HPA-axis reactivity interacts with stage of pubertal development to predict the onset of depression

Anterior pituitary gland volume mediates associations between pubertal hormones and changes in transdiagnostic symptoms in youth

The pituitary gland (PG) plays a central role in the production and secretion of pubertal hormones, with documented links to the emergence and increase in mental health symptoms known to occur during adolescence. Although much of the literature has focused on examining whole PG volume, recent findings suggest that there are associations among pubertal hormone levels, including dehydroepiandrosterone (DHEA), subregions of the PG, and elevated mental health symptoms (e.g., internalizing symptoms) during adolescence. Surprisingly, studies have not yet examined associations among these factors and increasing transdiagnostic symptomology, despite DHEA being a primary output of the anterior PG. Therefore, the current study sought to fill this gap by examining whether anterior PG volume specifically mediates associations between DHEA levels and changes in dysregulation symptoms in an adolescent sample ( N = 114, 9 - 17 years, M age = 12.87, SD = 1.88). Following manual tracing of the anterior and posterior PG, structural equation modeling revealed that greater anterior, not posterior, PG volume mediated the association between greater DHEA levels and increasing dysregulation symptoms across time, controlling for baseline dysregulation symptom levels. These results suggest specificity in the role of the anterior PG in adrenarcheal processes that may confer risk for psychopathology during adolescence. This work not only highlights the importance of separately tracing the anterior and posterior PG, but also suggests that transdiagnostic factors like dysregulation are useful in parsing hormone-related increases in mental health symptoms in youth.

Brain, behavior, and physiological changes associated with predator stress-An animal model for trauma exposure in adult and neonatal rats

The use of predators and predator odor as stressors is an important and ecologically relevant model for studying the impact of behavioral responses to threat. Here we summarize neural substrates and behavioral changes in rats resulting from predator exposure. We briefly define the impact predator exposure has on neural targets throughout development (neonatal, juvenile, and adulthood). These findings allow us to conceptualize the impact of predator exposure in the brain, which in turn may have broader implications for human disorders such as PTSD. Importantly, inclusion of sex as a biological variable yields distinct results that may indicate neural substrates impacted by predator exposure differ based on sex.

Environmental stress during adolescence promotes depression-like behavior and endocrine abnormalities in rats

OBJECTIVE

To assess the ability of environmental stress (ES) during adolescence on depression-like behaviors and endocrinology in rats.

METHODS

Male and female Sprague-Dawley rats before or during puberty were divided into three groups: control group (CON), low-frequency ES group (LF), and high-frequency ES group (HF). ES included water/food deprivation and reversal of day and night. After 4 weeks of ES, the behavioral tests were performed. Plasma concentrations of hormones and peptides were determined by enzyme-linked immunosorbent assay (ELISA).

RESULTS

ES induced a significant decrease in sucrose preference value in female adolescent rats but not males. In prepubertal rats, the reductions in sucrose preference upon ES were observed without a sex-specific effect. Compared with the CON group, female adolescent rats showed a significant increase, while male adolescent rats showed a significant decrease in plasma corticosterone (CORT) after ES. Also, ES significantly increased plasma leptin in female and male adolescent rats. Moreover, ES significantly increased plasma cholecystokinin (CCK), neuropeptide Y (NPY), and testosterone (TS) levels in adolescent female rats but not in males. No significant differences were found in plasma progesterone and E2 among adolescent rats. The prepubertal male rats showed significant plasma E2 and TS increase after ES, while there were no significant differences between groups in plasma CORT, leptin, CCK, NPY, and progesterone.

CONCLUSIONS

ES may cause depression-like behaviors in adolescent female rats. Our findings supplement the scientific basis for formulating strategies to treat and prevent adolescent depression.

The role of the hypothalamic-pituitary-adrenal axis in depression across the female reproductive lifecycle: current knowledge and future directions

The aim of this narrative review is to consolidate knowledge on the role of the hypothalamic-pituitary-adrenal (HPA) axis in depression pathophysiology at different reproductive stages across the female lifespan. Despite growing evidence about the impact of gonadal hormones on mood disorders, no previous review has examined the interaction between such hormonal changes and the HPA axis within the context of depressive disorders in women. We will focus on HPA axis function in depressive disorders at different reproductive stages including the menstrual cycle (e.g., premenstrual dysphoric disorder [PMDD]), perinatally (e.g., postpartum depression), and in perimenopausal depression. Each of these reproductive stages is characterized by vast physiological changes and presents major neuroendocrine reorganization. The HPA axis is one of the main targets of such functional alterations, and with its key role in stress response, it is an etiological factor in vulnerable windows for depression across the female lifespan. We begin with an overview of the HPA axis and a brief summary of techniques for measuring HPA axis parameters. We then describe the hormonal milieu of each of these key reproductive stages, and integrate information about HPA axis function in depression across these reproductive stages, describing similarities and differences. The role of a history of stress and trauma exposure as a contributor to female depression in the context of HPA axis involvement across the reproductive stages is also presented. This review advances the pursuit of understanding common biological mechanisms across depressive disorders among women. Our overarching goal is to identify unmet needs in characterizing stress-related markers of depression in women in the context of hormonal changes across the lifespan, and to support future research in women's mental health as it pertains to pathophysiology, early diagnosis, and treatment targets.

Biobehavioral mechanisms underlying testosterone and mood relationships in peripubertal female adolescents

The pubertal transition is characterized by pronounced sex hormone fluctuation, refinement of affective neural circuitry, and an increased risk of depression in female adolescents. Sex hormones, including testosterone, exert modulatory effects on frontal-limbic brain networks and are associated with emotion dysregulation and depressive symptoms. Weekly changes in hormones predict affective symptoms in peripubertal female adolescents, particularly in the context of stress; however, the biobehavioral mechanisms underlying hormone change and mood relationships during the pubertal transition have yet to be determined and was the objective of the present study. Forty-three peripubertal female adolescents (ages 11-14) collected 8-weekly salivary hormone (estrone, testosterone) samples and mood assessments to evaluate hormone-mood relationships, followed by a biobehavioral testing session with psychosocial stress and EEG. Within-person correlations between weekly hormone changes and corresponding mood were performed to determine individual differences in mood sensitivity to weekly hormone change. Increased frontal theta activity indexing emotion reactivity, reduced cortisol reactivity, and reduced vagal efficiency predicted the strength of the relationship between testosterone and mood. Further, testosterone-sensitivity strength was associated with the enhancement of negative affect following stress testing. Results identify divergent frontal theta and stress responses as potential biobehavioral mechanisms underlying mood sensitivity to peripubertal testosterone fluctuation.

Study protocol for a randomized controlled trial investigating the effect of online interpretation bias intervention on stress reactivity in the children of parents with depression: the CoCo study

BACKGROUND

Current preventive interventions for the children of parents with depression demonstrate modest effects on depression incidence. This may be because existing interventions tend to comprise general psychotherapeutic tools, rather than targeting the specific mechanisms underlying familial transmission. Improved theoretical models of familial transmission could enhance the development of targeted interventions. Although existing models assume that cognitive and biological vulnerability factors influence one another, the precise mechanisms are unknown. This project is the first to experimentally test whether negative interpretation bias has an impact on cortisol response in children of parents with depression. This study protocol reports a randomised controlled trial of an interpretation bias intervention which aims to shift participants' interpretation bias in a more positive direction and thereby alter their stress response.

METHODS

Children aged 10-14 years who have i) one parent with a current or previous depression diagnosis, with at least one episode occurring during the child's lifetime and ii) do not have a current or previous psychiatric diagnosis themselves, will be assigned to one of two conditions: an interpretation bias intervention (n = 50) or a structurally similar placebo intervention (n = 50). The interpretation bias intervention consists of a short lab-based cognitive reappraisal of interpretations training, a four-week app-based Cognitive Bias Modification of Interpretations intervention and interpretation bias specific if-then plans. Interpretation bias will be assessed before and after the intervention using the Scrambled Sentences Task. The effect of the intervention on participants' stress response will be assessed by salivary cortisol collected at five different time points: from immediately before until 45 min after administering the Trier Social Stressor Test for Children. Stress reactivity will be measured via baseline to peak cortisol and stress recovery will be measured via the 45 min cortisol marker. We hypothesise that children who participate in the interpretation bias intervention will display a positive shift in interpretation bias and this, in turn, will alter their stress response. Children who receive the placebo intervention are expected to show a smaller positive shift in interpretation bias and stress reactivity.

DISCUSSION

The findings of the present study will contribute to models of familial depression transmission as well as informing preventive interventions. If training a more positive interpretation bias subsequently alters participants' stress response, then incorporating such tools may increase the efficacy of existing preventive interventions.

TRIAL REGISTRATION

Deutsches Register Klinischer Studien DRKS00028842. Registered August 19, 2022.

Associations Between Pubertal Stage and Depression: A Systematic Review of the Literature

The current article systematically reviews the literature and provides results from 36 studies testing the relation between pubertal stage and depression, as well as moderators and mediators of this relation. Results indicate that there is a significant relation between advancing pubertal stage and depression among girls, and this effect is strongest among White girls. Among boys, risk for depression does not increase with pubertal stage. Importantly, gonadal development appears to be driving the pubertal stage effect. Increasing hormone concentrations, shared environmental stressors, and body esteem appear to be mechanisms of this relation; increases in nonshared environmental stressors (negative life events, peer victimization) moderate the relation between pubertal stage and depression. Inconsistencies in findings across studies can be explained by methodological differences. Future work on this topic should control for age, examine differences by sex, and utilize within-person analyses to evaluate the effect of pubertal stage on depression over time.

Explaining the Female Preponderance in Adolescent Depression-A Four-Wave Cohort Study

In the transition from childhood into adolescence, a female preponderance in depression emerges. Despite substantial empirical research to test theoretical propositions as to why this happens, our understanding is still limited. One explanation claims that girls become exposed to more stress (stress exposure model) whereas another proposes that girls become more vulnerable to the impact of stress (stress reactivity model) than boys when entering adolescence. Stressful life events (SLEs) and bullying victimization are established risk factors for adolescent depression. However, whether these factors contribute to the gender difference in depression is undetermined and thus investigated herein. Children (49.9% boys; n = 748) and parents from two birth cohorts in Trondheim, Norway, were followed biennially from ages 8 to 14 with clinical interviews about symptoms of depressive disorders and self-reports on SLEs. Teachers reported on bullying victimization. Prospective associations were investigated using an autoregressive latent trajectory model with structured residuals, examining within-person longitudinal associations while accounting for all time-invariant confounding effects. The number of depressive symptoms increased from ages 12 to 14 among girls. In the period before (ages 10 to 12), girls and boys were equally exposed to SLEs and bullying victimization. Increased stress (both SLEs and bullying victimization) at age 12 predicted increased depression at age 14 more strongly among girls than boys. Hence, increased impact-but not exposure-of SLEs and bullying victimization in girls may partly explain the emerging female preponderance in depression, in line with a stress reactivity model.

ADHD symptoms and diurnal cortisol in adolescents: The importance of comorbidities

BACKGROUND

Altered regulation of diurnal cortisol has been associated with both dimensional symptoms and clinical diagnoses of attention deficit-hyperactivity disorder (ADHD). Indeed, a recent meta-analysis suggests that lower diurnal cortisol output may be a biomarker of attention deficit-hyperactivity disorder (ADHD); importantly, however, the influence of psychiatric comorbidities on this association has not been characterized. Approximately two-thirds of children with ADHD have at least one co-occurring neuropsychiatric condition, and altered HPA-axis function has been implicated in many of these conditions. Using dimensional measures of psychopathology, we examined whether comorbid symptoms influence the association of ADHD symptoms with daily cortisol output.

METHODS

138 adolescents (ages 11-15 years) completed measures of symptoms of psychopathology and provided saliva samples over two days. We analyzed whether ADHD symptoms were related to morning, afternoon, and evening cortisol, the cortisol awakening response (CAR) and cumulative daily cortisol (area under the curve with respect to ground [AUCg]) while accounting for symptoms of three psychiatric disorders that are commonly comorbid with ADHD: conduct disorder (CD), anxiety, and depression. In sensitivity analyses, we included symptoms of oppositional defiant disorder (ODD) in place of CD symptoms.

FINDINGS

After controlling for symptoms of CD, anxiety, and depression, ADHD symptoms were associated significantly with higher cumulative diurnal cortisol (AUCg), morning cortisol, and afternoon cortisol. Symptoms of CD, anxiety and depression were not associated significantly with any cortisol metrics; however, in sensitivity analyses, ODD symptoms were associated with lower AUCg and morning cortisol.

DISCUSSION

Our findings highlight the distinct influence of ADHD and externalizing symptoms on cortisol output. Further work is needed to examine the specificity of altered HPA-axis activity as a biomarker of ADHD and to elucidate whether symptoms of ADHD differ in their association with diurnal cortisol as a function of their severity.

Associations between HPA axis reactivity and PTSD and depressive symptoms: Importance of maltreatment type and puberty

The functioning of the hypothalamic-pituitary-adrenal (HPA) axis is implicated in the etiology and maintenance of depressive and posttraumatic stress disorder (PTSD) symptoms. However, different maltreatment experiences as well as the increased sensitivity of the HPA axis during puberty may alter associations between the HPA axis and mental health. To address these gaps, the current study examined the potential bidirectional associations between cortisol reactivity to a stressor, PTSD symptoms, and depressive symptoms among early adolescents across two time points, 1 year apart (n = 454; Mage = 10.98 at Time 1 and Mage = 12.11 at Time 2). Multiple-group path models tested the pathways between cortiol reactivity and mental health prior to and during puberty, for different types of maltreatment . Overall, the results showed that associations between cortisol output and symptoms of PTSD and depression were driven by those in the midst of puberty. Specifically, higher cortisol output at Time 1 was linked with higher levels of subsequent PTSD and depressive symptoms for neglected youth who had reached puberty. However, depressive symptoms predicted subsequent lower cortisol output for the physical abuse and emotional abuse groups. These findings demonstrate longitudinal links between cortisol, depressive symptoms, and PTSD symptoms among youth with different types of maltreatment histories and highlight the need to consider the reorganization of the stress system during puberty in order to advance our understanding of the HPA axis and mental health.

Longitudinal patterns of neuroendocrine coupling from middle childhood to early adolescence

Recent scholarship has highlighted the importance of understanding relations between hormones, rather than studying hormones in isolation. Considering neuroendocrine coupling, or the coordination of hypothalamic-pituitary-adrenal axis and hypothalamic-pituitary-gonadal axis hormones over time, is one way to investigate how systems governing stress responsiveness and pubertal development covary during critical periods. To date, however, most work has considered hormone coupling cross-sectionally. The current study investigated neuroendocrine coupling in a longitudinal sample from the Northeastern United States. Youth (N = 437, 53% male, 90% White) provided saliva samples for analysis of diurnal hormone activity at ages 9 (three samples per day across 3 days) and 12 (one sample per day on the same weekday for 4 weeks). At both timepoints, samples collected 30-min after waking were assayed for cortisol, dehydroepiandrosterone (DHEA), and testosterone. Multilevel growth modeling was used to determine how levels of morning cortisol changed in tandem with DHEA and testosterone. Morning cortisol-DHEA coupling varied by child sex, as males' cortisol-DHEA diminished over time, especially among pubertally advanced males. Females, in contrast, demonstrated strengthening cortisol-DHEA coupling over time, especially more pubertally advanced females. Morning cortisol-testosterone coupling did not vary by sex or pubertal status, demonstrating strengthening associations between ages 9 and 12. The current findings contribute to the literature on hormone coupling across development and expand this work into an earlier developmental phase than previously investigated.

Multi-level predictors of depression symptoms in the Adolescent Brain Cognitive Development (ABCD) study

BACKGROUND

While identifying risk factors for adolescent depression is critical for early prevention and intervention, most studies have sought to understand the role of isolated factors rather than across a broad set of factors. Here, we sought to examine multi-level factors that maximize the prediction of depression symptoms in US children participating in the Adolescent Brain and Cognitive Development (ABCD) study.

METHODS

A total of 7,995 participants from ABCD (version 3.0 release) provided complete data at baseline and 1-year follow-up data. Depression symptoms were measured with the Child Behavior Checklist. Predictive features included child demographic, environmental, and structural and resting-state fMRI variables, parental depression history and demographic characteristics. We used linear (elastic net regression, EN) and non-linear (gradient-boosted trees, GBT) predictive models to identify which set of features maximized prediction of depression symptoms at baseline and, separately, at 1-year follow-up.

RESULTS

Both linear and non-linear models achieved comparable results for predicting baseline (EN: MAE = 3.757; R2  = 0.156; GBT: MAE = 3.761; R2  = 0.147) and 1-year follow-up (EN: MAE = 4.255; R2  = 0.103; GBT: MAE = 4.262; R2  = 0.089) depression. Parental history of depression, greater family conflict, and shorter child sleep duration were among the top predictors of concurrent and future child depression symptoms across both models. Although resting-state fMRI features were relatively weaker predictors, functional connectivity of the caudate was consistently the strongest neural feature associated with depression symptoms at both timepoints.

CONCLUSIONS

Consistent with prior research, parental mental health, family environment, and child sleep quality are important risk factors for youth depression. Functional connectivity of the caudate is a relatively weaker predictor of depression symptoms but may represent a biomarker for depression risk.

Hair cortisol as a risk marker for increased depressive symptoms among older adults during the COVID-19 pandemic

Determining pre-existing biological risk markers of incident depression and other mental health sequelae after exposure to a new stressor would help identify vulnerable individuals and mechanistic pathways. This study investigated primarily whether hair cortisol predicted elevated depressive symptoms in middle-aged and older adults during the COVID-19 pandemic, 6 years later. A secondary aim was to deduce whether any association differed by sex.

METHODS

We studied 1025 adults aged 50 and older (75% female) as part of The Irish Longitudinal Study on Ageing. Hair cortisol samples were collected at 2014 (Wave 3) and depressive symptoms were assessed using the 8-item Center for Epidemiological Studies Depression Scale in 2014 (Wave 3), 2016 (Wave 4), 2018 (Wave 5) and again in 2020 as part of TILDA's COVID-19 Study. Hierarchical mixed effects logistic regression models were applied to investigate the association between cortisol levels and clinically significant depressive symptoms before and during the COVID-19 pandemic.

RESULTS

In a full covariate adjusted model there was a significant interaction between cortisol and wave on depressive symptoms (χ2 = 8.5, p = .03). Cortisol was positively and significantly associated with elevated depressive symptoms during the COVID-19 Study (OR =1.3, 95% CI 1.11, 1.56, p = .003), and was associated with an increased likelihood of reporting clinically significant depressive symptoms during first year of the COVID-19 pandemic, when compared with before, OR = 1.4, 95% CI 1.05, 1.9, p = .015. There was no evidence of effect modification by sex.

CONCLUSIONS

Higher hair cortisol, assessed 6 years previously, predicted clinically significant depressive symptoms among middle-aged and older adults during (but not before) the pandemic. Findings suggest a biological phenotype which denotes increased susceptibility to the negative impact of environmental stress on psychological health.

Gonadal and adrenal hormones interact with pubertal maturation to predict depressive symptoms in a group of high-school females

Adolescent females are at elevated risk for the development of depression. In this study, we addressed two questions: Are pubertal hormones associated with adolescent mental health? Might this association depend on pubertal development? We tested the hypothesis that estradiol, which has been associated with adolescent social sensitivity, might interact with pubertal stage to predict depression risk at three time points in ninth and tenth grade. Hormones and pubertal development were measured ninth-grade females. Linear regression analyses were used to predict fall ninth-grade (N = 79), spring ninth-grade (N = 76), and spring tenth-grade (N = 67) Children's Depression Inventory (CDI) scores. The hypothesized model was not statistically significant, but exploratory analyses revealed that two- and three-way interactions incorporating estradiol, puberty (stage and perceived onset), and cortisol predicted current and future CDI scores. Our exploratory model did not predict changes in CDI but did account for future (spring of ninth grade) CDI scores. Specifically, estradiol was positively correlated with fall and spring ninth-grade depressive symptoms in participants with high cortisol who also reported earlier stages and later perceived onset of pubertal development. These findings suggest that hormones associated with sensitivity to the social environment deserve consideration in models of adolescent depression risk.

Depressive symptoms among Mexican adolescent girls in relation to iron status, anaemia, body weight and pubertal status: results from a latent class analysis

OBJECTIVE

The study examined the association between depressive symptoms and iron status, anaemia, body weight and pubertal status among Mexican adolescent girls.

DESIGN

In this cross-sectional study, depressive symptoms were assessed by the 6-item Kutcher Adolescent Depression Scale, and latent class analysis (LCA) was used to identify and characterise groups of girls based on depressive symptoms. Iron status and inflammation were assessed using ferritin and soluble transferrin receptor, C-reactive protein and alpha-1-acid glycoprotein, respectively. Multiple logistic and linear regressions were applied to model class membership as a function of iron status, anaemia, body weight and pubertal status.

PARTICIPANTS

We collected data from 408 girls aged 12-20 years.

SETTING

Public schools in northern Mexico.

RESULTS

LCA yielded three classes of depressive symptoms: 44·4 % of the adolescents were 'unlikely to be depressed', 41·5 % were 'likely to be depressed' and 14·1 % were 'highly likely to be depressed'. Our analyses demonstrated that iron-deficient girls had greater odds of being 'likely depressed' (OR 2·01, 95 % CI 1·01, 3·00) or 'highly likely depressed' (OR 2·80, 95 % CI 1·76, 3·84). Linear regression analyses revealed that lower Hb concentrations and higher body weight increased the probability of being 'likely depressed'. There was no evidence that depressive symptoms were associated with age at menarche and years since menstruation.

CONCLUSIONS

This study shows that iron-deficient adolescent girls are more likely to suffer from depressive symptoms and that lower concentrations of Hb and higher body weight increased the probability of experiencing depressive symptoms.

Chemiluminescent immunoassay overestimates hormone concentrations and obscures testosterone sex differences relative to LC-MS/MS in a field study of diverse adolescents

Background

Methodological comparisons of hormone quantification techniques have repeatedly demonstrated that, in adults, enzyme immunoassay (EIA) inflates steroid hormone concentrations relative to mass spectrometry. However, methodological comparisons in adolescent samples remain rare, and few studies have examined how chemiluminescent immunoassay (CLIA), another popular immunoassay, compares to mass spectrometry. Additionally, no studies have examined how differences in analytical techniques may be affecting relationships between steroid hormone levels and outcomes of interest, such as psychopathology. This pre-registered analysis of an existing dataset measured salivary cortisol and testosterone using both CLIA and liquid chromatography dual mass spectrometry (LC-MS/MS) in a repeated measures (516 samples) sample of 207 9th graders.

Methods

In aim 1, this study sought to expand on past findings by 1) measuring inflation of testosterone and cortisol by CLIA in a relatively large adolescent sample, and 2) showing that CLIA (like EIA) testosterone inflation was especially true in groups with low ‘true’ testosterone levels. In aim 2, this study sought to examine the impact of hormone quantification method on relationships between hormone levels and psychopathological measures (the Children's Depression Inventory, the Perceived Social Stress Scale, the UCLA Loneliness Scale, and the Anxious Avoidant and Negative Self Evaluation subscales of the Social Anxiety Scale for Adolescents).

Results

We found that CLIA, like EIA, inflated testosterone and cortisol levels and overestimated female testosterone resulting in suppressed sex differences in testosterone. We did not observe these same patterns when examining testosterone in individuals with differing levels of pubertal development. Results of psychopathology analyses demonstrated no significant method differences in hormone-psychopathology relationships.

Conclusions

Our findings show that CLIA introduces proportional bias in cortisol and testosterone in a manner that suppresses sex differences in testosterone. Steroid measurement method did not significantly moderate the relationship between hormones and psychopathology in our sample, though more work is needed to investigate this question in larger, clinical samples.

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Pre-registered comparison of 516 samples of CLIA and LC/MS-MS-assessed cortisol and testosterone from 207 adolescents.

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CLIA overestimated cortisol and testosterone relative to LC-MS/MS and suppressed sex differences in testosterone.

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No significant moderating effect of method on hormone-psychopathology relationships.

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LC-MS/MS should be used to measure steroid hormones when possible.

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Further research is needed to examine how method differences may be impacting hormone-psychopathology findings.

DHEA Moderates the Impact of Childhood Trauma on the HPA Axis in Adolescence

BACKGROUND

Trauma can lead to long-term downregulation of the hypothalamic pituitary adrenal (HPA) axis. However, dehydroepiandrosterone (DHEA) has neuroprotective effects that may reduce the need for downregulation of the axis in response to stress. Furthermore, high DHEA/cortisol ratios are often conceptualized as better markers of DHEA's availability than DHEA alone, as ratios account for the coupling of DHEA and cortisol in response to stress.

OBJECTIVES

In this study, we explored if DHEA and DHEA/cortisol ratios moderated the association between childhood maltreatment and the HPA axis stress response.

METHODS

The sample consisted of 101 adolescents (ages 12-16) who completed the Child Trauma Questionnaire (CTQ) and the Trier Social Stress Test (TSST). Cortisol was modeled using saliva samples at 8 time points throughout the TSST. Cortisol and DHEA ratios were examined at baseline and 35 min after stress initiation.

RESULTS

Childhood maltreatment was associated with less steep cortisol activation slope and peak cortisol levels, but DHEA and DHEA/cortisol ratios moderated this effect. At high levels of DHEA, the impact of childhood maltreatment on cortisol peak levels was no longer significant. In contrast, high DHEA/cortisol ratios were associated with an intensification of the impact of childhood maltreatment on peak levels.

CONCLUSIONS

Results suggest that DHEA can limit the blunting of the HPA axis in response to childhood maltreatment. However, this protective effect was not reflected in high DHEA/cortisol ratios as predicted. Therefore, high DHEA and high DHEA/cortisol ratios may reflect different, and potentially opposite, processes.

Basal and reactive cortisol: A systematic literature review of offspring of parents with depressive and bipolar disorders

One of the most consistent biological findings in the study of affective disorders is that those with depression commonly show abnormal cortisol response, which suggests dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Children of parents with mood disorders offer the opportunity to explore the biological pathways that may confer risk for psychopathology. This review explores basal and reactive cortisol in the offspring of parents who are currently depressed or have had a history of a depressive or bipolar disorder. Using PRISMA guidelines, search terms yielded 2002 manuscripts. After screening, 87 of these manuscripts were included. Results from the literature suggest that while the degree and direction of dysregulation varies, offspring of a parent with depression tend to show elevations in both basal (particularly morning and evening) and reactive (tentatively for social stressors) cortisol levels. There were few studies focused on offspring of parents with bipolar disorder. This review also discusses implications and recommendations for future research regarding the HPA axis in the intergenerational transmission of depressive disorders.

Preventive strategies for adolescent depression: What are we missing? A focus on biomarkers

Adolescent depression is an important global issue with several unmet needs that still must be addressed and, to date, there are only few effective preventive strategies to reduce the burden of this disorder worldwide. In this mini-review, the evidence and potential ways to improve an early detection will be discussed as well as prompt interventions by focusing on a better understanding of the risks underlying the developing of adolescent depression from both a sociodemographic and a biological perspective.

Sexual dimorphism in pre-clinical studies of depression

Although there is a sex bias in the pathological mechanisms exhibited by brain disorders, investigation of the female brain in biomedical science has long been neglected. Use of the male model has generally been the preferred option as the female animal model exhibits both biological variability and hormonal fluctuations. Existing studies that compare behavioral and/or molecular alterations in animal models of brain diseases are generally underrepresented, and most utilize the male model. Nevertheless, in recent years there has been a trend toward the increased inclusion of females in brain studies. However, current knowledge regarding sex-based differences in depression and stress-related disorders is limited. This can be improved by reviewing preclinical studies that highlight sex differences in depression. This paper therefore presents a review of sex-based preclinical studies of depression. These shed light on the discrepancies between males and females regarding the biological mechanisms that underpin mechanistic alterations in the diseased brain. This review also highlights the conclusions drawn by preclinical studies to advance our understanding of mood disorders, encouraging researchers to promote ways of investigating and managing sexually dimorphic disorders.

Increased Reward-Related Activation in the Ventral Striatum During Stress Exposure Associated With Positive Affect in the Daily Life of Young Adults With a Family History of Depression. Preliminary Findings

Background: Being the offspring of a parent with major depression disorder (MDD) is a strong predictor for developing MDD. Blunted striatal responses to reward were identified in individuals with MDD and in asymptomatic individuals with family history of depression (FHD). Stress is a major etiological factor for MDD and was also reported to reduce the striatal responses to reward. The stress-reward interactions in FHD individuals has not been explored yet. Extending neuroimaging results into daily-life experience, self-reported ambulatory measures of positive affect (PA) were shown to be associated with striatal activation during reward processing. A reduction of self-reported PA in daily life is consistently reported in individuals with current MDD. Here, we aimed to test (1) whether increased family risk of depression is associated with blunted neural and self-reported reward responses. (2) the stress-reward interactions at the neural level. We expected a stronger reduction of reward-related striatal activation under stress in FHD individuals compared to HC. (3) the associations between fMRI and daily life self-reported data on reward and stress experiences, with a specific interest in the striatum as a crucial region for reward processing. Method: Participants were 16 asymptomatic young adults with FHD and 16 controls (HC). They performed the Fribourg Reward Task with and without stress induction, using event-related fMRI. We conducted whole-brain analyses comparing the two groups for the main effect of reward (rewarded > not-rewarded) during reward feedback in control (no-stress) and stress conditions. Beta weights extracted from significant activation in this contrast were correlated with self-reported PA and negative affect (NA) assessed over 1 week. Results: Under stress induction, the reward-related activation in the ventral striatum (VS) was higher in the FHD group than in the HC group. Unexpectedly, we did not find significant group differences in the self-reported daily life PA measures. During stress induction, VS reward-related activation correlated positively with PA in both groups and negatively with NA in the HC group. Conclusion: As expected, our results indicate that increased family risk of depression was associated with specific striatum reactivity to reward in a stress condition, and support previous findings that ventral striatal reward-related response is associated with PA. A new unexpected finding is the negative association between NA and reward-related ventral striatal activation in the HC group.

Maltreatment timing, HPA axis functioning, multigenic risk, and depressive symptoms in African American youth: Differential associations without moderated mediation

Utilizing a large (N = 739), ancestrally homogenous sample, the current study aimed to better understand biological risk processes involved in the development of depressive symptoms in maltreated, African American children age 8-12 years. Maltreatment was independently coded from Child Protective Services records and maternal report. Self-reported depressive symptoms were attained in the context of a week-long, summer research camp. DNA was acquired from buccal cell or saliva samples and genotyped for nine polymorphisms in four hypothalamic-pituitary-adrenal (HPA)-axis-related genes: FKBP5, NR3C1, NR3C2, and CRHR1. Salivary cortisol samples were collected each morning (9 a.m.) and late afternoon (4 p.m.) throughout the week to assess HPA functioning. Results revealed that experiences of maltreatment beginning prior to age 5 were most predictive of depressive symptoms, whereas maltreatment onset after age 5 was most predictive of HPA axis dysregulation (blunted daytime cortisol patterns). Multigenic risk did not relate to HPA functioning, nor did it moderate the relationship between maltreatment and HPA activity. There was no mediation of the relationship between maltreatment and depressive symptoms by HPA dysfunction. Results are interpreted through a developmental psychopathology lens, emphasizing the principle of equifinality while carefully appraising racial differences. Implications for future research, particularly the need for longitudinal studies, and important methodological considerations are discussed.

Neural mechanisms of acute stress and trait anxiety in adolescents

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The Montreal Imaging Stress Task is an effective acute stressor for adolescents.

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Acute stress exposure impacts fMRI measures of brain activation in adolescents.

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Hippocampal deactivation during acute stress is associated with cortisol release.

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Trait anxiety is linked to stress-related hippocampus, VS, and putamen activity.

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Males exhibit greater putamen deactivation during acute stress than females.

Adolescence is a critical period of heightened stress sensitivity and elevated vulnerability for developing mental illness, suggesting a possible association between stress exposure and the etiology of psychiatric disorders. In adults, aberrant neurobiological responses to acute stress relate to anxiety symptoms, yet less is known about the neural stress response in adolescents and how it relates to biological and psychological variables. Here we characterize the neurobiology of stress response in adolescents using multiple modalities, including neuroimaging, subjective stress ratings, heart rate, and cortisol data. We evaluated stress response in adolescents using the Montreal Imaging Stress Task (MIST), an acute psychosocial stressor commonly administered in adult functional magnetic resonance imaging (fMRI) studies but not previously utilized with this population. FMRI data were acquired from 101 adolescents (44 female; 9–16 years) exhibiting varied trait anxiety severity.

The MIST elicited decreased high-frequency heart rate variability and increased heart rate, subjective stress and cortisol. Whole-brain analyses comparing fMRI activity during experimental versus control MIST conditions revealed stress-related activation in regions including the anterior insula, dorsal anterior cingulate cortex, and dorsolateral prefrontal cortex and deactivations in the hippocampus, ventral striatum, and putamen. Region of Interest analyses found that during acute stress (a) hippocampal deactivation corresponded to heightened cortisol release, (b) trait anxiety was associated with increased hippocampal and ventral striatum activation and decreased putamen activity, and (c) males exhibited greater putamen deactivation than females. These results provide novel evidence that the MIST is an effective stressor for adolescents. Associations between the neural acute stress response, other biological factors, and trait anxiety highlight the importance of these neurobiological mechanisms in understanding anxiety disorders.

miR-218 in Adolescence Predicts and Mediates Vulnerability to Stress

BACKGROUND

Adolescence is a period of increased vulnerability to psychiatric disorders, including depression. Discovering novel biomarkers to identify individuals who are at high risk is very much needed. Our previous work shows that the microRNA miR-218 mediates susceptibility to stress and depression in adulthood by targeting the netrin-1 guidance cue receptor gene Dcc in the medial prefrontal cortex (mPFC).

METHODS

Here, we investigated whether miR-218 regulates Dcc expression in adolescence and could serve as an early predictor of lifetime stress vulnerability in male mice.

RESULTS

miR-218 expression in the mPFC increases from early adolescence to adulthood and correlates negatively with Dcc levels. In blood, postnatal miR-218 expression parallels changes occurring in the mPFC. Notably, circulating miR-218 levels in adolescence associate with vulnerability to social defeat stress in adulthood, with high levels associated with social avoidance severity. Indeed, downregulation of miR-218 in the mPFC in adolescence promotes resilience to stress in adulthood.

CONCLUSIONS

miR-218 expression in adolescence may serve both as a marker of risk and as a target for early interventions.

Serum nesfatin-1, ghrelin, and lipid levels in adolescents with first episode drug naïve unipolar depression

Background: Major depressive disorder (MDD) is a mental health and emotional disorder that affects children and adolescents worldwide. This study aimed to evaluate serum nesfatin-1, ghrelin, and lipid levels as biological markers of adolescent MDD and their relationship with the severity of depression-anxiety and suicide risk in MDD. Methods:This study included 37 drug naïve adolescents between the ages of 12 and 18 who were diagnosed with a first episode MDD according to the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) and DSM-V diagnostic criteria. Thirty-three healthy adolescents between the ages of 12 and 18 were included as the control group. The Children's Depression Inventory (CDI), Screen for Child Anxiety Related Disorders (SCARED), and Suicide Probability Scale (SPS) were used to evaluate the subjects in the MDD and control groups. In the first stage, serum nesfatin-1, ghrelin, and lipid levels were compared between the adolescents diagnosed with MDD and the control group. Next, the correlations between these levels and the CDI, SCARED, and SPS scores were evaluated. Results: Nesfatin-1 levels were significantly lower in the MDD group than the control group (p < 0.001) A positive correlation was found between the nesfatin-1 levels and the SPS scores. Conclusions: This is the first study to evaluate nesfatin-1 levels in adolescent depression, suggesting that nesfatin-1, ghrelin, total cholesterol, and low-density lipoprotein cholesterol (LDL) levels can be used as biomarkers in child-adolescent MDD. However, it is evident that further studies with larger samples and post-treatment measurements are needed.

Stress Impairs Episodic Retrieval by Disrupting Hippocampal and Cortical Mechanisms of Remembering

Despite decades of science investigating the neural underpinnings of episodic memory retrieval, a critical question remains: how does stress influence remembering and the neural mechanisms of recollection in humans? Here, we used functional magnetic resonance imaging and multivariate pattern analyses to examine the effects of acute stress during retrieval. We report that stress reduced the probability of recollecting the details of past experience, and that this impairment was driven, in part, by a disruption of the relationship between hippocampal activation, cortical reinstatement, and memory performance. Moreover, even memories expressed with high confidence were less accurate under stress, and this stress-induced decline in accuracy was explained by reduced posterior hippocampal engagement despite similar levels of category-level cortical reinstatement. Finally, stress degraded the relationship between the engagement of frontoparietal control networks and retrieval decision uncertainty. Collectively, these findings demonstrate the widespread consequences of acute stress on the neural systems of remembering.

Intergenerational Transmission of Depression

The study of depression in mothers in relation to transmission of risk for the development of psychopathology in their children relies on solid foundations in the understanding of psychopathology, of development, and of developmental psychopathology per se. This article begins with a description of the scope of the problem, including a summary of knowledge of how mothers’ depression is associated with outcomes in children and of moderators of those associations. The sense of scope then informs a theoretical and empirical perspective on knowledge of mechanisms in those associations, with a focus on what has been learned in the past 20 years. Throughout the article, and in conclusions at the end, are suggestions for next steps in research and practice.

Associations of waking cortisol with DHEA and testosterone across the pubertal transition: Effects of threat-related early life stress

Atypical regulation of the hypothalamic-pituitary-adrenal (HPA) axis is a putative mechanism underlying the association between exposure to early life stress (ELS) and the subsequent development of mental and physical health difficulties. Recent research indicates that puberty is a period of HPA-axis plasticity during which the effects of exposure to ELS on cortisol regulation may change. In particular, increases in the sex hormones that drive pubertal maturation, including dehydroepiandrosterone (DHEA) and testosterone, may be implicated in pubertal recalibration of cortisol regulation. In the current study, we examined the associations among levels of objectively-rated threat-related ELS and salivary waking cortisol, DHEA, and testosterone in a sample of 178 adolescents (55 % female) who were in early puberty at baseline (Tanner stages 1-3; mean Tanner stage[SD] = 1.93[0.64]; mean age[SD] = 11.42[1.04]) and were followed up approximately two years later (mean Tanner stage[SD] = 3.46[0.86]; mean age[SD] = 13.38[1.06]). Using multi-level modeling, we disaggregated the effects of between-individual levels and within-individual increases in pubertal stage and sex hormones on change in cortisol. Controlling for between-individual differences in average pubertal stage, the association between levels of cortisol and DHEA was more strongly positive among adolescents who evidenced greater within-individual increases in pubertal stage across time. Both higher average levels and greater within-individual increases in DHEA and testosterone were associated with increases in cortisol across time, indicating positive coupling of developmental changes in these hormones; however, coupling was attenuated in adolescents who were exposed to more severe threat-related ELS prior to puberty. These findings advance our understanding of the development of the HPA-axis and its association with childhood environmental risk during puberty.

Studying the Intergenerational Transmission of Risk for Depression: Current Status and Future Directions

Studying offspring of depressed mothers is a promising strategy for elucidating factors that contribute to depression onset, given that these offspring are three to six times more likely to develop depression than are their low-risk peers. In this paper we briefly describe representative findings from studies of younger and older offspring of depressed mothers and identify factors that have garnered the most consistent empirical support across development. We discuss what these studies can and cannot tell us about mechanisms that might underlie the intergenerational transmission of risk for depression, regardless of the age of offspring being studied. Finally, in light of limitations of this literature, we offer recommendations for future research.

Prospective biomarkers of major depressive disorder: a systematic review and meta-analysis

Leading biological hypotheses propose that biological changes may underlie major depressive disorder onset and relapse/recurrence. Here, we investigate if there is prospective evidence for biomarkers derived from leading theories. We focus on neuroimaging, gastrointestinal factors, immunology, neurotrophic factors, neurotransmitters, hormones, and oxidative stress. Searches were performed in Pubmed, Embase and PsychInfo for articles published up to 06/2019. References and citations of included articles were screened to identify additional articles. Inclusion criteria were having an MDD diagnosis as outcome, a biomarker as predictor, and prospective design search terms were formulated accordingly. PRISMA guidelines were applied. Meta-analyses were performed using a random effect model when three or more comparable studies were identified, using a random effect model. Our search resulted in 67,464 articles, of which 75 prospective articles were identified on: Neuroimaging (N = 24), Gastrointestinal factors (N = 1), Immunology (N = 8), Neurotrophic (N = 2), Neurotransmitters (N = 1), Hormones (N = 39), Oxidative stress (N = 1). Meta-analyses on brain volumes and immunology markers were not significant. Only cortisol (N = 19, OR = 1.294, p = 0.024) showed a predictive effect on onset/relapse/recurrence of MDD, but not on time until MDD onset/relapse/recurrence. However, this effect disappeared when studies including participants with a baseline clinical diagnosis were removed from the analyses. Other studies were too heterogeneous to compare. Thus, there is a lack of evidence for leading biological theories for onset and maintenance of depression. Only cortisol was identified as potential predictor for MDD, but results are influenced by the disease state. High-quality (prospective) studies on MDD are needed to disentangle the etiology and maintenance of MDD.

The Effect of Visual Stressors on Adolescents' Neural Response: A Review of Laboratory Research

Laboratory models that help us understand the neural mechanisms associated with how stress, particularly interpersonal stress, affects children's and adolescents' emotions are paramount but are limited if that understanding lacks validity in adolescents' daily lives. There is a lack of research that addresses the ecological validity of visual stimuli to induce stress in participants while measuring participants' neural response to that stimuli. This approach is needed if we are to identify the neural mechanisms that underlie the effect of stressful events on individuals' emotional functioning. The current study conducted a systematic literature review to identify visual tasks that have been used in laboratory settings to induce stress in participants. The most frequent tasks identified were developed to induce peer rejection/exclusion in youth (e.g., Chatroom and Cyberball). These tasks were generally effective at bringing about a neural response in areas of the brain traditionally associated with social cognitive processing, such as the cingulate cortex, prefrontal cortex, insula, and striatum. In particular, the cingulate cortex and prefrontal cortex are associated with the Social Information Processing Network. Almost entirely absent from the literature are systematic evaluations of ecological validity and parent-child based visual stimuli that approximate the stress that adolescents might experience in their relationships with parents. The present article highlights trends and gaps in the current research, and examines the ecological validity of current stimuli used as laboratory based stressors, which can be used to fuel further investigation into adolescent neural response to stimuli, and further evaluation of the ecological validity of tasks.

Hair cortisol and depressive symptoms in youth: An investigation of curvilinear relationships

BACKGROUND

As the prevalence of depression is increasing among youth in the U.S., research on the utility of biomarkers in predicting depressive symptomatology is burgeoning. Hair cortisol may be a useful biomarker as it is a retrospective and longer-term measure of the mean cortisol level. However, studies have yet to examine the relationships between hair cortisol and depressive symptoms in samples of youth, and findings with adult samples are mixed. This study examined hair cortisol as a predictor of depressive symptoms, including the potential for nonlinear relationships.

METHODS

A representative community sample of 432 adolescents aged 11 to 17 years was examined. Depressive symptoms were measured using a 9-item short-form of the Center for Epidemiologic Studies-Depression scale. Hair was cut from the posterior vertex region of the scalp using thinning shears. Hair was washed, minced, ground and assayed with Salimetrics® Cortisol Enzyme Immunoassay Kit. Hair cortisol levels were logged for statistical analysis.

RESULTS

In multivariable regression analysis, no significant linear relationship was found in model 1 between hair cortisol and depressive symptoms (b= -0.036, se = 0.02, p = 0.13). In model 2, a marginally significant linear association (b= -0.044, se = 0.02, p-value = 0.06) and a significant curvilinear relationship (b = 0.039, se = 0.01, p-value = 0.005) were found between hair cortisol and depressive symptoms. The results were graphed depicting a u-shaped curve such that hair cortisol levels on the lower and higher end of the distribution predicted depressive symptoms.

CONCLUSIONS

The findings highlight the need to consider investigation of nonlinear associations between cortisol and depressive symptoms. Longitudinal mechanistic research is needed to elucidate the causal relationships between hypothalamic-pituitary-adrenal axis dysregulation and depressive symptoms as well as a better understanding of the biological mechanisms through which cortisol may contribute to depressive symptoms and psychopathology.

DNA methylation of HPA-axis genes and the onset of major depressive disorder in adolescent girls: a prospective analysis

The stress response system is disrupted in individuals with major depressive disorder (MDD) as well as in those at elevated risk for developing MDD. We examined whether DNA methylation (DNAm) levels of CpG sites within HPA-axis genes predict the onset of MDD. Seventy-seven girls, approximately half (n = 37) of whom were at familial risk for MDD, were followed longitudinally. Saliva samples were taken in adolescence (M age = 13.06 years [SD = 1.52]) when participants had no current or past MDD diagnosis. Diagnostic interviews were administered approximately every 18 months until the first onset of MDD or early adulthood (M age of last follow-up = 19.23 years [SD = 2.69]). We quantified DNAm in saliva samples using the Illumina EPIC chip and examined CpG sites within six key HPA-axis genes (NR3C1, NR3C2, CRH, CRHR1, CRHR2, FKBP5) alongside 59 genotypes for tagging SNPs capturing cis genetic variability. DNAm levels within CpG sites in NR3C1, CRH, CRHR1, and CRHR2 were associated with risk for MDD across adolescence and young adulthood. To rule out the possibility that findings were merely due to the contribution of genetic variability, we re-analyzed the data controlling for cis genetic variation within these candidate genes. Importantly, methylation levels in these CpG sites continued to significantly predict the onset of MDD, suggesting that variation in the epigenome, independent of proximal genetic variants, prospectively predicts the onset of MDD. These findings suggest that variation in the HPA axis at the level of the methylome may predict the development of MDD.

Is one secure attachment enough? Infant cortisol reactivity and the security of infant-mother and infant-father attachments at the end of the first year

Attachment security is theorized to shape stress reactivity, but extant work has failed to find consistent links between attachment security to mothers and infant cortisol reactivity. We examined family configurations of infant-mother and infant-father attachment security in relation to infant cortisol reactivity. One-year old infants (N = 180) participated in the Strange Situation with mothers and fathers in two counterbalanced lab visits, one month apart (12 and 13 months). Infants with secure attachments only to their fathers and not their mothers had higher cortisol levels than infants with a secure attachment to mother and also exhibited a blunted cortisol response (high at baseline and then a decrease after stress). Results suggest that a secure attachment to father may not be enough to reduce infant stress reactivity when the infant-mother attachment is insecure, and future research is needed to uncover the family dynamics that underlie different family configurations of attachment security.

Early life stress, cortisol, frontolimbic connectivity, and depressive symptoms during puberty

Early life stress (ELS) is a risk factor for the development of depression in adolescence; the mediating neurobiological mechanisms, however, are unknown. In this study, we examined in early pubertal youth the associations among ELS, cortisol stress responsivity, and white matter microstructure of the uncinate fasciculus and the fornix, two key frontolimbic tracts; we also tested whether and how these variables predicted depressive symptoms in later puberty. A total of 208 participants (117 females; M age = 11.37 years; M Tanner stage = 2.03) provided data across two or more assessment modalities: ELS; salivary cortisol levels during a psychosocial stress task; diffusion magnetic resonance imaging; and depressive symptoms. In early puberty there were significant associations between higher ELS and decreased cortisol production, and between decreased cortisol production and increased fractional anisotropy in the uncinate fasciculus. Further, increased fractional anisotropy in the uncinate fasciculus predicted higher depressive symptoms in later puberty, above and beyond earlier symptoms. In post hoc analyses, we found that sex moderated several additional associations. We discuss these findings within a broader conceptual model linking ELS, emotion dysregulation, and depression across the transition through puberty, and contend that brain circuits implicated in the control of hypothalamic-pituitary-adrenal axis function should be a focus of continued research.

Transcriptome profiles of corticosterone-induced cytotoxicity reveals the involvement of neurite growth-related genes in depression

Corticosterone (CORT), the main HPA-axis glucocorticoid hormone in rodents, is involved in the regulation of animal stress responses. However, the neural mechanisms underlying the effects of corticosteroids on depression are yet to be elucidated. We found that fluoxetine reversed neurite growth inhibition induced by CORT in PC12 cells, a widely used model system for neurobiological and neurotoxicological studies. Transcriptome profiling showed that 1,609 genes were up-regulated, whereas 1,764 genes were down-regulated significantly in the CORT group in comparison with the Control group. Of them, the expression of 589 DEGs was reversed after fluoxetine treatment, and genes related to cell morphogenesis, neurite growth, and immune function were involved in the neuroprotective effect of fluoxetine against CORT. Furthermore, expression of neurite growth-related genes, such as such as Calpain 2 (Capn2), vesicle-associated membrane protein 7 (Vamp7) and C-type natriuretic peptide (Cnp), altered in a brain region- or treatment-specific manner in the animal models of depression. Therefore, the interaction between stress, glucocorticoids, and neurite growth inhibition may be a candidate pathophysiology underlying major depressive disorder (MDD), and the identification of Capn2, Vamp7 and Cnp might provide insight into treatment of MDD.

Validating a Self-Report Measure of Student Athletes' Perceived Stress Reactivity: Associations With Heart-Rate Variability and Stress Appraisals

Student athletes experience multiple stressors relating to both their sporting and academic commitments. Individual differences play a significant role in how well student athletes cope with the demands they face. When assessing individual differences in stress reactivity, there are a lack of valid alternatives to costly and time-consuming lab-based physiological methods (e.g., cortisol sampling, cardiac variables). This paper aims to further validate a self-report measure of adolescent athletes’ individual differences in perceived stress reactivity, by comparing to a psycho-physiological measure of emotion regulation (heart-rate variability) assessed during a socially evaluated cold pressor test. 30 student athletes and 31 student non-athletes completed a measure of perceived stress reactivity and took part in the socially evaluated cold pressor test while their heart-rate variability was assessed, along with their self-reported appraisals of stress, pain, and unpleasantness experienced during the procedure. Controlling for gender and athleticism, individual differences in perceived stress reactivity showed no associations with tonic or phasic levels of heart-rate variability. However, perceived stress reactivity was associated with levels of self-reported stress, pain, and unpleasantness experienced during the socially evaluated cold pressor test. These findings therefore suggest that perceived stress reactivity is associated with cognitive responses to stress (i.e., stress appraisals). However, further research is needed to confirm its relationship with physiological measures and responses. This further adds to the understanding of perceived stress reactivity, and validity of the perceived stress reactivity scale for adolescent athletes.

Heightened HPA-axis stress reactivity and accelerated pubertal progression predicts depressive symptoms over 4-year follow up

Pubertal timing has been suggested as biological factors implicated in the onset of depression in girls. This study aims to examine the prospective association between accelerated pubertal progression with depressive symptoms, and to further explore the possible role of individual reactivity to social stress in this association. A total of 56 girls with early puberty timing (assessed through breast Tanner stage) and 56 age-matched normal breast development girls were recruited at Wave 1 (grade 3) and followed for 4 years biennially. Hypothalamic-pituitary-adrenal axis stress reactivity was indexed by four cortisol samples collected before, during and after the Groningen Social Stress Test (GSST) at Wave 1. Depressive symptoms were interviewed through Mood & Feeling Questionnaire (MFQ) at each wave. About 42.9% (24/56) from early pubertal timing group and 19.6% (11/56) from normal control group were found accelerated breast development during 4-year follow-up. Mixed effects linear models illustrated that among accelerated breast development girls, those with heightened stress reactivity is likely to have a 6.62 (95% CI, 1.14-12.11)-point higher MFQ scores, and 41.9% (95%CI: 25.2 to 58.6%) higher probability for depressive symptoms, compared with girls with persistent normal breast development and moderate stress reactivity. However, no similar effects were found in girls with accelerated breast development but attenuated stress reactivity. The finding suggests that heightened cortisol reactivity to social stress may represent a useful biomarker in identifying girls at greatest risk of development of depressive symptoms following accelerated pubertal progression.

Puberty Education in a Global Context: Knowledge Gaps, Opportunities, and Implications for Policy

Youth programs and policies provide opportunities for institutions and societies to support healthy adolescent development. Puberty education programs are universally important, as they provide crucial knowledge and skills to help youth and their caregivers navigate the physical, emotional, and interpersonal changes of puberty with positive outcomes. However, few puberty programs have been rigorously evaluated, resulting in a lack of evidence-based knowledge and practice in this area. This review examines the status of research on puberty education and related programs and draws on the broader intervention literature and recent research findings on adolescence to identify program features that might improve program effectiveness. Implications for policy are also discussed. The need for rigorous program evaluation is emphasized throughout.

Conceptualizing Puberty as a Window of Opportunity for Impacting Health and Well-Being Across the Life Span

We promote the perspective that puberty, a separate biological process embedded in adolescence, is a "window of opportunity" for understanding and impacting health and development. First, we include a brief overview of pubertal change. Second, we propose a critical role for puberty in shaping life span health due to its connections with early life precursors, health issues and risks emerging during puberty, and health in young adulthood and beyond. Next, we discuss the importance of puberty measures in developmental research and suggest ways to make the science of puberty an important standalone research entity, as well as an essential component of studies conducted during adolescence. Finally, we discuss measurement issues, novel theoretical models of puberty, and the necessity of adopting an interdisciplinary perspective in research on puberty and in adolescence more broadly.

Stress reactivity in healthy child offspring of parents with anxiety disorders

Several studies suggest that anxiety disorders (AD) involve dysregulation of the autonomic nervous system (ANS) and hypothalamic-pituitary (HPA) axis. However, it is unknown if alterations in these biological systems are premorbid markers of AD risk or a state-dependent feature of anxiety. This study examined ANS and HPA-axis response to a laboratory stressor in healthy child offspring of parents with (n = 55) and without (n = 98) a history of AD. High frequency heart rate variability (HF-HRV) was assessed during sitting and standing baseline conditions and during a speech task where participants remained standing. Salivary cortisol was measured at baseline and at 15, 30, 45 and 60 min post-speech. Subjective anxiety was assessed with a visual analogue scale. Children of parents with AD displayed reduced HRV and a blunted cortisol response to the speech task compared to children of non-anxious parents. No risk group effect was found for anxiety ratings. These preliminary data suggest that healthy children of anxious parents exhibit altered stress reactivity to an acute laboratory stressor. Further research is needed to confirm findings and identify mechanisms that may account for altered self-regulation processes to a stressor in children at familial risk for AD.

At-risk studies and clinical antecedents of psychosis, bipolar disorder and depression: a scoping review in the context of clinical staging

Identifying young people at risk of developing serious mental illness and identifying predictors of onset of illness has been a focus of psychiatric prediction research, particularly in the field of psychosis. Work in this area has facilitated the adoption of the clinical staging model of early clinical phenotypes, ranging from at-risk mental states to chronic and severe mental illness. It has been a topic of debate if these staging models should be conceptualised as disorder-specific or transdiagnostic. In order to inform this debate and facilitate cross-diagnostic discourse, the present scoping review provides a broad overview of the body of literature of (a) longitudinal at-risk approaches and (b) identified antecedents of (homotypic) illness progression across three major mental disorders [psychosis, bipolar disorder (BD) and depression], and places these in the context of clinical staging. Stage 0 at-risk conceptualisations (i.e. familial high-risk approaches) were identified in all three disorders. However, formalised stage 1b conceptualisations (i.e. ultra-high-risk approaches) were only present in psychosis and marginally in BD. The presence of non-specific and overlapping antecedents in the three disorders may support a general staging model, at least in the early stages of severe psychotic or mood disorders.

Developmental influences on stress response systems: Implications for psychopathology vulnerability in adolescence

The adolescent transition is marked by increases in stress exposure and significant maturation of neural and hormonal stress processing systems. Variability in the development of these systems during adolescence may influence the risk for stress-related psychopathology. This paper aims to review the developmental maturation of the HPA axis and related stress regulation systems, and demonstrate how interference in this adaptive developmental process may increase the risk for negative outcomes. We argue that the developmental maturation of the HPA axis aims to improve the regulatory capacity of the axis in order to more adaptively respond to these increases in stress reactivity. Additionally, we review evidence that sex differences in the development of the HPA and related axes may contribute to sex differences in the risk for stress-related psychopathology. Finally, we discuss how contextual factors, such as early trauma and obesity may alter the development of HPA axis during the adolescence transition and how alterations of normative development increase the risk for stress-related disorders.

Macrophage migration inhibitory factor (MIF) gene is associated with adolescents' cortisol reactivity and anxiety

Emerging evidence points to interactions between inflammatory markers and stress reactivity in predicting mental health risk, but underlying mechanisms are not well understood. Macrophage Migration Inhibitory Factor (MIF) is a pleiotropic cytokine involved in inflammatory signaling and Hypothalamus Pituitary Adrenal (HPA) axis stress-response, and has recently been identified as a candidate biomarker for depression and anxiety risk. We examined polymorphic variations of the MIF gene in association with baseline MIF levels, HPA axis reactivity, and self-reported anxiety responses to a social stressor in 74 adolescents, ages 10-14 years. Genotyping was performed for two polymorphisms, the -794 CATT5-8 tetranucleotide repeat and the -173*G/C single nucleotide polymorphism (SNP). Youth carrying the MIF-173*C and CATT7 alleles displayed attenuated cortisol reactivity when compared with non-carriers. Children with the CATT7-173*C haplotype displayed lower cortisol reactivity to the stressor compared to those without this haplotype. Additionally, the CATT5-173*C and CATT6-173*C haplotypes were associated with lower self-reported anxiety ratings across the stressor. Results extend prior work pointing to the influence of MIF signaling on neuroendocrine response to stress and suggest a potential pathophysiological pathway underlying risk for stress-related physical and mental health disorders. To our knowledge, these are the first data showing associations between the MIF gene, HPA axis reactivity, and anxiety symptoms during adolescence.

The cortisol reactivity threshold model: Direction of trait rumination and cortisol reactivity association varies with stressor severity

Various internalizing risk factors predict, in separate studies, both augmented and reduced cortisol responding to lab-induced stress. Stressor severity appears key: We tested whether heightened trait-like internalizing risk (here, trait rumination) predicts heightened cortisol reactivity under modest objective stress, but conversely predicts reduced reactivity under more robust objective stress. Thus, we hypothesized that trait rumination would interact with a curvilinear (quadratic) function of stress severity to predict cortisol reactivity. Evidence comes from 85 currently non-depressed emerging adults who completed either a non-stressful control protocol (n = 29), an intermediate difficulty Trier Social Stress Test (TSST; n = 26), or a robustly stressful negative evaluative TSST (n = 30). Latent growth curve models evaluated relationships between trait rumination and linear and quadratic effects of stressor severity on the change in cortisol and negative affect over time. Among other findings, a significant Trait Rumination x Quadratic Stress Severity interaction effect for cortisol's Quadratic Trend of Time (i.e., reactivity, B = .125, p = .017) supported the hypothesis. Rumination predicted greater cortisol reactivity to intermediate stress (r_p = .400, p = .043), but blunted reactivity to more robust negative evaluative stress (r_p = -0.379, p = 0.039). Contrasting hypotheses, negative affective reactivity increased independently of rumination as stressor severity increased (B = .453, p = 0.044). The direction of the relationship between an internalizing risk factor (trait rumination) and cortisol reactivity varies as a function of stressor severity. We propose the Cortisol Reactivity Threshold Model, which may help reconcile several divergent reactivity literatures and has implications for internalizing psychopathology, particularly depression.

Like mother like daughter: putamen activation as a mechanism underlying intergenerational risk for depression

Having a depressed mother is one of the strongest predictors for developing depression in adolescence. Given the role of aberrant reward processing in the onset and maintenance of depression, we examined the association between mothers’ and their daughters’ neural response to the anticipation of reward and loss. Fifteen non-depressed mothers with a history of recurrent depression and their never-disordered daughters, and 23 mothers without past or current depression and their never-disordered daughters, underwent functional magnetic resonance imaging while performing the monetary incentive delay task. To assess mother-daughter concordance, we first identified ROIs involved in the anticipation of reward and loss across all mother-daughter pairs. Within each of these ROIs, we examined the association between mothers’ and daughters’ neural response, and the interaction between group status and mothers’ neural response in predicting daughters’ neural response. We found a significant association between mothers’ and daughters’ putamen response to the anticipation of loss, regardless of mother’s depression history. Furthermore, pubertal stage moderated the association between mother-daughter putamen concordance. Our findings suggest a unique role of the putamen in the maternal transmission of reward learning and have important implications for understanding disorders characterized by disturbances in reward learning and processing, such as major depression.

Annual Research Review: Early adversity, the hypothalamic-pituitary-adrenocortical axis, and child psychopathology

BACKGROUND

Research on early adversity, stress biology, and child development has grown exponentially in recent years.

FINDINGS

We review the current evidence for the hypothalamic-pituitary-adrenocortical (HPA) axis as a stress-mediating mechanism between various forms of childhood adversity and psychopathology. We begin with a review of the neurobiology of the axis and evidence for relations between early adversity-HPA axis activity and HPA axis activity-psychopathology, as well as discuss the role of regulatory mechanisms and sensitive periods in development.

CONCLUSIONS

We call attention to critical gaps in the literature to highlight next steps in this research including focus on developmental timing, sex differences, stress buffering, and epigenetic regulation. A better understanding of individual differences in the adversity-HPA axis-psychopathology associations will require continued work addressing how multiple biological and behavioral systems work in concert to shape development.

Negative cognitive style and cortisol recovery accentuate the relationship between life stress and depressive symptoms

When exposed to stressful life events, a significant number of adolescents will experience depressive symptoms. One model of depression suggests that individuals with a negative cognitive style are most vulnerable to depression following life stress. Alternatively, altered activation of the hypothalamic-pituitary-adrenal axis may explain vulnerability to depression following life stress. Each of these models plausibly explains the emergence of depressive symptoms during adolescence and have been investigated largely independently. The current study recruited a sample of urban adolescents (N = 179) to evaluate whether cortisol response to a laboratory stress induction and negative cognitive style are related and whether they independently interact with exposure to stressful life events to predict symptoms of depression. Negative cognitive style was not associated with cortisol response to the laboratory stressor. Rather, negative cognitive style and cortisol recovery independently interacted with stressful life events to predict current symptoms of depression. Results support a heterogeneous etiology of depression.

The stress response HPA-axis hormone, glucocorticoid, reduces cellular SKA complex gene expression

The Spindle- and Kinetochore-Associated (SKA) complex has been proven to be involved in many human mental behavioral disorders. Glucocorticoid, a hypothalamic-pituitary-adrenal (HPA) axis hormone, is a critical mediator of stress response in neurons. However, the underlying mechanisms of glucocorticoid's effects on human neuronal cells remain unclear. This study demonstrates that increased extracellular glucocorticoid levels significantly reduce neuronal cell SKA complex genes' expression levels, followed by altered neuronal cell viability and neurite development. The results suggest that the abnormality of this HPA-axis hormone could impact the neuronal cell functions through the alternation of SKA complex functions, which might induce cell death.