Nicholas A. Hazel

Early childhood adversity and adolescent depression: the mediating role of continued stress

BACKGROUNDnWhile various conceptualizations of the link between childhood adversity and later depression have been offered, most have not accounted for the possibility that early adversity predicts continuing stress proximal to depression onset. Thus, the present study tested the possible mediating role of recent stress in the association between early adversity and depression in late adolescence.nnnMETHODnStudy questions were examined in a longitudinal community sample of 705 youth who were contemporaneously assessed for early adversity exposure prior to age 5 years, chronic and episodic stress at age 15 years, and major depression prior to age 15 years and between 15 and 20 years.nnnRESULTSnTotal youth stress burden at age 15 years mediated the effect of early adversity on depression between ages 15 and 20 years, and none of the observed relationships were moderated by onset of depression prior to age 15 years.nnnCONCLUSIONSnThese findings suggest that continued stress exposure proximal to depression onset largely accounts for the association between early adversity and depression in late adolescence. Intervention should thus focus on disrupting the continuity of stressful conditions across childhood and adolescence. Future studies of the neurobiological and psychosocial mechanisms of the link between early experiences and depression should explore whether the effects of early experiences are independent of continuing adversity proximal to depressive onset.

Intergenerational Transmission and Continuity of Stress and Depression: Depressed Women and their Offspring in 20 Years of Follow-up

BACKGROUNDnChildren of depressed mothers not only have higher risk of depression, but also may experience both elevated and continuing exposure to stressful experiences. The study tested hypotheses of the intergenerational transmission of stress and depression and examined the role of early childhood adversity and maternal depression in the interplay between youth depression and stress over 20 years.nnnMETHODnIn a longitudinal community study of 705 families selected for history or absence of maternal depression, mothers and youth were studied from pregnancy to age 5 years and at youth ages 15 and 20 years. Youth and maternal depression were assessed with diagnostic interviews, acute and chronic interview-based stress assessment in the youth and contemporaneous measures of childhood adversity obtained between pregnancy and youth age 5 years.nnnRESULTSnRegression analyses indicated evidence of intergenerational transmission and continuity of depression over time, continuity of acute and chronic stress and reciprocal predictive associations between depression and stress. Maternal depression and exposure to adversities by childs age 5 years contributed to the youths continuing experiences of depression and stress. An overall path model was consistent with stress continuity and intergenerational transmission and highlighted the mediating role of age 15 youth chronic interpersonal stress.nnnCONCLUSIONSnYouth of depressed mothers are at risk not only for depression but also for continuing experiences of acute and chronic stress from childhood to age 20. The associations among depression and stress are bidirectional and portend continuing experiences of depression and further stress.

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

BACKGROUNDnMany 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.nnnMETHODSnInterview 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.nnnRESULTSnChronic 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.nnnCONCLUSIONSnCareful 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.

Parent relationship quality buffers against the effect of peer stressors on depressive symptoms from middle childhood to adolescence.

During the transition to adolescence, several developmental trends converge to increase the importance of peer relationships, the likelihood of peer-related stressors, and the experience of depressive symptoms. Simultaneously, there are significant changes in parent-child relationships. The current study sought to evaluate whether positive relationship quality with parents continued to serve a protective effect by buffering the relationship between stressful life events, especially peer stress, and increases in depressive symptoms throughout the transition to adolescence. Participants in a large (N = 692) 2-site accelerated longitudinal study were recruited in 3rd, 6th, and 9th grade and followed every 3 months for 1 year. At baseline, parents and youth reported on parent-child relationship quality, and every 3 months thereafter reported on their levels of stressors and depressive symptoms. Parent relationship quality moderated the relationship of person-level fluctuations in peer stressors, such that there was a stronger association between peer stressors and increases in depressive symptoms in youth with lower levels of positive parental relationship quality. This effect was specific to peer stressors. These results suggest that low levels of parent relationship quality leave youth particularly vulnerable to the depressogenic effects of peer stressors from childhood through adolescence.

Cortisol secretion in depressed, and at-risk adults

Distinct patterns of cortisol secretion have been associated with depression in past research, but it remains unclear whether individuals at-risk for depression may also have similar patterns of cortisol secretion. This is the first study to date of both naturalistic diurnal cortisol secretion and cortisol reactivity to a psychosocial laboratory stressor in depressed and at-risk adults. Cortisol secretion patterns were compared for 57 currently depressed, at-risk (based on trait-level positive and negative affect), and control participants over 5 days and in response to a laboratory stressor. After controlling for potentially confounding biobehavioral variables, the depressed group had a larger cortisol awakening response (CAR) and higher average diurnal cortisol compared to control participants. Individuals at-risk for depression also had significantly higher waking cortisol levels than control participants. Results for the psychosocial laboratory stressor did not show the predicted elevations in cortisol for depressed and at-risk participants compared to controls. The at-risk group recovered more quickly when compared to the depressed group both in levels of cortisol and concurrent measures of negative affect. The at-risk and depressed participants were similar on the diurnal cortisol measures, but differed on response to the laboratory social stressor, suggesting divergence in cortisol secretion patterns between currently depressed and temperamentally at-risk individuals. Further investigation of HPA functioning of individuals at-risk for depression may clarify the stress processes involved in risk for depression onset.

Cognitive Vulnerability to Depressive Symptoms in Children: The Protective Role of Self-efficacy Beliefs in a Multi-Wave Longitudinal Study

The current multi-wave longitudinal study on childhood examined the role that social and academic self-efficacy beliefs and cognitive vulnerabilities play in predicting depressive symptoms in response to elevations in idiographic stressors. Children (Nu2009=u2009554; males: 51.4xa0%) attending second and third grade completed measures of depressive symptoms, negative cognitive styles, negative life events, and academic and social self-efficacy beliefs at four time-points over 6xa0months. Results showed that high levels of academic and social self-efficacy beliefs predicted lower levels of depressive symptoms, whereas negative cognitive styles about consequences predicted higher depression. Furthermore, children reporting higher social self-efficacy beliefs showed a smaller elevation in levels of depressive symptoms when reporting an increases in stress than children with lower social self-efficacy beliefs. Findings point to the role of multiple factors in predicting children’s depression in the long term and commend the promotion of self-efficacy beliefs and the modification of cognitive dysfunctional styles as relevant protective factors.

Effect of holding on co-regulation in preterm infants: A randomized controlled trial

OBJECTIVEnTo determine whether kangaroo holding of healthy preterm infants over the first eight weeks of an infants life facilitates co-regulation of salivary cortisol between mother and infant.nnnSTUDY DESIGNnRandomized control trial. Infants were assigned to receive 1h of daily kangaroo (skin-to-skin contact on the chest of mother) or blanket holding (dressed and held in mothers arms). A registered nurse visited mothers weekly for eight weeks to encourage holding and provide information about infant development. A control group had no holding restrictions and received weekly brief social visits.nnnSUBJECTSnThe study included 79 preterm infants, born between 32 and 35weeks gestational age and were a mean of 15days (±5.7) at enrollment.nnnOUTCOME MEASURESnCo-regulation was conceptualized as progressive reduction in the absolute difference between mother and infant cortisol levels across 60min of holding at each holding session. Mother and infant cortisol levels were measured before holding and at 30 and 60min after holding began during three holding sessions (baseline and at two and eight weeks after study initiation). Primary analyses were conducted using hierarchical linear models.nnnRESULTSnThere was much variability in cortisol levels. Levels of mother and infant cortisol decreased during holding. No significant co-regulation occurred in any group at any holding session or over time.nnnCONCLUSIONSnDecreasing level of cortisol in both mothers and infants suggests that holding promoted the expected decline in stress hormone levels. However, supported holding methods did not differentially affect co-regulation compared to controls. Holding is pleasurable and stress may need to be present in order for mothers and infants to demonstrate co-regulation in cortisol levels.

Negative attachment cognitions and emotional distress in mainland Chinese adolescents: a prospective multiwave test of vulnerability-stress and stress generation models.

The present study examined the relation between attachment cognitions, stressors, and emotional distress in a sample of Chinese adolescents. Specifically, it was examined whether negative attachment cognitions predicted depression and anxiety symptoms, and if a vulnerability-stress or stress generation model best explained the relation between negative attachment cognitions and internalizing symptoms. Participants included 558 adolescents (310 females and 248 males) from an urban school in Changsha and 592 adolescents (287 female, 305 male) from a rural school in Liuyang, both in Hunan province located in mainland China. Participants completed self-report measures of negative attachment cognitions at baseline, and self-report measures of negative events, depression symptoms, and anxiety symptoms at baseline and at regular 1-month intervals for an overall 6-month follow-up (i.e., six follow-up assessments). Higher levels of negative attachment cognitions predicted prospective depression and anxiety symptoms. Furthermore, support was found for a stress generation model that partially mediated this longitudinal association. No support was found for a vulnerability-stress model. Overall, these findings highlight new developmental pathways for development of depression and anxiety symptoms in mainland Chinese adolescents.

Stress sensitivity interacts with depression history to predict depressive symptoms among youth: prospective changes following first depression onset.

Predictors of depressive symptoms may differ before and after the first onset of major depression due to stress sensitization. Dependent stressors, or those to which characteristics of individuals contribute, have been shown to predict depressive symptoms in youth. The current study sought to clarify how stressors’ roles may differ before and after the first depressive episode. Adolescents (Nu2009=u2009382, aged 11 to 15 at baseline) were assessed at baseline and every 3xa0months over the course of 2xa0years with measures of stressors and depressive symptoms. Semi-structured interviews were conducted every 6xa0months to assess for clinically significant depressive episodes. Hierarchical linear modeling showed a significant interaction between history of depression and idiographic fluctuations in dependent stressors to predict prospective elevations of symptoms, such that dependent stressors were more predictive of depressive symptoms after onset of disorder. Independent stressors predicted symptoms, but the strength of the association did not vary by depression history. These results suggest a synthesis of dependent stress and stress sensitization processes that might maintain inter-episode depressive symptoms among youth with a history of clinical depression.