Electrocortical Reactivity during Self-Referential Processing Predicts the Development of Depression across Adolescence.

BACKGROUND: Negative attentional biases and self-schemas have been implicated in the development of depression. Research has indicated that a larger late positive potential (LPP) to negative self-referential words is associated with depression-as well as a maternal history of depression, an indicator of risk. However, it is unclear whether the LPP to self-referential words predicts the actual development of depression. The present study examined whether electrocortical reactivity during self-referential processing predicts the development of depression across adolescence. METHODS: The sample consisted of 165 8 to 14-year-old girls with no lifetime history of a depressive disorder who completed the self-referential encoding task (SRET) while electroencephalography was recorded at a baseline assessment. Participants and their parent completed the Kiddie Schedule for Affective Disorders and Schizophrenia for School Aged Children at the baseline, 2-year, 4-year, and 6-year follow-up assessments. RESULTS: Results indicated that a larger LPP to negative self-referential words at baseline predicted an increased likelihood of developing chronic-intermittent depression (i.e., persistent and/or recurrent), but not non-chronic, single episode depression, across adolescence. In contrast, neither SRET recall biases nor the LPP to positive self-referential words predicted the development of either type of depression. CONCLUSIONS: The present study suggests that electrocortical reactivity associated with a negative self-schema in late childhood predicts the development of a more pernicious subtype of depression across adolescence. Moreover, the present study highlights the importance of considering clinical course in the examination of biomarkers of risk for depression.

The associations among sleep-related difficulties, anxiety, and error-related brain activity in youth.

Given the high prevalence of anxiety disorders and their associated impairment, elucidating neural mechanisms related to these disorders has been increasingly prioritized. The error-related negativity (ERN) has been identified as a neural marker that indexes risk for anxiety across development. The ERN seems to confer risk for developing anxiety, especially in the context of stressful life events. The present study sought to examine sleep-related difficulties as another stressful factor that might impact the ERN. In a sample of 221 girls, aged 8 to 15 years old, we first examined the relationship between longer-term (i.e., over the past month) and shorter-term (i.e., over the past week) sleep difficulties and the ERN. We then investigated whether specific sleep difficulties uniquely predict the ERN. In exploratory analyses, we assessed whether sleep difficulties moderate the relationship between the ERN and anxiety. Results indicated that youth who report longer-term lower sleep duration, longer-term worse sleep, and shorter-term lower sleep duration on school days over the past week have a larger (i.e., more negative) ERN. Additionally, only shorter-term sleep duration on school days over the past week uniquely predicted the ERN. Finally, an elevated ERN predicted greater clinical anxiety in the context of longer-term sleep difficulties. Future studies should clarify the direction of these associations via longitudinal designs.

Antenatal anxiety symptoms outperform antenatal depression symptoms and suicidal ideation as a risk factor for postpartum suicidal ideation.

BACKGROUND AND OBJECTIVES: Suicidal ideation (SI) during the postpartum phase is linked with suicide, a leading cause of death during this period. Antenatal depression and anxiety symptoms have both been linked with increased risk for postpartum SI. However, research aimed at examining the relative contributions of antenatal anxiety and depression symptoms towards postpartum SI remains nascent. In this study, we investigated the relative contribution of antenatal anxiety symptoms, depression symptoms, and SI towards postpartum SI. DESIGN: These data are from a longitudinal study in which American mothers were assessed during pregnancy and again at six- to eight weeks postpartum. METHODS: Data were analyzed using correlations and logistic regression models. RESULTS: Antenatal anxiety symptoms and antenatal depression symptoms were significantly correlated with postpartum SI. Results from a logistic regression model indicated that antenatal anxiety symptoms (T1; OR = 1.185 [1.125, 1.245], p = .004), but not antenatal depression symptoms (T1; OR = 1.018 [0.943, 1.093], p = .812) or antenatal SI (T1; OR = 1.58 [0.11, 22.29], p = 0.73), were significantly associated with postpartum SI. CONCLUSIONS: Antenatal anxiety symptoms, depression symptoms, and SI were positively associated with postpartum SI. When examined simultaneously, anxiety symptoms during the antenatal phase (but not depression symptoms or SI) predicted SI in the postpartum phase.

Neural response to monetary and social rewards and familial risk for psychopathology in adolescent females.

BACKGROUND: Adolescence is a key developmental period for the emergence of psychopathology. Reward-related brain activity increases across adolescence and has been identified as a potential neurobiological mechanism of risk for different forms of psychopathology. The reward positivity (RewP) is an event-related potential component that indexes reward system activation and has been associated with both concurrent and family history of psychopathology. However, it is unclear whether the RewP is also associated with higher-order psychopathology subfactors and whether this relationship is present across different types of reward. METHODS: In a sample of 193 adolescent females and a biological parent, the present study examined the association between adolescent and parental psychopathology subfactors and adolescent RewP to monetary and social reward. RESULTS: Results indicated that the adolescent and parental distress subfactors were negatively associated with the adolescent domain-general RewP. The adolescent and parental positive mood subfactors were negatively associated with the adolescent domain-general and domain-specific monetary RewP, respectively. Conversely, the adolescent and parental fear/obsessions subfactors were positively associated with the adolescent domain-general RewP. The associations between parental and adolescent psychopathology subfactors and the adolescent RewP were independent of each other. CONCLUSIONS: The RewP in adolescent females is associated with both concurrent and parental psychopathology symptoms, suggesting that it indexes both severity and risk for higher-order subfactors.

Examining Blunted Initial Response to Reward and Recent Suicidal Ideation in Children and Adolescents Using Event-Related Potentials: Failure to Conceptually Replicate Across Two Independent Samples.

A recent study by Tsypes and colleagues (2019) found that children with recent suicidal ideation had blunted neural reward processing, as measured by the reward positivity (RewP), compared to matched controls, and that this difference was driven by reduced neural responses to monetary loss, rather than to reward. Here, we aimed to conceptually replicate and extend these findings in two samples (n = 264, 27 with suicidal ideation; and n = 314, 49 with suicidal ideation at baseline) of children and adolescents (11 to 15 years and 8 to 15 years, respectively). Results from both samples showed no evidence that children and adolescents with suicidal ideation have abnormal reward or loss processing, nor that reward processing predicts suicidal ideation two years later. The results highlight the need for greater statistical power, as well as continued research examining the neural underpinnings of suicidal thoughts and behaviors.

The free-viewing matrix task: A reliable measure of attention allocation in psychopathology.

Aberrant attention allocation has been implicated in the etiology and maintenance of a range of psychopathologies. However, three decades of research, relying primarily on manual response-time tasks, have been challenged on the grounds of poor reliability of its attention bias indices. Here, in a large, multisite, international study we provide reliability information for a new eye-tracking-based measure of attention allocation and its relation to psychopathology and age. Data from 1567 participants, across a wide range of psychiatric diagnoses and ages, were aggregated from nine sites around the world. Of these, 213 participants also provided retest data. Acceptable overall internal consistency and test-retest reliability were observed among adult participants (Cronbach's alpha = 0.86 and r(213) = 0.89, respectively), as well as across all examined psychopathologies. Youth demonstrated lower internal consistency scores (Cronbach's alpha = 0.65). Finally, the percent dwell time index derived from the task statistically differentiated between healthy participants and participants diagnosed with social anxiety disorder, major depression, and post-traumatic stress disorder. These results potentially address a long-standing reliability crisis in this research field. Aberrant attention allocation patterns in a variety of psychiatric disorders may be targeted with the hope of affecting symptoms. The attention allocation index derived from the matrix task offers reliable means to measure such cognitive target engagement in clinical contexts.

Effort and Appetitive Responding in Depression: Examining Deficits in Motivational and Consummatory Stages of Reward Processing Using the Effort-Doors Task.

Background: Reward sensitivity is a dimensional construct central to understanding the nature of depression. Psychophysiological research on this construct has primarily focused on the reward positivity, an event-related potential (ERP) that indexes consummatory reward sensitivity. This study extended prior research by focusing on ERPs that index the motivational component of reward. Methods: A novel effort-for-reward task was used to elicit motivational and consummatory ERPs. Groups consisting of 34 participants with depression and 32 participants without depression were compared across a range of reward-related ERPs. Results: Participants with depression exhibited reduced responsivity to effort completion cues following high effort expenditure, reduced anticipation of rewards after low effort expenditure (i.e., the stimulus preceding negativity), and reduced reward positivity following high effort expenditure. ERPs occurring prior to reward receipt accounted for unique variance in depression status and differentiated between subgroups of depressed individuals. Conclusions: Findings support the utility of leveraging multiple ERPs that index separate reward processing deficits to better characterize depression and depressive subtypes.

Cumulative lifetime acute stressor exposure interacts with reward responsiveness to predict longitudinal increases in depression severity in adolescence.

BACKGROUND: Life stress and blunted reward processing each have been associated with the onset and maintenance of major depressive disorder. However, much of this work has been cross-sectional, conducted in separate lines of inquiry, and focused on recent life stressor exposure, despite the fact that theories of depression posit that stressors can have cumulative effects over the lifespan. To address these limitations, we investigated whether acute and chronic stressors occurring over the lifespan interacted with blunted reward processing to predict increases in depression over time in healthy youth. METHOD: Participants were 245 adolescent girls aged 8-14 years old (Mage = 12.4, s.d. = 1.8) who were evaluated at baseline and two years later. The reward positivity (RewP), an event-related potential measure of reward responsiveness, was assessed at baseline using the doors task. Cumulative lifetime exposure to acute and chronic stressors was assessed two years later using the Stress and Adversity Inventory for Adolescents (Adolescent STRAIN). Finally, depressive symptoms were assessed at both baseline and follow-up using the Children's Depression Inventory. RESULTS: As hypothesized, greater lifetime acute stressor exposure predicted increases in depressive symptoms over two years, but only for youth exhibiting a blunted RewP. This interaction, however, was not found for chronic stressors. CONCLUSIONS: Lifetime acute stressor exposure may be particularly depressogenic for youth exhibiting a blunted RewP. Conversely, a robust RewP may be protective in the presence of greater acute lifetime stressor exposure.

The balance N1 and the ERN correlate in amplitude across individuals in small samples of younger and older adults.

The error-related negativity (ERN) is a neural correlate of error monitoring often used to investigate individual differences in developmental, mental health, and adaptive contexts. However, limited experimental control over errors presents several confounds to its measurement. An experimentally controlled disturbance to standing balance evokes the balance N1, which we previously suggested may share underlying mechanisms with the ERN based on a number of shared features and factors. We now measure whether the balance N1 and ERN are correlated across individuals within two small groups (N = 21 young adults and N = 20 older adults). ERNs were measured in arrow flanker tasks using hand and foot response modalities (ERN-hand and ERN-foot). The balance N1 was evoked by sudden slip-like movements of the floor while standing. The ERNs and the balance N1 showed good and excellent internal consistency, respectively, and were correlated in amplitude in both groups. One principal component strongly loaded on all three evoked potentials, suggesting that the majority of individual differences are shared across the three ERPs. However, there remains a significant component of variance shared between the ERN-hand and ERN-foot beyond what they share with the balance N1. It is unclear whether this component of variance is specific to the arrow flanker task, or something fundamentally related to error processing that is not evoked by a sudden balance disturbance. If the balance N1 were to reflect error processing mechanisms indexed by the ERN, balance paradigms offer several advantages in terms of experimental control over errors.

Drinking alcohol by mid-adolescence is related to reduced reward reactivity: Novel evidence of positive valence system alterations in early initiating female youth.

Initiation of alcohol use at younger ages is prognostic of later drinking problems. Reward system dysfunction is theorized to contribute to early initiation and escalation of drinking, but existing evidence supports both hyposensitivity and hypersensitivity as risk-markers; research employing effective indices of reward processing is needed for clarification. The reward positivity (RewP) is a well-established neurophysiological index of hedonic "liking," an important aspect of reward processing. Adult research has yielded conflicting findings, with different studies reporting reduced, enhanced, or null associations of RewP with engagement in or risk for harmful alcohol use. No study has examined relations between RewP and multiple indices of drinking in youth. Here, we examined how RewP measured in a gain/loss feedback task related to self-reported drinking initiation and past-month drinking, when accounting for age along with depression and externalizing symptoms, in 250 mid-adolescent females. Analyses showed that (1) compared to not-yet drinkers, adolescents endorsing drinking initiation responded less strongly to monetary gain (RewP) but not loss feedback (FN), and (2) past-month drinking was unrelated to both RewP and FN magnitude. These findings provide evidence for reduced hedonic "liking" as a concomitant of early drinking initiation in adolescent females and warrant further research with mixed-sex adolescent samples exhibiting greater drinking variability.

Deficits in doors P300 amplitude during adolescence associated with preschool-onset depression.

The psychophysiological underpinnings of preschool-onset depression (PO-MDD) remain underexplored. Moreover, there is currently a limited understanding of the potential impact that PO-MDD might have on neurobiological functions later in development such as general cognitive domains and reward processing. Thus, the current study sought to examine potential neurophysiological differences, measured via electroencephalography (EEG), in adolescents with and without a history of PO-MDD. Participants and their caregivers (N = 138) from a large longitudinal study completed semi-structured clinical interviews at a baseline visit (ages 3-7) to determine PO-MDD status. At a follow-up visit approximately 11 years later, adolescents (ages 13-19) completed the doors gambling task while EEG was recorded to measure event-related potentials (ERPs) elicited by both the doors and feedback stimuli, to index cognitive and reward processing functions (i.e., doors-P300, gain/loss feedback-P300, and RewP). Adolescents with a history of PO-MDD exhibited significantly smaller doors-P300 compared with adolescents with no history of PO-MDD, whereas there were no group differences in gain/loss feedback-P300 or RewP. Additionally, reduced doors-P300 was independently associated with lower baseline income-to-needs ratio, older age, and female gender. The current study suggests that reduced doors-P300 amplitude during adolescence might reflect impaired neurophysiological development related to PO-MDD. Thus, the P300 derived from the doors stimuli might be a valuable neural measure to further our understanding of potential neurophysiological differences associated with early-onset childhood depression.

Relational victimization prospectively predicts increases in error-related brain activity and social anxiety in children and adolescents across two years.

Recent research has focused on identifying neural markers associated with risk for anxiety, including the error-related negativity (ERN). An elevated ERN amplitude has been observed in anxious individuals from middle childhood onward and has been shown to predict risk for future increases in anxiety development. The ERN is sensitive to environmental influences during development, including interpersonal stressors. Of note, one particular type of interpersonal stressor, relational victimization, has been related to increases in anxiety in adolescents. We tested whether relational victimization predicts increases in the ERN and social anxiety symptoms across two years in a sample of 152 child and adolescent females (ages 8 - 15). Results indicated that children and adolescents' baseline ERN was positively related to the ERN two years later. Furthermore, greater relational victimization at baseline predicted greater increases in the ERN two years later, controlling for baseline ERN. Moreover, relational victimization at baseline predicted increases in social anxiety, and this relationship was mediated by increases in the ERN. These results suggest that relational victimization impacts the developmental trajectory of the neural response to errors and thereby impacts increases in social anxiety among children and adolescents.

Neurophysiology of predictable unpleasant event processing in pre-adolescents and early adolescents, part II: Reflex and event-related potential markers of defensive reactivity and peripheral attention modulation.

The ability to anticipate and process predictable unpleasant events, while also regulating emotional reactivity, is an adaptive skill. The current article and a companion in this issue test for potential changes in predictable event processing across the childhood-to-adolescence transition, a key developmental period for biological systems that support cognitive/ emotional abilities. While the companion article focuses on neurophysiology of predictable event processing itself, the present article examines peripheral emotional response regulation and attention modulation that coincides with event processing. A total of 315 third-, sixth-, or ninth-grade individuals saw 5-s cues predicting "scary," "every day," or uncertain pictures, and here, blink reflexes and brain event-related potentials (ERPs) elicited by peripheral noise probes are analyzed. During the cue, blink reflexes and probe ERP (P200) amplitudes were increased when the cue predicted scary, compared to everyday, content. After picture onset, reflex enhancement by scary content then disappeared for predictable images, whereas ERP modulation was similar regardless of predictability. Patterns are similar to those in adults and suggest (1) sustained defensive response priming and enhancement of peripheral attention during aversive anticipation, and (2) an ability, even in pre-adolescents, to downregulate defensive priming while maintaining attentional modulation once an awaited predictable aversive event occurs.

Neurophysiology of predictable unpleasant event processing in preadolescents and early adolescents, part I: Event-related potential markers of unpleasant image anticipation and processing.

The ability to anticipate and process predictable unpleasant events, while also regulating emotional reactivity, is an adaptive skill. The current article and a companion in this issue test for potential changes in predictable event processing across the childhood-to-adolescence transition, a key developmental period for biological systems that support cognitive/emotional abilities. While the companion article focuses on emotion regulation and peripheral attention modulation in predictable unpleasant contexts, the current paper presents neurophysiological markers of predictable event processing itself. 315 third-, sixth-, or ninth-grade individuals saw 5-s cues predicting "scary," "every day," or uncertain image content; in this paper, cue- and picture-locked event-related potentials (ERPs) are analyzed. During the cue, early ERP positivities were increased and later slow-wave negativities were reduced when predicted content was scary as compared with mundane. After picture onset, a picture processing-related positivity was then increased for scary compared with everyday images regardless of predictability. Cue-interval data suggest enhanced processing of scary cues and reduced anticipatory processing of scary images-opposite to adults. After event onset, meanwhile, emotional ERP enhancement regardless of predictability is similar to adults and suggests that even preadolescent individuals maintain preferential engagement with unpleasant events when they are predictable.

A longitudinal examination of the protective effect of resilience against anxiety among older adults with high COVID-related worry.

This longitudinal study of community dwelling older adults (N = 453) examined consequences of COVID-related worries on changes in anxiety symptoms before relative to during the pandemic. We further evaluated if pre-COVID psychological resilience (PR) buffered the impact of COVID-related worry. Pre-COVID data were collected in September 2018. COVID-related worry and COVID anxiety symptoms were collected in October 2020 (Wave 2). Controlling for pre-COVID anxiety symptoms, we examined if COVID-related worries (e.g. I'm worried that I might die from COVID-19) were associated with increased anxiety symptoms, and whether pre-COVID PR moderated the association between COVID-related worries and prospective increases in anxiety symptoms. COVID-related worries were associated with increased anxiety symptoms (ß = 0.005, p < .01), whereas pre-COVID PR was associated with a decrease in anxiety symptoms (ß = -0.029, p < .05). PR moderated the association; COVID-related worries were associated with greater increases in anxiety symptoms among those with low pre-COVID PR (Model η2 = 0.35). Thus, the extent to which COVID-related worries influenced psychological health was dependent on pre-COVID levels of PR. We conclude the combined vulnerabilities of low pre-COVID PR and high COVID-related worries significantly increased the psychological consequences of COVID-19 for our sample of older adults.

Longitudinal Associations Between Reward Responsiveness and Depression Across Adolescence.

OBJECTIVE: Lower neural response to reward predicts subsequent depression during adolescence. Both pubertal development and biological sex have important effects on reward system development and depression during this period. However, relations among these variables across the transition from childhood to adolescence are not well characterized. METHOD: Depressive symptoms, pubertal status, and the reward positivity (RewP) event-related potential component, a neural indicator of reward responsivity, were assessed in 609 community-recruited youth at 9, 12, and 15 years of age. Structural equation modeling was used to examine concurrent and prospective relations within and between depression and reward responsiveness as well as the influence of pubertal status and biological sex on these variables across assessments. RESULTS: Stability paths for depression, the RewP, and pubertal status were significant across assessments. Compared with male participants, female participants reported more advanced pubertal status at all assessments, a smaller RewP at age 9, and higher levels of depression at age 15. More advanced pubertal status was associated with a larger RewP at age 15. Most importantly, there were bidirectional prospective effects between the RewP and depression from ages 12 to 15; a lower RewP at age 12 predicted increases in depression at age 15, whereas increased depression at age 12 predicted a lower RewP at age 15. CONCLUSION: These findings indicate that there are bidirectional prospective effects between reward responsiveness and depression that emerge between ages 12 and 15. This may be a crucial time for studying bidirectional reward responsiveness-depression associations across time.

Influences of age and pubertal development on P300 amplitude trajectory across two years in female adolescents.

The P300 event-related potential (ERP) has been extensively studied across the human lifespan. However, many studies examining age-related effects are cross-sectional, and few have considered the unique role that pubertal development may have on P300 developmental trajectories. The current study examined whether age, pubertal maturation or their interaction predicted changes in P300 amplitude over two years among 129 females between the ages of 8 and 15 years at baseline. Participants completed a flanker task while EEG was recorded at a baseline and two-year follow-up visit. Both baseline age and increased pubertal development were associated with smaller P300 amplitude at follow-up. However, the influence of age was qualified by an interaction between age and pubertal maturation: among younger girls only, increased pubertal development predicted decreases in P300, whereas decreased pubertal development predicted increases in P300. These data indicate that pubertal timing impacts neurodevelopmental changes in P300 amplitude - such that high versus low pubertal development among 8- to 10-year-old girls predicted differential trajectories of neural activity. In light of links between reduced P300 and mental health disorders, such as depression, future studies might examine whether neurodevelopmental changes influenced by early-onset pubertal development could account for increases in these mental health problems.

Neural deficits in anticipatory and consummatory reward processing are uniquely associated with current depressive symptoms during adolescence.

Deficits within the consummatory phase of reward processing are associated with increased depression symptoms and risk; however, few studies have also examined other aspects of reward processing in relation to depression. In the current study, a community sample of 121 adolescents (Mage  = 13.1, Min = 11.14; Max = 15.12; 54% male) completed self-report questionnaires to assess depressive symptoms and the monetary incentive delay (MID) task while EEG was recorded. Results indicated that a reduced cue-P300 as well as a reduced reward positivity (RewP) and feedback negativity (FN) to gain and loss feedback, respectively, were associated with increased depressive symptoms; on the other hand, SPN and feedback P300 were unrelated to depressive symptoms. An exploratory multiple regression analysis revealed that a reduced money cue-P300, a reduced RewP, and a reduced (i.e., less negative) FN, all explained unique variance in depressive symptoms. The current study demonstrates that reduced cue-P300, RewP, and FN amplitudes may reflect distinct deficits in reward processing among adolescents with increased depressive symptoms. Notably, this study is one of the first to leverage the MID task in adolescents in relation to depressive symptoms, allowing for a more in-depth view of the individual differences in reward processing among adolescents with increased depressive symptomatology.