Embodied Decision-Making Style: Below and Beyond Cognition.

There is growing recognition of the essential role of sensorimotor processes as not just a supporter of the cognitive aspects of decision making, but rather as a foundation for all the coordinated physical and mental activities that go into how we make decisions. We illuminate concepts and methods for examining embodied decision making through the lens of Movement Pattern Analysis (MPA). MPA is as a prime example of a conceptually rooted observational methodology for deciphering embodied decision making and for decoding how people differ as decision makers with respect to cognitive motivational priorities. The historical origins of MPA that predated the formalized recognition of embodied cognition are presented, along with an overview of both the theoretical model and methodology. Advances in research on two psychometric benchmarks of observational research-inter-rater reliability and predictive validity-are highlighted as an empirical platform for the strong promise of MPA as a tool for understanding individual differences in embodied decision-making style. Future directions for research are considered-specifically with respect to the potential for utilizing automated coding, and the need for collaborative neuroscience research efforts-which would support further understanding of how decoding movement patterning captures human motivation at the level of sensory, motoric, cognitive and action integration which drives how people function as decision makers.

Beyond Self-Report: Emerging Methods for Capturing Individual Differences in Decision-Making Process.

People vary in the way in which they approach decision-making, which impacts real-world behavior. There has been a surge of interest in moving beyond reliance on self-report measures to capture such individual differences. Particular emphasis has been placed on devising and applying a range of methodologies that include experimental, neuroscience, and observational paradigms. This paper provides a selective review of recent studies that illustrate the methods and yield of these approaches in terms of generating a deeper understanding of decision-making style and the notable differences that can be found across individuals.

Inter-rater reliability for movement pattern analysis (MPA): measuring patterning of behaviors versus discrete behavior counts as indicators of decision-making style.

The unique yield of collecting observational data on human movement has received increasing attention in a number of domains, including the study of decision-making style. As such, interest has grown in the nuances of core methodological issues, including the best ways of assessing inter-rater reliability. In this paper we focus on one key topic - the distinction between establishing reliability for the patterning of behaviors as opposed to the computation of raw counts - and suggest that reliability for each be compared empirically rather than determined a priori. We illustrate by assessing inter-rater reliability for key outcome measures derived from movement pattern analysis (MPA), an observational methodology that records body movements as indicators of decision-making style with demonstrated predictive validity. While reliability ranged from moderate to good for raw counts of behaviors reflecting each of two Overall Factors generated within MPA (Assertion and Perspective), inter-rater reliability for patterning (proportional indicators of each factor) was significantly higher and excellent (ICC = 0.89). Furthermore, patterning, as compared to raw counts, provided better prediction of observable decision-making process assessed in the laboratory. These analyses support the utility of using an empirical approach to inform the consideration of measuring patterning versus discrete behavioral counts of behaviors when determining inter-rater reliability of observable behavior. They also speak to the substantial reliability that may be achieved via application of theoretically grounded observational systems such as MPA that reveal thinking and action motivations via visible movement patterns.

Parental smoking exposure and adolescent smoking trajectories.

OBJECTIVE: In a multigenerational study of smoking risk, the objective was to investigate the intergenerational transmission of smoking by examining if exposure to parental smoking and nicotine dependence predicts prospective smoking trajectories among adolescent offspring. METHODS: Adolescents (n = 406) ages 12 to 17 and a parent completed baseline interviews (2001-2004), and adolescents completed up to 2 follow-up interviews 1 and 5 years later. Baseline interviews gathered detailed information on parental smoking history, including timing and duration, current smoking, and nicotine dependence. Adolescent smoking and nicotine dependence were assessed at each time point. Latent Class Growth Analysis identified prospective smoking trajectory classes from adolescence into young adulthood. Logistic regression was used to examine relationships between parental smoking and adolescent smoking trajectories. RESULTS: Four adolescent smoking trajectory classes were identified: early regular smokers (6%), early experimenters (23%), late experimenters (41%), and nonsmokers (30%). Adolescents with parents who were nicotine-dependent smokers at baseline were more likely to be early regular smokers (odds ratio 1.18, 95% confidence interval 1.05-1.33) and early experimenters (odds ratio 1.04, 95% confidence interval 1.04-1.25) with each additional year of previous exposure to parental smoking. Parents' current non-nicotine-dependent and former smoking were not associated with adolescent smoking trajectories. CONCLUSIONS: Exposure to parental nicotine dependence is a critical factor influencing intergenerational transmission of smoking. Adolescents with nicotine-dependent parents are susceptible to more intense smoking patterns and this risk increases with longer duration of exposure. Research is needed to optimize interventions to help nicotine-dependent parents quit smoking early in their children's lifetime to reduce these risks.

Influences of tobacco advertising exposure and conduct problems on smoking behaviors among adolescent males and females.

INTRODUCTION: Adolescents with conduct problems are more likely to smoke, and tobacco advertising exposure may exacerbate this risk. Males' excess risk for conduct problems and females' susceptibility to advertising suggest gender-specific pathways to smoking. We investigated the associations between gender, conduct problems, and lifetime smoking and adolescents' exposure to tobacco advertising, and we examined prospective relationships with smoking behaviors. METHODS: Adolescents completed baseline (2001-2004; n = 541) and 5-year follow-up (2007-2009; n =320) interviews for a family study of smoking risk. Baseline interviews assessed conduct problems and tobacco advertising exposure; smoking behavior was assessed at both timepoints. Generalized linear models analyzed gender differences in the relationship between conduct problems, advertising exposure, and smoking behavior at baseline and longitudinally. RESULTS: At baseline, among males, conduct problems were associated with greater advertising exposure independent of demographics and lifetime smoking. Among females at baseline, conduct problems were associated with greater advertising exposure only among never-smokers after adjusting for demographics. In longitudinal analyses, baseline advertising exposure predicted subsequent smoking initiation (i.e., smoking their first cigarette between baseline and follow-up) for females but not for males. Baseline conduct problems predicted current (i.e., daily or weekly) smoking at follow-up for all adolescents in adjusted models. CONCLUSIONS: The findings of this study reinforce that conduct problems are a strong predictor of subsequent current smoking for all adolescents and reveal important differences between adolescent males and females in the relationship between conduct problems, tobacco advertising behavior, and smoking behavior. The findings suggest gender-specific preventive interventions targeting advertising exposure may be warranted.

Predicting individual differences in decision-making process from signature movement styles: an illustrative study of leaders.

There has been a surge of interest in examining the utility of methods for capturing individual differences in decision-making style. We illustrate the potential offered by Movement Pattern Analysis (MPA), an observational methodology that has been used in business and by the US Department of Defense to record body movements that provide predictive insight into individual differences in decision-making motivations and actions. Twelve military officers participated in an intensive 2-h interview that permitted detailed and fine-grained observation and coding of signature movements by trained practitioners using MPA. Three months later, these subjects completed four hypothetical decision-making tasks in which the amount of information sought out before coming to a decision, as well as the time spent on the tasks, were under the partial control of the subject. A composite MPA indicator of how a person allocates decision-making actions and motivations to balance both Assertion (exertion of tangible movement effort on the environment to make something occur) and Perspective (through movements that support shaping in the body to perceive and create a suitable viewpoint for action) was highly correlated with the total number of information draws and total response time-individuals high on Assertion reached for less information and had faster response times than those high on Perspective. Discussion focuses on the utility of using movement-based observational measures to capture individual differences in decision-making style and the implications for application in applied settings geared toward investigations of experienced leaders and world statesmen where individuality rules the day.

Behavioral resilience in the post-genomic era: emerging models linking genes with environment.

One of the most important deliverables of the post-genomic era has been a new and nuanced appreciation of how the environment shapes-and holds potential to alter-the expression of susceptibility genes for behavioral dimensions and disorders. This paper will consider three themes that have emerged from cutting-edge research studies that utilize newer molecular genetic approaches as well as tried-and-true genetic epidemiological methodologies, with particular reference to evolving perspectives on resilience and plasticity. These themes are: (1) evidence for replicable and robust shared environmental effects on a number of clinically relevant behaviors in childhood and adolescence; (2) evolving research on gene-environment interaction; and (3) a newer focus on differential susceptibility and plasticity. The net sum of these themes is that consideration of genetic effects on behavioral dimensions and disorders needs to be connected to thinking about the role of environment as a potent source for promoting resilience and change.

Genetic and environmental influences upon the CBCL/6-18 DSM-oriented scales: similarities and differences across three different computational approaches and two age ranges.

Inasmuch as the newly established DSM-oriented CBCL/6-18 scales are to be increasingly employed to assess clinical/high-risk populations, it becomes important to explore their aetiology both within the normal- and the extreme range of variation in general population samples and to compare the results obtained in different age groups. We investigated by the Quantitative Maximum Likelihood, the De Fries-Fulker, and the Ordinal Maximum Likelihood methods the genetic and environmental influences upon the five DSM-oriented CBCL/6-18 scales in 796 twins aged 8-17 years belonging to the general population-based Italian Twin Registry. When children were analysed together regardless of age, most best-fitting solutions yielded genetic and non-shared environmental factors as the sole influences for DSM-oriented CBCL/6-18 behaviours, both for the normal and the extreme variations. When analyses were conducted separately for two age groups, shared environmental influences emerged consistently for Affective and Anxiety Problems in children aged 8-11. Oppositional-Defiant, Attention Deficit/Hyperactivity, and Conduct Problems appeared-with few exceptions-influenced only by genetic and non-shared environmental factors in both age groups, according to all three computational approaches. The De Fries-Fulker method appeared to be more sensitive in detecting shared environmental effects. Analysing the same set of data with different analytic approaches leads to better-balanced views on the aetiology of psychopathological behaviours in the developmental years.

Anxiety sensitivity as a predictor of the clinical course of panic disorder: a 1-year follow-up study.

BACKGROUND: There is evidence that negative affect (NA) and anxiety sensitivity (AS) predict the development of anxiety disorders, particularly panic disorder (PD). The main purpose of this study was to examine whether NA and AS will also predict the clinical course of PD. METHODS: Participants were 136 individuals with a DSM-III-R diagnosis of PD (with or without agoraphobia) enrolled in a naturalistic and longitudinal study of anxiety disorders, the Harvard/Brown Anxiety Research Project (HARP). Participants were administered the Anxiety Sensitivity Index and the Negative Affect Scales of the Positive and Negative Affect Schedule-Expanded Form (PANAS-X-NA) and their percentage of time in PD episode was followed for 1 year after the administration of the measures. RESULTS: Multiple regression analyses indicated that AS, but not NA, was a significant predictor of percentage of time in PD episode after controlling for previous time in PD episodes, comorbid depression, other anxiety disorders, and exposure to psychopharmacological and behavioral treatments. As expected, the Physical Concerns subscale of the Anxiety Sensitivity Index had a significant independent contribution in predicting the course of the disorder. CONCLUSIONS: Overall, these findings suggest that AS, as a unique construct, may be predictive of the amount of time patients are in episode of PD.

Parental smoking and adolescent smoking initiation: an intergenerational perspective on tobacco control.

OBJECTIVE: Adolescence is an important period of risk for the development of lifelong smoking behaviors. Compelling, although inconsistent, evidence suggests a relationship between parental smoking and the risk of smoking initiation during adolescence. This study investigates unresolved issues concerning the strength and nature of the association between parent smoking and offspring smoking initiation. METHODS: We enrolled 564 adolescents aged 12 to 17, along with 1 of their parents, into the New England Family Study between 2001 and 2004. Lifetime smoking histories were obtained from parents and their adolescent offspring. Discrete-time survival analysis was used to investigate the influence of parental smoking histories on the risk of adolescent smoking initiation. RESULTS: Parental smoking was associated with a significantly higher risk of smoking initiation in adolescent offspring. In addition, the likelihood of offspring smoking initiation increased with the number of smoking parents and the duration of exposure to parental smoking, suggesting a dose-response relationship between parental smoking and offspring smoking. Offspring of parents who had quit smoking were no more likely to smoke than offspring of parents who had never smoked. The effects of parental smoking on offspring initiation differed by sex (with a stronger effect of fathers' smoking on boys than girls), developmental period (with a stronger effect of parental smoking before the adolescent was age 13 than afterward), and residence of parents (with effects of fathers' smoking being dependent on living in the same household as the adolescent). Parental smoking was also associated with stronger negative reactions to adolescents' first cigarette, a potential marker of the risk of progression to higher levels of use. CONCLUSIONS: Parental smoking is an important source of vulnerability to smoking initiation among adolescents, and parental smoking cessation might attenuate this vulnerability.

Sibling Contagion for Drinking in Adolescence: A Micro Process Framework.

Siblings represent an important social influence on alcohol use in adolescence. That said, there is a need for studies that examine potential mechanisms by which siblings exert an influence on the likelihood of drinking in adolescence. This paper illustrates a method that utilizes videotaped interaction between sibling dyads along with a micro social coding system that captures rule break behavior between siblings. Sibling interaction was observed in sibling pairs participating in the Iowa Youth and Families Project (IYFP) at baseline; younger sibling use of alcohol was tracked for 3 additional annual assessments. Exposure to older sibling rule break at baseline was associated with later use of alcohol by younger siblings across the 3 annual assessments. Micro social methods hold promise for uncovering processes that underlie sibling contagion for alcohol use in adolescence.

Incorporating the family as a critical context in genetic studies of children: implications for understanding pathways to risky behavior and substance use.

The availability of candidate gene markers for biobehavioral traits will undoubtedly result in increasing attention to genetic influences in studies of childhood risk factors for health behaviors. However, a strict emphasis on genomics without consideration of the social contexts that give rise to risky behaviors will miss opportunities to understand more fully the powerful effect of the family on childhood development. This article discusses the rationale for using the family as a critical context for studying the translation of genetic propensity for risky behavior into developmental pathways that span childhood and adolescence. Attention is given to the importance of family environmental factors; the emerging literature on genetic influences on potential intermediate phenotypes; the need for rich and detailed characterizations of both phenotypes and environmental risk factors embedded within genomic studies of children; and implications for interventions and preventions aimed at risky behaviors. Via discussion of these issues, pragmatic considerations of how studying families as a context may facilitate the thoughtful inclusion of children into genetic paradigms are emphasized.

Use of benzodiazepines and selective serotonin reuptake inhibitors in middle-aged and older adults with anxiety disorders: a longitudinal and prospective study.

OBJECTIVE: The purpose of this study was to examine the use of benzodiazepines (BZs) and selective serotonin reuptake inhibitors/selective norepinephrine reuptake inhibitors (SSRIs/SNRIs) over nine years of follow-up in middle-aged and older adults with diagnoses of panic disorder with or without agoraphobia, social phobia, or generalized anxiety disorder. SETTING AND PARTICIPANTS: Participants in this study were enrolled in the Harvard/Brown Anxiety Research Project (HARP). HARP is a naturalistic, longitudinal, multisite study of adults with anxiety disorders who are recruited from psychiatric settings. The analytic sample consisted of 51 participants with anxiety disorders who were 55 to 70 years old at baseline and a younger cohort of 211 participants added for comparative analysis. DESIGN: The authors examined patterns of medication use (BZs and SSRIs/SNRIs) in participants with anxiety disorders as they aged, by assessing the proportion of participants taking these medications using generalized estimating equation modeling. MEASUREMENTS: The present data were derived from the structured diagnostic interview administered at enrollment using a combination of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Third Edition-R Non-Affective Disorder, Patient Version, Research Diagnostic Criteria Schedule for Affective Disorders-Lifetime, and subsequent follow-up interviews over a nine-year period using the Longitudinal Interval Follow-up Evaluation-Pharmacia & Upjohn to assess the weekly course of disorders to indicate syndrome severity and document medication use by specific type and dose on a weekly basis. RESULTS: Findings showed that rates of BZ use were high among both the older (53% at baseline) and the younger (57.4%) age groups and did not significantly decrease over time, after controlling for time in episode of their anxiety disorders. There was a statistically significant increase in SSRI/SNRI use over time in both groups. At the beginning of the study, 18% of the older group and 21% of the younger group were using SSRIs/SNRIs; however, at the end of the study, the rates increased to 35% and 43%, respectively. CONCLUSIONS: Although there was an increase in SSRI/SNRI use in older participants with anxiety disorders over the course of study, at nine years of follow-up, only 35% of participants were utilizing SSRI/SNRI medication, while more than one-half of the same participants were continuing to use BZs. To the authors' knowledge, there are no randomized clinical trials that have addressed comparative efficacy and safety of BZs and SSRIs/SNRIs in this population. However, there is documented evidence of adverse effects of chronic BZ use and the risk of developing dependency in older populations.

A twin study of smoking, nicotine dependence, and major depression in men.

This study examined the nature of the relationship among lifetime major depression, smoking, and nicotine dependence. Subjects were 8,169 male twins from the Vietnam Era Twin Registry. Biometrical modeling demonstrated a genetic influence on daily smoking, nicotine dependence, and major depression, and a family environmental influence on daily smoking. Genetic factors influencing nicotine dependence also strongly influenced major depression. We also compared probands with a history of major depression (n = 398) from pairs discordant for major depression, their nondepressed cotwins (n = 364), and controls (n = 1,863) on a number of secondary smoking outcomes. Major depression was associated with current daily smoking and certain nicotine withdrawal symptoms. Individuals with a familial vulnerability for major depression, even without a personal history of major depression, were more likely to smoke despite a serious illness and to report nervousness, restlessness, difficulty concentrating, and depressed mood during past quit attempts. Among the 237 monozygotic pairs discordant for major depression, depressed probands were more likely to have a lifetime history of nicotine dependence than were cotwins. Findings extend Kendler and colleague's (1993) study of female twins by demonstrating in men that shared genetic factors predispose not only to major depression and daily smoking but also to major depression and nicotine dependence.

Educational attainment and cigarette smoking: a causal association?

BACKGROUND: Despite abundant evidence that lower education is associated with a higher risk of smoking, whether the association is causal has not been convincingly established. METHODS: We investigated the association between education and lifetime smoking patterns in a birth cohort established in 1959 and followed through adulthood (n = 1311). We controlled for a wide range of potential confounders that were measured prior to school entry, and also estimated sibling fixed effects models to control for unmeasured familial vulnerability to smoking. RESULTS: In the full sample of participants, regression analyses adjusting for multiple childhood factors (including socioeconomic status, IQ, behavioural problems, and medical conditions) indicated that the number of pack-years smoked was higher among individuals with less than high school education [rate ratio (RR) = 1.58, confidence interval (CI) = 1.31, 1.91]. However, in the sibling fixed effects analysis the RR was 1.23 (CI = 0.80, 1.93). Similarly, adjusted models estimated in the full sample showed that individuals with less than high school education had fewer short-term (RR = 0.40; CI = 0.23, 0.69) and long-term (RR = 0.59; CI = 0.42, 0.83) quit attempts, and were less likely to quit smoking (odds ratio = 0.34; CI = 0.19, 0.62). The effects of education on quitting smoking were attenuated in the sibling fixed effects models that controlled for familial vulnerability to smoking. CONCLUSIONS: A substantial portion of the education differential in smoking that has been repeatedly observed is attributable to factors shared by siblings that contribute to shortened educational careers and to lifetime smoking trajectories. Reducing disparities in cigarette smoking, including educational disparities, may therefore require approaches that focus on factors early in life that influence smoking risk over the adult life span.

Effects of progression to cigarette smoking on depressed mood in adolescents: evidence from the National Longitudinal Study of Adolescent Health.

AIMS: To investigate the relationship between smoking status and continuously distributed depressed mood among a cohort of adolescents. DESIGN: Quasi-experimental design, selecting the subset of adolescents who reported never having smoked a cigarette at baseline, some of whom progressed subsequently to smoking at follow-up approximately 1 year later. SETTING: Data were drawn from the National Longitudinal Study of Adolescent Health, an ongoing study designed to assess the health status of adolescents, and explore the causes of adolescent health-related behaviours. PARTICIPANTS: Nationally representative sample of adolescents from the USA (n = 12 149), including a subsample who reported never having smoked a cigarette at baseline (n = 5475), aged on average 15 years at baseline and of predominantly European ancestry. MEASUREMENTS: Logistic and linear regression models controlling for potential confounders to explore the relationship between smoking status and depressed mood measured using the Centers for Epidemiological Studies Depression Scale (CES-D). FINDINGS: Various relationships between smoking status and depressed mood were observed, with a general trend for these effects to be greater among females. Smoking status at baseline did not significantly predict CES-D score at follow-up, although this effect approached significance in females (P = 0.077). Among never smokers at baseline, level of depressed mood at baseline predicted subsequent progression to smoking initiation (P = 0.022) but not progression to regular smoking (P = 0.229). Among never smokers at baseline, progression to smoking initiation during the follow-up period was associated with higher CES-D scores at follow-up, even after adjusting for baseline depressed mood (P < 0.001), with this effect greater for females than for males. Among those who initiated smoking, progression to regular smoking was associated with higher CES-D score at follow-up among females (P = 0.001), but not males (P = 0.966). CONCLUSIONS: These data appear to support a complex model of the relationship between depressed mood and smoking status which includes elements of both confounding and causal models. The relationship between cigarette smoking and depression may be a factor in the development of subsequent dependence.

Impact of parental history of substance use disorders on the clinical course of anxiety disorders.

BACKGROUND: Among the psychological difficulties seen in children of parents with substance use problems, the anxiety disorders are among the most chronic conditions. Although children of alcoholic parents often struggle with the effects of parental substance use problems long into adulthood, empirical investigations of the influence of parental substance use disorders on the course of anxiety disorders in adult offspring are rare. The purpose of this study was to examine prospectively the relationship between parental substance use disorders and the course of anxiety disorders in adulthood over the course of 12 years. METHODS: Data on 618 subjects were derived from the Harvard/Brown Anxiety Research Project (HARP), a longitudinal naturalistic investigation of the clinical course of multiple anxiety disorders. Kaplan-Meier survival estimates were used to calculate probabilities of time to anxiety disorder remission and relapse. Proportional hazards regressions were conducted to determine whether the likelihood of remission and relapse for specific anxiety disorders was lower for those who had a history of parental substance use disorders than for individuals without this parental history. RESULTS: Adults with a history of parental substance use disorders were significantly more likely to be divorced and to have a high school level of education. History of parental substance use disorder was a significant predictor of relapse of social phobia and panic disorders. CONCLUSION: These findings provide compelling evidence that adult children of parents with substance use disorders are more likely to have relapses of social phobia and panic disorders. Clinicians who treat adults with anxiety disorders should assess parental substance use disorders and dependence histories. Such information may facilitate treatment planning with regards to their patients' level of vulnerability to perceive scrutiny by others in social situations, and ability to maintain a long-term panic-free state.

Childhood-onset bipolar disorder: Evidence for increased familial loading of psychiatric illness.

OBJECTIVE: To determine whether childhood-onset bipolar disorder (BP) is associated with an increased psychiatric family history compared with adolescent-onset BP. METHOD: Semistructured psychiatric interviews were conducted for 438 youth with BP spectrum disorders. To evaluate the effects of age at onset and psychiatric family history, the sample was divided into childhood-onset BP (age and BP onset <12 years; n = 192), adolescents with early-onset BP (age > or =12 years and BP onset <12 years; n = 136), and adolescents with late-onset BP (age and BP onset > or =12 years; n = 110). Lifetime family history of psychiatric illness was ascertained for first- and second-degree relatives through both direct interview of caretakers and the Family History Screen. RESULTS: After significant demographic and clinical factors were controlled for, children and adolescents with childhood-onset BP showed higher percentages of positive first-degree family history for depression, anxiety, attention-deficit/hyperactivity, conduct, and substance dependence disorders and suicidal behaviors compared with adolescents with late onset. Subjects with childhood-onset BP also showed elevated familial loading for depression and attention-deficit/hyperactive disorder in second-degree relatives. CONCLUSIONS: These data support a model that postulates a higher density of familial risk for a broad range of psychopathology in childhood-onset BP.

Psychotic symptoms in pediatric bipolar disorder and family history of psychiatric illness.

BACKGROUND: Few studies have examined the specificity and non-specificity in patterns of familial loading for presentation of psychotic symptoms in pediatric bipolar disorder (BP). METHODS: Diagnostic assessment of 263 pediatric BP probands included lifetime history of psychotic symptoms as well as longitudinal follow-up; family history of psychiatric illness was determined for 1st degree relatives. RESULTS: Pediatric BP probands with lifetime history of psychosis had a higher percentage of positive family history of anxiety disorders and suicide attempts as compared to probands with no history of psychosis. DISCUSSION: Familial loading for a spectrum of internalizing disorders is associated with presentation of psychotic symptoms in pediatric BP.

Estimating genetic and environmental influences on depressive symptoms in adolescence: differing effects on higher and lower levels of symptoms.

We estimate the relative effect sizes of genetic and environmental influences on both higher and lower levels of depressive symptoms with attention to persistence over a 1-year period in the genetically informative subsample of adolescents participating in the National Longitudinal Study of Adolescent Health (Add Health). Shared environmental effects were significant for persistent higher levels of depressive symptoms but not nonpersistent symptoms. Genetic effects were significant for both persistent and nonpersistent lower levels of depressive symptoms. Nongenetic factors that promote similarity between siblings for high levels of depressive symptoms are important and should be considered in both etiological and applied research. Genetic contributions to lack of susceptibility to depression should be considered in biological models of depression suppression.