John R. Z. Abela

Rumination as a Vulnerability Factor to Depression During the Transition From Early to Middle Adolescence: A Multiwave Longitudinal Study

The current study examined vulnerability to depression during the transition from early to middle adolescence from the perspective of the response styles theory. During an initial assessment, 382 adolescents (ages 11-15 years) completed self-report measures assessing rumination and depressive symptoms as well as a semistructured clinical interview assessing current and past major depressive episodes. Every 3 months for the subsequent 2 years, adolescents completed self-report measures assessing depressive symptoms and negative events. Every 6 months, adolescents completed a semistructured clinical interview assessing the onset of new major depressive episodes. Higher levels of rumination were associated with a greater likelihood of exhibiting a past history of major depressive episodes, a greater likelihood of experiencing the onset of a future major depressive episode, and greater duration of future depressive episodes. Consistent with a vulnerability-stress perspective, rumination moderated the association between the occurrence of negative events and the development of future depressive symptoms and major depressive episodes.

Nonsuicidal self-injury in adolescence: Prospective rates and risk factors in a 2 !year longitudinal study

Little is known about which risk factors longitudinally predict non-suicidal self-injury (NSSI) during adolescence, a period when these self-injurious behaviors become alarmingly prevalent. We prospectively studied the rates, course, and longitudinal prediction of NSSI from early through middle adolescence with a community sample of 103 youth (ages 11-14) who were assessed for NSSI at baseline and 2 ½ years later (94% retention; final N=97). Multiple risk factors (temperament, cognitive and interpersonal vulnerabilities, stressors; youths and mothers depression) were examined as prospective predictors of NSSI over the 2½ year follow-up. Analyses showed that 18% of youth engaged in NSSI over the 2½-year follow-up; 14% for the first time. Distal risks (assessed at baseline) that differentiated youth who engaged in NSSI from those who did not included negative cognitive style and mothers prior depression. Proximal factors (assessed 2 years after baseline) that differentiated NSSI from non-NSSI youth included stressors, depressive symptoms, poor relationship quality, excessive reassurance seeking, and mothers onset of depression. Several of these factors predicted new engagement of NSSI over 2½ years.

Hypothalamic-Pituitary-Adrenal Axis Dysregulation in Dysphoric Children and Adolescents: Cortisol Reactivity to Psychosocial Stress from Preschool Through Middle Adolescence

BACKGROUNDnMost depressed adults exhibit dysregulation of the hypothalamic-pituitary-adrenal axis, including cortisol hyperreactivity to psychosocial challenge. In contrast, remarkably little is known about hypothalamic-pituitary-adrenal axis activity in response to psychosocial challenge among at-risk children and adolescents. This study examined cortisol response to psychosocial challenge in nondepressed, at-risk, dysphoric and nondysphoric control youth across different developmentally salient age groups (preschool, third-, sixth-, and ninth-graders).nnnMETHODSnTwo samples of youth (Study 1-preschoolers; Study 2-third-, sixth-, and ninth-graders) without a history of clinical depression were administered developmentally appropriate psychosocial challenges. Of these nondepressed children, we examined youth at high-risk (n = 60) and low-risk (n = 223) status, as defined by elevated but subthreshold dysphoric symptoms according to multiple informants. Cortisol levels were assessed before and after a psychosocial stressor.nnnRESULTSnNondysphoric control youth at all ages displayed the expected cortisol rise to challenge followed by return to baseline. However, prepubertal, at-risk, dysphoric children--specifically preschoolers and third-graders--exhibited cortisol hyporeactivity to challenge, whereas postpubertal dysphoric adolescents (ninth-graders) displayed hyperreactivity to the stressor. Additional analyses revealed that this switch from cortisol hyporeactivity to hyperreactivity among at-risk, dysphoric youth occurred as a function of pubertal development.nnnCONCLUSIONSnFindings suggest a developmental switch in cortisol response for at-risk, dysphoric youth from preschool through adolescence and have implications for a developmental pathophysiological understanding of how at-risk youth across the lifespan might develop depressive disorder.

Rates of Nonsuicidal Self-Injury in Youth: Age, Sex, and Behavioral Methods in a Community Sample

OBJECTIVE: The goal was to assess the rate and behavioral methods of nonsuicidal self-injury (NSSI) in a community sample of youth and examine effects of age and sex. METHODS: Youth in the third, sixth, and ninth grades (ages 7–16) at schools in the community were invited to participate in a laboratory study. A total of 665 youth (of 1108 contacted; 60% participation rate) were interviewed about NSSI over their lifetime via the Self-Injurious Thoughts and Behaviors Interview. RESULTS: Overall, 53 (8.0%) of the 665 youth reported engaging in NSSI; 9.0% of girls and 6.7% of boys reported NSSI engagement; 7.6% of third-graders, 4.0% of sixth-graders, and 12.7% of ninth-graders reported NSSI engagement. There was a significant grade by gender interaction; girls in the ninth grade (19%) reported significantly greater rates of NSSI than ninth-grade boys (5%). Behavioral methods of NSSI differed by gender. Girls reported cutting and carving skin most often, whereas boys reported hitting themselves most often. Finally, 1.5% of youth met some criteria for the proposed fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnosis of NSSI. CONCLUSIONS: Children and adolescents engage in NSSI. Ninth-grade girls seem most at risk, as they engage in NSSI at 3 times the rate of boys. Behavioral methods of NSSI also vary by grade and gender. As possible inclusion of an NSSI diagnosis in the fifth edition of the DSM-5 draws near, it is essential to better understand NSSI engagement across development and gender.

Differential susceptibility in youth: evidence that 5-HTTLPR x positive parenting is associated with positive affect 'for better and worse'

Positive affect has been implicated in the phenomenological experience of various psychiatric disorders, vulnerability to develop psychopathology and overall socio-emotional functioning. However, developmental influences that may contribute to positive affect have been understudied. Here, we studied youths’ 5-HTTLPR genotype and rearing environment (degree of positive and supportive parenting) to investigate the differential susceptibility hypothesis (DSH) that youth carrying short alleles of 5-HTTLPR would be more influenced and responsive to supportive and unsupportive parenting, and would exhibit higher and lower positive affect, respectively. Three independent studies tested this gene–environment interaction (GxE) in children and adolescents (age range 9–15 years; total N=1874). In study 1 (N=307; 54% girls), positive/supportive parenting was assessed via parent report, in study 2 (N=197; 58% girls) via coded observations of parent–child interactions in the laboratory and in study 3 (N=1370; 53% girls) via self report. Results from all the three studies showed that youth homozygous for the functional short allele of 5-HTTLPR were more responsive to parenting as environmental context in a ‘for better and worse’ manner. Specifically, the genetically susceptible youth (that is, S’S’ group) who experienced unsupportive, non-positive parenting exhibited low levels of positive affect, whereas higher levels of positive affect were reported by genetically susceptible youth under supportive and positive parenting conditions. These GxE findings are consistent with the DSH and may inform etiological models and interventions in developmental psychopathology focused on positive emotion, parenting and genetic susceptibility.

Co-Rumination Predicts the Onset of Depressive Disorders During Adolescence

The tendency to co-ruminate, or frequently discuss and rehash problems with peers, may serve as one mechanism in the dramatic rise in depression observed during adolescence, particularly among adolescent girls. In the current study, our goal was (a) to test the hypothesis that adolescents levels of co-rumination would predict the onset of clinically significant depressive episodes over a 2-year follow-up and (b) to determine whether levels of co-rumination would mediate gender differences in risk for depression onset. Both hypotheses were supported. Results of survival analysis revealed that adolescents with higher levels of co-rumination at the initial assessments exhibited a significantly shorter time to depression onset. Levels of co-rumination also mediated the gender difference in time to depression onset. These results were maintained even when adolescents baseline levels of depressive symptoms and rumination were covaried statistically. Finally, co-rumination also predicted the course of illness in terms of episode severity and duration. Results suggest that co-rumination contributes a unique risk for the development of depression in adolescents.

Depression from childhood into late adolescence: Influence of gender, development, genetic susceptibility, and peer stress.

Depression is a debilitating mental illness with clear developmental patterns from childhood through late adolescence. Here, we present data from the Gene Environment Mood (GEM) study, which used an accelerated longitudinal cohort design with youth (N = 665) starting in 3rd, 6th, and 9th grades, and a caretaker, who were recruited from the general community, and were then assessed repeatedly through semistructured diagnostic interviews every 6 months over 3 years (7 waves of data) to establish and then predict trajectories of depression from age 8 to 18. First, we demonstrated that overall prevalence rates of depression over time, by age, gender, and pubertal status, in the GEM study closely match those trajectories previously obtained in past developmental epidemiological research. Second, we tested whether a genetic vulnerability-stress model involving 5-HTTLPR and chronic peer stress was moderated by developmental factors. Results showed that older aged adolescents with SS/SL genotype, who experienced higher peer chronic stress over 3 years, were the most likely to be diagnosed with a depressive episode over time. Girls experiencing greater peer chronic stress were the most likely to develop depression. This study used repeated assessments of diagnostic interviewing in a moderately large sample of youth over 3 years to show that depression rates increase in middle to late adolescence, or postpubertally, and that the gender difference in depression emerges earlier in adolescence (age 12.5), or postpubertally. Additionally, genetically susceptible older adolescents who experience chronic peer stress were the most likely to become depressed over time.

Measuring Adolescent Psychopathology: Psychometric Properties of the Self-Report Strengths and Difficulties Questionnaire in a Sample of Chinese Adolescents

PURPOSEnThe Strengths and Difficulties Questionnaire (SDQ) is a brief but comprehensive screening tool for adolescent psychopathology. The current study examined the psychometric properties of the Chinese version of the self-report form of the SDQ (SDQ-C).nnnMETHODSnParticipants included 1135 adolescents (15.1 +/- 1.8 years, 561 boys and 574 girls) recruited from five schools in mainland China. During a single school-based assessment, participants completed the SDQ-C and the Youth Self Report (YSR).nnnRESULTSnChinese adolescents scored significantly higher on the peer problems subscale and significantly lower on the emotional symptoms, hyperactivity, and prosocial behavior subscales than did the British normative sample. Girls scored higher on the emotional symptoms subscale and lower on the conduct and peer problems subscales than did boys. Participants between the ages of 15 and 18 years scored higher on the hyperactivity and prosocial behavior subscales and lower on the peer problems subscale than did participants between the ages of 11 and 14. The SDQ-C exhibited strong internal consistency (overall Cronbachs alpha coefficient was .81) and moderate test-retest reliability (Pearsons correlation coefficient was .71 over an 8-week interval). Each SDQ-C subscale score was highly correlated with the corresponding subscale score of the YSR. Confirmatory factor analysis indicated that both the five-factor structure and the higher-order structure of the SDQ-C were suitable and invariant across sex and age.nnnCONCLUSIONSnThe SDQ-C exhibited high levels of reliability and validity, indicating that the SDQ-C is appropriate for assessing psychopathology in Chinese adolescents.

Cognitive Vulnerability to Depression in Canadian and Chinese Adolescents

The goal of the current study was to compare diathesis-stress and transactional models of cognitive vulnerability to depression in samples of Canadian (nu2009=u2009118) and Chinese (nu2009=u2009405) adolescents. We utilized a six-month multi-wave, longitudinal design in order to examine whether (a) perceived control moderated the association between the occurrence of dependent interpersonal stressors and subsequent increases in depressive symptoms (i.e., a diathesis-stress perspective) and (b) dependent interpersonal stressors mediated the association between perceived control and subsequent increases in depressive symptoms (i.e., a transactional perspective). Results from idiographic, time-lagged, hierarchical linear modeling analyses indicated that for Canadian adolescents both diathesis-stress and transactional models were significant predictors of depressive symptomology. When examining the diathesis-stress model, boys, but not girls, who reported lower perceived control, reported higher levels of depressive symptoms following the occurrence of dependent interpersonal stress. Gender differences, however, were not present in the transactional model. In contrast, transactional, but not diathesis-stress, models were significant in Chinese adolescents, and gender differences did not emerge. Overall, these results may reflect culturally-relevant differences in the etiology of depression in Canadian and Chinese adolescents.

The impact of stress on depressive symptoms is moderated by social support in Chinese adolescents with subthreshold depression: A multi-wave longitudinal study

BACKGROUNDnMost studies have shown that negative life events and social support are important factors in the development and outcome of depression. It is unknown if these factors are important in adolescents with subthreshold depression. Thus, the current study examined whether high levels of social support from peers buffer adolescents exhibiting subthreshold depressive symptoms against experiencing further increases in such symptoms following the occurrence of negative events.nnnMETHODSnParticipants included 143 adolescents (aged 14 to 18; M=16.07, SD=.66) in Hunan Province China who were selected because they were exhibiting subthreshold depressive symptoms at the time of initial assessment. During an initial assessment, participants completed measures assessing social support from peers and depressive symptoms. Participants subsequently completed measures assessing depressive symptoms and the occurrence of negative events once every three months for the subsequent fifteen months.nnnRESULTSnThe prevalence of lifetime subthreshold depression in Hunan was 22.9% (n=143). The results of hierarchical linear modeling analyses indicated that lower levels of social support from peers was associated with greater increases in depressive symptoms following the occurrence of negative events.nnnCONCLUSIONSnThe results suggested that the association between the occurrence of negative events and increased depressive symptoms is moderated by social support from peers in adolescents with subthreshold depression in mainland China, in line with the buffering hypothesis.nnnLIMITATIONSnThe adolescent sample used in the current study was from Hunan, China, which could limit the generalizability of our results to other populations. In addition, given that it is possible that cultural context shapes symptom manifestation, future research should assess a broader array of symptom outcomes.