Neural systems of positive affect: relevance to understanding child and adolescent depression?

Stability and change in maternal wellbeing and illbeing from pregnancy to three years postpartum

PURPOSE

Motherhood affects women's mental health, encompassing aspects of both wellbeing and illbeing. This study investigated stability and change in wellbeing (i.e., relationship satisfaction and positive affect) and illbeing (i.e., depressive and anxiety symptoms) from pregnancy to three years postpartum. We further investigated the mutual and dynamic relations between these constructs over time and the role of genetic propensities in their time-invariant stability.

DATA AND METHODS

This four-wave longitudinal study included 83,124 women from the Norwegian Mother, Father, and Child Cohort Study (MoBa) linked to the Medical Birth Registry of Norway. Data were collected during pregnancy (30 weeks) and at 6, 18 and 36 months postpartum. Wellbeing and illbeing were based on the Relationship Satisfaction Scale, the Differential Emotions Scale and Hopkins Symptoms Checklist-8. Genetics were measured by the wellbeing spectrum polygenic index. Analyses were based on random intercept cross-lagged panel models using R.

RESULTS

All four outcomes showed high stability and were mutually interconnected over time, with abundant cross-lagged predictions. The period of greatest instability was from pregnancy to 6 months postpartum, followed by increasing stability. Prenatal relationship satisfaction played a crucial role in maternal mental health postpartum. Women's genetic propensity to wellbeing contributed to time-invariant stability of all four constructs.

CONCLUSION

Understanding the mutual relationship between different aspects of wellbeing and illbeing allows for identifying potential targets for health promotion interventions. Time-invariant stability was partially explained by genetics. Maternal wellbeing and illbeing develop in an interdependent way from pregnancy to 36 months postpartum.

Dissecting the antidepressant effect of troxerutin: modulation of neuroinflammatory and oxidative stress biomarkers in lipopolysaccharide-treated mice

The role of neuroinflammation in the pathogenesis of depression has prompted the search for new antidepressants. Troxerutin, a bioflavonoid with anti-inflammatory and antioxidant properties, has shown promise, but its impact on neurobehavioral functions remains poorly understood. This study aimed to investigate the antidepressant potential of troxerutin and its effect on the neuroinflammatory response. Here, we exposed male Swiss mice (n = 5/group) to various treatments, including naive and negative controls receiving distilled water, troxerutin-treated groups administered at different doses (10, 20, 40 mg/kg, i.p.), and an imipramine-treated group (25 mg/kg, i.p.). After seven days of treatment, with the exception of the naive group, mice were administered a single dose of lipopolysaccharide (LPS, 0.83 mg/kg). Behavioral evaluations, consisting of the novelty-suppressed feeding (NSF) test, forced swim test (FST), and open field test (OFT), were conducted. Additionally, brain samples were collected for biochemical and immunohistochemical analyses. Troxerutin significantly reduced immobility time in the FST and mitigated behavioral deficits in the NSF test. Additionally, troxerutin increased glutathione (GSH) and superoxide dismutase (SOD) levels while reducing nitrite, malondialdehyde (MDA), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interferon-gamma (IFN-γ) levels compared to the negative control. Immunohistochemistry analysis revealed decreased expression of inducible nitric oxide synthase (iNOS) and nuclear factor-kappa B (NF-κB) in troxerutin-treated mice. Overall, these findings suggest that troxerutin exerts significant antidepressive-like effects, likely mediated by its anti-inflammatory and antioxidant mechanisms. The reduction in neuroinflammatory and oxidative stress biomarkers, along with the improvement in behavioral outcomes, underscores troxerutin's potential as a therapeutic agent for depression.

Annual Research Review: Puberty and the development of anhedonia - considering childhood adversity and inflammation

Anhedonia, or diminished pleasure and motivation, is a symptom of severe mental illness (e.g., depressive disorder, bipolar disorder, schizophrenia) that emerges during adolescence. Anhedonia is a pernicious symptom that is related to social impairments, treatment resistance, and suicide. As the mechanisms of anhedonia are postulated to include the frontostriatal circuitry and the dopamine neuromodulatory system, the development and plasticity of these systems during the vulnerable period of adolescence, as well as their sensitivity to pubertal hormones, suggest that pubertal maturation could play a role in the development of anhedonia. This review takes a developmental perspective, considering the possibility that anhedonia emerges in the context of pubertal maturation and adolescent development, with childhood adversity and chronic inflammation influencing neural reward systems to accelerate anhedonia's progression. Here, we review the relevant extant literature on the components of this model and suggest directions for future research.

Distinct functional patterns in child and adolescent bipolar and unipolar depression during emotional processing

Accumulating evidence from functional magnetic resonance imaging studies supported brain dysfunction during emotional processing in bipolar disorder (BD) and major depressive disorder (MDD). However, child and adolescent BD and MDD could display different activation patterns, which have not been fully understood. This study aimed to investigate common and distinct activation patterns of pediatric BD (PBD) and MDD (p-MDD) during emotion processing using meta-analytic approaches. Literature search identified 25 studies, contrasting 252 PBD patients, and 253 healthy controls (HCs) as well as 311 p-MDD patients and 263 HCs. A total of nine meta-analyses were conducted pulling PBD and p-MDD experiments together and separately. The results revealed that PBD and p-MDD showed distinct patterns during negative processing. PBD patients exhibited activity changes in bilateral precuneus, left inferior parietal gyrus, left angular gyrus, and right posterior cingulate cortex while p-MDD patients showed functional disruptions in the left rectus, left triangular part of the inferior frontal gyrus, left orbital frontal cortex, left insula, and left putamen. In conclusion, the activity changes in PBD patients were mainly in regions correlated with emotion perception while the dysfunction among p-MDD patients was in the fronto-limbic circuit and reward-related regions in charge of emotion appraisal and regulation.

The effects of Lysergic Acid Diethylamide (LSD) on the Positive Valence Systems: A Research Domain Criteria (RDoC)-Informed Systematic Review

BACKGROUND AND OBJECTIVES

The renewed interest in psychedelic research provides growing evidence of potentially unique effects on various aspects of reward processing systems. Using the Research Domain Criteria (RDoC) framework, as proposed by the National Institute of Mental Health, we aim to synthesize the existing literature concerning the impact of lysergic acid diethylamide (LSD) on the RDoC's Positive Valence Systems (PVS) domain, and to identify potential avenues for further research.

METHODS

Two LSD-related terms (lysergic acid diethylamide and LSD) and 13 PVS-related terms (reward, happiness, bliss, motivation, reinforcement learning, operant, conditioning, satisfaction, decision making, habit, valence, affect, mood) were used to search electronic databases such as PubMed, Scopus, PsychINFO, and Web of Science for relevant articles. A manual search of the reference list resulted in nine additional articles. After screening, articles and data were evaluated and included based on their relevance to the objective of investigating the effects of LSD on the PVS. Articles and data were excluded if they did not provide information about the PVS, were observational in nature, lacked comparators or reference groups, or were duplicates. A risk of bias assessment was performed using the National Toxicology Program's Office of Health Assessment and Translation (NTP OHAT) risk of bias (RoB) tool. Data from the included articles were collected and structured based on the RDoC bio-behavioral matrix, specifically focusing on the PVS domain and its three constituent constructs: reward responsiveness, reward learning, and reward valuation.

RESULTS

We reviewed 28 clinical studies with 477 participants. Lysergic acid diethylamide, assessed at self-report (23 studies), molecular (5 studies), circuit (4 studies), and paradigm (3 studies) levels, exhibited dose-dependent mood improvement (20 short-term and 3 long-term studies). The subjective and neural effects of LSD were linked to the 5-HT2A receptor (molecular). Animal studies (14 studies) suggested LSD could mildly reinforce conditioned place preference without aversion and reduce responsiveness to other rewards. Findings on reward learning were inconsistent but hinted at potential associative learning enhancements. Reward valuation measures indicated potential reductions in effort expenditure for other reinforcers.

CONCLUSION

Our findings are consistent with our previous work, which indicated classical psychedelics, primarily serotonin 2A receptor agonists, enhanced reward responsiveness in healthy individuals and patient populations. Lysergic acid diethylamide exhibits a unique profile in the reward learning and valuation constructs. Using the RDoC-based framework, we identified areas for future research, enhancing our understanding of the impact of LSD on reward processing. However, applying RDoC to psychedelic research faces limitations due to diverse study designs that were not initially RDoC-oriented. Limitations include subjective outcome measure selection aligned with RDoC constructs and potential bias in synthesizing varied studies. Additionally, some human studies were open-label, introducing potential bias compared to randomized, blinded studies.

Familial risk for depression is associated with reduced P300 and late positive potential to affective stimuli and prolonged cardiac deceleration to unpleasant stimuli

Despite evidence of abnormal affective processing as a key correlate of depression, specific attentional mechanisms underlying processing of emotions in familial risk for depression have yet to be investigated in a single study. To this end, the amplitude of the P300 and late positive potential (LPP) complex and cardiac deceleration were assessed during the passive viewing of affective pictures in 32 individuals who had family history of depression (without depressive symptoms) and in 30 controls (without depressive symptoms and family history of depression). Individuals with familial risk for depression revealed reduced P300-LPP amplitudes in response to pleasant and unpleasant stimuli relative to controls, and comparable P300-LPP amplitudes in response to pleasant and neutral stimuli. Controls, but not individuals with familial risk for depression, reported cardiac deceleration during the viewing of pleasant vs. neutral and unpleasant stimuli in the 0-3 s time window. Also, only individuals with familial risk for depression showed a prolonged cardiac deceleration in response to unpleasant vs. neutral stimuli. Overall, the present study provides new insights into the characterization of emotion-related attentional processes in familial risk for depression as potential vulnerability factors for the development of the disorder.

Reward processing in adolescents with social phobia and depression

OBJECTIVE

Impaired reward processing has been found in individuals with anxiety, but also major depressive disorder (MDD). Here, we studied neural correlates of reward anticipation and processing in a sample of youth with severe social phobia and comorbid depression (SP/MDD) and investigated the specific contribution of SP and MDD symptoms.

METHODS

15 affected, unmedicated and 25 typically developing (TD) youth completed a monetary gambling task, which included a positive, negative and ambiguous reward condition. Event-related potentials representing cue processing (cue P300), reward anticipation (stimulus preceding negativity, SPN), reward sensitivity (feedback related negativity, FRN) and reward processing (reward P300) were analysed.

RESULTS

Reduced amplitudes of the right hemispheric (r)SPN and reward P300 were observed in SP/MDD compared to TD. Within the SP/MDD group SP symptoms correlated with larger rSPN, and FRN amplitudes. MDD symptoms correlated with smaller rSPN and smaller FRN positive-negative difference wave.

CONCLUSIONS

Reward anticipation and feedback processing are reduced in SP/MDD. Higher SP symptoms are associated with stronger neural activation during reward anticipation and reward sensitivity. Depressive symptoms are associated with decreased reward anticipation and sensitivity. Findings are in line with the theory of heightened vigilance in anxiety and blunted reward processing due to anhedonia in MDD.

SIGNIFICANCE

The study results can inform behavioural interventions for SP and MDD.

Brain functional abnormality in drug treated and drug naïve adolescents with borderline personality disorder: Evidence for default mode network dysfunction

BACKGROUND

Patients with borderline personality disorder (BPD) have been found to show functional brain abnormality, including in the medial frontal cortex and other areas of the default mode network (DMN). The current study aimed to examine activations and de-activations in drug treated and medication-free female adolescents with the disorder.

METHODS

39 DSM-5 adolescent female patients with BPD without psychiatric comorbidity and 31 matched healthy female adolescents underwent fMRI during the performance of 1-back and 2-back versions of the n-back working memory task. Linear models were used to obtain maps of within-group activations and de-activations and areas of differences between the groups.

RESULTS

On corrected whole-brain analysis, the BPD patients showed failure to de-activate a region of the medial frontal cortex in the 2-back > 1-back comparison. The 30 never-medicated patients additionally showed a failure to de-activate the right hippocampus in the 2-back versus baseline contrast.

CONCLUSIONS

Evidence of DMN dysfunction was observed in adolescent patients with BPD. Because the relevant medial frontal and hippocampal changes were seen in unmedicated young patients without comorbidity, they might be considered intrinsic to the disorder.

A positive parenting program to enhance positive affect in children of previously depressed mothers

Children of mothers with a history of depression are at heightened risk for developing depression and other maladaptive outcomes. Deficits in parenting are one putative mechanism underlying this transmission of risk from mother to child. The present study evaluated whether a brief intervention with mothers with a history of depression produced greater use of positive parenting behaviors and an increase in observed positive affect in their 8- to 10-year-old children. Mothers with a history of depression (n = 65) were randomly assigned to either a positive parenting intervention or an attention control intervention condition. In addition, a comparison group of 66 mothers with no history of depression was evaluated one time. Results revealed significant increases in positive parenting behaviors (e.g., active listening, praise) immediately postintervention in mothers randomized to the positive parenting intervention as compared to those in the attention control condition. Children of mothers in the positive parenting intervention showed increases in positive affect as compared to children of mothers in the attention control intervention. Increases in mothers' active listening and smiling/laughing significantly predicted increases in children's positive affect. The intervention did not increase the rate of children's moment-by-moment positive affect contingent on mothers' positive parenting behaviors. This study showed the short-term effectiveness of a brief parenting intervention for enhancing interactions between mothers with a history of depression and their children by directly targeting mothers' positive parenting and, indirectly, children's expressions of positive affect. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Positive valence systems in youth anxiety development: A scoping review

Research on pathophysiological mechanisms supporting anxiety development in youth has traditionally focused on the role of threat systems. However, emerging research suggests that the positive valence system (PVS) may also play a strong and unique role in the development and maintenance of anxiety during childhood and adolescence. To better understand the connection between the PVS and anxiety, this scoping review describes current research spanning multiple units of analysis (i.e., self-report, behavior, neural circuits) linking child and adolescent anxiety and risk for anxiety to various PVS constructs (i.e., positive affect, reward responsiveness, reward learning and decision-making). After screening, 78 peer-reviewed articles and dissertations published between 1998 and May 2021 were included in a qualitative review. Though some consistencies in the literature were found, such as high neural reactivity to incentive anticipation in youth at temperamental risk for social anxiety and blunted positive affect in youth with social anxiety disorder, the literature is largely inconsistent. Inconsistencies could be related to the small number of similar studies, small and homogenous study samples, and variability in methodologies employed in this research. It cannot be confirmed whether findings linking PVS constructs to anxiety are unique to anxiety symptoms or better accounted for by co-occurring depressive symptoms. This review concludes with recommendations for robust future research in this area.

The impact of adolescent nicotine exposure on alcohol use during adulthood: The role of neuropeptides

Nicotine and alcohol abuse and co-dependence represent major public health crises. Indeed, previous research has shown that the prevalence of alcoholism is higher in smokers than in non-smokers. Adolescence is a susceptible period of life for the initiation of nicotine and alcohol use and the development of nicotine-alcohol codependence. However, there is a limited number of pharmacotherapeutic agents to treat addiction to nicotine or alcohol alone. Notably, there is no effective medication to treat this comorbid disorder. This chapter aims to review the early nicotine use and its impact on subsequent alcohol abuse during adolescence and adulthood as well as the role of neuropeptides in this comorbid disorder. The preclinical and clinical findings discussed in this chapter will advance our understanding of this comorbid disorder's neurobiology and lay a foundation for developing novel pharmacotherapies to treat nicotine and alcohol codependence.

Assessing Resources in a Population of Hemodialysis Patients: A New Approach to Improve Quality of Care

Hemodialysis patients constitute a vulnerable population. Their health needs are considerable and they often present psychological symptoms such as depression and anxiety. Empirical studies have demonstrated the efficacy of positive psychology interventions to enhance the well-being of patients and alleviate their depressive symptoms. One such intervention consists in identifying and mobilizing patient resources to activate their recovery. An intervention of the sort was implemented in Switzerland with hemodialysis nurses using AERES, a novel self-assessment instrument. AERES covers 31 domains under three dimensions: personal characteristics/qualities, hobbies/passions, and social/environmental resources. The aim of this qualitative study was to explore hemodialysis nurse perceptions of the use of this instrument. Sixteen hemodialysis nurses were recruited in six hospitals in French-speaking Switzerland and interviewed after delivering the intervention. A consensual qualitative research method was used to analyze the data. Results showed that the resources instrument was easy to administer and beneficial to patients and health professionals. Patient wellbeing became the top priority for the nurses and new interventions centered on patient resources were undertaken. Quality of patient care was improved. Nurses perceived this positive psychology instrument as a means of creating a positive relationship with patients and supporting them emotionally. Assessing the resources of this vulnerable population can provide health professionals with a powerful tool to understand patient intact resources, which can be used to alleviate symptoms and foster wellbeing.

Mindfulness and Behavior Change

Initiating and maintaining behavior change is key to the prevention and treatment of most preventable chronic medical and psychiatric illnesses. The cultivation of mindfulness, involving acceptance and nonjudgment of present-moment experience, often results in transformative health behavior change. Neural systems involved in motivation and learning have an important role to play. A theoretical model of mindfulness that integrates these mechanisms with the cognitive, emotional, and self-related processes commonly described, while applying an integrated model to health behavior change, is needed. This integrative review (1) defines mindfulness and describes the mindfulness-based intervention movement, (2) synthesizes the neuroscience of mindfulness and integrates motivation and learning mechanisms within a mindful self-regulation model for understanding the complex effects of mindfulness on behavior change, and (3) synthesizes current clinical research evaluating the effects of mindfulness-based interventions targeting health behaviors relevant to psychiatric care. The review provides insight into the limitations of current research and proposes potential mechanisms to be tested in future research and targeted in clinical practice to enhance the impact of mindfulness on behavior change.

Disentangling emotional processing in dysphoria: An ERP and cardiac deceleration study

The present study aimed to investigate emotional processing in dysphoria. To this end, the amplitude of the Late Positive Potential (LPP) and cardiac deceleration were assessed during the passive viewing of affective (pleasant, neutral, and unpleasant) pictures in 26 individuals with dysphoria and in 25 non-depressed controls. The group with dysphoria revealed a smaller LPP amplitude than the group without dysphoria in response to pleasant and neutral, but not unpleasant, stimuli at centro-parieto-occipital sites. Interestingly, whereas both groups showed cardiac deceleration when viewing pleasant compared to neutral pictures (3-6 s time window), only individuals with dysphoria showed a prolonged cardiac deceleration in response to unpleasant stimuli as compared with neutral ones. This study suggests that dysphoria is characterized by reduced motivated attentional allocation to positive information and by sustained intake of unpleasant information. Overall, the present findings provide novel insights into the characterization of valence-specific attentional processes in dysphoria as potential vulnerability factors for clinically significant depression.

The Immediate and Lasting Effect of Emotion Regulation in Adolescents: An ERP Study

The immediate effect is an important index of the outcomes of emotion regulation. However, in daily life, whether the effect of emotion regulation lasts and the lasting mechanism have been examined less. The present research focused on the relationships between the immediate and lasting effect of the emotion regulation of adolescents. Electroencephalogram (EEG) was recorded from 51 adolescents (31 boys and 20 girls, Mage = 12.82) during online emotion regulation using the Reactivity and Regulation-Image Task (phase 1) and re-presentation of emotional stimuli after a period of time (phase 2). Event-related potentials (ERPs) related to emotion regulation, such as N2, P3, and the late positive potential (LPP), were examined in the two phases. The results showed that: (1) In both of the two phases, in negative emotion conditions, the amplitudes of P3 and LPP 300-600 of no-regulation conditions were significantly higher than those in reappraisal conditions. However, there was no significant difference under neutral conditions; (2) The amplitudes of P3, N2, and LPP 300-600 during emotion regulation in phase 1 positively predicted the amplitudes of P3, N2, and LPP300-600 in phase 2 in different experimental conditions. Results from the regression analysis implied that the immediate effect of online emotion regulation may predict the lasting effect when adolescents face the same emotions again. In addition, our findings provide neurological evidence that the use of cognitive reappraisal could effectively help adolescents to reduce the recruitment of cognitive resources when they regulate negative emotions and when they face those negative emotions again.

Effects of Father and Mother Attachment on Depressive Symptoms in Middle Childhood and Adolescence: The Mediating Role of Emotion Regulation

Background: Attachment and emotion regulation play a decisive role in the developmental pathways of adaptation or maladaptation. This study tested concurrent and longitudinal associations between the attachment to mother and father, sadness regulation, and depressive symptoms. Methods: A total of 1110 participants from middle childhood to adolescence completed measures of attachment, emotion regulation, and depressive symptomatology. In total, 307 of them participated in the longitudinal assessment. Results: Results revealed attachment affects emotion regulation strategies and depressive symptoms. Furthermore, we found linear effects of the cumulative number of secure attachment relationships on adaptive and maladaptive deactivating sadness regulation, as well as on depressive symptoms. Longitudinal analysis showed the significant mediating role of sadness regulation in the relationship between attachment and depressive symptoms. Conclusions: Adaptive and maladaptive deactivating sadness regulation explain the longitudinal effects of attachment on depressive symptoms. Insecurely attached children and adolescents use maladaptive and adaptive sadness regulation strategies, but differ in their hierarchy of strategy use.

Examining the relationship between anhedonia symptoms and trait positive appraisal style in adolescents: A longitudinal survey study

INTRODUCTION

Anhedonia, defined as a loss of interest and pleasure in previously enjoyable activities, is a core symptom of depression that predicts a poor treatment response in adolescents. We know little about the cognitive vulnerability factors that contribute to the development of anhedonia in youth. This cross-sectional and longitudinal survey study investigated the link between anhedonia symptoms and cognitive appraisal of positive affect.

METHODS

Baseline data were collected from 392 secondary school students in the UK (aged 13-16, 54 % Female), 170 of whom went on to complete the three-month follow-up assessment (a 43 % response rate). Participants rated their anhedonia symptoms and appraisal styles which were measured in terms of use of amplifying appraisals, dampening appraisals, and fear of positive emotion.

RESULTS

At baseline, greater anhedonia was significantly associated with increased levels of dampening and reduced levels of amplifying but was not significantly related to fear of positive emotion. Prospectively, greater baseline levels of amplifying uniquely predicted lower anhedonia severity at three-month follow-up, and vice-versa. There was no evidence for reciprocal prospective associations between anhedonia and, appraisal styles of dampening and fear of positive emotion.

CONCLUSION

These results indicate that cognitive appraisal of positive affect is associated with concurrent and to some extent can predict future symptoms of anhedonia in youth.

Estudo de validade do Questionário Online de Regulação Emocional

Regulação emocional é a capacidade de alterar a experiência afetiva com objetivo de se adaptar às situações. Esta pesquisa teve como objetivo estudar a validade do Questionário Online de Regulação Emocional (QoRE) relacionando-o com outros instrumentos que avaliam construtos relacionados. Participaram 824 pessoas adultas de diferentes regiões do Brasil que responderam ao QoRE e Difficulties in Emotion Regulation Scales (desregulação emocional), Inventário Dimensional Clínico da Personalidade (instabilidade de humor), Bateria Fatorial de Personalidade (neuroticismo), Qualidade de Vida e Índice de Direção Perigosa de Dula (comportamentos perigosos no trânsito). Os resultados mostraram correlações negativas altas com desregulação emocional, instabilidade de humor e neuroticismo, correlações positivas moderadas a altas com qualidade de vida, e correlações negativas moderadas com direção perigosa para todos os escores do QoRE exceto o fator 2. Considera-se que há evidências de validade para o QoRE na avaliação da regulação emocional.

Abnormal neural activities in adults and youths with major depressive disorder during emotional processing: a meta-analysis

BACKGROUND

Abnormal neural activities during emotional processing have been found in both adults and youths with major depressive disorder. However, findings were inconsistent in each group and cannot be compared to each other.

METHODS

We first identified neuroimaging experiments that revealed abnormal neural activities during emotional processing in patients with major depressive disorder published from January 1997 to January 2019. Then we conducted voxel-wise meta-analyses on adult and youth patients separately and compared the two age groups using direct meta-comparison.

RESULTS

Fifty-four studies comprising 1141 patients and 1242 healthy controls were identified. Both adult and youth patients showed abnormal neural activities in anterior cingulate cortex, insula, superior and middle temporal gyrus, and occipital cortex compared to healthy controls. However, hyperactivities in the superior and middle frontal gyrus, amygdala, and hippocampus were only observed in adult patients, while hyperactivity in the striatum was only found in youth patients compared to controls. In addition, compared with youths, adult patients exhibited significantly greater abnormal activities in insula, middle frontal gyrus, and hippocampus, and significantly lower abnormal activities in middle temporal gyrus, middle occipital gyrus, lingual gyrus, and striatum.

CONCLUSIONS

The common alterations confirmed the negative processing bias in major depressive disorder. Both adult and youth patients were suggested to have disturbed emotional perception, appraisal, and reactivity. However, adult patients might be more subject to the impaired appraisal and reactivity processes, while youth patients were more subject to the impaired perception process. These findings help us understand the progressive pathophysiology of major depressive disorder.

Prevalence of depressive symptoms among older children and young adolescents: a longitudinal population-based study

Introduction

This paper investigates levels of depressive symptoms among older children and young adolescents, 11-14 years of age. The population-based sample was assessed twice during a 12-month period. Point-prevalence, 12-month prevalence, and 12-month incidence were measured by a validated self-reported scale (SFMQ) and are presented in this paper.

Methods

A total of 2148 pupils were invited to participate in this study, and 1748 pupils and at least one parent/guardian provided informed consent. The population was assessed twice within one 12-month period resulting in 1439 participants at both data collection points. Depressive symptoms were measured by a validated self-reported scale, The Short Mood and Feelings Questionnaire (SMFQ).

Results

The results indicate that the point-prevalence was just under 10% in 6^th to 10^th grade with a 12-month prevalence at almost 3%. The results also indicate an incidence rate of 4.5% over 12-months. This study confirms that girls report a higher range of point prevalence, 12- month-prevalence, and 12-month incidence compared to boys.

Conclusions

The results indicate that depressive symptoms among children and young adolescents is a serious health challenge. The results demonstrate substantial gender differences even at an early age (11-14 years), where girls report significantly higher point prevalence, 12-month-prevalence, and 12-month incidence compared to boys. Results from this study suggest that depressive symptoms are an important problem that young adolescents face, and the study underlines the need for more intervention tailored to gender at the middle-school level, especially with respect to those children and adolescents who experience persistent depressive symptoms.

Examining Maternal Elaborative Reminiscing as a Protective Factor in the Intergenerational Transmission of Psychopathology

Most research examining the impact of early parental depression on the developing child has focused on the nature of parenting practices observed in depressed adults. Maternal elaborative reminiscing, or the extent to which mothers elaboratively discuss past shared experiences with their children, has a considerable influence on children's emotional and social development and is understudied within the context of maternal depression. The current study is the first to examine whether maternal elaborative reminiscing in middle childhood mediates the association between exposure to maternal depressive symptoms in infancy and later internalizing and externalizing problems. The study included 206 mother-child dyads recruited from the community who participated in a prospective longitudinal study. Maternal depressive symptoms were assessed when offspring were 6-months old. At 5-years old, dyads were observed during a free play task to measure sensitive and harsh-intrusive parenting and during a reminiscing task to measure maternal elaboration. Teacher-reported internalizing and externalizing problems were collected at age 7. A saturated path model revealed that maternal elaborative reminiscing, but not sensitive or harsh-intrusive parenting, fully mediated the association between maternal depression in infancy and externalizing, but not internalizing, problems. Reduced maternal elaboration during parent-child reminiscing constitutes one way in which risk from early maternal depression is associated with later externalizing problems.

Principles for Guiding the Selection of Early Childhood Neurodevelopmental Risk and Resilience Measures: HEALthy Brain and Child Development Study as an Exemplar

The vast individual differences in the developmental origins of risk and resilience pathways combined with sophisticated capabilities of big data science increasingly point to the imperative of large, neurodevelopmental consortia to capture population heterogeneity and key variations in developmental trajectories. At the same time, such large-scale population-based designs involving multiple independent sites also must weigh competing demands. For example, the need for efficient, scalable assessment strategies must be balanced with the need for nuanced, developmentally sensitive phenotyping optimized for linkage to neural mechanisms and specification of common and distinct exposure pathways. Standardized epidemiologic batteries designed for this purpose such as PhenX (consensus measures for Phenotypes and eXposures) and the National Institutes of Health (NIH) Toolbox provide excellent "off the shelf" assessment tools that are well-validated and enable cross-study comparability. However, these standardized toolkits can also constrain ability to leverage advances in neurodevelopmental measurement over time, at times disproportionately advantaging established measures. In addition, individual consortia often expend exhaustive effort "reinventing the wheel," which is inefficient and fails to fully maximize potential synergies with other like initiatives. To address these issues, this paper lays forth an early childhood neurodevelopmental assessment strategy, guided by a set of principles synthesizing developmental and pragmatic considerations generated by the Neurodevelopmental Workgroup of the HEALthy Brain and Child Development (HBCD) Planning Consortium. These principles emphasize characterization of both risk- and resilience-promoting processes. Specific measurement recommendations to HBCD are provided to illustrate application. However, principles are intended as a guiding framework to transcend any particular initiative as a broad neurodevelopmentally informed, early childhood assessment strategy for large-scale consortia science.

Depression in adolescence: a review

Background

Depression is a common mental health disease, especially in mid to late adolescence that, due to its particularities, is a challenge and requires an effective diagnosis. Primary care providers are often the first line of contact for adolescents, being crucial in identifying and managing this pathology. Besides, several entities also recommend screening for depression on this period. Thus, the main purpose of this article is to review the scientific data regarding screening, diagnosis and management of depression in adolescence, mainly on primary care settings.

Main body

Comprehension of the pathogenesis of depression in adolescents is a challenging task, with both environmental and genetic factors being associated to its development. Although there are some screening tests and diagnostic criteria, its clinical manifestations are wide, making its diagnosis a huge challenge. Besides, it can be mistakenly diagnosed with other psychiatric disorders, making necessary to roll-out several differential diagnoses. Treatment options can include psychotherapy (cognitive behavioural therapy and interpersonal therapy) and/or pharmacotherapy (mainly fluoxetine), depending on severity, associated risk factors and available resources. In any case, treatment must include psychoeducation, supportive approach and family involvement. Preventive programs play an important role not only in reducing the prevalence of this condition but also in improving the health of populations.

Conclusion

Depression in adolescence is a relevant condition to the medical community, due to its uncertain clinical course and underdiagnosis worldwide. General practitioners can provide early identification, treatment initiation and referral to mental health specialists when necessary.

Stressful life events moderate the effect of neural reward responsiveness in childhood on depressive symptoms in adolescence

BACKGROUND

Reward processing deficits have been implicated in the etiology of depression. A blunted reward positivity (RewP), an event-related potential elicited by feedback to monetary gain relative to loss, predicts new onsets and increases in depression symptoms. Etiological models of depression also highlight stressful life events. However, no studies have examined whether stressful life events moderate the effect of the RewP on subsequent depression symptoms. We examined this question during the key developmental transition from childhood to adolescence.

METHODS

A community sample of 369 children (mean age of 9) completed a self-report measure of depression symptoms. The RewP to winning v. losing was elicited using a monetary reward task. Three years later, we assessed stressful life events occurring in the year prior to the follow-up. Youth depressive symptoms were rated by the children and their parents at baseline and follow-up.

RESULTS

Stressful life events moderated the effect of the RewP on depression symptoms at follow-up such that a blunted RewP predicted higher depression symptoms in individuals with higher levels of stressful life events. This effect was also evident when events that were independent of the youth's behavior were examined separately.

CONCLUSIONS

These results suggest that the RewP reflects a vulnerability for depression that is activated by stress.

Efficacy of a Primary Care-Based Intervention to Promote Parent-Teen Communication and Well-Being: A Randomized Controlled Trial

OBJECTIVE

To evaluate the impact of a primary care-based, parent-directed intervention on changes in parent-teen communication, parental beliefs about adolescents, parent and adolescent well-being, adolescent distress, and adolescent positive affect from baseline to 2-month follow-up.

STUDY DESIGN

In this randomized controlled trial, 120 adolescents (13-15 years of age) scheduled for well visits and their parents were randomized to the strength intervention or control group. The intervention included a booklet highlighting 3 key messages about adolescence, instructions to have a discussion with their teen about each other's strengths, and clinician endorsement. Outcomes were assessed before the well visit and 2 months later.

RESULTS

Adolescents were 61% female and 65% black. Parents were primarily female (97%); 72% had a 4-year degree or higher. The intervention had a positive impact on adolescent-reported open communication among adolescents with baseline low open communication scores (B = 3.55; P = .005; 95% CI, 1.07-6.03). Adolescents in the intervention group reported a decrease in distress (-1.54 vs 3.78; P = .05; partial eta squared [η²] = 0.038) and increase in positive affect (1.30 vs -3.64; P = .05; η² = 0.04) compared with control group adolescents. The intervention did not affect parent-reported communication, parental beliefs, or adolescent well-being. Control parents demonstrated a marginal increase in well-being, whereas intervention parents did not (0.82 vs -0.18; P = .07; η² = 0.029).

CONCLUSIONS

This study highlights the potential impact of primary care-based, universal, low-intensity interventions targeting parents of adolescents on parent-teen communication and important adolescent health outcomes.

TRIAL REGISTRATION

Clinicaltrials.gov: NCT03496155.

Balancing act: Neural correlates of affect dysregulation in youth depression and substance use - A systematic review of functional neuroimaging studies

Both depression and substance use problems have their highest incidence during youth (i.e., adolescence and emerging adulthood), and are characterized by emotion regulation deficits. Influential neurodevelopmental theories suggest that alterations in the function of limbic and frontal regions render youth susceptible to these deficits. However, whether depression and substance use in youth are associated with similar alterations in emotion regulation neural circuitry is unknown. In this systematic review we synthesized the results of functional magnetic resonance imaging (fMRI) studies investigating the neural correlates of emotion regulation in youth depression and substance use. Resting-state fMRI studies focusing on limbic connectivity were also reviewed. While findings were largely inconsistent within and between studies of depression and substance use, some patterns emerged. First, youth depression appears to be associated with exaggerated amygdala activity in response to negative stimuli; second, both depression and substance use appear to be associated with lower functional connectivity between the amygdala and prefrontal cortex during rest. Findings are discussed in relation to support for existing neurodevelopmental models, and avenues for future work are suggested, including studying neurodevelopmental trajectories from a network perspective.

Preschool-Onset Major Depressive Disorder is Characterized by Electrocortical Deficits in Processing Pleasant Emotional Pictures

Reductions in positive affect are a salient feature of preschool-onset major depressive disorder. Yet, little is known about the psychophysiological correlates of this blunted positive affect and whether reduced physiological responding to pleasant stimuli may differentiate depressed and healthy young children. 120 four-to-seven year old children with current depression and 63 psychiatrically healthy 4-to-7 year old children completed a simple picture-viewing task of pleasant and neutral pictures while event-related potentials (ERPs) were recorded. The early-childhood version of the Kiddie Schedule for Affective Disorders and Depression was used to establish psychiatric diagnoses. A one-way ANCOVA was used to test for group differences in response to pleasant and neutral pictures. Young children with depression showed a reduced response to pleasant vs. neutral pictures (LPP), after controlling for children's age (F(1,180) = 4.15, p = 0.04, η2 = 0.02). The LPP for the children with preschool-onset depression (M = 0.99, SE = 0.65) was significantly smaller than the LPP in the healthy group of young children (M = 3.27, SE = 0.90). This difference did not vary as a function of depression or anhedonia severity within the group with depression or the healthy children. Similar to older children and adolescents with depression, young children with depression display reductions in responsivity to pleasant stimuli as indexed by the LPP. These findings extend prior findings indicating a blunted response to pleasant stimuli in preschool- onset depression. Given the greater neuroplasticity of emotional response and regulation, these findings suggest clinical attention to emotional response to pleasure is an important target in preschool-onset depression. Clinical trial registration information: A Randomized Control Trial of PCIT-ED for Preschool Depression; http://clinicaltrials.gov/;NCT02076425.

An Imbalance of Approach and Effortful Control Predicts Externalizing Problems: Support for Extending the Dual-Systems Model into Early Childhood

Although the association between deficits in effortful control and later externalizing behavior is well established, many researchers (Nigg Journal of Child Psychology and Psychiatry, 47(3-4), 395-422, 2006; Steinberg Developmental Review, 28(1), 78-106, 2008) have hypothesized this association is actually the product of the imbalance of dual systems, or two underlying traits: approach and self-regulation. Very little research, however, has deployed a statistically robust strategy to examine that compelling model; further, no research has done so using behavioral measures, particularly in longitudinal studies. We examined the imbalance of approach and self-regulation (effortful control, EC) as predicting externalizing problems. Latent trait models of approach and EC were derived from behavioral measures collected from 102 children in a community sample at 25, 38, 52, and 67 months (2 to 5 ½ years), and used to predict externalizing behaviors, modeled as a latent trait derived from parent-reported measures at 80, 100, 123, and 147 months (6 ½ to 12 years). The imbalance hypothesis was supported: Children with an imbalance of approach and EC had more externalizing behavior problems in middle childhood and early preadolescence, relative to children with equal levels of the two traits.

Differential neural responding to affective stimuli in 6- to 8-year old children at high familial risk for depression: Associations with behavioral reward seeking

OBJECTIVE

Children of depressed parents are at increased risk for psychopathology. One putative mechanism of risk appears to be altered processing of emotion-related stimuli. Although prior work has evaluated how adolescent offspring of depressed parents may show blunted reward processing compared to low-risk youth, there has been less attention to how young children with this familial history may differ from their peers during middle childhood, a period of critical socio-affective development METHOD: The current study evaluated 56 emotionally healthy 6-to 8-year children who were deemed at high-risk (n = 25) or low-risk (n = 31) for depression based on maternal history of depression. Children completed a behavioral reward seeking task in the laboratory and an fMRI paradigm assessing neural response to happy faces, a social reward.

RESULTS

Findings demonstrated that high-risk children showed blunted responding to happy faces in the dorsal striatum compared to low-risk children. Further, lower responding in the dorsal striatum and dorsolateral prefrontal cortex was related to lower behavioral reward seeking, but only in high-risk children.

CONCLUSION

Function within neural reward regions may be altered in high-risk offspring as young as 6- to 8-years of age. Further, neural reward responding may be linked to lower behavioral response to obtain reward in these high-risk offspring.

Neural Activation to Parental Praise Interacts With Social Context to Predict Adolescent Depressive Symptoms

Negative relationships with parents and peers are considered risk factors for depression in adolescence, yet not all adolescents perceiving negative social relationships develop depression. In line with neurobiological susceptibility to social context models, we examined how individual differences in neural processing of parental praise, a unique form of social reward, might explain variability in susceptibility to perceived maternal acceptance and peer victimization. During neuroimaging, 38 11- to 17-year-olds with a history of anxiety listened to audio clips of a parent (predominately mothers) providing personalized praise and neutral statements. Average activation during parental praise clips relative to neutral clips was extracted from several anatomically-defined reward-related regions-of-interest (ROIs): the subgenual anterior cingulate cortex, caudate nucleus, amygdala, nucleus accumbens, and insula. Moderation models included direct effects and interactions between neural activation to social reward, peer victimization, and maternal acceptance at the time of scanning on depressive symptoms 1 year later. Results showed a significant three-way interaction for the bilateral caudate such that peer victimization was associated with depressive symptoms only for individuals with higher caudate response to praise who perceived maternal acceptance as low. Consistent with neurobiological susceptibility to social context models, caudate activation to social reward could represent a neural marker that helps explain variability in adolescent sensitivity to social contexts. High caudate activation to praise could reflect a history of negative experiences with parents and/or peers that places youth at greater risk for depressive symptoms. Findings suggest that interactions between neural response to reward and salient social contexts may help us understand changes in depressive symptoms during a period of development marked by significant biopsychosocial change.

Excitability and irritability in preschoolers predicts later psychopathology: The importance of positive and negative emotion dysregulation

Emotion dysregulation is a risk factor for the development of a variety of psychopathologic outcomes. In children, irritability, or dysregulated negative affect, has been the primary focus, as it predicts later negative outcomes even in very young children. However, dysregulation of positive emotion is increasingly recognized as a contributor to psychopathology. Here we used an exploratory factor analysis and defined four factors of emotion dysregulation: irritability, excitability, sadness, and anhedonia, in the preschool-age psychiatric assessment collected in a sample of 302 children ages 3-5 years enriched for early onset depression. The irritability and excitability factor scores defined in preschoolers predicted later diagnosis of mood and externalizing disorders when controlling for other factor scores, social adversity, maternal history of mood disorders, and externalizing diagnoses at baseline. The preschool excitability factor score predicted emotion lability in late childhood and early adolescence when controlling for other factor scores, social adversity, and maternal history. Both excitability and irritability factor scores in preschoolers predicted global functioning into the teen years and early adolescence, respectively. These findings underscore the importance of positive, as well as negative, affect dysregulation as early as the preschool years in predicting later psychopathology, which deserves both further study and clinical consideration.

Nonsuicidal Self-Injury and Suicidal Behaviors in Girls: The Case for Targeted Prevention in Preadolescence

Non-suicidal self-injury (NSSI) affects 15-20% of adolescents-disproportionately girls-and is a strong predictor of eventual suicide attempts and suicide. Many girls now initiate NSSI before age 10. These early-starters exhibit greater frequency of NSSI, use more diverse methods, and are hospitalized more often, yet there are no empirically supported prevention programs for preadolescents. Obstacles to prevention include ascertaining who is sufficiently vulnerable and specifying mechanistic intervention targets. Recent research indicates that (1) preadolescent girls with ADHD who are also maltreated are at alarming risk for NSSI and suicide attempts by adolescence, and (2) the conjoint effects of these vulnerabilities are sufficiently potent for targeted prevention. Research also indicates that existing interventions are effective in altering child- and family-level mechanisms of NSSI. These interventions alter neurobiological markers of vulnerability, which can be used as proximal efficacy signals of prevention response, without waiting for NSSI and suicide attempts to emerge.

Implications for Reward Processing in Differential Responses to Loss: Impacts on Attachment Hierarchy Reorganization

When an attachment relationship is severed, so is homeostatic maintenance, leading to dysregulation of multiple physiological systems. Expanding upon Sbarra and Hazan's original model, we suggest that the degree to which an individual's physiological systems remain dysregulated depends on the state of one's attachment hierarchy-namely, whether an individual continues to seek a lost partner for support as their primary attachment figure. To recover from the loss of a romantic partner, an individual's attachment hierarchy must be reorganized. Our model proposes that an individual will go through a series of physiological changes before their attachment hierarchy is reorganized, which can either help or hinder their recovery. We consider the role of reward processing, including endogenous opioids, in this recovery process. Along the way, we identify mechanisms for continued dysregulation of biological systems among those who take longer to recover from a loss.

Associations of longitudinal sleep trajectories with risky sexual behavior during late adolescence

OBJECTIVE

The current study examines longitudinal sleep patterns in relation to risky sexual behaviors in a racially/ethnically diverse sample of adolescents.

METHOD

The sample comprises 1,850 youth (mean age at first wave = 16.21; 57% female). Sleep duration, sleep variability (difference between weekend and weekday sleep duration), and sleep quality were collected over four annual assessments from 2013 to 2017. Risky sexual behaviors (i.e., sex without condom use or sex after using drugs or alcohol) were examined at the fourth follow-up assessment when youth were 19 years old. Longitudinal latent class analysis characterized patterns of individual sleep dimensions over time, as well as the combination of sleep dimensions, and examined how emergent sleep classes associated with subsequent risky sexual behavior, after adjustment for sociodemographics and mental health.

RESULTS

After covariate adjustment, persistent "short" weekend sleepers were 2.2 times more likely to engage in risky sexual behaviors, compared to youth with sufficient weekend sleep duration. Contrary to expectations, adolescents with more consistent weekend/weekday sleep were 1.6-2 times more likely to engage in risky sexual behaviors, compared to those with greater variability; however, lack of variability may be an indicator of chronic insufficient sleep, both weekdays and weekends. There were no significant differences in risky sexual behavior according to classes of weekday sleep duration or quality. In the combined class model, those with persistently short and poor-quality sleep were at marginally greater risk for engaging in risky sexual behaviors.

CONCLUSION

Insufficient sleep in adolescents may increase risk for sexual risk-taking and may set the stage for accelerated health risk trajectories into adulthood. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Incorporating the social context into neurocognitive models of adolescent decision-making: A neuroimaging meta-analysis

Neurobiological models of adolescent decision-making emphasize developmental changes in brain regions involved in affect (e.g., ventral striatum) and cognitive control (e.g., lateral prefrontal cortex). Although social context plays an important role in adolescent decision-making, current models do not discuss brain regions implicated in processing social information (e.g., dorsomedial prefrontal cortex). We conducted a coordinate-based meta-analysis using the Multilevel peak Kernel Density Analysis (MKDA) method to test the hypothesis that brain regions involved in affect, cognitive control, and social information processing support adolescent decision-making in social contexts (N = 21 functional neuroimaging studies; N = 1292 participants). Results indicated that dorsomedial prefrontal cortex, inferior frontal gyrus/insula and ventral striatum are consistently associated with adolescent decision-making in social contexts. Activity within these regions was modulated by the type of social context and social actors involved. Findings suggest including brain regions involved in social information processing into models of adolescent decision-making. We propose a 'constructionist' model, which describes psychological processes and corresponding neural networks related to affect, cognitive control, and social information processing.

Affect, reward, and punishment in anorexia nervosa: a narrative overview

INTRODUCTION

Anorexia nervosa (AN) is a serious psychiatric disorder that is difficult to treat and often follows a protracted course. A number of theoretical models have been proposed for the etiology and maintenance of AN. Two domains that have received substantial attention in the literature on AN are affect and reward/punishment processes. However, despite an overlap in the nature and implications of these processes, studies of AN addressing these constructs have typically investigated them independently.

PURPOSE

The purpose of this narrative review is to integrate the literature on the role of affect, reward, and punishment in AN.

METHOD

We provide a focused narrative overview of the literature relating to the affect, reward, and punishment in AN via a synthesis of recent reviews and meta-analyses.

RESULTS

We first describe several prominent affect and reward/punishment-based conceptualizations of AN, followed by a brief overview of the existing empirical literature in these domains.

CONCLUSION

We provide a critical discussion of the disparate nature of these literatures in AN, including associated limitations. We then conclude with an extensive discussion of directions for future research that integrate the study of affect and reward/punishment processes in AN.

LEVEL OF EVIDENCE

Level V, narrative review.

Racial/ethnic disparities in cortisol diurnal patterns and affect in adolescence

Racial/ethnic minorities are more vulnerable to mental and physical health problems, but we know little about the psychobiological underpinnings of these disparities. In this study, we examined racial/ethnic differences in cortisol diurnal patterns and affect as initial steps toward elucidating long-term health disparities. A racially/ethnically diverse (39.5% White, 60.5% minority) sample of 370 adolescents (57.3% female) between the ages of 11.9 and 18 years (M = 14.65 years, SD = 1.39) participated in this study. These adolescents provided 16 cortisol samples (4 samples per day across 4 days), allowing the computation of diurnal cortisol slopes, the cortisol awakening response, and diurnal cortisol output (area under the curve), as well as daily diary ratings of high-arousal and low-arousal positive and negative affect. Consistent with prior research, we found that racial/ethnic minorities (particularly African American and Latino youth) exhibited flatter diurnal cortisol slopes compared to White youth, F (1, 344.7) = 5.26, p = .02, effect size g = 0.25. Furthermore, African American and Asian American youth reported lower levels of positive affect (both high arousal and low arousal) compared to White youth. Racial/ethnic differences in affect did not explain differences in cortisol patterns, suggesting a need to refine our models of relations between affect and hypothalamic-pituitary-adrenocortical activity. We conclude by proposing that a deeper understanding of cultural development may help elucidate the complex associations between affect and hypothalamic-pituitary-adrenocortical functioning and how they explain racial/ethnic differences in both affect and stress biology.

When it feels good to give: Depressive symptoms, daily prosocial behavior, and adolescent mood

Past research has suggested that engaging in prosocial acts enhances the well-being of the helper, but does prosocial behavior benefit some individuals more than others? The current study implements a daily diary design to test associations between adolescents' daily prosocial behaviors toward relationally close others and mood. The main goal was to investigate whether daily help-giving has unique benefits for adolescents experiencing greater emotional distress. For 10 days, a diverse sample of youth (N = 99; Mage = 18.01) reported on their prosocial behaviors toward friends and romantic partners as well as their mood; depressive symptoms were assessed in a prior lab visit. Multilevel models showed that participants experienced increased positive mood on days that they were more prosocial, even when controlling for received support; this association was strongest among those reporting higher depressive symptoms. The findings highlight the unique benefits of prosociality in adolescents' daily lives, suggesting that everyday help-giving behaviors may fulfill social and emotional needs of depressed youth. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Maternal Affective Expression and Adolescents' Subjective Experience of Positive Affect in Natural Settings

This study investigated the association between maternal affective expression during laboratory-based interaction tasks and adolescents' experience of positive affect (PA) in natural settings. Participants were 80 healthy adolescents and their mothers. Durations of maternal positive (PA) and negative affective (NA) expressions were observed during a conflict resolution task and a positive event planning interaction task. Ecological momentary assessment (EMA) procedures were employed to assess adolescents' momentary and peak experience of PA in daily life. Results indicated that maternal NA, but not maternal PA, was related to adolescents' EMA-reported PA. Adolescents whose mothers expressed more NA experienced less PA in daily environments. Results suggest that adolescents' exposure to maternal negative affective behavior is associated with adolescents' subjective daily well-being.

Mobile Phone Intervention to Reduce Youth Suicide in Rural Communities: Field Test

BACKGROUND

Suicide is a leading cause of death among 10- to 19-year-olds in the United States, with 5% to 8% attempting suicide each year. Suicide risk rises significantly during early adolescence and is higher in rural and underserved communities. School-based universal prevention programs offer a promising way of reducing suicide by providing strategies for emotion regulation and encouraging help-seeking behaviors and youth-adult connectedness. However, such programs frequently run into difficulties in trying to engage a broad range of students. Text messaging is a dominant medium of communication among youths, and studies show both efficacy and uptake in text messaging interventions aimed at adolescents. Text-based interventions may, thus, offer a means for school-based universal prevention programs to engage adolescents who would otherwise be difficult to reach.

OBJECTIVE

We field tested Text4Strength, an automated, interactive text messaging intervention that seeks to reach a broad range of early adolescents in rural communities. Text4Strength extends Sources of Strength, a peer-led school suicide prevention program, by encouraging emotion regulation, help-seeking behaviors, and youth-adult connectedness in adolescents. The study tested the appeal and feasibility of Text4Strength and its potential to extend universal school-based suicide prevention.

METHODS

We field tested Text4Strength with 42 ninth-grade students. Over 9 weeks, students received 28 interactive message sequences across 9 categories (Sources of Strength introduction, positive friend, mentors, family support, healthy activities, generosity, spirituality, medical access, and emotion regulation strategies). The message sequences included games, requests for advice, questions about students' own experiences, and peer testimonial videos. We measured baseline mental health characteristics, frequency of replies, completion of sequences and video viewing, appeal to students, and their perception of having benefited from the program.

RESULTS

Of the 42 participating students, 38 (91%) responded to at least one sequence and 22 (52%) responded to more than a third of the sequences. The proportion of students who completed multistep sequences they had started ranged from 35% (6/17) to 100% (3/3 to 28/28), with responses dropping off when more than 4 replies were needed. With the exception of spirituality and generosity, each of the content areas generated at least a moderate number of student replies from both boys and girls. Students with higher and lower levels of risk and distress interacted with the sequences at similar rates. Contrary to expectations, few students watched videos. Students viewed the intervention as useful-even those who rarely responded to messages. More than 70% found the texts useful (3 items, n range 29-34) and 90% (36) agreed the program should be repeated.

CONCLUSIONS

Text4Strength offers a potentially engaging way to extend school-based interventions that promote protective factors for suicide. Text4Strength is ready to be revised, based on findings and student feedback from this field test, and rigorously tested for efficacy.

The (Suicidal-) Depressive Position: A Scientifically Informed Reformulation

Despite considerable progress in depression research and treatment, the disorder continues to pose daunting challenges to scientists and practitioners alike. This article presents a novel conceptualization of the psychological dynamics of depression which draws from Melanie Klein's notion of the positions, reformulated using social-cognitive terms. Specifically, Klein's notion of position, consisting of anxieties (persecutory vs. "depressive"), defense mechanisms ("primitive"/split based vs. neurotic/repression based), and object relations (part vs. whole) is reformulated to include (1) affect, broadly defined, (2) affect regulatory strategies (defense mechanisms, coping strategies, and motivation regulation), and (3) mental representations of self-with-others, all pertaining to the past, present, and future. I reformulate the depressive position to include-beyond sadness, anxiety, and anhedonia-also anger/agitation, shame, disgust, and contempt, all of which are down-regulated via diverse mechanisms. In the depressive position, the self is experienced as wronged and others as punitive, albeit seductive. Attempts to appease internal others (objects) are projected into the future, only to be thwarted by awkward and inept interpersonal behavior. This might propel the use of counter-phobic, counter-dependent, and "manic" affect regulatory mechanisms, potentially leading to suicidal depression.

Altered neural processing of reward and punishment in adolescents with Major Depressive Disorder

BACKGROUND

Altered reward and punishment function has been suggested as an important vulnerability factor for the development of Major Depressive Disorder (MDD). Prior ERP studies found evidence for neurophysiological dysfunctions in reinforcement processes in adults with MDD. To date, only few ERP studies have examined the neural underpinnings of reinforcement processing in adolescents diagnosed with MDD. The present event-related potential (ERP) study aimed to investigate neurophysiological mechanisms of anticipation and consumption of reward and punishment in adolescents with MDD in one comprehensive paradigm.

METHOD

During ERP recording, 25 adolescents with MDD and 29 healthy controls (12-17 years) completed a Monetary Incentive Delay Task comprising both a monetary reward and a monetary punishment condition. During anticipation, the cue-P3 signaling attentional allocation was recorded. During consumption, the feedback-P3 and Reward Positivity (RewP) were recorded to capture attentional allocation and outcome evaluation, respectively.

RESULTS

Compared to controls, adolescents with MDD showed prolonged cue-P3 latencies to reward cues. Furthermore, unlike controls, adolescents with MDD displayed shorter feedback-P3 latencies in the reward versus punishment condition. RewPs did not differ between groups.

LIMITATIONS

It remains unanswered whether the observed alterations in adolescent MDD represent a state or trait.

CONCLUSIONS

Delayed neural processing of reward cues corresponds to the clinical presentation of adolescent MDD with reduced motivational tendencies to obtain rewards. Relatively shorter feedback-P3 latencies in the reward versus punishment condition could indicate a high salience of performance-contingent reward. Frequent exposure of negatively biased adolescents with MDD to performance-contingent rewards might constitute a promising intervention approach.

Core dimensions of anxiety and depression change independently during adolescence

The developmental trajectories of emotional disorder symptoms during adolescence remain elusive, owing in part to a shortage of intensive longitudinal data. In the present study, we charted the temporal course of the tripartite model of anxiety and depression-which posits an overarching negative affect dimension and specific anhedonia and anxious arousal dimensions-over adolescence and emerging adulthood to construct a developmental map of the core dimensions of emotional disorders. We recruited 604 high school juniors, overselecting those at high risk for emotional disorders, and assessed the tripartite symptom domains 5 times annually. Latent curve modeling revealed that negative affect and anxious arousal declined over follow up, whereas anhedonia did not. Moreover, the correlation in rate of change varied across pairs of symptom domains. Change in negative affect was moderately correlated with change in anxious arousal, but change in anhedonia was not significantly related to change in any other domain. Symptom trajectories, and the pattern of covariation among trajectories, were equivalent across gender and comorbidity status. We discuss implications of these findings for developmental models of anxiety and depression, as well as transdiagnostic frameworks for emotional disorders. (PsycINFO Database Record

Development and Evaluation of the PROMIS® Pediatric Positive Affect Item Bank, Child-Report and Parent-Proxy Editions

OBJECTIVE

The purpose of this study is to describe the psychometric evaluation and item response theory calibration of the PROMIS Pediatric Positive Affect item bank, child-report and parent-proxy editions.

METHODS

The initial item pool comprising 53 items, previously developed using qualitative methods, was administered to 1,874 children 8-17 years old and 909 parents of children 5-17 years old. Analyses included descriptive statistics, reliability, factor analysis, differential item functioning, and construct validity. A total of 14 items were deleted, because of poor psychometric performance, and an 8-item short form constructed from the remaining 39 items was administered to a national sample of 1,004 children 8-17 years old, and 1,306 parents of children 5-17 years old. The combined sample was used in item response theory (IRT) calibration analyses.

RESULTS

The final item bank appeared unidimensional, the items appeared locally independent, and the items were free from differential item functioning. The scales showed excellent reliability and convergent and discriminant validity. Positive affect decreased with children's age and was lower for those with a special health care need. After IRT calibration, we found that 4 and 8 item short forms had a high degree of precision (reliability) across a wide range of the latent trait (>4 SD units).

CONCLUSION

The PROMIS Pediatric Positive Affect item bank and its short forms provide an efficient, precise, and valid assessment of positive affect in children and youth.

Longitudinal associations between physically abusive parents' emotional expressiveness and children's self-regulation

The present study took a developmental psychopathology approach to examine the longitudinal association between parents' emotional expressiveness and children's self-regulation. Data collection spanned from 2004 to 2008. Ninety-two physically abusive parents completed yearly assessments of their emotional expressiveness, as well as their children's self-regulation abilities. Observational and behavioral measures were also obtained yearly to capture both parents' emotional expressiveness and children's self-regulation. Specifically, parents participated in a parent-child interaction task, which provided insight into their levels of flat affect. A puzzle box task was completed by each child to assess self-regulation. Results indicated, first, that greater parental expression of negative emotions predicted poorer self-regulation in children, both concurrently and across time. Second, parental expressions of positive emotions and parents' flat affect were unrelated to children's self-regulation. Findings inform our understanding of parental socialization of self-regulation and provide insight into the roles of distinct components of emotional expressiveness. Moreover, findings have crucial implications for understanding emotional expressiveness in high-risk samples and increase our understanding of within-group functioning among maltreating families that may serve as a means to direct intervention efforts.