Prenatal Maternal Stress and Pediatric Asthma Across Development: Adolescent Female-Specific Vulnerability.

Prenatal maternal stress (PNMS) is linked to physical sequelae in offspring, including childhood asthma. This study sought to examine the roles of objective and subjective PNMS in the development of asthma at offspring ages 5 and 15. The sample included 815 mother-child dyads from the Mater Misericordiae Mothers' Hospital-University of Queensland Study of Pregnancy. PNMS was measured via retrospective self-report during pregnancy and 3-5 days after birth. Postnatal maternal stress was measured at offspring age 5. Objective PNMS was associated with elevated asthma risk at age 5 (OR 1.21, 95% CI 1.00, 1.45, p = 0.05), albeit not above concurrent postnatal stress. Sex moderated the association between PNMS and asthma at age 15, controlling for postnatal stress. Sex stratified analyses revealed a positive association between objective PNMS and age 15 asthma in females, but not males. Results provide evidence that PNMS may impact asthma outcomes in adolescence.

The Role of Positive and Negative Aspects of Life Events in Depressive and Anxiety Symptoms.

Negative or stressful life events are robust risk factors for depression and anxiety. Less attention has been paid to positive aspects of events and whether positivity buffers the impact of negative aspects of events. The present study examined positivity and negativity of interpersonal and non-interpersonal episodic life events in predicting anxiety and depressive symptoms in a sample of 373 young adults. Regressions tested main and interactive effects of positivity and negativity ratings of events in predicting symptom factors (Fears, Anhedonia-Apprehension (AA), General Distress (GD)) relevant to anxiety and depression. A significant interaction demonstrated that positivity protected against high levels of negativity of non-interpersonal events in predicting GD. A main effect of interpersonal negativity predicting higher AA was observed. Results for Fears were non-significant. Findings suggest that positivity of life events may buffer against negativity in predicting symptoms shared between anxiety and depression.

Examining the indirect contributions of irritability and chronic interpersonal stress on symptoms of anxiety and depression in adolescents.

BACKGROUND: Chronic interpersonal stress has been identified as predictive of anxiety and depression. However, more research is needed to understand predictors of chronic interpersonal stress and mediators of its relationship with anxiety and depression. Irritability, a transdiagnostic symptom closely related to chronic interpersonal stress, may provide more insight into this relationship. While some research has demonstrated that irritability is related to chronic interpersonal stress, directionality is unknown. A bidirectional relationship between irritability and chronic interpersonal stress was hypothesized, such that irritability mediates the relationship between chronic interpersonal stress and internalizing symptoms and chronic interpersonal stress mediates the relationship between irritability and internalizing symptoms. METHODS: This study used three cross-lagged panel models to investigate the indirect effects of irritability and chronic interpersonal stress on anxiety and depression symptoms using data from 627 adolescents (68.9 % female, 57.7 % white) over a six-year period. RESULTS: In partial support for our hypotheses, we found that the relationships between chronic interpersonal stress and both fears and anhedonia were mediated by irritability, and that the relationship between irritability and anhedonia was mediated by chronic interpersonal stress. LIMITATIONS: Study limitations include some temporal overlap in symptom measurements, an irritability measure that has not been previously validated to measure the construct, and lack of a lifespan perspective. CONCLUSIONS: More targeted approaches in intervention for both chronic interpersonal stress and irritability may improve prevention and intervention efforts to address anxiety and depression.

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.

Early Life Adversity and Clinical Intimate Partner Violence in Adulthood: The Mediating Role of Interpersonal Conflict in Adolescence.

Intimate partner violence (IPV) is associated with adverse outcomes for both victims and perpetrators, though there is significant heterogeneity in manifestations of relationship violence. A growing amount of research has focused on elucidating predictors of clinical IPV-defined as severe violence involving institutional or medical intervention due to actual or potential injury-so as to better understand potential prevention and intervention targets. Early life adversity (ELA) is associated with IPV in adulthood, yet this literature focuses on discrete, retrospectively reported adversities (e.g., physical abuse and neglect) and has yet to consider clinical IPV as an outcome. Little is known about if and how broadly adverse early environments may confer risk for this specific form of relationship violence. We investigated associations between exposure to ELA prior to age five and clinical IPV victimization and perpetration by age 20 in a longitudinal, community-based sample of men and women in Australia (N = 588). Early life adversity was prospectively indexed by maternal reports of financial hardship, child chronic illness, maternal stressful life events, maternal depressive symptoms, parental discord, and parental separation. Youth interpersonal conflict life events at age 15-an interviewer-rated assessment of episodic stressors involving conflict across relationships in mid-adolescence-was tested as a potential mediator for both victims and perpetrators. Among women, ELA predicted IPV victimization and perpetration, and interpersonal conflict life events partially mediated the link between ELA and victimization, but not perpetration. Neither ELA nor interpersonal conflict life events predicted victimization or perpetration among men. Women exposed to ELA are at-risk for conflictual interpersonal relationships later in life, including violent intimate relationships, and deficits in conflict resolution skills may be one mechanism through which ELA leads to IPV victimization among this subgroup. Violence prevention and intervention efforts should target interpersonal skills, including conflict resolution, among women and girls exposed to adverse early environments.

Romantic relationship status, stress, and maturing out of problematic drinking.

OBJECTIVE: The current study examined the unique influences of romantic relationship status and episodic and chronic stress associated with relationships in predicting changes in alcohol consumption and drinking motivations from college to post-college life. METHOD: Moderate to heavy college student drinkers reported their drinking level and drinking motives using an Internet-based daily diary for 30 days in college and again 5 years later. At the post-college wave, participants also completed a semi-structured phone-based interview to assess romantic relationship stress. RESULTS: Multiple regression analysis indicated that chronic relationship stress and relationship dissolution stress were uniquely related to mean daily levels of post-college drinking to cope (DTC) motivation, but not to mean daily levels of enhancement motivation. Some evidence was found for the effect of relationship status, but not stress, on mean daily heavy drinking levels. We also found evidence that chronic stress moderated the effect of relationship dissolution stress, with individuals showing higher mean daily chronic stress levels displaying a stronger positive association between relationship dissolution and post-college DTC motivation. CONCLUSIONS: Results are discussed in terms of how negative reinforcement processes might be an important mechanism underlying commonly found associations between romantic relationship status and problematic drinking during young adulthood. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Patterns of stress generation differ depending on internalizing symptoms, alcohol use, and personality traits in early adulthood: a five year longitudinal study.

BACKGROUND: Depression is thought to generate stressful life events. However, other internalizing symptoms such as anxiety or post-traumatic stress and individual difference variables such as personality traits and alcohol use may contribute to stressful life events. Whether stress generation is specific to depression or generalized to these other variables is unclear. Therefore, we tested whether stress generation was depression specific or generalizable to anxiety, PTSD, alcohol use, neuroticism, and extraversion. DESIGN: Two-wave longitudinal study with a five-year follow-up. METHODS: 917 young adults completed measures of internalizing symptoms, alcohol use, neuroticism, and extraversion during college and five years later along with an interview-based measure of life events. RESULTS: Symptoms of depression, anxiety, PTSD, and neuroticism exhibited bivariate predictive effects on interpersonal-dependent events. When considering internalizing symptoms in the aggregate, stress generation was specific to symptoms rather than neuroticism. Furthermore, interpersonal-dependent life events mediated Time 1 internalizing symptoms predicting Time 2 symptoms. CONCLUSION: Our results indicate that stress generation applies to internalizing symptoms broadly rather than specifically to depression. Moreover, neuroticism was no longer a significant predictor of life events when examined with internalizing symptoms simultaneously. These results support the value of integrative models that test numerous factors predicting stressful life events.

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.

HPA-axis multilocus genetic profile score moderates the association between maternal prenatal perceived stress and offspring depression in early adulthood.

Maternal stress during pregnancy can cause alterations to the fetal hypothalamus-pituitary-adrenal (HPA) axis, a phenomenon known as fetal programming that may have lasting effects on offspring outcomes, including depression. Evidence suggests that these effects may vary with respect to the offspring's genetic risk. Nonetheless, few studies have examined these effects into adulthood, when risk for depression onset is highest. The present study builds upon the extant literature by examining the interaction of maternal prenatal perceived stress (MPPS) and offspring HPA-axis polygenic risk to predict offspring depression in early adulthood. A total of 381 mother-child dyads participated in a prospective, longitudinal study that spanned from pregnancy until offspring were 20 years of age. Polygenic risk was defined by a multilocus genetic profile score (MGPS) that reflected the additive risk of three HPA-axis candidate genes. The results indicated that the interaction of MPPS and HPA-axis MGPS confers risk for offspring depression at age 20, in line with the differential susceptibility model. This interaction may be specific to prenatal stress, as maternal stress during early childhood did not interact with genetic risk to predict depression. These findings provide the first evidence that genetic variants that are associated with the HPA axis may act in a polygenic, additive fashion to moderate the association between fetal programming and adult depression.

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).

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.

Chronic Stress in Vocational and Intimate Partner Domains as Predictors of Depressive Symptoms After Breast Cancer Diagnosis.

BACKGROUND: After cancer diagnosis, depressive symptoms are elevated on average and decline over time, but substantial variability is apparent. Few studies have examined to what extent chronic stress in distinct life domains affects depressive symptoms. PURPOSE: Chronic stress in vocational and intimate partner life domains, and their interaction, were tested as predictors of depressive symptoms after breast cancer diagnosis. METHODS: Women (N = 460) completed validated interviews regarding chronic stress in specific life domains shortly after diagnosis and a measure of depressive symptoms every 6 weeks for 6 months. RESULTS: In latent growth curve modeling analyses, greater chronic stress in work (b = 2.90; p < .001) and intimate partner domains (b = 1.38, p = .02) was associated with higher depressive symptoms at study entry (intercept), and greater work stress predicted faster recovery from depressive symptoms over time (b = -0.10; p = .01). The two domains of chronic stress also interacted significantly on depressive symptoms at study entry (b = -1.54; p < .02) and over time (b = 0.14; p < .001). Greater work stress was associated with higher depressive symptoms at study entry regardless of intimate partner stress, but greater intimate partner stress was associated with higher depressive symptoms when work stress was low. The decline over 6 months in initially elevated depressive symptoms predicted by high work stress was significantly steeper when intimate partner stress was low. CONCLUSIONS: Targeting interventions to recently diagnosed breast cancer patients living with chronically stressful vocational and intimate partner life circumstances could be worthwhile.

A Daily Diary Investigation of the Influence of Early Family Adversity on Social Functioning during the Transition to Adulthood.

Early life stressors are associated with maladaptive social functioning in childhood and adolescence, but it is unclear whether and how the negative interpersonal effects of stress persist into adulthood. Daily diary surveys were used to examine young adults' social behavior and mood reactivity to social stressors as a function of experiences of early family adversity. Stressful early family environments predicted more daily reassurance seeking, but not aggression, withdrawal, or positive social behavior. Early family adversity also moderated the within-person effects of social stressors on next-day mood, such that individuals with high levels of adversity had elevated next-day negative affect in response to higher than average social stress. Findings highlight the enduring impact of early adversity on social development, with implications for developing targeted policies and interventions.

Independent and relative effects of stress, depressive symptoms, and affect on college students' daily health behaviors.

Stress and depressive symptoms are associated with maladaptive health behavior practices such as unhealthy eating, sedentary behavior, insufficient sleep, and substance use. The relative and interactive effects of stress and depressive symptoms on health behavior practices are less well understood. The present study examined these processes in a daily diary study of 127 college students. Results from hierarchical generalized linear models indicated that depressive symptoms, and chronic and daily stress, but not acute stressful life events, were significantly associated with a composite score of daily maladaptive health behavior engagement (depressive symptoms b = .01, SE= .00, p < .01; chronic stress, b = .03, SE= .01, p < .01; daily stress, b = .01, SE= .01, p = .02); unexpectedly, the effect of stress on health behaviors was not moderated by depressive symptoms. Additionally, results demonstrated that the effect of depressive symptoms on health behaviors was mediated by fluctuations in daily negative affect. These results bear implications for intervention during a crucial period in the development of mental and physical health.

Association of Maternal Depressive Symptoms and Offspring Physical Health in Low-Income Families.

Objectives The present study sought to examine the association between maternal depressive symptoms and characteristics of offspring physical health, including health status, health behaviors, and healthcare utilization, among low-income families. Maternal engagement was explored as a mediator of observed effects. Methods Cross-sectional survey data from a community sample of 4589 low-income women and their preschool-age children participating in the WIC program in Los Angeles County were analyzed using logistic, Poisson, and zero-inflated negative binomial regression. Mediation was tested via conditional process analyses. Results After controlling for the effects of demographic characteristics including maternal health insurance coverage, employment status, education, and preferred language, children of depressed women (N = 1025) were significantly more likely than children of non-depressed women (N = 3564) to receive a "poor" or "fair" maternal rating of general health (OR 2.34), eat fewer vegetables (IRR: 0.94) more sweets (IRR: 1.20) and sugary drinks daily (IRR: 1.32), and consume fast food more often (OR 1.21). These children were also less likely to have health insurance (OR 1.59) and more likely to receive medical care from a public medical clinic or hospital emergency room (OR 1.30). Reduced maternal engagement partially mediated associations between maternal depressive symptoms and several child health outcomes including poor diet, health insurance coverage, and use of public medical services. Conclusions for Practice Maternal depressive symptoms are associated with poor health among preschool-age children in low-income families. Prevention, screening, and treatment efforts aimed at reducing the prevalence of maternal depression may positively affect young children's health.

Transdiagnostic pathways from early social stress to psychopathology: a 20-year prospective study.

BACKGROUND: Adverse family environments confer susceptibility to virtually all psychiatric problems. This study evaluated two possible models to explain this diversity of associations. Stressful family circumstances during childhood could either activate general, transdiagnostic liabilities to mental disorder or promote numerous disorder-specific liabilities. METHODS: We recruited a high-risk sample of 815 mother-offspring pairs and assessed social stressors in the family context prospectively from the perinatal period through offspring age 5. We factor analyzed offspring mental disorder diagnoses at age 20 to parse transdiagnostic and disorder-specific dimensions of psychopathology. RESULTS: Structural analyses revealed nearly equivalent prospective effects of early family stress on overarching Internalizing (ß = .30) and Externalizing (ß = .29) dimensions. In contrast, there was no evidence of disorder-specific effects. CONCLUSIONS: Social stressors early in life activate transdiagnostic, and not disorder-specific, liabilities to psychopathology. A focus on higher-order dimensions of psychopathology could accelerate etiological research and intervention efforts for stress-linked mental disorders.

Risk Factors for Depression: An Autobiographical Review.

I have been given a priceless opportunity to reflect on my career in the remarkably productive field of risk factors for depression. Psychological research on depression exploded in the early years of my work. I try to give an account of the choices and challenges, and reflect on the influences, some calculated and some serendipitous, that determined the paths I have followed. I focus mostly on the robust depression risk factors that have influenced my research, including dysfunctional cognitions, stressful life events and circumstances, parental depression, interpersonal dysfunction, and being female, and I cover some of what I did but also the influential work of others. This is a selective review of depression research in the past 40 or so years, noting some of the big developments that set the stage for the remarkable activity that continues today. In the conclusion, there is a brief statement of aspirations for future developments in our field.

Parental Serotonin Transporter Polymorphism (5-HTTLPR) Moderates Associations of Stress and Child Behavior With Parenting Behavior.

The serotonin transporter-linked polymorphic region (5-HTTLPR) is associated with caregiving in nonhuman animals and with affective and cognitive correlates of human parenting, yet its association with human parenting is largely unknown. Using a well-characterized sample of parents and offspring, we evaluated the association of parental 5-HTTLPR with observed positive and negative parenting behavior, as well as its biologically plausible moderation of child-related stress and disruptive child behavior as predictors of parenting. One hundred and sixty-two parents (86% mothers) and their 6- to 9-year-old children with and without attention-deficit/hyperactivity disorder were ascertained using multiple methods including structured interviews, rating scales, and observed parent-child interaction, yielding strong measures of key constructs. Controlling for multiple youth-level (e.g., sex, 5-HTTLPR genotype, disruptive behavior) and parent-level (e.g., demographics, depression, attention-deficit/hyperactivity disorder) factors, parents with an S allele exhibited significantly less observed positive parenting than those with the LL genotype. Significant Gene × Environment interactions were also observed: Child-related stress was negatively associated with observed parental negativity among SS/SL genotype parents but not LL genotype parents; next, observed disruptive child behavior was positively associated with parental negativity for both genotypes, but the effect was strongest in SS/SL parents. These preliminary findings suggest that parental 5-HTTLPR is uniquely associated with positive and negative parenting behavior, with more specific patterns according to child-related stress and disruptive child behavior. We consider implications for future research evaluating genetic influences on parenting as well as considerations for designing and delivering parenting-based interventions.

Chronic and episodic stress predict physical symptom bother following breast cancer diagnosis.

Breast cancer patients often experience adverse physical side effects of medical treatments. According to the biobehavioral model of cancer stress and disease, life stress during diagnosis and treatment may negatively influence the trajectory of women's physical health-related adjustment to breast cancer. This longitudinal study examined chronic and episodic stress as predictors of bothersome physical symptoms during the year after breast cancer diagnosis. Women diagnosed with breast cancer in the previous 4 months (N = 460) completed a life stress interview for contextual assessment of chronic and episodic stress severity at study entry and 9 months later. Physical symptom bother (e.g., pain, fatigue) was measured at study entry, every 6 weeks through 6 months, and at nine and 12 months. In multilevel structural equation modeling (MSEM) analyses, both chronic stress and episodic stress occurring shortly after diagnosis predicted greater physical symptom bother over the study period. Episodic stress reported to have occurred prior to diagnosis did not predict symptom bother in MSEM analyses, and the interaction between chronic and episodic stress on symptom bother was not significant. Results suggest that ongoing chronic stress and episodic stress occurring shortly after breast cancer diagnosis are important predictors of bothersome symptoms during and after cancer treatment. Screening for chronic stress and recent stressful life events in the months following diagnosis may help to identify breast cancer patients at risk for persistent and bothersome physical symptoms. Interventions to prevent or ameliorate treatment-related physical symptoms may confer added benefit by addressing ongoing non-cancer-related stress in women's lives.