Depressive symptom composites associated with cortisol stress reactivity in adolescents

Abstract

Background Altered hypothalamic-pituitary-adrenal (HPA) function is common in youth with major depressive disorder (MDD) but variability in the strength and direction of HPA alterations has prompted a search for symptom-based subtypes with unique neuroendocrine signatures. This study investigated the extent to which depressive symptom composites were differentially associated with cortisol responses to psychosocial stress. Methods This study examined salivary cortisol responses to the Trier Social Stress Test (TSST) in 145 adolescents who varied in their risk for MDD: 38 had current MDD; 35 were healthy but at high risk for MDD based on having one or both parents with unipolar MDD; and 72 were healthy youth with no personal or family history of a psychiatric disorder. Multilevel models examined within-person change in cortisol levels during a 2-hour resting phase prior to the TSST and both linear and quadratic changes in cortisol levels following the TSST. Results Anticipatory cortisol reactivity was lower in MDD youth compared to low-risk youth, and in youth with higher compared to lower depressive symptom severity. Whereas affective symptoms were associated with increased anticipatory cortisol reactivity and more rapid recovery to the TSST, neurovegetative symptoms were associated with decreased anticipatory cortisol reactivity and slower recovery. Limitations The cross-sectional design does not permit inferences regarding temporal relations between cortisol responses and depressive symptom composites. Conclusions The present findings suggest that heterogeneity among studies examining HPA reactivity in depressed youth may be driven, in part, by differences in depressive symptom composites across samples.

Early life stress, cortisol, frontolimbic connectivity, and depressive symptoms during puberty

“…ELS-related aberrant cortisol regulation, in turn, has been associated with emotion dysregulation in youth, including elevated negative affect and social withdrawal (e.g., Alink, Cicchetti, Kim, & Rogosch, 2012; Cicchetti, Rogosch, Gunnar, & Toth, 2010). The decreased cortisol pattern linked to ELS parallels findings in adolescents with higher depressive symptoms (e.g., Morris, Kouros, Meilock, & Rao, 2017). Harkness, Stewart, and Wynne-Edwards (2011) reported that a history of maltreatment interacted with subsequent high levels of depressive symptoms to predict decreased cortisol responses to a psychosocial stressor in adolescents.…”

Cognitive reappraisal attenuates the association between depressive symptoms and emotional response to stress during adolescence

“…In contrast, emotional recovery has been studied as the ability to return to a baseline level of emotionality after arousal, which can be studied as negative affective persistence to events, or as the level of distress after a stressor has ceased. For example, a recent study that differentiated between stress reactivity and stress recovery found that affective symptoms of depression were associated with increased stress reactivity and fast recovery following a social stress task, whereas neurovegetative symptoms of depression were associated with blunted reactivity and slower recovery following the social stress task among adolescents (Morris et al, 2017). In addition, a recent examination found that depressive symptoms were associated with a more sustained emotional activation to stress, but were not associated with a greater intensity of activation (Lopez-Duran et al, 2015).…”

In(s) and out(s) of adolescent depression – Trajectories of development and recovery

“…Two studies reported that adolescents with MDD had greater cortisol response to social stress tests compared with HC whilst the other two found no difference between the groups ( Ming et al., 2017 ; Rao et al., 2008 ; Klimes-Dougan et al., 2014 ; Morris, 2014 ). Morris and colleagues used TSST to compare cortisol reactivity between adolescents with low and high risk for MDD and current MDD, and reported higher cortisol reactivity in the low-risk group compared with MDD and high-risk groups ( Morris Chrystyna et al., 2017 ). Furthermore, adolescents with MDD had significantly higher levels of nocturnal UFC compared with HC ( Rao and Poland, 2009 ).…”