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Gepubliceerd in: Journal of Abnormal Child Psychology 6/2016

26-11-2015

Stressful Life Events Prior to Depression Onset and the Cortisol Response to Stress in Youth with First Onset Versus Recurrent Depression

Auteurs: R. Mazurka, K. E. Wynne-Edwards, K. L. Harkness

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 6/2016

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Abstract

The strongest proximal predictors of depression onset in adolescence are stressful life events (SLEs). Changes in the hypothalamic-pituitary-adrenal (HPA) axis response to stress are theorized to mediate the etiological effect of SLEs on depression onset. The goal of the current study was to examine differences in the cortisol response to a laboratory-induced stressor between youth with versus without at least one SLE in the etiologically-central 3-month period prior to depression onset. One hundred adolescents (24 first-onset depression, 18 recurrent depression, and 58 non-depressed controls) had five salivary cortisol samples collected over the course of the Trier Social Stress Test (TSST). SLEs were assessed using a rigorous contextual interview and rating system. Among those with an SLE, youth on their first onset of depression had a flatter cortisol reactivity slope relative to non-depressed adolescents, and youth on a recurrent episode of depression had a steeper recovery slope relative to first-onsets and non-depressed adolescents. In contrast, no between-group differences were found among those with no SLE prior to onset. These results suggest that differences in the HPA axis response pattern may represent a neurobiological mechanism that distinguishes depressed and non-depressed groups but only for adolescents whose depression is precipitated by SLEs. Further, this neurobiological mechanism may play a different role in the very first episode of depression than it does in recurrent episodes.
Voetnoten
1
We did not have complete data on oral contraceptive use for our sample; however, there were no significant differences in the distribution of users across the study variables. We ran our main analyses below controlling for the use of antidepressant medication. The pattern of our results remained unchanged. Results are available upon request.
 
2
These participants met the adolescent criteria for dysthymia, which requires only a 1-year duration.
 
3
Results of the main statistical model including only those participants who met strict criteria for MDD did not differ from the full sample. Results are available upon request.
 
4
We also ran our analyses with SLEs defined as a continuous measure of cumulative threat (i.e., the sum of the contextual threat rating for all SLEs in the relevant 3-month period). Although the pattern of results was the same, the models were not significant, suggesting that the dichotomous event definition may be most powerful in reflecting the nature of the relation between environmental triggering stress and HPA axis function.
 
5
Although some comparisons no longer reached conventional statistical levels of significance, removing chronic stress as a covariate from our models did not change the pattern of results.
 
6
Other researchers have fit the curve to a polynomial function (i.e., linear, quadratic, cubic etc.). However, we had fewer sampling points and, thus, a piecewise MLM approach provided a better fit for our data.
 
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Metagegevens
Titel
Stressful Life Events Prior to Depression Onset and the Cortisol Response to Stress in Youth with First Onset Versus Recurrent Depression
Auteurs
R. Mazurka
K. E. Wynne-Edwards
K. L. Harkness
Publicatiedatum
26-11-2015
Uitgeverij
Springer US
Gepubliceerd in
Research on Child and Adolescent Psychopathology / Uitgave 6/2016
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI
https://doi.org/10.1007/s10802-015-0103-y