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Interaction of Biological Stress Recovery and Cognitive Vulnerability for Depression in Adolescence

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Abstract

Major Depressive Disorder is a common mental illness with rates increasing during adolescence. This has led researchers to examine developmental antecedents of depression. This study examined the association between depressive symptoms and the interaction between two empirically supported risk factors for depression: poor recovery of the biological stress system as measured through heart rate and cortisol, and cognitive vulnerabilities as indexed by rumination and a negative cognitive style. Adolescents (n = 127; 49 % female) completed questionnaires and a social stress task to elicit a stress response measured with neuroendocrine (cortisol) and autonomic nervous system (heart rate) endpoints. The findings indicated that higher depressive symptoms were associated with the combination of higher cognitive vulnerabilities and lower cortisol and heart rate recovery. These findings can enhance our understanding of stress responses, lead to personalized treatment, and provide a nuanced understanding of depression in adolescence.

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Notes

  1. Thirteen participants met DSM-IV criteria for past major depressive episode. Bivariate correlations were run to examine whether this determination was associated with any study variables. History of MDD was associated with baseline cortisol (r = −.21, p = .024). Sensitivity analyses were run to determine whether including history of MDD as a covariate changed the results. Sensitivity analysis confirmed the prior findings and suggested that the presence of a history of MDD did not alter the results of the current study. However, it is important to note that a history of MDD was associated with lower baseline cortisol.

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Acknowledgments

This research was supported by National Institute of Mental Health Grants MH79369 and MH101168 to Lauren B. Alloy and MH099764 to Benjamin G. Shapero.

Authors’ Contributions

BGS conceived of the study, obtained funding, collected the data, performed statistical analyses and drafted the manuscript; GM analyzed the biological data and drafted a section of the manuscript; DB participated in the design of the study, oversaw the biological analysis and helped draft and review the manuscript; LYA obtained funding for the original study and helped review the manuscript; LBA participated in the design and coordination of the study, obtained the funding for the original study, and reviewed multiple drafts of the manuscript. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Department of Psychology, Temple University, 1701 N. 13th St., Philadelphia, PA, 19122, USA

    Benjamin G. Shapero, George McClung, Debra A. Bangasser & Lauren B. Alloy

  2. Department of Psychiatry, Massachusetts General Hospital, One Bowdoin Square, 6th Floor, Boston, MA, 02114, USA

    Benjamin G. Shapero

  3. Harvard Medical School, Boston, MA, USA

    Benjamin G. Shapero

  4. Neuroscience Program, Temple University, 1701 N. 13th St., Philadelphia, PA, 19122, USA

    George McClung & Debra A. Bangasser

  5. Department of Psychology, University of Wisconsin-Madison, 1201 W. Johnson St., Madison, WI, 53706, USA

    Lyn Y. Abramson

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  1. Benjamin G. Shapero
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Correspondence to Benjamin G. Shapero.

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Conflict of Interest

The authors Benjamin G. Shapero, George McClung, Debra A. Bangasser, Lyn Y. Abramson, and Lauren B. Alloy declare that they have no conflict of interest or other financial disclosures. This manuscript presents findings that have not been previously published or submitted elsewhere.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Appendix: Additional Information Regarding the TSST

Appendix: Additional Information Regarding the TSST

The TSST was chosen as a stress procedure because it has been shown to be particularly effective in eliciting a stress response in adolescents and is less invasive (e.g., physical examination, inoculation, venipuncture) and more feasible (e.g., peer rejection paradigm, parent–child conflict discussion) than other paradigms. After a 30 min baseline period, in which participants completed the consent forms and other measures in this study, participants were given instructions for the task. In addition, adolescents were told that an expert panel of judges would rate their performance and that those who performed the best would get a prize. They received 5 min to prepare their speech while alone in the room. Following the 5 min preparation time, the interviewer came back into the room and read a condensed portion of the instructions for the job interview speech. Participants were asked to stand, face the camera, and were prompted to speak for 2 min. In addition, the interviewer sat in the room with a clipboard during the TSST and was instructed to maintain a neutral expression. Standardized prompts were given to the participants if there were long pauses (e.g., 20 s), such as “You still have time remaining, please continue.” After the two min speech, the participants were prompted to stop but remain standing. An unexpected additional task was then introduced as participants were asked to solve a calculation task aloud. They were asked to count backwards from 2083 to zero in 13-step sequences. They were instructed to calculate as quickly and correctly as possible and if they made a mistake, the interviewer would say “error, 2083” and were asked to start over. They were not instructed on the duration of this task but after they began, participants completed this task for 1 min. All portions of the TSST were videotaped. Following this task, participants were told that the new task was completed and continued to complete other study measures in the remaining time of the regular assessment. At the end of the day’s session, participants and their mothers were debriefed on the study protocol.

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Shapero, B.G., McClung, G., Bangasser, D.A. et al. Interaction of Biological Stress Recovery and Cognitive Vulnerability for Depression in Adolescence. J Youth Adolescence 46, 91–103 (2017). https://doi.org/10.1007/s10964-016-0451-0

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