Danielle Keenan-Miller

Patterns of Adolescent Depression to Age 20: The Role of Maternal Depression and Youth Interpersonal Dysfunction

Considerable research has focused on youth depression, but further information is needed to characterize different patterns of onset and recurrence during adolescence. Four outcome groups by age 20 were defined (early onset-recurrent, early-onset-desisting, later-onset, never depressed) and compared on three variables predictive of youth depression: gender, maternal depression, and interpersonal functioning. Further, it was hypothesized that the association between maternal depression and youth depression between 15 and 20 is mediated by early-onset depression and interpersonal dysfunction by age 15. Eight hundred sixteen community youth selected for depression risk by history (or absence) of maternal depression were interviewed at age 15, and 699 were included in the 5-year follow-up. Controlling for gender, early onset and interpersonal dysfunction mediated the link between maternal depression and late adolescent major depression. Different patterns for males and females were observed. For males maternal depression’s effect was mediated by early onset but not interpersonal difficulties, while for females maternal depression’s effect was mediated by interpersonal difficulties but not early onset. Maternal depression did not predict first onset of major depression after age 15. The results suggest the need for targeting the impact of maternal depression’s gender-specific effects on early youth outcomes, and also highlight the different patterns of major depression in youth and their likely implications for future course of depression.

Chronic and Acute Stress, Gender, and Serotonin Transporter Gene-Environment Interactions Predicting Depression Symptoms in Youth.

BACKGROUND Many recent studies of serotonin transporter gene by environment effects predicting depression have used stress assessments with undefined or poor psychometric methods, possibly contributing to wide variation in findings. The present study attempted to distinguish between effects of acute and chronic stress to predict depressive symptoms at age 20 among 346 youth varying in polymorphisms of the 5HTT gene who had been assessed at ages 15 and 20. METHODS Interview measures assessed major acute life events between 15 and 19, and multiple interviews and questionnaires with youths and their parents at youth age 15 provided an index of chronic family stress. Lg alleles were reclassified as S. RESULTS Chronic family stress at age 15 predicted higher depression scores at 20 among those with one or two S alleles, and the effects of genetic moderation were significant only for females. Gene-environment interactions with acute stress were nonsignificant. CONCLUSIONS Careful measurement and separation of the effects of chronic and acute stress, and gender, are encouraged in the study of mechanisms of the stress-depression association.

Early onset recurrent subtype of adolescent depression: clinical and psychosocial correlates

BACKGROUND Evaluated trajectories of adolescent depression and their correlates in a longitudinal study of a community sample: early onset (by age 15) with major depression (MDE) recurrence between 15 and 20; early onset with no recurrence; later onset of major depression after age 15 with and without recurrence by 20; and never-depressed. METHODS Eight-hundred sixteen youth were studied at age 15, and 699 were included at age 20, with diagnostic evaluations and assessments of functioning in major roles. RESULTS Youth with early onset and recurrent MDE differed from both those with early onset but nonrecurrent MDE and those with later onset-no recurrence in terms of clinical features, adolescent social functioning, and later psychosocial adjustment. The early onset recurrent depressed youth had more severe, chronic, suicidal depressions, greater anxiety comorbidity, worse social functioning at 15, and poorer psychosocial, especially social, outcomes at 20. CONCLUSIONS Youth with depression by 15 with recurrence by age 20 may represent a high-risk group, with likely life-course-persistent depression and maladjustment. Community youth whose early depression does not recur by age 20, or who have onset with no recurrence after age 15, may have more benign and possibly limited depressions. Later onset with recurrence is also a group at risk for dysfunctional outcomes, requiring further follow-up.

Adolescent Psychosocial Risk Factors for Severe Intimate Partner Violence in Young Adulthood.

The authors examined prospective measures of psychosocial risk factors as predictors of severe intimate partner violence among a community sample of 610 young adults at risk for intergenerational transmission of depression. The hypothesized risk factors were youth history of depression by age 15 and maternal history of depression. Youth social functioning at age 15 was tested as a mediator of these associations. Results showed that youth history of depression by age 15 predicted victimization at age 20. Severe violence perpetration was predicted by maternal depressive history among women but not men. Youth social functioning was a partial mediator of both associations. In sum, the findings suggest that psychosocial factors observed in adolescence may contribute to the risk of experiencing severe intimate partner violence during young adulthood.

Coaction of stress and serotonin transporter genotype in predicting aggression at the transition to adulthood.

Despite consistent evidence that serotonin functioning affects stress reactivity and vulnerability to aggression, research on serotonin gene–stress interactions (G × E) in the development of aggression remains limited. The present study investigated variation in the promoter region of the serotonin transporter gene (5-HTTLPR) as a moderator of the stress–aggression association at the transition to adulthood. Multiple informants and multiple measures were used to assess aggression in a cohort of 381 Australian youth (61% female, 93% Caucasian) interviewed at ages 15 and 20. At age 20, semistructured interviews assessed acute and chronic stressors occurring in the past 12 months. Structural equation modeling analyses revealed a significant main effect of chronic stress, but not 5-HTTLPR or acute stress, on increases in aggression at age 20. Consistent with G × E hypotheses, 5-HTTLPR short allele carriers demonstrated greater increments in aggression following chronic stress relative to long allele homozygotes. The strength of chronic stress G × E did not vary according to sex. Variation at 5-HTTLPR appears to contribute to individual differences in aggressive reactions to chronic stress at the transition to adulthood.

Inflammatory cytokines and nuclear factor-kappa B activation in adolescents with bipolar and major depressive disorders

UNLABELLED Adults with bipolar disorder (BD) and major depressive disorder (MDD) have higher circulating levels of proinflammatory cytokines than healthy controls. However, it is not known whether pediatric-onset patients with BD or MDD show increases in levels of inflammation or activation of nuclear factor kappa B (NF-κB), a key transcription factor in inflammatory signaling. Circulating levels of inflammatory cytokines, as well as spontaneous and stimulated levels of activated NF-κB in total peripheral blood mononuclear cells, monocytes and lymphocytes were measured in adolescents with BD (n=18), MDD (n=13), or no psychiatric history (n=20). Participants had a range of mood symptoms at time of testing. Adolescents with BD had significantly higher spontaneous levels of NF-κB in peripheral blood mononuclear cells, monocyte and lymphocyte populations, and higher plasma levels of IL-1β than healthy controls. Following stimulation with recombinant human TNF-α, participants with BD and MDD both had greater increases in NF-κB in monocytes than controls. Further, greater stimulated increases of NF-κB in monocytes were associated with the current severity of depressive symptoms. The results are limited by the small sample and cross-sectional design. Interventions that target early immunological dysregulation should be examined in relation to long-term outcomes in youth with bipolar and depressive disorders. CLINICAL TRIAL REGISTRATION INFORMATION Early Intervention for Youth at Risk for Bipolar Disorder, https://clinicaltrials.gov/ct2/show/NCT01483391.

Negative interpersonal events mediate the relation between borderline features and aggressive behavior: findings from a nonclinical sample of undergraduate women

Interpersonal dysfunction and aggression are features that are frequently found in individuals with borderline personality disorder (BPD); however, few studies have examined the possible causal relationship between aggressive actions and interpersonal problems. In a nonclinical sample of 98 women with a range of BPD features, the present study examined the prospective relationship between aggressive behaviors and negative interpersonal events using a weekly diary method. Results showed that higher BPD symptoms were related to higher aggression and more negative interpersonal events. Furthermore, the aggressive acts endorsed among women with more BPD features were more likely the effect, rather than the cause, of the negative interpersonal events they experienced. Implications for interventions targeting aggression among women with elevated BPD features and suggestions for future research are discussed.

Mediators of aggression among young adult offspring of depressed mothers

The current article explores the connection between maternal depression and offspring aggression during the transition to adulthood, expanding the scope of prior research on this topic. Both family-level factors (including parent-child relationship quality and maternal romantic relationship quality) and youth factors (including depression history and social functioning in midadolescence) were tested as potential mediators in a longitudinal community sample of 710 youth at ages 15 and 20. The results suggest that maternal depression confers a risk for higher levels of aggressive behavior by offspring at age 20. Structural equation models suggested that the association between maternal depression and youth aggression is fully mediated by youth history of depression by midadolescence, even when accounting for the stability of aggression between ages 15 and 20. Parent-child relationship quality, youth social functioning, and maternal relationship quality were not unique mediators of this association. Limitations and implications are discussed.