Spiraling out of control: Stress generation and subsequent rumination mediate the link between poorer cognitive control and internalizing psychopathology

Neural basis underlying the association between thought control ability and happiness: The moderating role of the amygdala

Thought control ability (TCA) plays an important role in individuals' health and happiness. Previous studies demonstrated that TCA was closely conceptually associated with happiness. However, empirical research supporting this relationship was limited. In addition, the neural basis underlying TCA and how this neural basis influences the relationship between TCA and happiness remain unexplored. In the present study, the voxel-based morphometry (VBM) method was adopted to investigate the neuroanatomical basis of TCA in 314 healthy subjects. The behavioral results revealed a significant positive association between TCA and happiness. On the neural level, there was a significant negative correlation between TCA and the gray matter density (GMD) of the bilateral amygdala. Split-half validation analysis revealed similar results, further confirming the stability of the VBM analysis findings. Furthermore, gray matter covariance network and graph theoretical analyses showed positive association between TCA and both the node degree and node strength of the amygdala. Moderation analysis revealed that the GMD of the amygdala moderated the relationship between TCA and happiness. Specifically, the positive association between TCA and self-perceived happiness was stronger in subjects with a lower GMD of the amygdala. The present study indicated the neural basis underlying the association between TCA and happiness and offered a method of improving individual well-being.

Major gender differences in relations between life stressor frequency and gray matter in adolescence and emerging adulthood

Adolescence and emerging adulthood is likely a sensitive period for the neural effects of stress due to increasing life stress, onset of stress-related disorders, and continued gray matter (GM) development. In adults, stress is associated with GM differences in the medial prefrontal cortex (mPFC), hippocampus, and amygdala, but little is known about these relations, and whether they differ by gender, during adolescence and emerging adulthood. Further, it is unknown whether dependent (self-generated) and independent (fateful) stressors have distinct associations with GM, as each have distinct relations with internalizing psychopathology. We tested relations between recent dependent and independent stressor frequency (ALEQ-R) and GM structure using MRI in a priori regions of interest (mPFC, amygdala, and hippocampus) and across the cortex in youth from the Denver/Boulder metro area ages 14-22 (N = 144). Across both genders, no effects passed multiple comparison correction (FDR q > .05). However, there were significant differences between male and female youth (FDR q < .05), with opposite relations between dependent stressor frequency and cortical GM thickness in the salience network and emotion regulation regions and with surface area in default mode network regions. These results motivate future investigations of gender differences in neural mechanisms of stress generation and reactivity. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Why is subjective stress severity a stronger predictor of health than stressor exposure? A preregistered two-study test of two hypotheses

Subjective stress severity appraisals have consistently emerged as better predictors of poor health than stressor exposure, but the reason for this is unclear. Subjective stress may better predict poor health for one of at least two reasons. First, because stressor exposure measures consider all stressors as equal, stress severity measures-which "weight" stressors by self-reported severity-might better predict poor health simply by not treating all stressors as being equally impactful. Second, subjective stress appraisals may index important individual differences in stress vulnerability. We tested these two possibilities in this preregistered, two-study manuscript. Across these two different studies, subjective stress severity was a better predictor of poor health than independently weighted stress severity or stressor exposure. These results demonstrate that, beyond weighting of stressful experiences, subjective stress severity indexes health-relevant individual differences. Moreover, the results suggest that subjective stress severity may be the preferred stress summary metric even when derived from imprecise stress assessment instruments.

Early Emergence of Rumination has no Association with Performance on a Non-affective Inhibitory Control Task

Rumination is a vulnerability for depression and potentially linked to inhibitory control weaknesses. We aimed to replicate the association observed in adults between inhibitory control and rumination in adolescents, and to examine putative moderating roles of childhood maltreatment and perceived family cohesion in an adolescent sample at risk for depression due to familial/personal history. Ninety adolescents aged 11-17 (M = 14.6, SD = 1.8) completed self-report scales of rumination, maltreatment, and family cohesion, and performed a task assessing inhibitory control. Hierarchical regression models showed no significant relation between inhibitory control and moderator variables on rumination. However, adolescents who reported higher levels of maltreatment and who perceived lower family cohesion tended to indicate higher levels of rumination (BChilhood Maltreatment = 27.52, 95% CIs [5.63, 49.41], BFamily Cohesion = -0.40, 95% CIs [-0.65, -0.15]). These findings demonstrate an alternative understanding of factors that increase depression onset risk and recurrence in adolescents.

Locus coeruleus catecholamines link neuroticism and vulnerability to tau pathology in aging

Higher neuroticism is a risk factor for Alzheimer's disease (AD), and is implicated in disordered stress responses. The locus coeruleus (LC)-catecholamine system is activated during perceived threat and is a centerpiece of developing models of the pathophysiology of AD, as it is the first brain region to develop abnormal tau. We examined relationships among the "Big 5" personality traits, LC catecholamine synthesis capacity measured with [18F]Fluoro-m-tyrosine PET, and tau burden measured with [18F]Flortaucipir PET in cognitively normal older adults (n = 47). β-amyloid (Aβ) status was determined using [11C]Pittsburgh compound B PET (n = 14 Aβ positive). Lower LC catecholamine synthesis capacity was associated with higher neuroticism, more depressive symptoms as measured by the Geriatric Depression Scale, and higher amygdala tau-PET binding. Exploratory analyses with other personality traits revealed that low trait conscientiousness was also related to both lower LC catecholamine synthesis capacity, and more depressive symptoms. A significant indirect path linked both high neuroticism and low conscientiousness to greater amygdala tau burden via their mutual association with low LC catecholamine synthesis capacity. Together, these findings reveal LC catecholamine synthesis capacity to be a promising marker of affective health and pathology burden in aging, and identifies candidate neurobiological mechanisms for the effect of personality on increased vulnerability to dementia.

Child executive function and future externalizing and internalizing problems: A meta-analysis of prospective longitudinal studies

To determine the association between executive function and later externalizing and internalizing problems, we conducted a meta-analysis of 167 studies (1098 effect sizes, total N = 66,119) that explored the longitudinal associations between executive functions in children and subsequent externalizing and internalizing problems. The results indicated that greater child executive function was prospectively associated with fewer attention-deficit/hyperactivity disorder (ADHD) symptoms, fewer conduct problems, fewer oppositional defiant disorder symptoms, less substance use, fewer broad externalizing problems, fewer depression symptoms, and fewer broad internalizing problems, but not with subsequent anxiety symptoms. Moderator analyses revealed that the sample type moderated the associations of executive function with both ADHD symptoms and conduct problems. Age of assessment moderated the association with broad externalizing problems, and executive function context moderated associations with both substance use and broad internalizing problems. These findings suggest that executive function in children prospectively predicts numerous externalizing and internalizing behaviors, suggesting that executive function may be an important target for psychopathology prevention programs and interventions.

Neuroanatomical Correlates of Perceived Stress Controllability in Adolescents and Emerging Adults

Stressful life events predict changes in brain structure and increases in psychopathology, but not everyone is equally affected by life stress. The learned helplessness theory posits that perceiving life stressors as uncontrollable leads to depression. Evidence supports this theory for youth, but the impact of perceived control diverges based on stressor type: perceived lack of control over dependent (self-generated) stressors is associated with greater depression symptoms when controlling for the frequency of stress exposure, but perceived control over independent (non-self-generated) stressors is not. However, it is unknown how perceived control over these stressor types is associated with brain structure. We tested whether perceived lack of control over dependent and independent life stressors, controlling for stressor exposure, is associated with gray matter (GM) in a priori regions of interest (ROIs; mPFC, hippocampus, amygdala) and across the cortex in a sample of 108 adolescents and emerging adults ages 14-22. There were no associations across the full sample between perceived control over either stressor type and GM in the ROIs. However, less perceived control over dependent stressors was associated with greater amygdala gray matter volume in female youth and greater medial prefrontal cortex thickness in male youth. Furthermore, whole-cortex analyses revealed less perceived control over dependent stressors was associated with greater GM thickness in cortical regions involved in cognitive and emotional regulation. Thus, appraisals of control have distinct associations with brain morphology while controlling for stressor frequency, highlighting the importance of differentiating between these aspects of the stress experience in future research.

Preliminary validation of the self-report measure assessing experiences of negative independent and dependent event frequency in Japanese university students

Background

In the past, different stress generation studies have used self-report measures comprising different items to assess each category of negative events. Moreover, the validity of these scales has not been adequately investigated. Therefore, we developed a self-report measure dedicated to assessing experiences of negative interpersonal dependent events, negative non-interpersonal dependent events, and negative independent events in university students, which was named the Negative Independent/Dependent Events Scale.

Methods

Japanese undergraduate students (N = 247; mean age = 19.18 years, SD = 3.08) responded to the Negative Independent/Dependent Events Scale, which had items selected for adequate content validity. They also responded to self-report measures of depressive symptoms, reassurance-seeking behaviors, inattention, and lack of perseverance.

Results

All the negative events subscales had moderate positive correlations with depressive symptoms. In addition, the negative interpersonal dependent events subscale showed a moderate positive correlation with reassurance-seeking behaviors, and the negative non-interpersonal dependent events subscale showed a strong positive correlation with inattention. Furthermore, the negative non-interpersonal dependent events subscale was more strongly correlated with inattention than the other two negative events subscales. In contrast, the negative interpersonal dependent events subscale was more strongly correlated with reassurance-seeking behaviors than with the negative independent events subscale but not more strongly than with the negative non-interpersonal dependent events subscale.

Conclusions

These findings indicated the acceptable construct validity of the Negative Independent/Dependent Events Scale. However, further research is necessary to establish the discriminant validity of the negative interpersonal dependent events subscale and the negative non-interpersonal dependent events subscale.

Rumination Derails Reinforcement Learning with Possible Implications for Ineffective Behavior

How does rumination affect reinforcement learning-the ubiquitous process by which we adjust behavior after error in order to behave more effectively in the future? In a within-subject design (n=49), we tested whether experimentally manipulated rumination disrupts reinforcement learning in a multidimensional learning task previously shown to rely on selective attention. Rumination impaired performance, yet unexpectedly this impairment could not be attributed to decreased attentional breadth (quantified using a "decay" parameter in a computational model). Instead, trait rumination (between subjects) was associated with higher decay rates (implying narrower attention), yet not with impaired performance. Our task-performance results accord with the possibility that state rumination promotes stress-generating behavior in part by disrupting reinforcement learning. The trait-rumination finding accords with the predictions of a prominent model of trait rumination (the attentional-scope model). More work is needed to understand the specific mechanisms by which state rumination disrupts reinforcement learning.

Anger Rumination in Early Adolescence: Risk Factor or Outcome of Depressive Symptoms? A Prospective Study

Anger rumination is a maladaptive cognitive-emotional process associated with aversive adjustment outcomes. Despite of evidence showing a close relationship between anger rumination and depressive symptoms across adolescence, their longitudinal relationship is still unknown. The goal of the present study was to examine the bidirectional association between self-reported anger rumination and depressive symptoms at two waves, spaced 1-year. Participants were 304 early adolescents (44.7% boys; M_age = 10.80 years, SD = 0.16). Cross-lagged analyses showed that depressive symptoms predicted increases in anger rumination but not vice versa. These relationships were consistent across boys and girls. Overall, the findings suggest that depressive symptoms may be a potential risk factor for anger rumination in early adolescence. Implications for preventions and treatments are also discussed.

General and Specific Dimensions of Mood Symptoms Are Associated With Impairments in Common Executive Function in Adolescence and Young Adulthood

Both unipolar and bipolar depression have been linked with impairments in executive functioning (EF). In particular, mood symptom severity is associated with differences in common EF, a latent measure of general EF abilities. The relationship between mood disorders and EF is particularly salient in adolescence and young adulthood when the ongoing development of EF intersects with a higher risk of mood disorder onset. However, it remains unclear if common EF impairments have associations with specific symptom dimensions of mood pathology such as blunted positive affect, mood instability, or physiological arousal, or if differences in common EF more broadly relate to what is shared across various symptom domains, such as general negative affect or distress. To address this question, bifactor models can be applied to simultaneously examine the shared and unique contributions of particular mood symptom dimensions. However, no studies to our knowledge have examined bifactor models of mood symptoms in relation to measures of common EF. This study examined associations between common EF and general vs. specific symptom dimensions (anhedonia, physiological arousal, and mania) using structural equation modeling in adolescents and young adults with varying severity of mood symptoms (n = 495, ages = 13-25 years, 68.69% female). A General Depression factor capturing shared variance across symptoms statistically predicted lower Common EF. Additionally, a factor specific to physiological arousal was associated with lower Common EF. Anhedonia-specific and Mania-specific factors were not significantly related to Common EF. Altogether, these results indicate that deficits in common EF are driven by, or reflect, general features of mood pathology that are shared across symptom dimensions but are also specifically associated with physiological arousal.

Causes and consequences of stress generation: Longitudinal associations of negative events, aggressive behaviors, rumination, and depressive symptoms

The present study examined the causes and consequences of stress generation in university students in Japan. A two-wave longitudinal study with an 8- or 9-week interval was conducted in the fall of 2020. Undergraduate and graduate students at four universities in Japan (N = 201) completed self-report measures assessing experiences of negative interpersonal dependent events, negative non-interpersonal events, and negative independent events at two times. At the same time, they also responded to measures of aggressive behaviors, trait rumination, and depressive symptoms. Path analyses revealed that baseline aggressive behaviors were positively associated with an increase in subsequent negative interpersonal dependent events, even after controlling for the influences of negative interpersonal dependent events, rumination, and depressive symptoms at baseline. However, aggressive behaviors were not significantly associated with subsequent negative non-interpersonal dependent events or negative independent events. These findings suggest that aggressive behaviors may have been a factor leading to interpersonal stress generation. Furthermore, all categories of negative event experiences predicted an increase in subsequent depressive symptoms, but not subsequent rumination, and rumination was not significantly associated with subsequent depressive symptoms. This research extends previous studies on the causes and consequences of stress generation conducted in the US by using specific measures of aggressive behaviors and including a non-restricted sample of university students in Japan.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12144-022-02859-9.

Both sides of the screen: Predictors of parents' and teachers' depression and food insecurity during COVID-19-related distance learning

The COVID-19 pandemic has placed unprecedented strains on both parents and teachers, both of whose mental and financial hardships have serious implications for young children's wellbeing. We drew on an existing cohort study of families with low incomes in Tulsa, OK when children were in their Spring of first grade in 2020. We surveyed parents and teachers - children's caregivers on both sides of the screen during distance learning - before and after the COVID-19 pandemic hit and schools were closed. We first compared the proportion of parents and teachers who were depressed and food-insecure before and after the pandemic struck. We then used pre-pandemic characteristics of parents and teachers in separate models to predict their depression and food insecurity during the pandemic. Results showed that rates of depression among both parents and teachers spiked after COVID-19, and food insecurity rates also increased among parents. For both parents and teachers, the strongest predictor of depression during COVID-19 was having experienced depression before the pandemic. Similarly, the strongest predictor of food insecurity during COVID-19 was having experienced food insecurity beforehand. These results point intervention efforts towards identifying the caregivers of children in low-income contexts whose mental and financial wellbeing are likely to be most compromised during this and perhaps future disasters.

Childhood ADHD and Executive Functioning: Unique Predictions of Early Adolescent Depression

Given the increasing prevalence of adolescent depression, identification of its early predictors and elucidation of the mechanisms underlying its individual differences is imperative. Controlling for baseline executive functioning (EF), we tested separate ADHD dimensions (i.e., inattention, hyperactivity-impulsivity) as independent predictors of early adolescent depression, including temporally-ordered causal mediation by academic functioning and social problems, using structural equation modeling. At baseline, participants consisted of 216 children (67% male) ages 6–9 years old with (n = 112) and without (n = 104) ADHD who subsequently completed Wave 2 and 3 follow-ups approximately two and four years later, respectively. Predictors consisted of separate parent and teacher ratings of childhood ADHD and laboratory-based assessments of key EF domains. At Wave 2, parents and teachers completed normed rating scales of youth academic and social functioning; youth completed standardized assessments of academic achievement. At Wave 3, youth self-reported depression. Baseline inattention positively predicted early adolescent depression whereas childhood hyperactivity-impulsivity and EF did not. Neither academic nor social functioning significantly mediated predictions of depression from baseline ADHD and EF. We consider prediction of early adolescent depression from inattention, including directions for future intervention and prevention research.

Prevalence and risk factors for acute stress disorder in female victims of sexual assault

Sexual assault is one of the most traumatic events a person can experience. Despite this, information regarding the risk factors associated with the development of Acute Stress Disorder (ASD) in sexual assault victims is scarce. A follow-up prospective cohort study was designed to examine the prevalence and risk factors of ASD in women exposed to a recent sexual assault. A total of 156 women were treated at the Emergency Department of a university general hospital shortly after sexual assault. Sociodemographic, clinical and sexual assault-related variables were collected. The Acute Stress Disorder Interview was used to estimate the prevalence of ASD at three weeks post-SA. From the 156 victims, 66.6% (N = 104) met ASD diagnosis using DSM-5 criteria, whereas 59.6% (N = 93) met ASD diagnosis using DSM-IV criteria. The risk factors associated with the development of ASD were nationality, psychiatric history, peritraumatic dissociation and type of assault. In conclusion, the prevalence of ASD in female victims of recent sexual assault was high, affecting approximately two thirds of them. The recognition of the risk factors associated with ASD development, like peritraumatic dissociation or type of assault, may aid in the prompt detection of vulnerable women that require early and specific interventions shortly after trauma.

Improved emotion regulation in depression following cognitive remediation: A randomized controlled trial

OBJECTIVE

Executive functions (EFs) play a key role in emotion regulation and, related to this, depression. Cognitive remediation (CR) targeting EFs, such as Goal Management Training (GMT) and computerized cognitive training (CCT), may reduce maladaptive emotion regulation. However, the clinical potential of GMT in the context of depression and emotion regulation remains to be tested. Hence, the primary aim of the present study was to compare effects of GMT with CCT on symptoms of emotion dysregulation.

METHOD

The paper reports the effects of a preregistered randomized controlled trial. Sixty-three participants (18-60yrs) with active or remitted depression and EF complaints were randomized to nine sessions of GMT (n = 35) or CCT (n = 28). All were assessed at baseline, post-intervention, and at 6-month follow-up. The Ruminative Response Scale and the Difficulties in Emotion Regulation Scale were employed to assess emotion regulation.

RESULTS

Both groups improved following the intervention on emotion regulation domains after controlling for intention-to-treat, including brooding rumination and on items reflecting non-accepting reactions to distress. Relative to CCT, the GMT-group demonstrated increased clarity of emotional responses in the per protocol analysis.

CONCLUSIONS

Our findings demonstrate the potential of GMT and CCT in reducing maladaptive emotion regulation in depression.

Computational Psychiatry Needs Time and Context

Why has computational psychiatry yet to influence routine clinical practice? One reason may be that it has neglected context and temporal dynamics in the models of certain mental health problems. We develop three heuristics for estimating whether time and context are important to a mental health problem: Is it characterized by a core neurobiological mechanism? Does it follow a straightforward natural trajectory? And is intentional mental content peripheral to the problem? For many problems the answers are no, suggesting that modeling time and context is critical. We review computational psychiatry advances toward this end, including modeling state variation, using domain-specific stimuli, and interpreting differences in context. We discuss complementary network and complex systems approaches. Novel methods and unification with adjacent fields may inspire a new generation of computational psychiatry. Expected final online publication date for the Annual Review of Psychology, Volume 73 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Childhood maltreatment predicts poorer executive functioning in adulthood beyond symptoms of internalizing psychopathology

BACKGROUND

A history of childhood maltreatment predicts poorer functioning in several domains during childhood, including executive function (EF). While there is also evidence of poorer EF in adults with a history of childhood trauma, results are mixed. Notable limitations of previous research are (a) the use of single indicators of EF, and/or (b) not consistently assessing whether childhood maltreatment predicts poorer EF beyond internalizing psychopathology.

OBJECTIVE

We sought to overcome limitations of prior work by examining relationships between childhood maltreatment and EF in adulthood by using a latent factor of EF derived from multiple indicators and including psychopathology covariates in our analyses.

PARTICIPANTS AND SETTING

The present study included a large sample of community adults (n = 489) who were oversampled for internalizing psychopathology symptoms.

METHODS

Primary analyses examined whether childhood maltreatment (cumulative and subtypes) predicted EF using a latent factor approach and linear mixed effects models. Follow-up analyses assessed the impact of childhood maltreatment on EF beyond internalizing psychopathology symptoms and assessed whether gender moderated relationships between EF and childhood maltreatment.

RESULTS

Greater cumulative maltreatment predicted poorer EF (B = -0.15), and emotional neglect emerged as a unique predictor of EF (B = -0.18). These results remained after controlling for psychopathology symptoms. Gender moderated the relationship between physical abuse and EF, with physical abuse predicting poorer EF among males (B = 0.30), but not females (B = -0.04).

CONCLUSIONS

Overall, results indicate that general EF deficits are related to a history of childhood maltreatment, which is not accounted for by internalizing psychopathology symptoms. Potential implications and future directions are discussed.

The relationship between executive functioning and repetitive negative thinking in youth: A systematic review of the literature

Repetitive negative thinking (RNT) and executive functioning (EF) deficits are each characteristic of many forms of youth psychopathology. Extensive work has examined the relationship between rumination, a form of RNT, and EF in adults. However, less is known about the relationship between RNT more broadly and EF in youth, for whom these constructs are developing and emerging. Here, we systematically and qualitatively reviewed 27 studies on the associations between EF (e.g., shifting, inhibition, working memory) and RNT (e.g., rumination, worry, obsessions) in youth. All forms of RNT were more commonly positively associated with questionnaire-reported EF problems in daily life, most frequently in the domain of shifting. Task-based assessments of EF were less consistently associated with RNT in youth, with no strong pattern of presence vs. absence of associations. Further, limited longitudinal work has been conducted on this topic to date. This review integrates initial work with regard to RNT and EF deficits in a still-developing population, and discusses clear future need for longitudinal, multi-method assessments of the relationship between RNT and EF subtypes in youth.

Investigating whether depressed youth exhibiting elevated C reactive protein perform worse on measures of executive functioning, verbal fluency and episodic memory in a large, population based sample of Dutch adolescents

Cognitive functioning is disrupted during a depressive episode and cognitive dysfunction persists when depression is in remission. A subtype of depressed individuals who exhibit elevated inflammatory biomarkers may be at particular risk for cognitive dysfunction. We examined whether an elevated inflammatory biomarker (C-reactive protein: CRP) in acute and/or remitted depression was associated with specific deficits in executive functioning, episodic memory, and verbal fluency. Data were drawn from a population-based sample of Dutch adolescents (N = 1066; 46% male) recruited at the age of 11 and followed over the course of eight years. We tested whether adolescents with either, (i) a history of depression (Wave 1-3) or (ii) current depression (Wave 4), and elevated levels of C-reactive protein measured in blood at Wave 3 performed worse on cognitive assessments at Wave 4. Eight measures of cognitive functioning were hypothesized to load on to one of three dimensions of cognitive functioning (executive functioning, episodic memory, and verbal fluency) within a structural equation model framework. Higher levels of CRP were associated with worse future executive functioning in adolescents with and without current/prior depression. A current depression diagnosis also was associated with worse executive functioning. There was consistent evidence linking low socioeconomic status and health-related covariates (high body mass index/sedentary behavior) with worse performance across multiple measures of cognitive functioning and, importantly, the association of depression/CRP and executive functioning was no longer significant when controlling for these covariates. Future studies may benefit from investigating whether specific depressogenic behaviors (e.g., sedentary behavior/substance use) mediate a relationship between depression and worse executive functioning, potentially via a prospective pathway through elevated inflammation.

Internalising symptoms in Developmental Coordination Disorder: The indirect effect of everyday executive function

BACKGROUND

Individuals with Developmental Coordination Disorder (DCD) report elevated executive function (EF) difficulties and internalising symptoms. Previous research suggests EF is important for wellbeing, yet no research has examined its role in internalising symptoms in DCD.

AIMS

To explore an indirect relationship between DCD and internalising symptoms, through everyday EF difficulties.

METHOD AND PROCEDURES

Thirty-two children with a DCD diagnosis and 51 typically-developing children (ages 8-15) participated. A cross-sectional survey was conducted to collect parent-reported EF and self-reported internalising symptoms.

OUTCOMES AND RESULTS

Internalising symptoms and everyday EF difficulties were significantly higher in the DCD group. A bias-corrected, bootstrapped mediation analysis identified an indirect effect of everyday EF difficulties on the relationship between DCD diagnosis and internalising symptoms.

CONCLUSIONS AND IMPLICATIONS

This supports previous research indicating that individuals with DCD experience greater levels of internalising symptoms and EF difficulties than peers. It is the first to suggest an indirect effect of everyday EF difficulties in the pathway between DCD and internalising symptoms. This highlights hypotheses for future research into the role of EFs in understanding mental health in DCD. It suggests benefits from increased awareness, routine screening, and intervention for mental health and EF in people with poor motor skills.

Cognitive mechanisms underlying depressive disorders in ADHD: A systematic review

The risk for major depressive disorder (MDD) is considerably increased in young adults with attention-deficit/hyperactivity disorder (ADHD) but underlying mechanisms are poorly understood. This review explores ADHD-specific neurocognitive impairments as possible underlying mechanisms for ADHD-depression comorbidity. Two systematic literature searches were conducted in EBSCOhost, PubMED, and Cochrane Reviews databases according to PRISMA guidelines. The first search identified 18 meta-analyses of cross-sectional and longitudinal studies on cognitive dysfunctions in MDD across the lifespan. The second search identified six original studies on reaction time variability in MDD. During acute depression, children and adults showed cognitive deficits that overlapped with some of the ADHD-related impairments. Findings from remitted patients, high-risk individuals, and few prospective studies suggest that a subset of these shared impairments, specifically executive dysfunctions (selective attention, verbal fluency, working memory) and long-term memory problems, are candidate pre-existing risk markers of depression. We discuss if and how these specific neurocognitive mechanisms may mediate developmental pathways from ADHD to depression. If replicated by longitudinal studies, these findings may guide future prevention strategies.

Genetic and Environmental Influences on Stressful Life Events and their Associations with Executive Functions in Young Adulthood: A Longitudinal Twin Analysis

Although stress is frequently considered an environmental factor, dependent stressful life events (SLEs)--stressors that result from one's actions or behaviors--may in fact be evoked by a genetic liability. It has been suggested that dependent SLEs may be partially caused by poor executive function (EFs), higher-level cognitive abilities that enable individuals to implement goal-directed behavior. We investigated the possibility of genetic and environmental overlap between SLEs and EFs in a longitudinal twin study. We found high genetic stability in the number of dependent SLEs from age 23 to age 29, suggesting that the number of dependent stressors show persistence across time due to their genetic etiology. In addition, there was a nominally significant negative genetic correlation between a Common EF latent factor and dependent SLEs at age 23. The genetic stability of dependent SLEs and association with Common EF provides insight into how some behaviors may lead to persistent stress.

Anxiety and executive functions in mid-to-late life: the moderating role of sleep

Objectives: The goal of the study was to examine the influence of sleep efficiency on the relationship between anxiety and executive functions.Method: Secondary data analyses of 82 community-dwelling middle-aged and older adults were performed (M age = 63.00, SD = 8.64). Anxiety was measured using the trait anxiety subscale of the State-Trait Anxiety Inventory. Sleep efficiency was measured using one-week of sleep diary data. Two executive functions, cognitive flexibility and inductive reasoning, were measured using the Trail-Making Test and Letter Series task, respectively. SPSS PROCESS macro software version 2 was used to assess the moderating role of sleep efficiency in the relationship between anxiety and executive functions.Results: Sleep significantly moderated the relationship between anxiety and inductive reasoning. Among middle-aged and older adults with high anxiety, those with good sleep efficiency displayed significantly better inductive reasoning than those with poor sleep efficiency after controlling for age, gender, and education (ΔR2 = .05, p = .017). Sleep efficiency did not significantly moderate the relationship between anxiety and cognitive flexibility.Conclusion: Sleep efficiency weakened the association between anxiety and inductive reasoning in middle-aged and older adults. Evidence from the study suggests better sleep may limit the negative effects of anxiety on executive functions in mid-to-late life. Further research is needed to elucidate the impact of anxiety and sleep on executive functions in clinical populations with anxiety.

Clarifying stress-internalizing associations: Stress frequency and appraisals of severity and controllability are differentially related to depression-specific, anxiety-specific, and transdiagnostic internalizing factors

BACKGROUND

Dependent (self-generated) stress is a strong risk factor for depression and anxiety, but perceptions of stress can alter its impact. Appraisals of dependent stress controllability and severity additionally relate to depression and anxiety over and above stress exposure. Due to the high comorbidity of depression and anxiety, it is unclear whether dependent stress frequency and appraisals relate specifically to depression or anxiety or are transdiagnostically associated shared aspects of internalizing disorders. Consistent with the tripartite model, the current study represented internalizing symptoms with three latent factors - depression-specific, anxiety-specific, and common internalizing - and tested how dependent stress frequency and appraisals of controllability and severity were associated with these factors.

METHODS

Bifactor modeling was used to create the latent internalizing factors in a treatment-seeking sample of emerging adults (n = 356). Structural equation models tested dependent stress frequency and appraisals of controllability and severity as predictors of these latent factors.

RESULTS

Dependent stress frequency was associated with common internalizing while perceived controllability was associated uniquely with depression-specific variance. Continuous stress severity was not associated with latent factors, but high-severity stressors were associated with anxiety-specific variance.

LIMITATIONS

Without longitudinal data conclusions regarding temporal directionality cannot be made. Participants' appraisals of stressors could not be compared to expert ratings.

CONCLUSIONS

Dependent stress frequency, controllability appraisals, and high-severity stressful events have distinct links with different dimensions of internalizing psychopathology. This suggests there may be several distinct mediating mechanisms between stress constructs and psychopathology, which have potential to serve as targets for intervention.

A Hot-Cold Cognitive Model of Depression: Integrating the Neuropsychological Approach Into the Cognitive Theory Framework

In the 50 years following Beck’s cognitive theory, empirical research has consistently supported the role of dysfunctional, ‘hot’ cognition in the onset and maintenance of major depressive disorder. Compromised ‘cold’ cognition in attention, memory, and executive control abilities, independent of the affective state, has attracted much clinical interest for its role throughout the course of illness and into remission. We propose integrating cold cognition into Beck’s cognitive theory framework to account for the complementary roles of both hot and cold cognition in depression onset and maintenance.

A critical review of cognitive research was conducted to inform an integrated hot-cold cognitive model of depression.

Cold cognitive deficits likely act as a gateway to facilitate the activation and expression of the hot cognitive biases through a weakened ability to attend, retrieve, and critically assess information. Cold deficits become exacerbated by the negative mood state, essentially ‘becoming hot’, lending to maladaptive emotion regulation through ruminative processes. Depleted cognitive resources contribute to the manifestation of further deficit in problem-solving ability in everyday life, which in itself, may act as a stressor for the onset of recurrent episodes, perpetuating the depressive cycle.

We discuss the interaction between hot and cold cognition within the cognitive theory framework and the potential of complementary hot-cold pathways to elucidate novel means of prevention and treatment for depression.

Dysfunction in hot (emotion-dependent) and cold (emotion-independent) cognition has been demonstrated in depression, but psychological treatment has largely focused on hot cognition only.

Hot and cold cognition are complementary processes throughout the activation and maintenance of depressive schemas and biases, necessitating the consideration of both hot and cold cognitive aspects to disrupt the depressive cycle.

The proposed hot-cold cognitive model shows promise to stimulate new research avenues for the prevention and treatment of depression.

Behavioral and Neural Dysregulation to Social Rewards and Links to Internalizing Symptoms in Adolescents

Adolescence is a time of unique sensitivity to socially salient stimuli such as social rewards. This period overlaps with the onset of psychopathology such as internalizing and externalizing symptoms. In the current studies, we examined behavioral and neural patterns of dysregulation to social rewards and threats, and links to internalizing and externalizing symptoms in youths. In study 1, we used a social Go/NoGo cognitive control task using peer faces to test for age-related behavioral differences in inhibitory failures in adolescents (N = 53, Mage = 13.37 years), and adults (N = 51, Mage = 43.71 years). In study 2, an independent adolescent sample (N = 51, Mage = 13.98 years) completed a similar social Go/NoGo cognitive control task during fMRI. Results show that adolescents had greater inhibitory failures - as measured by false alarm rate - to both social reward and threat cues than adults, and more so to social reward than threat cues. Greater inhibitory failures to social reward than threat cues were associated with greater internalizing symptoms, but were not significantly related to externalizing symptoms. At the neural level, greater inhibitory failures to social reward than threat cues as well as greater internalizing symptoms were both associated with heightened amygdala-ventral striatum connectivity. Our findings indicate that subcortico-subcortical connectivity, which is deemed to occur chronologically earlier and thus necessary for subcortico-cortical circuits, may serve as an early biomarker for emotion dysregulation and a risk factor for internalizing symptoms.

Impulsivity and Behavior-Dependent Life Events Mediate the Relationship of Reward Sensitivity and Depression, but Not Hypomania, Among at-Risk Adolescents

Both reward sensitivity and impulsivity are related to the development and course of bipolar spectrum disorders (BSDs) and have been implicated in other disorders and negative functional outcomes such as substance abuse, obesity, suicidal behaviors, and risk-taking. Furthermore, according to the transactional component of the Behavioral Approach System (BAS)/reward hypersensitivity theory of BSDs, people with reward hypersensitivity should experience more BAS-relevant events, and thus, are more vulnerable to mood symptoms and episodes via stress generation. Impulsivity may exacerbate stress generation in individuals at risk for BSDs based on exhibiting reward hypersensitivity. The current study examined whether impulsivity explained the generation of stress and subsequent mood symptoms beyond what is explained by reward sensitivity alone. Participants were 131 Moderate BAS and 216 High BAS sensitivity adolescents (M = 18.43 years, SD = 1.40), who completed baseline measures of reward sensitivity and impulsivity, as well as follow-up measures of life events and mood symptoms. Results from linear regression analyses indicated that higher baseline impulsivity predicted behavior-dependent, but not behavior-independent, life events. Furthermore, path analyses suggested that the effect of BAS group on depression symptoms at next follow-up was partly explained via the indirect effect of impulsivity and negative behavior-dependent life events. We did not find these effects for behavior-independent or positive-dependent events or for prediction of hypomanic symptoms. The findings suggest that impulsivity may account for stress generation of negative events that precede depression.

Beyond uncertainty: A broader scope for "incentive hope" mechanisms and its implications

We propose that food-related uncertainty is but one of multiple cues that predicts harsh conditions and may activate "incentive hope." An evolutionarily adaptive response to these would have been to shift to a behavioral-metabolic phenotype geared toward facing hardship. In modernity, this phenotype may lead to pathologies such as obesity and hoarding. Our perspective suggests a novel therapeutic approach.

Examining differential relationships among self-reported attentional control, depression, and anxiety in a transdiagnostic clinical sample

BACKGROUND

Poor attentional control, defined as difficulty focusing attention on a task or shifting attention flexibly between tasks, is a transdiagnostic construct theorized to confer risk for, and maintain, depression and anxiety. Research to date in non-clinical samples has suggested a dissociable relationship between the two factors of self-reported attentional control and psychopathology, with depression being associated with difficulties shifting and anxiety being associated with focusing. However, to our knowledge no study has tested this differential set of relationships in a clinical sample.

METHODS

Adults (N = 493) presenting for psychiatric treatment completed measures of depressive and anxiety symptom severity and self-reported attentional control. Hierarchical linear regression and Zou's (2007) confidence interval method were used to examine the relationship between clinical symptoms and attentional control.

RESULTS

Both shifting and focusing were significantly correlated with anxiety and depressive symptoms in this sample. However, focusing was more strongly associated with clinical symptomatology than shifting, which showed a weak correlation.

LIMITATIONS

All constructs were measured cross-sectionally by self-report questionnaires.

CONCLUSIONS

In contrast to studies conducted in non-clinical samples, attentional focusing appears to be more relevant than attentional shifting in a clinical sample for both depression and anxiety symptoms. These findings lend support to efforts to develop neurocognitive interventions that improve focusing. Replication of these findings, particularly in longitudinal studies, is warranted.

Transdiagnostic mechanisms of psychopathology in youth: Executive functions, dependent stress, and rumination

Executive function (EF) deficits have been proposed as transdiagnostic risk factors for psychopathology, and recent research suggests EF impairments are associated with what is shared across forms of psychopathology (p factor). However, most research has not employed methods that differentiate between EF components, and little is known about the mediating mechanisms linking EF and psychopathology dimensions. The current study tested associations between the latent unity/diversity model of EF and latent dimensions of psychopathology and investigated mediating mechanisms in a community sample of 292 youth age 13-22. The results confirmed the finding that poor EF is associated with internalizing psychopathology in older youth via higher dependent stress and rumination, and showed that this pathway was transdiagnostic, predicting the p factor rather than internalizing specifically. Links with psychopathology were specific to the common EF factor, rather than updating- or shifting-specific EF.

Early childhood depression, emotion regulation, episodic memory, and hippocampal development

Depression in adults is associated with deficits in a number of cognitive domains, however it remains less clear how early in development theses deficits can be detected in early onset depression. There are several different hypotheses about the links between cognitive function and depression. For example, it has been argued that executive function deficits contribute to emotion regulation difficulties, which in turn increase risk for depression. Further, it has been suggested that some cognitive deficits, such as episodic memory, may reflect hippocampal abnormalities linked to both depression and episodic memory. We examined these questions in adolescents participating in a longitudinal study of preschool onset depression. We measured cognitive function at adolescence using the National Institutes of Health toolbox (vocabulary, processing speed, executive function, working memory and episodic memory), and examined relationships of cognitive deficits to depression, emotion regulation, life stress and adversity, as well as hippocampal volume trajectories over three imaging assessments starting at school age. Depression related deficits in episodic memory were found. Youths with either current and past depression showed episodic memory deficits even after controlling for other psychopathology and family income. Depression severity, emotion dysregulation, and life stress/adversity all predicted episodic memory impairment, as did smaller intercepts and slopes of hippocampal growth over time. Modest relationships of depression to hippocampal volume and strong relationships between emotion regulation and both episodic memory and hippocampal volume were found. These data are consistent with prior work in adults linking depression, episodic memory, emotion regulation, life stress/adversity, and hippocampal volume in adults and suggest similar relations are evident as early as adolescence when memory systems are under development. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Cognitive and attentional vulnerability to depression in youth: A review

Although depressive disorders are among the most common disorders in youth, highly efficacious treatments for childhood affective disorders are lacking. There is significant need to better understand the factors that contribute to the development and maintenance of depression in youth so that treatments can be targeted at optimal mechanisms. The aim of the current paper was to synthesize research on cognitive and neurobiological factors associated with youth depression, guided by De Raedt and Koster's model (2010) for vulnerability to depression in adults. Consistent with model predictions, there is evidence that attentional impairments are greatest in the context of negative information, relative to positive or neutral information, and some evidence that attentional deficits are associated with rumination in depressed youth. However, we found little evidence for the model's assumption that attentional bias is an etiological and maintenance factor for depression. There are several other model predictions that require additional study as current data are lacking. Overall, De Raedt and Koster's (2010) integrative cognitive and biological framework has tremendous potential to move the field forward in understanding the development of depression in youth. Additional longitudinal studies incorporating measures across biological and cognitive levels of analysis are needed.

Appraisals of dependent stressor controllability and severity are associated with depression and anxiety symptoms in youth

BACKGROUND AND OBJECTIVES

Stress is well established as a strong risk factor for internalizing psychopathology. Learned helplessness research demonstrates that perceived controllability of stressors affects internalizing symptoms. Furthermore, subjective perceived stress is associated with psychopathology. However, most recent research has focused on measuring the frequency and expert-rated severity of stressful life events despite evidence for the importance of stress perceptions. The present study brings together past and current literatures to investigate the importance of perceived severity and controllability of recent life events in the association between stressors and internalizing symptoms.

DESIGN AND METHODS

We used a revised version of the Adolescent Life Events Questionnaire (ALEQ) that asked participants (ages 13-22, N = 328) to rate the frequency of 65 stressful events typical to youth, as well as the perceived stressfulness and control they felt over each event. Events were categorized prior to analysis as dependent (self-generated), independent (fateful) or neither.

RESULTS

Controllability and severity appraisals were associated with depression and anxiety symptoms, controlling for stressor frequency (which also predicted symptoms), for dependent but not independent stressors.

CONCLUSIONS

These results highlight the importance of controllability and severity appraisals as potential risk factors for internalizing disorders, exposing a potential target for therapy.

Is Worse Attention a Risk Factor for or a Consequence of Depression, or Are Worse Attention and Depression Better Accounted for by Stress? A Prospective Test of Three Hypotheses

It is unclear whether impaired cognition is a risk factor for depression, a consequence of depression, or whether both depression and impaired cognition are caused by a third underlying process (e.g., stress). These three hypotheses were tested in 523 adolescents assessed annually for depression, attentional functioning, and childhood/recent life stress. Baseline switching, sustained, and selective attention did not predict first onset of depression (foD) or depressive symptoms. Divided attention predicted depressive symptoms only. Piecewise growth modelling indicated that the trajectory of switching attention declined prior to foD; there was evidence of significant recovery in switching attention following foD. Structural equation modelling indicated that impaired switching attention prospectively predicted higher depressive symptoms and that higher depressive symptoms predicted worse selective and switching attention. Further, childhood stress prospectively predicted higher depressive symptoms via switching attention and worse switching attention via depressive symptoms.

Stress Reactivity as a Pathway from Attentional Control Deficits in Everyday Life to Depressive Symptoms in Adolescent Girls

The goal of this research was to expand theoretical models of adolescent depression to determine whether individual differences in cognitive processing-specifically attentional control deficits-help to explain increased risk for depression during adolescence. We also examined whether this pathway was stronger in girls than in boys. A longitudinal design was used to examine whether poor attentional control in everyday life (i.e., difficulties shifting between ideas, tasks, and activities) contributes to depression over time by fostering higher levels of stress reactivity. Youth (298 boys, 338 girls) completed questionnaires assessing stress reactivity (6th and 7th grades) and depressive symptoms (6th, 7th and, 8th grades); teachers completed the shifting subscale of the Behavior Rating Scale of Executive Function (Gioia et al. 2000a) to assess attentional control (6th and 7th grades). Structural equation modeling analyses provided support for the predicted pathway in girls but not boys, yielding a significant indirect effect from 6th grade shifting deficits to 8th grade depressive symptoms via 7th grade stress reactivity. These results suggest that attentional control deficits in early adolescence heighten girls' sensitivity to stress and consequent depressive symptoms, providing a critical direction for efforts to decrease adolescent girls' risk for depression.

Cognition-emotion interaction as a predictor of adolescent depressive symptoms

Given the sharp increase in rates of depression during adolescence, especially in girls, it is important to identify which youth are at greatest risk across this critical developmental transition. During the present research, we examined whether (a) individual differences in cognition-emotion interaction, as reflected in cognitive control (CC) deficits and trait negative emotionality (NE), predict depression levels across a 1-year period (sixth-seventh grades); and (b) these temperamental traits create a particularly strong risk in girls. Youth (338 girls, 298 boys; M age in 6th grade = 11.96, SD = .37) reported on their trait NE and depressive symptoms; teachers reported on CC deficits. As hypothesized, compromised CC predicted subsequent depressive symptoms in girls with high, but not average or low, trait NE. This research informs efforts to identify which adolescents are at heightened risk for depression during the adolescent transition and points to possible candidates for early intervention. (PsycINFO Database Record

Context and craving during stressful events in the daily lives of drug-dependent patients

RATIONALE

Knowing how stress manifests in the lives of people with substance-use disorders could help inform mobile "just in time" treatment.

OBJECTIVES

The purpose of this paper is to examine discrete episodes of stress, as distinct from the fluctuations in background stress assessed in most EMA studies.

METHODS

For up to 16 weeks, outpatients on opioid-agonist treatment carried smartphones on which they initiated an entry whenever they experienced a stressful event (SE) and when randomly prompted (RP) three times daily. Participants reported the severity of stress and craving and the context of the report (location, activities, companions). Decomposition of covariance was used to separate within-person from between-person effects; r _effect sizes below are within-person.

RESULTS

Participants (158 of 182; 87%) made 1787 stress-event entries. Craving for opioids increased with stress severity (r _effect = 0.50). Stress events tended to occur in social company (with acquaintances, 0.63, friends, 0.17, or on the phone, 0.41) rather than with family (spouse, -0.14; child, -0.18), and in places with more overall activity (bars, 0.32; outside, 0.28; walking, 0.28) and more likelihood of unexpected experiences (with strangers, 0.17). Being on the internet was slightly protective (-0.22). Our prior finding that being at the workplace protects against background stress in our participants was partly supported in these stressful-event data.

CONCLUSIONS

The contexts of specific stressful events differ from those we have seen in prior studies of ongoing background stress. However, both are associated with drug craving.

Understanding comorbidity among internalizing problems: Integrating latent structural models of psychopathology and risk mechanisms

It is well known that comorbidity is the rule, not the exception, for categorically defined psychiatric disorders, and this is also the case for internalizing disorders of depression and anxiety. This theoretical review paper addresses the ubiquity of comorbidity among internalizing disorders. Our central thesis is that progress in understanding this co-occurrence can be made by employing latent dimensional structural models that organize psychopathology as well as vulnerabilities and risk mechanisms and by connecting the multiple levels of risk and psychopathology outcomes together. Different vulnerabilities and risk mechanisms are hypothesized to predict different levels of the structural model of psychopathology. We review the present state of knowledge based on concurrent and developmental sequential comorbidity patterns among common discrete psychiatric disorders in youth, and then we advocate for the use of more recent bifactor dimensional models of psychopathology (e.g., p factor; Caspi et al., 2014) that can help to explain the co-occurrence among internalizing symptoms. In support of this relatively novel conceptual perspective, we review six exemplar vulnerabilities and risk mechanisms, including executive function, information processing biases, cognitive vulnerabilities, positive and negative affectivity aspects of temperament, and autonomic dysregulation, along with the developmental occurrence of stressors in different domains, to show how these vulnerabilities can predict the general latent psychopathology factor, a unique latent internalizing dimension, as well as specific symptom syndrome manifestations.