The cortisol awakening response (CAR) interacts with acute interpersonal stress to prospectively predict depressive symptoms among early adolescent girls

State rumination links major life stressors to acute stressor cortisol response in healthy adults

Experiencing major life stressors is associated with negative health outcomes, yet the mechanisms are not fully understood. Major stressors are threatening, discrete events that can have lingering consequences on emotional and cognitive processes. This can lead to maladaptive coping strategies, such as rumination, that compromise the ability to handle subsequent stressors and disrupt the hypothalamic-pituitary-adrenal (HPA) axis response. Based on the Perseverative Cognition Hypothesis, it was hypothesized that greater exposure to major stressors would be associated with greater rumination during a laboratory stressor, which, in turn, would predict higher cortisol reactivity and peak and delayed recovery. Participants were 211 healthy adults (Mage = 30.2, SD = 10.9, range = 18 - 55) who underwent the Trier Social Stress Test and self-reported rates of major stressors in the past 12 months and stress-related state rumination. Two-piece growth curve modeling with landmark registration was used to calculate peak salivary cortisol levels along with cortisol reactivity and recovery slopes to capture individual differences in the trajectory of cortisol response. Results showed that state rumination significantly mediated the link between more major stressors and elevated peak cortisol levels as well as steeper reactivity and recovery slopes. Interpersonal stressors and non-interpersonal stressors showed similar associations to cortisol response via state rumination. This study enhances our understanding of how stress contributes to HPA axis dysregulation by connecting major stressors with acute stressors, pointing at stress-induced rumination as a plausible mechanism.

Interplay of Adolescents' and Parents' Mindsets of Socioeconomic Status on Adolescents' Stress-Related Outcomes

The reciprocity and variation of values and beliefs are dynamic features of the parent-child relationship. Parents and adolescents may hold congruent or incongruent views regarding the malleability of socioeconomic status (mindset of SES), potentially influencing adolescents' psychological and physiological stress outcomes, as reflected in stress perceptions and the hypothalamic-pituitary-adrenal (HPA) axis functioning. The current study investigated how patterns of parent-adolescent congruence and incongruence in mindset of SES were associated with adolescents' perceived stress and diurnal cortisol patterns four months later. A total of 253 adolescents (Mage = 12.60, 46.2% girls) and their parents (Mage = 40.09 years, 59.5% mothers) participated in this study. Polynomial regression analyses and response surface analyses showed that adolescents perceived lower levels of stress when they themselves or their parents reported a stronger growth mindset of SES. Additionally, adolescents with a stronger growth mindset of SES also exhibited a steeper diurnal cortisol slope. Moreover, parents' mindset significantly interacted with adolescents' mindset to influence adolescents' diurnal cortisol patterns such that when adolescents hold weaker growth mindset of SES, those with higher parental growth mindsets had significantly higher cortisol awakening response and steeper diurnal cortisol slope. Furthermore, adolescents who showed incongruence with their parents but had averagely stronger growth mindsets of SES reported a significantly steeper diurnal cortisol slope than those who had averagely weaker growth mindsets with their parents. The findings point to the beneficial impacts of the growth mindset of SES on stress-related outcomes among adolescents, as well as the significance of considering both parents' and adolescents' mindsets when exploring these associations.

The association between depression and the cortisol awakening response is moderated by loneliness in men from a non-clinical sample

Previous studies investigating cortisol levels in people with depression or depressive symptoms have provided mixed findings. It has been suggested that the difficulty to generalize findings across studies in this field might be related to interindividual variability in experiencing depressive symptoms in terms of clinical and social contexts. Therefore, in the present study we aimed to test the association of morning cortisol levels and depressive symptoms in a non-clinical sample of young men taking into consideration the level of perceived loneliness. We hypothesized that the level of loneliness might moderate the association between morning cortisol levels and depressive symptoms. A total of 102 participants (aged 29.9 ± 5.0 years) completed questionnaires measuring the levels of depressive and anxiety symptoms, perceived stress, and loneliness. Cortisol levels were determined in four morning samples of saliva. There were significant positive correlations of the cortisol awakening response (CAR) and the mean increase in cortisol levels during the measurement period (MnInc) with the levels of depressive symptoms and loneliness. Moreover, a significant association of the depressive symptoms by loneliness interaction with the CAR and the MnInc was found. Specifically, the correlation of depressive symptoms with the CAR and the MnInc appeared to be significant and negative at high levels of loneliness. No significant association between depressive symptoms and the CAR was observed in men with low levels of loneliness. There were no significant associations of depressive symptoms, loneliness and the depressive symptoms by loneliness interaction with cortisol levels at awakening. In conclusion, findings from the present study indicate the importance of social contexts in understanding the association between altered activity of the hypothalamic-pituitary-adrenal axis and depressive symptoms in men.

Stress Hormone Dynamics Are Coupled to Brain Serotonin 4 Receptor Availability in Unmedicated Patients With Major Depressive Disorder: A NeuroPharm Study

BACKGROUND

A prominent finding in major depressive disorder (MDD) is distorted stress hormone dynamics, which is regulated by serotonergic brain signaling. An interesting feature of the cerebral serotonin system is the serotonin 4 receptor (5-HT4R), which is lower in depressed relative to healthy individuals and also has been highlighted as a promising novel antidepressant target. Here, we test the novel hypothesis that brain 5-HT4R availability in untreated patients with MDD is correlated with cortisol dynamics, indexed by the cortisol awakening response (CAR). Further, we evaluate if CAR changes with antidepressant treatment, including a selective serotonin reuptake inhibitor, and if pretreatment CAR can predict treatment outcome.

METHODS

Sixty-six patients (76% women) with a moderate to severe depressive episode underwent positron emission tomography imaging with [11C]SB207145 for quantification of brain 5-HT4R binding using BPND as outcome. Serial home sampling of saliva in the first hour from awakening was performed to assess CAR before and after 8 weeks of antidepressant treatment. Treatment outcome was measured by change in Hamilton Depression Rating Scale 6 items.

RESULTS

In the unmedicated depressed state, prefrontal and anterior cingulate cortices 5-HT4R binding was positively associated with CAR. CAR remained unaltered after 8 weeks of antidepressant treatment, and pretreatment CAR did not significantly predict treatment outcome.

CONCLUSIONS

Our findings highlight a link between serotonergic disturbances in MDD and cortisol dynamics, which likely is involved in disease and treatment mechanisms. Further, our data support 5-HT4R agonism as a promising precision target in patients with MDD and disturbed stress hormone dynamics.

Early adversity and depressive symptoms among early adolescent girls: the mediating role of exposure to recent interpersonal acute stress

Early adversity confers risk for depression in part through its association with recent (i.e., proximal) acute stress. However, it remains unresolved whether: a) early adversity predicts increases in recent acute stress over time; b) all - or only certain types - of recent events mediate the relationship between early adversity and depression; and c) early adversity places individuals at greater risk for depression via greater exposure to independent (i.e., fateful) interpersonal events or via greater generation of dependent (i.e., partially self-initiated) interpersonal events (i.e., stress generation) or both. These questions were examined in a 3-wave longitudinal study of early adolescent girls (N = 125; M = 12.35 years [SD = .77]) with no history of diagnosable depression using contextual life stress and diagnostic interviews. Path analyses indicated that increases in past-year acute interpersonal, but not non-interpersonal, stress mediated the link between early adversity and depressive symptoms. The mediating role of interpersonal events was limited to independent ones, suggesting increases in interpersonal event exposure, not interpersonal stress generation, acted as a mediator. Finally, findings support prior evidence that early adversity may not directly predict future depressive symptoms. Implications for understanding the role of recent stress in the association between early adversity and adolescent depression are discussed.

Characteristics of psychological time in patients with depression and potential intervention strategies

Psychological time reveals information about an individual's psychological state and psychopathological traits and, thus, has become a new perspective through which the occurrence and development of depression can be examined. Psychological time includes time perception, time perspective, circadian rhythms, and passage of time. Patients with depression are characterized by inaccurate time interval estimation, habitual negative thoughts about the past and future, evening-type circadian rhythms, and slow passage of time. Habitual negative thoughts about the past and future and evening-type circadian rhythms influence the formation of depression, and poor time interval estimation and slow passage of time may result from depression. Further study is needed accurately exploring psychological time and influencing factors in patients with depression, and prospective cohort studies could further clarify this complex relationship. In addition, the study of psychological time has important implications for developing effective interventions to reduce depression.

Individual differences in latent trait cortisol (LTC): Implications for the onset and course of future depressive symptoms

Research suggests that various indicators of hypothalamic pituitary adrenal (HPA) axis activity prospectively predict depression, but few studies have evaluated whether trait indicators of HPA axis activity are related to depression. Further, no prior study has examined links between trait cortisol and psychopathology using a trait indicator that captures HPA axis activity over multiple time points. Here we examined whether we could construct an across-wave latent trait cortisol (LTC) factor using cortisol samples collected over 13 weeks, and whether the across-wave LTC prospectively predicted new depressive symptom onsets and symptom duration. Emerging adults (n = 85; M age = 19.37 years) provided salivary cortisol samples four times a day (waking, 30 min and 45 min post-waking and bedtime) over three 3-day measurement waves separated by 6 weeks. Diagnostic interviews at 3 timepoints (baseline, 1- and 2.5 years post-baseline) assessed lifetime and current depressive symptoms. Results indicated that the across-wave LTC predicted new onsets of depressive symptoms and longer symptom duration. Follow-up tests revealed that the link between the across-wave LTC and new onsets was not significant after adjusting for past depressive symptoms. These findings suggest that an indicator of individual differences in HPA axis regulation has implications for depressive symptom onsets and course.

Does stress predict the development of internalizing symptoms in middle childhood? An examination of additive, mediated, and moderated effects of early family stress, daily interpersonal stress, and physiological stress

Early life stress, daily life experiences, and the stress responsive hypothalamic-pituitary-adrenal (HPA) axis have each been examined as predictors of the development of psychopathology. Rarely have researchers attempted to understand the covariation or interaction among these stress domains using a longitudinal design in the prediction of symptoms of internalizing psychopathology, particularly during childhood. This study examined early family stress, daily interpersonal stress, indicators of diurnal cortisol, and internalizing symptoms in a racially/ethnically and socioeconomically diverse sample of twins (N = 970 children; Mage at outcome = 9.73; 52% female; 23.7% Hispanic/Latino, 58.8% White; 30% below middle class; Lemery-Chalfant et al., 2019). An additive model of stress, a stress mediation model, and a stress sensitization framework model each delineated potential pathways linking stress and internalizing symptoms. Supporting additive pathways, multilevel models showed that all 3 stress indicators uniquely predicted internalizing symptoms. There was a significant indirect path from early family stress to 9 year internalizing symptoms through interpersonal stress, supporting stress mediation. Family stress moderated the association between interpersonal stress and internalizing symptoms, though not in the direction that would support stress sensitization. Child stress, including daily interpersonal stress and HPA axis activity, and internalizing symptoms are prevalent and family stress is a significant precursor to child internalizing symptoms across child development. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Salivary Cortisol Awakening Response as a Predictor for Depression Severity in Adult Patients with a Major Depressive Episode Performing a Daily Exercise Program

INTRODUCTION

The hypothalamic-pituitary-adrenal axis function in depression has been the subject of considerable interest, and its function has been tested with a variety of methods. We investigated associations between saliva cortisol at awakening and the 24-h urine cortisol output, both measured at study baseline, with endpoint depression scores.

METHODS

Patients were admitted to a psychiatric inpatient ward with a major depressive episode and were started on fixed duloxetine treatment. They delivered saliva samples at awakening and 15, 30, and 60 min post-awakening and sampled urine for 24 h. Subsequently, they started a daily exercise program maintained for a 9-week period. Clinician-rated depression severity was blindly assessed with the Hamilton Depression Rating 6-item subscale (HAM-D6). The cortisol awakening response was quantified by the area under the curve with respect to the ground (AUCG) and with respect to the rise (AUCI) using saliva cortisol levels in the 1-h period after awakening. Analysis of expected associations between depression severity, AUCG, AUCI, exercise, and 24-h cortisol output was performed in a general linear model.

RESULTS

In all, 35 participants delivered saliva or 24-h urine samples. The mean age was 49.0 years (SD = 11.0) with 48.6% females with a mean baseline HAM-D6 score of 12.2 (SD = 2.3). In a statistical model investigating the association between HAM-D6 at week 9 as a dependent variable and AUCI, concurrent HAM-D6, gender, smoking, and exercise volume as covariates, we found a significant effect of AUCI, concurrent HAM-D6, and exercise. The following statistics were found: AUCI (regression coefficient 0.008; F value = 9.1; p = 0.007), concurrent HAM-D6 (regression coefficient 0.70; F value = 8.0; p = 0.01), and exercise (regression coefficient -0.005; F value = 5.7; p = 0.03). The model had an R2 of 0.43. The association between HAM-D6 endpoint scores and the AUCI showed that higher AUCI values predicted higher HAM-D6 endpoint values. The association between HAM-D6 endpoint scores and the exercise level showed that a high exercise level was associated with lower HAM-D6 endpoint values.

CONCLUSION

The results thus showed that high AUCI values predicted less improvement of depression and high exercise levels predicted more improvement of depression. These findings need to be confirmed in larger samples to test if more covariates can improve prediction of depression severity.

Sleep quality and neurohormonal and psychophysiological accompanying factors in adolescents with depressive disorders: study protocol

BACKGROUND

Depressive disorders are common mental health problems during adolescence. Many adolescents with depression describe difficulties with sleeping. Findings of previous studies regarding changes in objective sleep quality in adolescents with depressive disorders are heterogeneous.

AIMS

This study aims to investigate differences in objective and subjective sleep quality between adolescents with depressive disorders and healthy peers, and to evaluate if potential changes in sleep occur concurrently with changes in the release of cortisol and alpha-amylase after awakening.

METHOD

This non-interventional parallel study examines correlations between depressive disorders, sleep quality and release of stress hormones. Sleep quality in the past 2 weeks, severity of depressive symptoms, psychiatric comorbidities and stress response of 30 adolescents with depressive disorders and 30 healthy controls (N = 60) are assessed via questionnaires. In participants' home environments, the objective sleep quality of seven consecutive nights is measured by sleep accelerometry. After awakening, participants answer sleep questionnaires to examine the subjective sleep quality of those nights. Furthermore, salivary cortisol and alpha-amylase are measured three times after awakening (+0 min, +30 min and +45 min after awakening).

CONCLUSIONS

Sleep is an important factor for prognosis and well-being in adolescents with depression. The results of this study can be highly valuable to integrate a more detailed examination of sleep quality and sleeping impairments in the treatment of adolescent depressive disorders.

Prevalence and prediction of PTSD and depression in mothers of children surviving a motor vehicle crash

Introduction: Few studies have examined the psychopathological consequences for parents of children who were survivors of a motor vehicle crash (MVC). This study assessed the impact of dissociation and peritraumatic distress on the severity of PTSD and post-traumatic major depressive episode (MDE) symptoms in mothers during the first years after the MVC and the role that cortisol response might play in this association. Methods: 125 mothers were included. Peritraumatic distress and dissociation were assessed. Morning salivary cortisol was tested at the baseline. Participants were assessed for a probable diagnosis of PTSD and MDE at 5 weeks, 6 months and 12 months. Results: At 5 weeks, 12 (13.6%) mothers exhibited probable PTSD. During the first year, the PCL score was higher when the (i) Peritraumatic Distress Inventory (PDI) score increased and (ii) the Peritraumatic Dissociation Experience Questionnaire (PDEQ) score increased. Cortisol levels were lower when the PDI score increased. Conclusion: This is the first study to assess the mothers of MVC survivors for one year following the trauma. We confirm that peritraumatic responses are useful for predicting the severity of PTSD symptoms. These results could encourage the implementation of follow-up programmes not only for survivors but also for their mothers. HIGHLIGHTS Mothers of children involved in motor vehicle accident are at risk for developing PTSD.Peritraumatic responses (distress and dissociation) are associated to the severity of PTSD symptoms.Low salivary cortisol levels were associated with high peritraumatic distress.

The Mediating and Moderating Roles of Life Skills and Cortisol in the Relationship Between Sleep Quality and Depressive Symptoms Among Chinese Adolescents With Childhood Household Dysfunction

BACKGROUND

Various studies show that sleep quality, life skills, and cortisol are associated with depressive symptoms, separately. However, the relationships between sleep quality, life skills, cortisol, and depressive symptoms remain unclear. Thus, this study aims to examine the mediating or moderating roles of life skills and cortisol in the relationship between sleep quality and depressive symptoms.

METHODS

A retrospective cross-sectional study was performed among 212 adolescents with childhood household dysfunction (CHD) from August to October 2020 in China. We used the Pittsburgh Sleep Quality Index, the Secondary School Student Life Skills Rating Scale, and the Center for Epidemiologic Studies Depression Scale to measure sleep quality, life skills, and depressive symptoms, respectively. Additionally, 65 participants provided blood samples to assess their blood cortisol levels. Analyses included correlations, regressions, and structural equation models. Bootstrapping was performed to examine the mediation effect. Multiple regression analysis was performed to examine the moderation effect.

RESULTS

The results showed that sleep quality and life skills were significantly associated with depressive symptoms (p < 0.01). Life skills mediated the relationship between sleep quality and depressive symptoms. Cortisol moderated the relationship between sleep quality and depressive symptoms.

CONCLUSION

Our findings support potential mediating and moderating roles of life skills and cortisol in the relationship between sleep quality and depressive symptoms, which suggests improving sleep quality, life skills are of great significance in the prevention and intervention of depression in adolescents with CHD, and disseminating knowledge about the high risk of developing increased depressive symptoms among adolescents with CHD with higher cortisol levels is indicated.

The cortisol awakening response and the late positive potentials evoked by unpleasant emotional pictures in healthy adults

The cortisol awakening response (CAR) refers to a sharp rise in cortisol concentrations within the 45 min following morning awakening. Alterations in CAR have been associated with various internalizing symptoms and brain function. The current study aimed to investigate the association between CAR and neural activity in response to unpleasant emotional pictures. A total of 46 healthy adults (22.55 years ± 1.69) collected saliva samples at 0, 30, and 45 min post-awakening on two days to assess the CAR. In the afternoon after CAR measurement on the first day, electroencephalograms were recorded when the participants completed a passive viewing task. The results showed that a greater CAR was associated with a decreased late positive potential difference score between unpleasant and neutral stimuli. This finding indicates that a larger CAR may be associated with decreased attentional engagement to unpleasant emotional information in healthy adults.

Biological, Psychological, and Social Determinants of Depression: A Review of Recent Literature

Depression is one of the leading causes of disability, and, if left unmanaged, it can increase the risk for suicide. The evidence base on the determinants of depression is fragmented, which makes the interpretation of the results across studies difficult. The objective of this study is to conduct a thorough synthesis of the literature assessing the biological, psychological, and social determinants of depression in order to piece together the puzzle of the key factors that are related to this condition. Titles and abstracts published between 2017 and 2020 were identified in PubMed, as well as Medline, Scopus, and PsycInfo. Key words relating to biological, social, and psychological determinants as well as depression were applied to the databases, and the screening and data charting of the documents took place. We included 470 documents in this literature review. The findings showed that there are a plethora of risk and protective factors (relating to biological, psychological, and social determinants) that are related to depression; these determinants are interlinked and influence depression outcomes through a web of causation. In this paper, we describe and present the vast, fragmented, and complex literature related to this topic. This review may be used to guide practice, public health efforts, policy, and research related to mental health and, specifically, depression.

The codevelopment of adolescents' and parents' anxiety and depression: Moderating influences of youth gender and psychophysiology

METHODS

In a 2-year longitudinal study of 220 families, we examined how youth gender and adrenocortical and parasympathetic activity moderated reciprocal, bidirectional relations between parent and youth anxiety and depression problems.

RESULTS

Maternal anxiety predicted subsequent youth anxiety and depression. Maternal depression predicted youth anxiety and, for daughters and youth with low adrenocortical reactivity, youth depression. Youth depression predicted maternal depression only for youth with high adrenocortical reactivity. There were no associations between paternal and youth psychopathology.

DISCUSSION

Examining youth gender and psychophysiological characteristics that shape the nature of bidirectional influences may inform efforts to identify families at heightened risk for intergenerational transmission of psychopathology.

School commute time, chronotype, and altered HPA axis functioning during adolescence

Hypothalamic pituitary adrenal gland (HPA) axis functioning has been linked with daily demands during adolescence. A ubiquitous, yet understudied daily demand in the lives of youth is the commute to school, which may be associated with the diurnal rhythm of cortisol as demonstrated in prior research among adults. The current study hypothesized that longer school commute times would be associated with altered HPA axis functioning as demonstrated by a heightened cortisol awakening response (CAR) and flatter diurnal slope. Additionally, given that the HPA axis follows a diurnal rhythm and adolescence is marked by changes in the circadian rhythm, adolescents with a more evening chronotype were hypothesized to evince even more altered HPA axis functioning in the face of long school commute times. A total of 269 adolescents (M = 16.38 years, SD = 0.74) provided saliva samples at wake, 15-min. post-wake, and 30-min. post-wake for the calculation of CAR and at dinnertime and bedtime for the calculation of diurnal slope, completed up to 8 nights of sleep actigraphy, and self-reported school commute time. Results suggest that more evening chronotype youth with longer school commute times evince a higher CAR, but not an altered diurnal slope. The present findings may have implications for adolescent mental health as higher CAR has been associated poor mental health and heightened stress.

Emotion Regulation and Diurnal Cortisol: A Longitudinal Study of Early Adolescents

Aberrant patterns of diurnal cortisol, a marker of stress reactivity, predict adverse physical and mental health among adolescents. However, the mechanisms underlying aberrant diurnal cortisol production are poorly understood. Thus, the objective of this study was to investigate, for the first time, whether the core emotion regulation (ER) strategies of rumination (brooding, reflection), reappraisal, and suppression were prospectively associated with individual differences in diurnal cortisol during the COVID-19 pandemic, a period of significant stress. A community sample of 48 early adolescents (M_age=13.45; 60% males) was recruited from British Columbia, Canada. Participants completed ER measures before the pandemic, and diurnal cortisol was assessed by collecting eight saliva samples over two days during the first COVID-19-related lockdown in the region. As expected, brooding predicted elevated waking cortisol and a blunted cortisol awakening response (CAR), whereas reflection predicted lower waking cortisol and suppression predicted a steeper CAR. Unexpectedly, reappraisal was not associated with diurnal cortisol production. Results indicate that ER strategies may represent a mechanism underlying individual differences in biological markers of wellbeing during stress.

The longitudinal association between individual differences in recall of positive specific autobiographical memories and daily cortisol

The present study examines the longitudinal association between cortisol (dys)regulation - mean cortisol awakening response (CAR) and area under the curve with respect to ground (AUCg) for total daily cortisol - and autobiographical memory. 135 participants (mean age at baseline = 16.1; Females = 78.5 %) provided cortisol samples (T1). Seven months later participants retrieved autobiographical memories cued by positive and negative words (T2). Four years subsequently, participants provided cortisol samples again (T3). The retrieval of more specific memories cued by positive words, but not negative words, was associated with higher AUCg four years later, independent of sex, recent life stressors and self-reported negative self-related cognitions. There were no associations between CAR and autobiographical memory. Neither AUC nor CAR at T1 predicted subsequent autobiographical memory abilities. People who retrieve more positive specific memories may be more likely to imagine and seek out positive experiences and this may be associated with higher cortisol levels.

Differential Susceptibility to the Impact of the COVID-19 Pandemic on Working Memory, Empathy, and Perceived Stress: The Role of Cortisol and Resilience

There are important individual differences in adaptation and reactivity to stressful challenges. Being subjected to strict social confinement is a distressful psychological experience leading to reduced emotional well-being, but it is not known how it can affect the cognitive and empathic tendencies of different individuals. Cortisol, a key glucocorticoid in humans, is a strong modulator of brain function, behavior, and cognition, and the diurnal cortisol rhythm has been postulated to interact with environmental stressors to predict stress adaptation. The present study investigates in 45 young adults (21.09 years old, SD = 6.42) whether pre-pandemic diurnal cortisol indices, overall diurnal cortisol secretion (AUCg) and cortisol awakening response (CAR) can predict individuals' differential susceptibility to the impact of strict social confinement during the Coronavirus Disease 2019 (COVID-19) pandemic on working memory, empathy, and perceived stress. We observed that, following long-term home confinement, there was an increase in subjects' perceived stress and cognitive empathy scores, as well as an improvement in visuospatial working memory. Moreover, during confinement, resilient coping moderated the relationship between perceived stress scores and pre-pandemic AUCg and CAR. In addition, in mediation models, we observed a direct effect of AUCg and an indirect effect of both CAR and AUCg, on change in perceived self-efficacy. These effects were parallelly mediated by the increase in working memory span and cognitive empathy. In summary, our findings reveal the role of the diurnal pattern of cortisol in predicting the emotional impact of the COVID-19 pandemic, highlighting a potential biomarker for the identification of at-risk groups following public health crises.

The interactive association of proximal life stress and cumulative HPA axis functioning with depressive symptoms

BACKGROUND

Stress is consistently implicated in depression. Using a vulnerability-stress framework, the hypothalamic-pituitary-adrenal (HPA) axis may be one factor affecting the stress-depression association. However, the interactive influence of recent life stress and HPA axis functioning on depressive symptoms remains unclear. It is particularly important to understand the synergistic association during adolescence, as this is a developmental period associated with a high risk for depression.

METHODS

A community sample of 58 adolescents (67% female, 59% Caucasian; mean age, 15.07 years) participated. Adolescents completed a well-validated measure of depressive symptoms and a structured life events interview to assess recent life stress. Hair cortisol concentration was obtained to measure cumulative exposure to HPA axis functioning.

RESULTS

Recent life stress and cumulative HPA axis exposure measured through hair cortisol were directly associated with higher depressive symptoms. Further, cumulative HPA axis exposure moderated the relationship between recent life stress and depressive symptoms. The recent life stress-depression association occurred for adolescents who experienced average and high, but not low, levels of cumulative HPA axis exposure.

CONCLUSIONS

The current study builds on prior work and finds both a direct and interactive association of recent life stress and cumulative HPA axis functioning with depressive symptoms during adolescence. Identifying youth who experience high levels of HPA axis exposure is important to prevent the onset of depression.

Cortisol awakening response and additive serotonergic genetic risk interactively predict depression in two samples: The 2019 Donald F. Klein Early Career Investigator Award Paper

BACKGROUND

The serotonin system and hypothalamic pituitary-adrenal (HPA)-axis are each implicated in the pathway to depression; human and animal research support these systems' cross-talk. Our work implicates a 5-variant additive serotoninergic multilocus genetic profile score (MGPS) and separately the cortisol awakening response (CAR) in the prospective prediction of depression; other work has shown that the serotonin transporter polymorphism 5HTTLPR predicts CAR and interacts with the CAR to predict depression.

METHODS

We tested the hypothesis that a 6-variant MGPS (original plus 5HTTLPR) would interact with CAR to predict prospective depressive episode onsets in 201 emerging adults using four annual follow-up interviews. We also tested whether MGPS predicted CAR. We attempted replication of significant findings in a sample of 77 early adolescents predicting depression symptoms.

RESULTS

In sample 1, MGPS did not significantly predict CAR. MGPS interacted with CAR to predict depressive episodes; CAR slopes for depression steepened as MGPS increased, for risk or protection. No single variant accounted for results, though CAR's interactions with 5HTTLPR and the original MGPS were both significant. In sample 2, the 6-variant MGPS significantly interacted with CAR to predict depression symptoms.

CONCLUSIONS

Higher serotonergic MGPS appears to sensitize individuals to CAR level-for better and worse-in predicting depression.