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Incorporating hypothalamic–pituitary–adrenal axis measures into preventive interventions for adolescent depression: Are we there yet?

Published online by Cambridge University Press:  07 July 2008

Emma K. Adam*
Affiliation:
Northwestern University
Jonathan M. Sutton
Affiliation:
Northwestern University
Leah D. Doane
Affiliation:
Northwestern University
Susan Mineka
Affiliation:
Northwestern University
*
Address correspondence and reprint requests to: Emma K. Adam, Program on Human Development and Social Policy, School of Education and Social Policy and Cells to Society Center, Institute for Policy Research, Northwestern University, 2120 Campus Drive, Room 201, Evanston, IL 60208; E-mail: ek-adam@northwestern.edu.

Abstract

Altered functioning of the hypothalamic–pituitary–adrenal (HPA) axis is a robust correlate of major depression in adults, and to a lesser extent, in adolescents. Premorbid differences in HPA axis function have been found to prospectively predict the onset of adolescent depression. To what extent might our knowledge of HPA axis function in adolescents with, or at risk for, depression, help guide efforts to prevent depression in this age group? We review evidence regarding the role of the HPA axis in the development of adolescent depression, and examine whether and which HPA axis measures might be useful in guiding prevention efforts as (a) as a criterion by which to select youth at risk for depression, (b) as a predictor of which youth will be most responsive to prevention efforts, and (c) as an indicator of whether prevention/intervention efforts are working. We conclude that our current understanding of the HPA axis, and its measurement, in adolescent depression are not sufficiently precise to be of immediate practical use in improving prevention efforts. Incorporating HPA axis measures into prevention studies, however, would be immensely useful in clarifying the role of the HPA axis in adolescent depression, such that future prevention efforts might more confidently rely on HPA axis information.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2008

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Footnotes

This research was supported by Grant R01 MH65652 (Richard E. Zinbarg, Susan Mineka, Michelle G. Craske, Principal Investigators) and by a William T. Grant Foundation Scholars Award (to E.K.A.). The writing of this manuscript was supported by a Scholars Award (to E.K.A.) and by an Institute for Policy Research Graduate Fellowship (to L.D.D.). We thank Jennifer Cueto for her assistance with the editing of this manuscript and the participants of the Youth Emotion Project/Sleep and Stress Study.

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