Transition from stress sensitivity to a depressive state: longitudinal twin study

An integrative analysis of potential mechanisms of reduced positive affect in daily life in depression: an ESM study

Decreased levels of positive affect (PA) are a hallmark of depression. Current models propose as potential main mechanisms a dysfunctional use of emotion regulation (ER) strategies (i.e. dampening, positive rumination), and a maladaptive activation of pro-hedonic goals. However, the role of these mechanisms in PA in daily life remains understudied. We used a 10-day ESM design to assess how these mechanisms influence each other and contribute to depressive symptomatology-related low momentary PA in 139 individuals. Higher depressive symptoms were associated with lower PA, pro-hedonic goals, more frequent use of positive rumination, and higher use of dampening. Further, experiencing higher levels of PA predicted lower following time point use of dampening in individuals with higher symptoms. Finally, using positive rumination was more beneficial (i.e. predicted higher PA increases one moment later) for individuals with higher symptomatology. Our findings suggest that moment-to-moment changes in PA daily life are affected by, and have an effect on, both pro-hedonic goals and the use of dampening and positive rumination, highlighting specific cognitive-affective mechanisms that should be considered when designing interventions aimed at improving low PA characterising depression symptomatology.

Environmental stress and emotional reactivity: an exploratory experience sampling method study

Background

Previous studies have shown a relationship between environments and mental health. However, limited studies have investigated the impact of environment stress (ES) on emotional reactivity. Our study aimed to fill this gap by examining how daily ES affects momentary emotional reactivity using experience sampling method (ESM).

Methods

Participants were randomly recruited from a prospective cohort study in Hong Kong to participate in a 7-day ESM study. The participants received eight electronic signals daily assessing their ES, positive affect (PA) and negative affect (NA). Participants were categorized into depressed group or control group based on Revised Clinical Interview Schedule. Psychometric properties of the ESM assessment were evaluated. Multilevel linear regression analyzes were conducted to examine the association of ES with PA, NA and the group status of the participants (cases versus controls).

Results

A total of 15 participants with depression and 15 healthy controls were recruited, and 1307 momentary assessments were completed with a compliance rate of 77.8%. The depressed group demonstrated a significant increase in NA in response to ES, while the control group showed a decrease in PA. In addition, the depressed group reported a lower perception of control and interaction with their environment compared to the control group.

Conclusion

Using ESM, a valid, reliable, and easy-to-use self-reporting tool, our findings provided valuable insights on the potential mechanisms underlying emotional responses to stressful environments.

Do deficits in subjective stress recovery predict subsequent stress sensitivity and symptoms in schizophrenia spectrum disorders?

High levels of stress play a crucial role in the development of psychotic symptoms, such as paranoia, and may stem in part from recovery deficits after stress exposure. However, it remains unclear whether deficient recovery causes a build-up of heightened stress levels that increases stress sensitivity and symptoms when exposed to another stressor. To test this, we investigated the effect of subjective stress recovery on the response to a subsequent stressor and paranoia. We applied two consecutive runs of the same combined physical and cognitive stressor separated by a recovery phase of 60 min in individuals with schizophrenia spectrum disorders (n = 49). We repeatedly assessed self-reported stress, negative affect, heart rate, heart rate variability, salivary cortisol, and paranoia. Recovery of self-reported stress was defined as the geometric mean of the percentage changes of self-reported stress during recovery after the first stressor, and was regressed on the response to the second stressor controlling for self-reported stress during the first stressor. Lower subjective stress recovery predicted higher levels of self-reported stress, negative affect, and paranoia in response to the second stressor. The subjective stress recovery was not predictive of the physiological stress response (heart rate, heart rate variability, or salivary cortisol). Taken together, the findings indicate that recovery deficits could contribute to high levels of self-reported stress, negative affect, and paranoia in schizophrenia spectrum disorders and that the improvement of stress recovery could be a promising approach for interventions.

Short-term cortisol adaption to discrimination and Mexican-origin adolescents' mental and sleep health

Discrimination experiences are a salient contributor to the health disparities facing Latina/x/o youth. The biopsychosocial model of minority health posits that discrimination influences health through wear and tear on the biological stress responses, including the hypothalamic-pituitary-adrenal (HPA) axis, which is a primary stress response system in the body. Emerging evidence suggests that discrimination alters the secretion of cortisol, the end product of the HPA axis, yet, whether the daily processes between discrimination and diurnal cortisol response influence mental and sleep health remains unanswered. This study integrated daily diary and post-diary survey data to examine whether daily diurnal cortisol responses to discrimination influence adolescents' mental (depressive symptoms, anxiety) and sleep (sleep quality, duration) health in a sample of Mexican-origin youth (N = 282; M age = 17.10; 55% female). Results showed that adolescents who experienced more discrimination across the four-day diary period exhibited steeper diurnal cortisol slopes and lower evening cortisol; however, such physiological responses tended to be associated with poorer adolescents' mental and sleep health. The current study underscores the potential adaptation cost associated with short-term cortisol adaptation in the face of discrimination.

Reactivity toward daily events: Intraindividual variability and change in recurrent depression - A measurement burst study

In Major Depressive Disorder, first evidence shows heightened mood-reactivity toward daily events. Related longitudinal studies in remitted patients with recurrent major depression are lacking. Long-term changes in such short-term within-person associations can be analysed via measurement burst designs. Two bursts, separated by approximately 4.4 years, consisted of a baseline session and an Ambulatory Assessment (burst-1: 3 days, burst-2: 5 days). Via smartphone, 54 initially remitted patients with recurrent major depression indicated their negative and positive affect, rumination, self-acceptance, and the occurrence of negative and positive daily events ten times and collected saliva cortisol samples five times per day. In bursts with higher depression levels, patients showed blunted negative affect- and cortisol-reactivity and stronger decreases in positive affect and self-acceptance toward negative daily events, as well as stronger increases in self-acceptance following positive daily events. However, patients with higher depression levels demonstrated stronger ruminative stress-reactivity within bursts. Furthermore, patients with higher depression levels showed an increase of affective stress-reactivity over bursts, such that negative affect more strongly increased and positive affect more strongly decreased following negative daily events over bursts. Following positive daily events, patients with higher depression levels showed stronger decreases in negative affect within bursts and a decrease of self-acceptance-reactivity over bursts. To conclude, measurement burst designs enable to examine intraindividual variability and change of micro-level processes, and possible moderators thereof, potentially providing prognostic information for the course of recurrent major depression.

Increased affective reactivity among depressed individuals can be explained by floor effects: An experience sampling study

Experience sampling studies into daily-life affective reactivity indicate that depressed individuals react more strongly to both positive and negative stimuli than non-depressed individuals, particularly on negative affect (NA). Given the different mean levels of both positive affect (PA) and NA between patients and controls, such findings may be influenced by floor/ceiling effects, leading to violations of the normality and homoscedasticity assumptions underlying the used statistical models. Affect distributions in prior studies suggest that this may have particularly influenced NA-reactivity findings. Here, we investigated the influence of floor/ceiling effects on the observed PA- and NA-reactivity to both positive and negative events. Data came from 346 depressed, non-depressed, and remitted participants from the Netherlands Study of Depression and Anxiety (NESDA). In PA-reactivity analyses, no floor/ceiling effects and assumption violations were observed, and PA-reactivity to positive events, but not negative events, was significantly increased in the depressed and remitted groups versus the non-depressed group. However, NA-scores exhibited a floor effect in the non-depressed group and naively estimated models violated model assumptions. When these violations were accounted for in subsequent analyses, group differences in NA-reactivity that had been present in the naive models were no longer observed. In conclusion, we found increased PA-reactivity to positive events but no evidence of increased NA-reactivity in depressed individuals when accounting for violations of assumptions. The results indicate that affective-reactivity results are very sensitive to modeling choices and that previously observed increased NA-reactivity in depressed individuals may (partially) reflect unaddressed assumption violations resulting from floor effects in NA.

Effects of a Novel, Transdiagnostic Ecological Momentary Intervention for Prevention, and Early Intervention of Severe Mental Disorder in Youth (EMIcompass): Findings From an Exploratory Randomized Controlled Trial

BACKGROUND/HYPOTHESIS

Digital interventions targeting transdiagnostic mechanisms in daily life may be a promising translational strategy for prevention and early intervention of psychotic and other severe mental disorders. We aimed to investigate the feasibility and initial signals of efficacy of a transdiagnostic, compassion-focused, hybrid ecological momentary intervention for improving resilience (ie, EMIcompass) in youth with early mental health problems.

STUDY DESIGN

In an exploratory, assessor-blind randomized controlled trial, youth aged 14-25 with current distress, broad at-risk mental state, or first episode of severe mental disorder were randomly allocated to experimental (EMIcompass+treatment as usual [TAU]) or control condition (TAU). Data on primary (stress reactivity) and secondary candidate mechanisms as well as candidate primary (psychological distress) and secondary outcomes were collected.

STUDY RESULTS

Criteria for the feasibility of trial methodology and intervention delivery were met (n = 92 randomized participants). No serious adverse events were observed. Initial outcome signals were evident for reduced momentary stress reactivity (stress×time×condition, B = -0.10 95%CI -0.16--0.03, d = -0.10), aberrant salience (condition, B = -0.38, 95%CI -0.57--0.18, d = -0.56) as well as enhanced momentary resilience (condition, B = 0.55, 95%CI 0.18-0.92, d = 0.33) and quality of life (condition, B = 0.82, 95%CI 0.10-1.55, d = 0.60) across post-intervention and 4-week follow-up. No outcome signals were observed for self-reported psychological distress (condition, B = 0.57, 95%CI -1.59-2.72, d = 0.09), but there was suggestive evidence of reduced observer-rated symptoms at the 4-week follow-up (B = -1.41, 95%CI -2.85-0.02, d = -0.41).

CONCLUSIONS

Our findings provide evidence of feasibility and initial signals that EMIcompass may reduce stress reactivity and improve quality of life. A definitive trial is now warranted.

The transdiagnostic use of worry and rumination to avoid negative emotional contrasts following negative events: A momentary assessment study

The contrast avoidance model (CAM) suggests that individuals with generalized anxiety disorder (GAD) are sensitive to a sharp increase in negative and/or decrease in positive affect. They thus worry to increase negative emotion to avoid negative emotional contrasts (NECs). However, no prior naturalistic study has examined reactivity to negative events, or ongoing sensitivity to NECs, or the application of CAM to rumination. We used ecological momentary assessment to examine effects of worry and rumination on negative and positive emotion before and after negative events and intentional use of repetitive thinking to avoid NECs. Individuals with major depressive disorder (MDD) and/or GAD (N = 36) or without psychopathology (N = 27) received 8 prompts/day for 8 days and rated items on negative events, emotions, and repetitive thoughts. Regardless of group, higher worry/rumination before negative events was associated with less increased anxiety and sadness, and less decreased happiness from before to after the events. Participants with MDD/GAD (vs. controls) reported higher ratings on focusing on the negative to avoid NECs and greater vulnerability to NECs when feeling positive. Results support the transdiagnostic ecological validity for CAM extending to rumination and intentional engagement in repetitive thinking to avoid NECs among individuals with MDD/GAD.

The mediating effect of stress reactivity in the 18-year bidirectional relationship between generalized anxiety and depression severity

BACKGROUND

Generalized anxiety disorder (GAD) and major depressive disorder (MDD) often precede and predict one another. Heightened stress reactivity may be a mediation mechanism underlying the long-term connections between GAD and MDD. However, cross-sectional studies on this topic have hindered directional inferences.

METHOD

The present study examined stress reactivity as a potential mediator of the sequential associations between GAD and MDD symptoms in a sample of 3,294 community-dwelling adults (M age = 45.6, range = 20-74). Participants completed three waves of measurement (T1, T2, and T3) spaced nine years apart. GAD and MDD symptom severity were assessed at T1, T2, and T3 (Composite International Diagnostic Interview-Short Form). Stress reactivity (Multidimensional Personality Questionnaire) was measured at T2.

RESULTS

Structural equation mediation modeling demonstrated that higher T1 GAD symptoms positively predicted more severe T3 MDD symptoms via T2 stress reactivity, controlling for T1 MDD (d = 0.45-0.50). However, T2 stress reactivity was not a significant mediator in the relationship between T1 MDD severity and T3 GAD symptoms after controlling for T1 GAD. Direct effects indicated that T1 GAD positively predicted T3 MDD 18 years later and vice versa (d = 1.29-1.65).

LIMITATIONS

Stress reactivity was assessed using a self-report measure, limiting conclusions to perceived (vs. physiologically indexed) stress reactivity.

CONCLUSIONS

These findings indicate that stress reactivity may be one mechanism through which GAD leads to later MDD over prolonged durations. Overall, results suggest that targeting stress reactivity in treatments for GAD may reduce the risk of developing subsequent MDD.

Perspectives on resilience: Trait resilience, correlates of resilience in daily life, and longer-term change in affective distress

Resilience describes successful adaptation in the face of adversity, commonly inferred from trajectories of well-being following major life events. Alternatively, resilience was conceptualised as a psychological trait, facilitating adaptation through stable individual characteristics. Both perspectives may relate to individual differences in how stress is regulated in daily life. In the present study, we combined these perspectives on resilience. Our sample consisted of N = 132 middle-aged adults, who experienced major life events in between two waves of a longitudinal study. We implemented latent change regression models to predict change in affective distress. As predictors, we investigated trait resilience and correlates of resilience in daily life (stressor occurrence, stress reactivity, positive reappraisal, mindful attention, and acceptance), measured using experience sampling (T = 70 occasions). Unexpectedly, trait resilience was not associated with change in distress. In contrast, resilience correlates in daily life, most notably lower stress reactivity, were associated with more favourable change. Higher trait resilience related to higher average mindfulness, higher reappraisal, and lower negative affect. Overall, while trait resilience translated into everyday correlates of resilience, it was not predictive of changes in affective distress. Instead, precursors of changes in well-being may be found in correlates of resilience in daily life.

Effects of Persistent Exposure to COVID-19 on Mental Health Outcomes Among Trainees: a Longitudinal Survey Study

BACKGROUND

The rapid spread of the coronavirus disease 2019 (COVID-19) has created considerable strain on the physical and mental health of healthcare workers around the world. The effects have been acute for physician trainees-a unique group functioning simultaneously as learners and care providers with limited autonomy.

OBJECTIVE

To investigate the longitudinal effects of physician trainee exposure to patients being tested for COVID-19 on stress, anxiety, depression, and burnout using three surveys conducted during the early phase of the pandemic.

DESIGN

Longitudinal survey study.

PARTICIPANTS

All physician trainees (N = 1375) at an academic medical center.

MAIN MEASURE

Assess the relationship between repeated exposure to patients being tested for COVID-19 and stress, anxiety, depression, and burnout.

KEY RESULTS

Three hundred eighty-nine trainees completed the baseline survey (28.3%). Of these, 191 and 136 completed the ensuing surveys. Mean stress, anxiety, and burnout decreased by 21% (95% confidence interval (CI): - 28 to - 12%; P < 0.001), 25% (95% CI: - 36 to - 11%; P < 0.001), and 13% (95% CI: - 18 to - 7%; P < 0.001), respectively, per survey. However, for each survey time point, there was mean increase in stress, anxiety, and burnout per additional exposure: stress [24% (95% CI: + 12 to + 38%; P < 0.001)], anxiety [22% (95% CI: + 2 to + 46%; P = 0.026)], and burnout [18% (95% CI: + 10 to + 28%; P < 0.001)]. For depression, the association between exposure was strongest for the third survey, where mean depression scores increased by 33% per additional exposure (95% CI: + 18 to + 50%; P < 0.001).

CONCLUSIONS

Training programs should adapt to address the detrimental effects of the "pileup" of distress associated with persistent exposure through adaptive programs that allow flexibility for time off and recovery.

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

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

Childhood maltreatment, subjective social status, and health disparities in bereavement

BACKGROUND

Spousal bereavement can lead to adverse health outcomes; however, not all widow(er)s experience the same degree of health problems. Thus, it is important to understand the contribution of disparities (e.g., childhood maltreatment and subjective social status) that may underlie adverse health outcomes that arise following bereavement.

METHODS

We collected data from 130 spousally bereaved individuals at 3-time points (3 months post-loss, 4 months post-loss, and 6 months post-loss). Using mixed models, we assessed the interaction of childhood maltreatment, subjective social status, and time to predict changes in proinflammatory cytokine production, depressive symptoms, grief symptoms.

RESULTS

We found a significant interaction between childhood maltreatment, subjective social status, and time predicting proinflammatory cytokine production (beta > -0.01, p = 0.048), depressive symptoms (beta = 0.008, p = .010), and grief symptoms (beta = 0.001 p = .001).

CONCLUSION

This study highlights the role of disparities related to childhood maltreatment and subjective social status on adverse health outcomes following spousal bereavement.

Do positive and negative emotional reactions during war predict subsequent symptomatology? A prospective experience sampling study

While peritraumatic negative emotions have been associated with subsequent posttraumatic stress and depression, the predictive role of real-time emotional reactions to specific stressors during prolonged stress exposure is still unclear, particularly that of positive emotions. The current study uses experience sampling methodology to examine individual general levels of negative and positive emotions, and emotional reactivity to specific stressors during war, as prospective predictors of posttraumatic stress and depression. Ninety-six civilians exposed to rocket fire during the 2014 Israel-Gaza war reported exposure to rocket warning sirens and levels of ten negative and six positive emotions twice a day for 30 days. Symptoms of posttraumatic stress and depression were then assessed two months post-war. Participants reported higher negative emotions and lower positive emotions during assessment windows with sirens. Over time, negative emotions decreased and positive emotions increased. Higher levels of overall negative emotions predicted posttraumatic stress symptoms and depression symptoms two months later. Levels of positive emotions, and negative and positive emotional reactivity to sirens, were not associated with subsequent symptomatology. Our results indicate the stronger role of overall negative emotions as predictors of symptomatology compared with momentary emotional reactivity, and the stronger predictive role of negative compared with positive emotions.

Affective and Autonomic Reactivity During Parent-Child Interactions in Depressed and Non-Depressed Mothers and Their Adolescent Offspring

Depression presents risks that are profound and intergenerational, yet research on the association of depression with the physiological processes that might be associated with impaired mental and physical health has only recently been contextualized within the family environment. Participants in this multi-method case-control study were 180 mother-adolescent dyads (50% mothers with a history of depression treatment and current depressive symptoms). In order to examine the association between maternal depression and affective and autonomic reactivity amongst these mothers and their adolescent offspring we collected self-reported measures of positive and negative affect, as well as measures of cardiovascular and electrodermal autonomic activity, during mother-adolescent interaction tasks. Findings indicated that depressed mothers and their adolescent offspring exhibited greater self-reported negative affect reactivity during a problem-solving interaction and blunted (i.e., low) sympathetic activity as measured via skin conductance level across both interaction tasks. These effects remained significant after controlling for a range of potential covariates, including medication use, sex, age, adolescents own mental health symptoms, and behavior of the other interactant, along with correcting for multiple comparisons. Findings indicate that depressed mothers and their adolescent offspring both exhibit patterns of affect and physiology during interactions that are different from those of non-depressed mothers and their offspring, including increased negative affect reactivity during negative interactions and blunted sympathetic activity across both positive and negative interactions. These findings have potential implications for understanding the role of family processes in the intergenerational transmission of risk for depressive disorders.

Shorter telomeres among individuals with physical disability: The moderating role of perceived stress

OBJECTIVES

Evidence suggests that individuals with physical disability may suffer from psychological distress and accelerated cellular aging, manifested by shortened telomere length (TL), compared with healthy individuals. Studies indicate that high levels of perceived stress and depression may increase the physiological susceptibility and thus, may contribute to a short TL. However, the moderating role of perceived stress and depression within the relationship between physical disability and TL remains unknown.

METHODS

The participants consisted of 119 male subjects (mean age 54.36 years, range 35-70). Of them, 30 were able-bodied and 86 had a physical disability: 34 were due to Poliomyelitis (polio) and 55 were due to spinal cord injury (SCI). Blood samples for TL analysis were collected; the participants completed questionnaires and underwent disability evaluation.

RESULTS

Participants with disability had a shorter TL as well as elevated levels of perceived stress and depression compared with able-bodied controls. Both the perceived stress and depression were correlated with a shorter TL. Nonetheless, perceived stress, rather than depression, moderated the relationship between disability and TL; among participants with higher perceived stress levels, in particular, individuals with physical disability had a shorter TL than the able-bodied controls.

DISCUSSION

The present findings suggest that individuals with physical disability and who exhibit high levels of perceived stress may be particularly vulnerable for accelerated cellular aging, suggesting that perceived stress can be used as a valuable target for intervention.

Does thinking make it so? Differential associations between adversity worries and experiences and mental health during the COVID-19 pandemic

BACKGROUND

There is evidence that the COVID-19 pandemic is having adverse effects on mental health. It is vital to understand what is causing this: worries over potential adversities due to the pandemic, or the toll of experiencing adverse events.

METHODS

We used panel data from 41 909 UK adults in the COVID-19 Social Study assessed weekly from 1 April 2020 to 12 May 2020 to study the association between adversities and anxiety and depressive symptoms. We studied six categories of adversity including both worries and experiences of: illness with COVID-19, financial difficulty, loss of paid work, difficulties acquiring medication, difficulties accessing food, and threats to personal safety. Anxiety and depression were measured using the 7-item Generalised Anxiety Disorder Assessment and the 9-item Patient Health Questionnaire. We used fixed-effect regression models to account for time-invariant confounders.

RESULTS

Cumulative number of worries and experience of adversities were both related to higher levels of anxiety and depression. A number of worries were associated more with anxiety than depression, but number of experiences were equally related to anxiety and depression. There were clear associations between specific worries and poorer mental health. There was weak evidence that individuals of lower socio-economic position were more negatively affected psychologically by the adverse experiences.

CONCLUSION

Measures over the first few weeks of lockdown in the UK appear to have been insufficient at reassuring people given that we see clear associations with mental health and cumulative worries. Interventions are required that seek to prevent adverse events (eg, redundancies) and reassure individuals and support adaptive coping strategies.

Emotional Responses to Stressors in Everyday Life Predict Long-Term Trajectories of Depressive Symptoms

BACKGROUND

Individuals' emotional responses to stressors in everyday life are associated with long-term physical and mental health. Among many possible risk factors, the stressor-related emotional responses may play an important role in future development of depressive symptoms.

PURPOSE

The current study examined how individuals' positive and negative emotional responses to everyday stressors predicted their subsequent changes in depressive symptoms over 18 months.

METHODS

Using an ecological momentary assessment approach, participants (n = 176) reported stressor exposure, positive affect (PA), and negative affect (NA) five times a day for 1 week (n = 5,483 observations) and provided longitudinal reports of depressive symptoms over the subsequent 18 months. A multivariate multilevel latent growth curve model was used to directly link the fluctuations in emotions in response to momentary stressors in everyday life with the long-term trajectory of depressive symptoms.

RESULTS

Adults who demonstrated a greater difference in stressor-related PA (i.e., relatively lower PA on stressor vs. nonstressor moments) reported larger increases in depressive symptoms over 18 months. Those with greater NA responses to everyday stressors (i.e., relatively higher NA on stressor vs. nonstressor moments), however, did not exhibit differential long-term changes in depressive symptoms.

CONCLUSIONS

Adults showed a pattern consistent with both PA and NA responses to stressors in everyday life, but only the stressor-related changes in PA (but not in NA) predicted the growth of depressive symptoms over time. These findings highlight the important-but often overlooked-role of positive emotional responses to everyday stressors in long-term mental health.

Mediation on the Association Between Stressful Life Events and Depression by Abnormal White Matter Microstructures

BACKGROUND

Stressful life events (SLEs) are an important causal factor in depression; however, the mechanism by which SLEs cause depression remains unclear. Recent studies suggested that white matter (WM) microstructures might be a potential mediator between SLEs and depression. Hence, we aimed to investigate the concrete correspondence among them using mediation effect models.

METHODS

In participants (N = 194) with SLEs experience prospectively recruited from six residential communities, WM microstructures were detected with diffusion tensor imaging. The interrelationship among SLEs, WM microstructures, and depression was explored with multiple linear regression models and logistic regression models. Furthermore, the influence of WM microstructures on the association between SLEs and depression was tested with mediation effect models.

RESULTS

Successfully established mediation effect models showed the specific influence of fractional anisotropy of the corpus callosum and left uncinate fasciculus on the association between SLEs and depression onset (ab path = 0.032; ab path = 0.026, respectively) and between SLEs and depressive severity (ab path = 0.052; ab path = 0.067, respectively). In addition, significant total mediation effects on the association between SLEs and depression onset (ab path = 0.031) and severity (ab path = 0.075) through fractional anisotropy of the corpus callosum and left uncinate fasciculus were noted.

CONCLUSIONS

WM microstructure alterations impose a substantial mediation effect on the association between SLEs and depression, which suggest that changes in WM microstructure integrity might increase the risk of depression onset and unfavorable disease courses induced by the SLEs.

Reciprocal effects between cognitive and affective states in women with Premenstrual Dysphoric Disorder: An Ecological Momentary Assessment study

Premenstrual Dysphoric Disorder (PMDD) is characterized by cyclical mood changes resulting in clinically significant distress and functional impairment. Studies on momentary cognitive and affective states and their interplay during daily life over the menstrual cycle in affected women are still lacking. Using Ecological Momentary Assessment with electronic diaries, 61 women with current PMDD and 61 healthy control women reported their current mood, rumination, and self-acceptance eight times a day over two consecutive days per cycle phase (menstrual, follicular, ovulatory, and late luteal phase). Results revealed that women with PMDD showed significant increases in negative affect and rumination and decreases in positive affect and self-acceptance toward the end of the cycle. Lagged analyses demonstrated stronger within-person reciprocal effects of cognitions and mood in PMDD women compared to controls with the effect of rumination on subsequent negative affect being limited to the late luteal phase. Identified stronger prospective associations between cognitive processes and mood deteriorations in women with PMDD suggest that affected women are more sensitive to detrimental effects of either dimension. Hence, therapeutic strategies aiming at reducing ruminative thoughts and improving self-acceptance such as mindfulness-based interventions could be promising for reducing the burden of PMDD.

Discrimination and Sleep Mediate Ethnic/Racial Identity and Adolescent Adjustment: Uncovering Change Processes With Slope-as-Mediator Mediation

This study employs slope-as-mediator techniques to explore how the daily association between ethnic/racial discrimination and sleep disturbances serves as an intermediary link between ethnic/racial identity (ERI) and psychological adjustment. In a diverse sample of 264 adolescents (Mage  = 14.3 years old, 70% female, 76% United States born, 25% African American, 32% Asian American, 43% Latinx), discrimination was associated with sleep disturbance. Furthermore, ERI commitment buffered the impact of discrimination on sleep, whereas ERI exploration exacerbated the impact of discrimination. Finally, the daily level association between discrimination and sleep (i.e., daily slope) mediated the association between ERI and adolescent adjustment. Substantive links between discrimination and sleep are discussed as well as broader applications of slope-as-mediator techniques.

Stress, mood, and cortisol during daily life in women with Premenstrual Dysphoric Disorder (PMDD)

Premenstrual Dysphoric Disorder (PMDD) is characterized by significant emotional, physical and behavioral distress during the late luteal phase that remits after menses onset. Outlined as a new diagnostic category in DSM-5, the mechanisms underlying PMDD are still insufficiently known. Previous research suggests that PMDD exacerbates with stressful events, indicating a dysregulation of the hypothalamic-pituitary-adrenal axis. However, studies measuring stress-related processes in affected women in real-time and real-life are lacking. We conducted an Ambulatory Assessment (AA) study to compare subjective stress reactivity together with basal and stress-reactive cortisol activity across the menstrual cycle in women with and without PMDD. Women with current PMDD (n = 61) and age- and education matched controls (n = 61) reported momentary mood, rumination, and daily events via smartphones at semi-random time points 8 times a day over two consecutive days per cycle phase (menstrual, follicular, ovulatory, and late luteal). Twenty minutes after assessments participants collected saliva cortisol samples. Three additional morning samples determined the cortisol awakening response (CAR). Women with PMDD reported particular high daily life stress and high arousal negative affect (NA_high) towards stressors during the late luteal phase. High momentary stress levels were linked to lower levels of high arousal positive affect (PA_high) and to higher levels of rumination in PMDD women compared to controls irrespective of cycle phase. Across groups, more stress was linked to higher levels of low arousal NA (NA_low) and to lower levels of low arousal PA (PA_low). Moreover, PMDD was associated with a delayed CAR peak and a flattened diurnal cortisol slope. While neither group showed cortisol reactivity towards daily life stress directly, high momentary NA_high and low momentary PA predicted high levels of cortisol across groups, whereas high momentary rumination predicted high cortisol output only in healthy women. In this AA-study we identified important stress-related psychological and endocrinological within-person variability in women with PMDD during daily life. Further research is warranted targeting identified AA-based mechanisms to study their predictive role for the clinical course of PMDD and to provide evidence-based therapeutic options for affected women.

The East Flanders Prospective Twin Survey (EFPTS): 55 Years Later

The East Flanders Prospective Twin Survey (EFPTS) is a registry of multiple births in the province of East Flanders, Belgium. Since its start in 1964, over 10,000 twin-pairs have been registered. EFPTS has several unique features: it is population-based and prospective, with the possibility of long-term follow-up; the twins (and higher order multiple births) are recruited at birth; basic perinatal data are recorded; chorion type and zygosity are established; since 1969, placental biopsies have been taken and frozen at -20°C for future research. Since its origin, the EFPTS has included placental data and allows differentiation of three subtypes of monozygotic twins based on the time of the initial zygotic division: the dichorionic-diamniotic pairs (early, with splitting before the fourth day after fertilization), the monochorionic-diamniotic pairs (intermediate, splitting between the fourth- and the seventh-day postfertilization) and the monochorionic-monoamniotic pairs (late, splitting after the eighth day postfertilization). Studies can be initiated taking into account primary biases, those originating 'in utero'. Such studies could throw new light on the consequences of early embryological events and the gene-environment interactions as far as periconceptional and intrauterine environment are concerned.

Coping styles mediate the association between negative life events and subjective well-being in patients with non-affective psychotic disorders and their siblings

Coping styles are associated with levels of subjective well-being. Negative life events and reduced subjective well-being are more prevalent in patients with psychotic disorders. The aims of the current study were to test a mediation model, with coping styles as potential mediators of the relation between negative life events and subjective well-being in patients with psychotic disorders (N = 259), and aimed to repeat the potential mediation model in patients' non-affected siblings (N = 309). Data pertains to a subsample of GROUP, a Dutch naturalistic cohort study. The Subjective Well-being under Neuroleptics-20 (SWN-20) scale was used to assess well-being. Coping styles were assessed with the Utrechtse Coping Lijst (UCL). Life events were assessed using an adaptation of the Interview of the Recent Life Event Scale (IRLES). Siblings, but not patients, who experienced negative life events in the previous three year period were more likely to experience a lower well-being. For both groups passive coping styles mediated the relation between negative life events and subjective well-being. Severity of positive, negative or affective symptoms did not change this relationship. Our findings point to a better recognition of copings styles as a therapeutic target to promote well-being and recovery.

Testosterone is related to GABA+ levels in the posterior-cingulate in unmedicated depressed women during reproductive life

BACKGROUND

The role of testosterone (T) in the pathophysiology of affective disorders and anxiety is broadly supported. Evidence suggests that T has anxiolytic and antidepressant properties. One proposed route for the central effects of T is its interaction with the gamma-aminobutyric acid (GABA) system. We explored the relationship between T levels and GABA+ levels in anterior-cingulate (ACC) and the posterior-cingulate (PCC) regions in depressed women, using magnetic resonance spectroscopy (1H-MRS).

METHODS

Twenty-one depressed patients with regularly cycling who were not taking hormonal or psychotropic drugs were recruited. We assessed severity of depression using the Hamilton Depression Rating Scale (HDRS). Blood samples were taken for quantification of free (FT) and total testosterone (TT) on the day of the magnetic resonance (MR) scan. We evaluated GABA+ levels in the PCC and ACC, using the Hadamard Encoding and Reconstruction of MEGA-Edited Spectroscopy (HERMES) sequence. Pearson correlations were used to evaluate the association between FT, TT, GABA+ concentrations, and HDRS scores.

RESULTS

TT and FT levels were positively correlated with GABA+ levels in the PCC. No correlation was observed between T levels and GABA+ levels in the ACC. The HDRS total scores correlated negatively with FT levels.

LIMITATIONS

Limitations include the cross-sectional evaluation and the lack of a comparative healthy group.

CONCLUSIONS

Our findings suggest that the potential anxiolytic and antidepressant properties of T are related to increased GABA+ levels in the PCC. This observation may contribute to increased understanding of the role of T in depressive and anxiety symptoms in women.

Affective reactivity to daily racial discrimination as a prospective predictor of depressive symptoms in African American graduate and postgraduate students

This study examined whether individual differences in affective reactivity, defined as changes in positive or negative affect in response to daily racial discrimination, predicted subsequent depressive symptoms. Participants were African American graduate and postgraduate students (N = 174; M age = 30 years) recruited for a measurement-burst study. Data on depressive symptoms were gathered at two assessment points 1 year apart. Affective reactivity data was obtained from participants via a 14-day diary study of daily racial discrimination and affect. Participants who experienced pronounced increases in negative affect on days when racial discrimination occurred had elevated depressive symptoms 1 year later. Heightened positive affect reactivity was also associated with more depressive symptoms at follow-up. The results suggest that affective reactivity (either greater increases in negative affect or greater decreases in positive affect in the context of racial discrimination) may be an underlying psychological mechanism that confers vulnerability to future depressive symptoms.

Experience sampling methodology in mental health research: new insights and technical developments

In the mental health field, there is a growing awareness that the study of psychiatric symptoms in the context of everyday life, using experience sampling methodology (ESM), may provide a powerful and necessary addition to more conventional research approaches. ESM, a structured self-report diary technique, allows the investigation of experiences within, and in interaction with, the real-world context. This paper provides an overview of how zooming in on the micro-level of experience and behaviour using ESM adds new insights and additional perspectives to standard approaches. More specifically, it discusses how ESM: a) contributes to a deeper understanding of psychopathological phenomena, b) allows to capture variability over time, c) aids in identifying internal and situational determinants of variability in symptomatology, and d) enables a thorough investigation of the interaction between the person and his/her environment and of real-life social interactions. Next to improving assessment of psychopathology and its underlying mechanisms, ESM contributes to advancing and changing clinical practice by allowing a more fine-grained evaluation of treatment effects as well as by providing the opportunity for extending treatment beyond the clinical setting into real life with the development of ecological momentary interventions. Furthermore, this paper provides an overview of the technical details of setting up an ESM study in terms of design, questionnaire development and statistical approaches. Overall, although a number of considerations and challenges remain, ESM offers one of the best opportunities for personalized medicine in psychiatry, from both a research and a clinical perspective.

Predicting Depression From Language-Based Emotion Dynamics: Longitudinal Analysis of Facebook and Twitter Status Updates

BACKGROUND

Frequent expression of negative emotion words on social media has been linked to depression. However, metrics have relied on average values, not dynamic measures of emotional volatility.

OBJECTIVE

The aim of this study was to report on the associations between depression severity and the variability (time-unstructured) and instability (time-structured) in emotion word expression on Facebook and Twitter across status updates.

METHODS

Status updates and depression severity ratings of 29 Facebook users and 49 Twitter users were collected through the app MoodPrism. The average proportion of positive and negative emotion words used, within-person variability, and instability were computed.

RESULTS

(49)=-.34, P=.01, 95% CI -0.58 to 0.09). Differences between Facebook and Twitter users in their emotion word patterns and psychological characteristics were also explored.

CONCLUSIONS

The findings suggest that negative emotion word instability may be a simple yet sensitive measure of time-structured variability, useful when screening for depression through social media, though its usefulness may depend on the social media platform.

Exploring the emotional dynamics of subclinically depressed individuals with and without anhedonia: An experience sampling study

BACKGROUND

Anhedonia has been linked to worse prognosis of depression. The present study aimed to construct personalized models to elucidate the emotional dynamics of subclinically depressed individuals with versus without symptoms of anhedonia.

METHODS

Matched subclinically depressed individuals with and without symptoms of anhedonia (N = 40) of the HowNutsAreTheDutch sample completed three experience sampling methodology assessments per day for 30 days. For each individual, the impact of physical activity, stress experience, and high/low arousal PA/NA on each other was estimated through automated impulse response function analysis (IRF). These individual IRF associations were combined to compare anhedonic versus non-anhedonic individuals.

RESULTS

Physical activity had low impact on affect in both groups. In non-anhedonic individuals, stress experience increased NA and decreased PA and physical activity more strongly. In anhedonic individuals, PA high arousal showed a diminished favorable impact on affect (increasing NA/stress experience, decreasing PA/physical activity). Finally, large heterogeneity in the personalized models of emotional dynamics were found.

LIMITATIONS

Stress experience was measured indirectly by assessing level of distress; the timeframe in between measurements was relatively long with 6h; and only information on one of the two hallmarks of anhedonia, loss of interest, was gathered.

CONCLUSIONS

Our results suggest different pathways of emotional dynamics underlie depressive symptomatology. Subclinically depressed individuals with anhedonic complaints are more strongly characterized by diminished favorable impact of PA high arousal and heightened NA reactivity, whereas subclinically depressed individuals without these anhedonic complaints seem more characterized by heightened stress reactivity. The automatically generated personalized models may offer patient-specific insights in emotional dynamics, which may show clinical relevance.

Effects of Antenatal Maternal Depressive Symptoms and Socio-Economic Status on Neonatal Brain Development are Modulated by Genetic Risk

This study included 168 and 85 mother–infant dyads from Asian and United States of America cohorts to examine whether a genomic profile risk score for major depressive disorder (GPRS_MDD) moderates the association between antenatal maternal depressive symptoms (or socio-economic status, SES) and fetal neurodevelopment, and to identify candidate biological processes underlying such association. Both cohorts showed a significant interaction between antenatal maternal depressive symptoms and infant GPRS_MDD on the right amygdala volume. The Asian cohort also showed such interaction on the right hippocampal volume and shape, thickness of the orbitofrontal and ventromedial prefrontal cortex. Likewise, a significant interaction between SES and infant GPRS_MDD was on the right amygdala and hippocampal volumes and shapes. After controlling for each other, the interaction effect of antenatal maternal depressive symptoms and GPRS_MDD was mainly shown on the right amygdala, while the interaction effect of SES and GPRS_MDD was mainly shown on the right hippocampus. Bioinformatic analyses suggested neurotransmitter/neurotrophic signaling, SNAp REceptor complex, and glutamate receptor activity as common biological processes underlying the influence of antenatal maternal depressive symptoms on fetal cortico-limbic development. These findings suggest gene–environment interdependence in the fetal development of brain regions implicated in cognitive–emotional function. Candidate biological mechanisms involve a range of brain region-specific signaling pathways that converge on common processes of synaptic development.

Affective reactivity to daily life stress: Relationship to positive psychotic and depressive symptoms in a general population sample

INTRODUCTION

Increased affective reactivity to daily life stress has been found in individuals with psychosis and depression, and in those at risk for these conditions. Because depressive and psychotic symptoms often co-occur, increased affective reactivity in these disorders may be explained by the presence of depressive symptoms, psychotic symptoms, or both. Therefore, we examined whether affective reactivity to daily stress is related to positive psychotic symptoms, independently of depressive symptoms, and vice versa.

METHODS

We used data from an intensive sampling study in the general population (n = 411), with three measurements a day (t = 90). The following subjective stressors were assessed: appraisal of activities, appraisal of social interactions, and experienced physical discomfort. Affective reactivity was conceptualized as both the positive affect (PA) and negative affect (NA) response to these stressors. By means of mixed model analyses, it was examined whether affective reactivity was independently related to depressive and/or positive psychotic symptoms.

RESULTS

The PA response to activities and NA response to social interactions were negatively and positively related to depressive symptoms, respectively, independent of psychotic symptoms. In contrast, no (in)dependent association was found between positive psychotic symptoms and affective reactivity to any of the daily life stressors. These findings were confirmed in a subsample with increased symptoms.

LIMITATIONS

The prevalence of positive psychotic symptoms was relatively low in this general population sample.

CONCLUSIONS

Increased affect reactivity predicts depressive symptoms, but not positive psychotic symptoms. Affective reactivity may still facilitate the development of psychotic symptomatology via its impact on depressive symptoms.

Sensitivity to Peer Evaluation and Its Genetic and Environmental Determinants: Findings from a Population-Based Twin Study

Adolescents and young adults are highly focused on peer evaluation, but little is known about sources of their differential sensitivity. We examined to what extent sensitivity to peer evaluation is influenced by interacting environmental and genetic factors. A sample of 354 healthy adolescent twin pairs (n = 708) took part in a structured, laboratory task in which they were exposed to peer evaluation. The proportion of the variance in sensitivity to peer evaluation due to genetic and environmental factors was estimated, as was the association with specific a priori environmental risk factors. Differences in sensitivity to peer evaluation between adolescents were explained mainly by non-shared environmental influences. The results on shared environmental influences were not conclusive. No impact of latent genetic factors or gene-environment interactions was found. Adolescents with lower self-rated positions on the social ladder or who reported to have been bullied more severely showed significantly stronger responses to peer evaluation. Not genes, but subjective social status and past experience of being bullied seem to impact sensitivity to peer evaluation. This suggests that altered response to peer evaluation is the outcome of cumulative sensitization to social interactions.

An experience sampling study on the ecological validity of the SWN-20: Indication that subjective well-being is associated with momentary affective states above and beyond psychosis susceptibility

Subjective well-being (SWB) is associated with treatment adherence and symptom outcome in people with psychotic disorders. Also, it is associated with psychosis susceptibility and it is partly hereditable. The SWN-20 is a widely used tool to assess subjective well-being in patients; it was also found to be suitable for assessing SWB in healthy populations. Yet it is unclear how this retrospectively measured construct may be associated with momentary affective state, which is the proposed underlying mechanism of subjective well-being. This study therefore investigated the ecological validity of the SWN-20 in people at different risk for psychosis. In 63 patients with a psychotic disorder and 61 siblings of patients with a psychotic disorder we assessed whether subjective well-being as measured with the SWN-20, was associated with momentary positive affect, negative affect, reward experience and stress-sensitivity as measured by the experience sample method (ESM). Higher subjective well-being was associated with higher momentary positive affect and lower negative affect, and this association was not conditional on psychosis vulnerability. Subjective well-being was not associated with stress-sensitivity or reward-experience. SWN-20 is an easy-to-use and ecologically valid tool to measure subjective well-being in people with different vulnerability for psychosis.

The cortisol:C-reactive protein ratio and negative affect reactivity in depressed adults

OBJECTIVE

We evaluated the effect of the cortisol (CORT) to high sensitivity C-reactive protein (hsCRP) ratio on stress-induced negative affect (NA) reactivity and whether the association was moderated by depressive symptom severity and gender. The CORT/CRP ratio was used to evaluate the integrity of the negative feedback loop between the hypothalamic-pituitary-adrenal axis and inflammatory response system.

METHOD

Basal CORT and hsCRP levels were measured in fasting blood samples from 198 medication-free and nonsmoking healthy men and women. Depressive symptom severity was assessed using the Hamilton Rating Scale for Depression (HAMD). NA ratings were collected at baseline and at the completion of the laboratory stressors, the Anger Recall Interview (ARI) and reading.

RESULTS

Adjusting for potential confounders and baseline NA, analysis revealed a significant relationship between CORT/CRP ratio and NA reactivity to ARI as a function of depressive symptom severity. Simple effects revealed that for participants with high HAMD, decreasing CORT/CRP ratio, suggestive of an insufficient CORT release relative to higher hsCRP, predicted increasing stress-induced NA reactivity. For participants with low HAMD, the CORT/CRP ratio failed to predict NA reactivity. Gender did not moderate the joint effect of depressive symptom severity and the CORT/CRP ratio on stress-induced NA reactivity.

CONCLUSIONS

This is the first study to document that a premorbid dysregulation of the neuro-immune relationship, characterized by an insufficient release of CORT in conjunction with higher CRP, plays a role in stress sensitivity, and specifically NA reactivity, in individuals with elevated levels of depression symptoms. (PsycINFO Database Record

Is sensitivity to daily stress predictive of onset or persistence of psychopathology?

PURPOSE

The aim of the current study was to replicate findings in adults indicating that higher sensitivity to stressful events is predictive of both onset and persistence of psychopathological symptoms in a sample of adolescents and young adults. In addition, we tested the hypothesis that sensitivity to mild stressors in particular is predictive of the developmental course of psychopathology.

METHODS

We analyzed experience sampling and questionnaire data collected at baseline and one-year follow-up of 445 adolescent and young adult twins and non-twin siblings (age range: 15-34). Linear multilevel regression was used for the replication analyses. To test if affective sensitivity to mild stressors in particular was associated with follow-up symptoms, we used a categorical approach adding variables on affective sensitivity to mild, moderate and severe daily stressors to the model.

RESULTS

Linear analyses showed that emotional stress reactivity was not associated with onset (β=.02; P=.56) or persistence (β=-.01; P=.78) of symptoms. There was a significant effect of baseline symptom score (β=.53; P<.001) and average negative affect (NA: β=.19; P<.001) on follow-up symptoms. Using the categorical approach, we found that affective sensitivity to mild (β=.25; P<.001), but not moderate (β=-.03; P=.65) or severe (β=-.06; P=.42), stressors was associated with symptom persistence one year later.

DISCUSSION

We were unable to replicate previous findings relating stress sensitivity linearly to symptom onset or persistence in a younger sample. Whereas sensitivity to more severe stressors may reflect adaptive coping, high sensitivity to the mildest of daily stressors may indicate an increased risk for psychopathology.

Lack of Social Support Raises Stress Vulnerability in Rats with a History of Ancestral Stress

Stress is a primary risk factor for psychiatric disorders. However, it is not fully understood why some stressed individuals are more vulnerable to psychiatric disorders than others. Here, we investigated whether multigenerational ancestral stress produces phenotypes that are sensitive to depression-like symptoms in rats. We also examined whether social isolation reveals potentially latent sensitivity to depression-like behaviours. F4 female rats born to a lineage of stressed mothers (F0-F3) received stress in adulthood while housed in pairs or alone. Social isolation during stress induced cognitive and psychomotor retardation only in rats exposed to ancestral stress. Social isolation also hampered the resilience of the hypothalamic-pituitary-adrenal axis to chronic stress and reduced hippocampal volume and brain-derived neurotrophic factor (BDNF) expression. Thus, synergy between social isolation and stress may unmask a latent history of ancestral stress, and raises vulnerability to mental health conditions. The findings support the notion that social support critically promotes stress coping and resilience.

Cognitive and affective trait and state factors influencing the long-term symptom course in remitted depressed patients

Background

Major depressive disorder (MDD) is characterized by a high risk for relapses and chronic developments. Clinical characteristics such as residual symptoms have been shown to negatively affect the long-term course of MDD. However, it is unclear so far how trait repetitive negative thinking (RNT) as well as cognitive and affective momentary states, the latter experienced during daily-life, affect the long-term course of MDD.

Method

We followed up 57 remitted depressed (rMDD) individuals six (T2) and 36 (T3) months after baseline. Clinical outcomes were time to relapse, time spent with significant symptoms as a marker of chronicity, and levels of depressive symptoms at T2 and T3. Predictors assessed at baseline included residual symptoms and trait RNT. Furthermore, momentary daily life affect and momentary rumination, and their variation over the day were assessed at baseline using ambulatory assessment (AA).

Results

In multiple models, residual symptoms and instability of daily-life affect at baseline independently predicted a faster time to relapse, while chronicity was significantly predicted by trait RNT. Multilevel models revealed that depressive symptom levels during follow-up were predicted by baseline residual symptom levels and by instability of daily-life rumination. Both instability features were linked to a higher number of anamnestic MDD episodes.

Conclusions

Our findings indicate that trait RNT, but also affective and cognitive processes during daily life impact the longer-term course of MDD. Future longitudinal research on the role of respective AA-phenotypes as potential transdiagnostic course-modifiers is warranted.

The shape of change in perceived stress, negative affect, and stress sensitivity during mindfulness-based stress reduction

Both daily stress and the tendency to react to stress with heightened levels of negative affect (i.e., stress sensitivity) are important vulnerability factors for adverse mental health outcomes. Mindfulness-based stress reduction (MBSR) may help to reduce perceived daily stress and stress sensitivity. The purpose of this study was to examine how change in perceived stress, negative affect (NA), and the decoupling between perceived stress and NA evolved over the course of a MBSR program, without making any a priori assumptions on the shape of change. Seventy-one adults from the general population participating in MBSR provided daily diary assessments of perceived stress and NA during MBSR. The time-varying effect model (TVEM) indicated that perceived stress and NA decreased in a linear fashion rather than in a non-linear fashion, both as a function of time and as a function of the cumulative number of days of mindfulness practice. Both TVEM and multilevel growth modeling showed that the association between perceived stress and NA did not decrease over the course of MBSR. The findings support the hypothesis that MBSR reduces NA and also reduces the extent to which individuals perceive their days as stressful. Also, the results suggest that there is a dose-response relationship between the amount of mindfulness practice and reductions in daily stress and NA.

Rumination predicts heightened responding to stressful life events in major depressive disorder and generalized anxiety disorder

Although studies have documented heightened stress sensitivity in major depressive disorder (MDD) and generalized anxiety disorder (GAD), the mechanisms involved are poorly understood. One possible mechanism is the tendency to ruminate in response to stress. We used ecological momentary assessment to study ruminative thoughts after stressful events in 145 adults with MDD, GAD, comorbid MDD-GAD, or no psychopathology. Diagnosed individuals reported more event-related rumination than controls, even after adjusting for event stressfulness. Rumination was equally common in MDD and GAD and was especially severe among comorbid cases. More rumination immediately after the event predicted poorer affect, more maladaptive behavior, and more MDD and GAD symptoms at the next signal, even when pre-event levels of these variables were controlled. Rumination mediated, but did not moderate, the association of stress with affect and with symptoms. Stress-related rumination was more deleterious for diagnosed than healthy individuals, more intense for more severe clinical cases, and more persistent for cases with a greater temperamental vulnerability for emotional disorders. These results implicate rumination as a mechanism of stress sensitivity and suggest pathways through which it may maintain depression and anxiety in everyday life.

The effect of childhood trauma and Five-Factor Model personality traits on exposure to adult life events in patients with psychotic disorders

INTRODUCTION

Recent life events are associated with transition to and outcome in psychosis. Childhood trauma and personality characteristics play a role in proneness to adult life events. However, little is known about the relative contribution and interrelatedness of these characteristics in psychotic disorders. Therefore, we investigated whether Five-Factor Model (FFM) personality traits and childhood trauma (abuse and neglect) predict adult life events, and whether the effect of childhood trauma on life events is mediated by personality traits.

METHOD

One hundred and sixty-three patients with psychotic disorders were assessed at baseline on history of childhood maltreatment and FFM personality traits, and on recent life events at 3-year follow-up.

RESULTS

Childhood abuse is associated with negative life events, and part of the effect of childhood abuse on negative life events is mediated by openness to experience. Openness to experience and extraversion are associated with more positive and negative life events. Childhood neglect and lower extraversion are related to experiencing less positive events.

CONCLUSION

The association between childhood trauma and recent life events is partly mediated by personality. Future research could focus on mechanisms leading to positive life events, as positive life events may buffer against development of mental health problems.

Negative emotional reactivity as a marker of vulnerability in the development of borderline personality disorder symptoms

Negative emotionality is a distinguishing feature of borderline personality disorder (BPD). However, this person-level characteristic has not been examined as a marker of vulnerability in the development of this disorder. The current study utilized a multimethod approach to examine the interplay between negative emotional reactivity and cumulative exposure to family adversity on the development of BPD symptoms across 3 years (ages 16-18) in a diverse, at-risk sample of adolescent girls (N = 113). A latent variable of negative emotional reactivity was created from multiple assessments at age 16: self-report, emotion ratings to stressors from ecological assessments across 1 week, and observer-rated negative affectivity during a mother-daughter conflict discussion task. Exposure to family adversity was measured cumulatively between ages 5 and 16 from annual assessments of family poverty, single parent household, and difficult life circumstances. The results from latent growth curve models demonstrated a significant interaction between negative emotional reactivity and family adversity, such that exposure to adversity strengthened the association between negative emotional reactivity and BPD symptoms. In addition, family adversity predicted increasing BPD symptoms during late adolescence. These findings highlight negative emotional reactivity as a marker of vulnerability that ultimately increases risk for the development of BPD symptoms.

Effects of the Social Environment and Stress on Glucocorticoid Receptor Gene Methylation: A Systematic Review

The early-life social environment can induce stable changes that influence neurodevelopment and mental health. Research focused on early-life adversity revealed that early-life experiences have a persistent impact on gene expression and behavior through epigenetic mechanisms. The hypothalamus-pituitary-adrenal axis is sensitive to changes in the early-life environment that associate with DNA methylation of a neuron-specific exon 17 promoter of the glucocorticoid receptor (GR) (Nr3c1). Since initial findings were published in 2004, numerous reports have investigated GR gene methylation in relationship to early-life experience, parental stress, and psychopathology. We conducted a systematic review of this growing literature, which identified 40 articles (13 animal and 27 human studies) published since 2004. The majority of these examined the GR exon variant 1F in humans or the GR17 in rats, and 89% of human studies and 70% of animal studies of early-life adversity reported increased methylation at this exon variant. All the studies investigating exon 1F/17 methylation in conditions of parental stress (one animal study and seven human studies) also reported increased methylation. Studies examining psychosocial stress and psychopathology had less consistent results, with 67% of animal studies reporting increased exon 17 methylation and 17% of human studies reporting increased exon 1F methylation. We found great consistency among studies investigating early-life adversity and the effect of parental stress, even if the precise phenotype and measures of social environment adversity varied among studies. These results are encouraging and warrant further investigation to better understand correlates and characteristics of these associations.

Early-life adversity and brain development: Is the microbiome a missing piece of the puzzle?

The prenatal and postnatal early-life periods are both dynamic and vulnerable windows for brain development. During these important neurodevelopmental phases, essential processes and structures are established. Exposure to adverse events that interfere with this critical sequence of events confers a high risk for the subsequent emergence of mental illness later in life. It is increasingly accepted that the gastrointestinal microbiota contributes substantially to shaping the development of the central nervous system. Conversely, several studies have shown that early-life events can also impact on this gut community. Due to the bidirectional communication between the gut and the brain, it is possible that aberrant situations affecting either organ in early life can impact on the other. Studies have now shown that deviations from the gold standard trajectory of gut microbiota establishment and development in early life can lead not only to disorders of the gastrointestinal tract but also complex metabolic and immune disorders. These are being extended to disorders of the central nervous system and understanding how the gut microbiome shapes brain and behavior during early life is an important new frontier in neuroscience.

Micro-Level Affect Dynamics in Psychopathology Viewed From Complex Dynamical System Theory

This article discusses the role of moment-to-moment affect dynamics in mental disorder and aims to integrate recent literature on this topic in the context of complex dynamical system theory. First, we will review the relevance of temporal and contextual aspects of affect dynamics in relation to psychopathology. Related to this, we will discuss recent insights resulting from a network view on affect dynamics in psychopathology. Next, we explore how we can reconcile literature findings from a perspective of complex dynamical system theory. Finally, future directions with regard to personalized assessment of risk and diagnostic use are discussed.

Early life adversity and the epigenetic programming of hypothalamic-pituitary-adrenal function

We review studies with human and nonhuman species that examine the hypothesis that epigenetic mechanisms, particularly those affecting the expression of genes implicated in stress responses, mediate the association between early childhood adversity and later risk of depression. The resulting studies provide evidence consistent with the idea that social adversity, particularly that involving parent-offspring interactions, alters the epigenetic state and expression of a wide range of genes, the products of which regulate hypothalamic-pituitary-adrenal function. We also address the challenges for future studies, including that of the translation of epigenetic studies towards improvements in treatments.

Emotional Reactivity to Negative Adult and Peer Events and the Maintenance of Adolescent Depressive Symptoms: a Daily Diary Design

Emotional reactivity to negative interpersonal events has been consistently linked with depressive symptoms in studies with adults. However, little is known about the role that emotional reactivity plays in the maintenance of depressive symptoms during adolescence. A structured diary, administered to 132 economically disadvantaged adolescents (53% female, 76% African American) at age 14, measured adolescent daily reports of negative events involving parents, teachers, and peers and ratings of negative and positive affect. We examined the relationship between emotional reactivity (changes in negative and positive affect that correspond with negative events) and the maintenance of depressive symptoms between ages 13 and 15. We also tested unique effects of different types of emotional reactivity, depending on the type of interpersonal event. Results provided support for the emotional reactivity model for negative teacher events: heightened reactivity to negative teacher events was related to the maintenance of depressive symptoms. Findings suggest that adolescents' emotional reactivity to teachers has important implications for the continuity of depressive symptoms during early adolescence for disadvantaged youth.