two women (ages 18-25) completed laboratory physiological assessments, including rumination and savoring tasks, and self-report measures of trait rumination. Dysphoric rumination was associated with sympathetic activation (i.e., decreases in PEP, increases in EDA), and subsequent savoring following a recovery period also corresponded with decreases in PEP. Trait rumination did not predict autonomic changes during state rumination. However, higher trait rumination was associated with greater sympathetic coordination (PEP-EDA correspondence) during savoring. In summary, dysphoric rumination co-occurred with sympathetic activation, and subsequent savoring successfully recruited sympathetic activity (PEP) redirected on positive moods and events. Results also emphasize the utility of examining sympathetic and parasympathetic indices, and coordination among autonomic indices to delineate autonomic activity associated with emotion regulation strategies.

How anxious is too anxious? State and trait physiological arousal predict anxious youth's treatment response to brief cognitive behavioral therapy.

BACKGROUND: Exposure therapy is the gold standard for treating childhood anxiety, yet not all youth improve. Children do not always have insight on their distress, which can limit the utility of self-reported units of distress (SUDS) during exposures. Physiological assessment provides an objective means of monitoring emotional arousal. Electrodermal activity (EDA) in particular indexes sympathetic nervous system arousal which is heavily linked to anxiety. The aim of the current study was to examine the feasibility and utility of incorporating EDA assessment in an in-session exposure. We examined concordance between EDA and SUDS, and whether either predicted treatment response. METHODS: Thirty-four youth who met DSM-5 criteria for generalized, separation, and/or social anxiety disorder completed brief CBT (8 sessions) and completed a survey on trait physiological arousal. EDA and SUDS were collected from 18 youth (9 female, ages 9-14) during a mid-treatment exposure. Changes in anxiety severity were examined post-treatment. RESULTS: SUDS were not correlated with trait or state physiological arousal. There was a large association between heightened sympathetic arousal and poorer post-treatment response. Similarly, SUDS indices of greater fear activation and habituation were associated with poorer post-treatment response with a small to moderate effect size. Supplemental analyses among the full sample aligned: trait physiological arousal predicted poorer treatment response. CONCLUSIONS: The lack of concordance between sympathetic arousal and SUDS indices highlights the limitations of relying solely on SUDS with pediatric populations. EDA provided unique data on youth's distress during exposures. Thus, results indicate that physiological assessment may exhibit clinical utility for aiding clinicians in monitoring youth's progress in exposure therapy. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02259036.

Help me Feel Better! Ecological Momentary Assessment of Anxious Youths' Emotion Regulation with Parents and Peers.

Anxious youth often have trouble regulating negative affect (NA) and tend to over-rely on parents when faced with challenges. It is unclear how social interactions with parents or peers actually helps or hinders anxious youths' success in regulating NA. The aim of this study was to examine whether the success of anxious youths' emotion regulation strategies differed according to social context. We compared the effectiveness of co-ruminating, co-problem solving and co-distracting with parents/peers for regulating anxious youth's NA in response to stress in their daily lives. We also examined the benefit of attempting each strategy socially vs. non-socially (e.g., co-ruminating vs. ruminating). One-hundred-seventeen youth (9-14) with a current diagnosis of Separation Anxiety Disorder, Generalized Anxiety Disorder, and/or Social Phobia completed an ecological momentary assessment (14 calls over 5 days), reporting on recent stressors, their affective state, presence of others, and emotion regulation strategies within the prior hour. Mixed linear models revealed that co-distracting was the most effective social strategy for reducing NA, but only for boys. Co-rumination was the least effective social strategy for regulating NA. Regarding social context, only co-distracting was more effective for regulating NA over distracting alone, but only among anxious boys. Results suggest that co-rumination is an ineffective use of social support for regulating NA. Anxious boys may benefit from social support by co-distracting with parents/peers, but improper use may reflect avoidance and contribute to long-term anxiety maintenance. Results extend research on gender differences in interpersonal relationships and emotion regulation.

The influence of family factors on time to suicidal ideation onsets during the adolescent developmental period.

Family factors are associated with suicidal behavior in youth, but little is known about how the joint influence of multiple family factors prospectively predicts onsets of suicidal ideation (SI) in adolescence, a developmental period characterized by increases in SI and risk for suicide. This study investigated whether parent history of SI interacted with either positive or negative parent-child relationship quality to longitudinally predict time to SI onsets during the transition into and across adolescence. Specifically, we used a longitudinal, multi-wave design and survival analyses to examine whether the interaction between these family factors prospectively predicted time to emergence of SI onsets (assessed at 6 month intervals over 3 years) in a community sample of youth ages 8 to 15 (N = 238; 57% girls). Results supported an interaction effect, such that more negative relationship quality with parents predicted earlier emergence of SI among those youth whose parents had no history of SI. However, negative parent relationship quality did not amplify risk among youth with parent history of SI; all youth with a parent history of SI were more likely to experience earlier emergence of SI regardless of level of negative relationship quality. Findings did not support an interaction between low levels of parent-child positive relationship quality and parent history of ideation. Implications for the role of family factors in the etiology and prevention of SI are discussed.

History of childhood emotional abuse predicts lower resting-state high-frequency heart rate variability in depressed women.

Childhood emotional abuse impairs emotion regulation and increases risk for major depressive disorder in adulthood. Mounting evidence suggests that decreased resting-state high-frequency heart rate variability, an index of parasympathetic function, represents a transdiagnostic biomarker of emotion dysregulation. We propose that adults with histories of major depressive disorder and childhood emotional abuse represent a subpopulation at particularly high risk to exhibit deficits in parasympathetic control. The current report compared resting-state high-frequency heart rate variability across three groups: (1) depressed women who endorsed childhood emotional abuse (N = 11); (2) depressed women without childhood emotional abuse (N = 19), and (3) never-depressed women without childhood emotional abuse (N = 22). Participants completed childhood trauma self-reports and assessment of resting-state high-frequency heart rate variability. ANCOVAs comparing the three groups after controlling for health-related, psychiatric, and respiratory factors were significant. Depressed women with childhood emotional abuse exhibited lower high-frequency heart rate variability than both groups without childhood emotional abuse (d's ranging from 0.81-0.92). Surprisingly, psychiatric factors were non-significant predictors, indicating that childhood emotional abuse may have a unique impact on autonomic functioning. Future research on larger samples is needed to disentangle the relative and synergistic burdens of depression and childhood trauma on physiologic indicators of emotion dysregulation.

Neural correlates of autobiographical problem-solving deficits associated with rumination in depression.

BACKGROUND: Analytical rumination can be characterized as negative thoughts focused on searching for answers to personal problems. Failure to think concretely during autobiographical problem-solving (APS) is hypothesized to drive the inability of ruminators to generate effective solutions. Clarifying the brain correlates underlying APS deficits in depressed ruminators may identify novel biological targets for treatment. METHOD: Forty participants (22 unmedicated depressed and 18 never-depressed adults) ranging in rumination engaged in APS and negative self-referential processing (NSP) of negative trait adjectives during fMRI. We contrasted activation during APS with activation during NSP to isolate regions contributing to APS. RESULTS: Rumination was associated with having generated fewer solutions during APS and with a failure to recruit the angular gyrus (AG) and the medial frontal gyrus (MFG) during APS. Rumination was associated with greater MFG activation during NSP and stronger connectivity between the AG and the rostrolateral prefrontal cortex (RLPFC) during APS relative to NSP. Findings were not driven by clinical status. LIMITATIONS: The use of an extreme groups approach can result in overestimation of effects sizes. CONCLUSIONS: Ruminators fail to recruit regions with the default network (DN) that support APS. In particular, a failure to recruit the AG during APS may drive the abstract thinking style previously shown to explain depressed ruminator's difficulty generating concrete solutions. Targeting this mechanism directly may reduce rumination.

Adolescent inpatient girls׳ report of dependent life events predicts prospective suicide risk.

Adolescents with a history of suicidal behavior are especially vulnerable for future suicide attempts, particularly following discharge from an inpatient psychiatric admission. This study is the first to test whether adolescents׳ tendency to generate stress, or report more dependent events to which they contributed, was predictive of prospective suicide events. Ninety adolescent psychiatric inpatients who were admitted for recent suicide risk, completed diagnostic interviews, assessments of history of suicidal behavior, and a self-report questionnaire of major life events at baseline. Participants were followed over the subsequent 6 months after discharge to assess stability vs. onset of suicide events. Cox proportional hazard regressions were used to predict adolescents׳ time to suicide events. Results supported hypothesis, such that only recent greater dependent events, not independent or overall events, predicted risk for prospective suicide events. This effect was specific to adolescent girls. Importantly, dependent events maintained statistical significance as a predictor of future suicide events after co-varying for the effects of several established risk factors and psychopathology. Results suggest that the tendency to generate dependent events may contribute unique additional prediction for adolescent girls׳ prospective suicide risk, and highlight the need for future work in this area.

Co-rumination and co-problem solving in the daily lives of adolescents with major depressive disorder.

OBJECTIVE: This study examines differences in the prevalence and nature of co-rumination during real-world social interactions with peers and parents among adolescents with major depressive disorder (MDD) compared to healthy controls. METHOD: A total of 60 youth (29 with current MDD and 31 controls without psychopathology) completed a self-report measure of co-rumination and a 3-week ecological momentary assessment (EMA) protocol that measured the nature of face-to-face social interactions with peers and parents after a negative event in the adolescents' daily lives. Specifically, EMA was used to assess rates of problem talk, including both co-rumination and co-problem solving. Group differences in self-report and EMA measures were examined. RESULTS: Adolescents with MDD reported co-ruminating more often than adolescents with no Axis 1 disorders during daily interactions with both parents (Cohen's d = 0.78) and peers (d = 1.14), and also reported more co-rumination via questionnaire (d = 0.58). Adolescents with MDD engaged in co-problem solving with peers less often than did healthy controls (d = 0.78), but no group differences were found for rates of co-problem solving with parents. CONCLUSIONS: Results are consistent with previous research linking co-rumination and depression in adolescence and extend these self-report-based findings to assessment in an ecologically valid context. Importantly, the results support that MDD youth tend to co-ruminate more and to problem-solve less with peers in their daily lives compared to healthy youth, and that co-rumination also extends to parental relationships. Interventions focused on decreasing co-rumination with peers and parents and improving problem-solving skills with peers may be helpful for preventing and treating adolescent depression.