Depressed adolescents of depressed and nondepressed mothers: tests of an interpersonal impairment hypothesis

Social Rejection and Suicidal Ideation and Attempts among Adolescents Following Hospitalization: a Prospective Study

Despite research indicating that stressful life events are associated with subsequent suicidal ideation (SI) and behavior, there is a lack of clarity regarding whether specific types of life events are differentially related to SI and attempts. The current prospective study examines whether social rejection related life events are proximally related to SI and suicide attempts in a clinically acute sample of adolescents. Adolescents aged 12 to 18 (n = 219) were followed for 6 months after discharge from inpatient hospitalization. A contextual threat interview of stressful life events between index admission and 6-month follow-up was administered. Participants were also assessed for current SI and suicide attempts at baseline and 6-month follow-up. Results from a multiple linear regression model indicated a significant prospective association between number of social rejection stressors and SI, even after controlling for baseline depressive symptoms, SI at study entry, gender, age, and number of non-social rejections stressors. An Anderson-Gill recurrent events model was conducted to examine the relationship between SR stressors and suicide attempts. Results demonstrated that the 31 days following a major social rejection stressor were associated with heightened risk for prospective suicide attempts. However, social rejection stressors were not more strongly related to risk for suicide attempt than non-social rejection stressors. These findings help clarify the role of social rejection as a precipitant of suicidal crises and have potential to inform more accurate, targeted risk assessment.

The intergenerational transmission of partnering

As divorce and cohabitation dissolution in the US have increased, partnering has expanded to the point that sociologists describe a merry-go-round of partners in American families. Could one driver of the increase in the number of partners be an intergenerational transmission of partnering? We discuss three theoretical perspectives on potential mechanisms that would underlie an intergenerational transmission of partnering: the transmission of economic hardship, the transmission of marriageable characteristics and relationship skills, and the transmission of relationship commitment. Using the National Longitudinal Survey of Youth 1979 Child and Young Adult study (NLSY79 CYA) and their mothers in the National Longitudinal Survey of Youth 1979 (NLSY79), we examined the intergenerational transmission of partnering, including both marital and cohabitating unions, using prospective measures of family and economic instability as well as exploiting sibling data to try to identify potential mechanisms. Even after controlling for maternal demographic characteristics and socioeconomic factors, the number of maternal partners was positively associated with offspring's number of partners. Hybrid sibling Poisson regression models that examined sibling differential experiences of maternal partners indicated that there were no differences between siblings who witnessed more or fewer maternal partners. Overall, results suggested that the transmission of poor marriageable characteristics and relationship skills from mother to child may warrant additional attention as a potential mechanism through which the number of partners continues across generations.

Stress responsivity and the structure of common mental disorders: Transdiagnostic internalizing and externalizing dimensions are associated with contrasting stress appraisal biases

Biased stress appraisals critically relate to the origins and temporal course of many-perhaps most-forms of psychopathology. We hypothesized that aberrant stress appraisals are linked directly to latent internalizing and externalizing traits that, in turn, predispose to multiple disorders. A high-risk community sample of 815 adolescents underwent semistructured interviews to assess clinical disorders and naturalistic stressors at ages 15 and 20. Participants and blind rating teams separately evaluated the threat associated with acute stressors occurring in the past year, and an appraisal bias index (i.e., discrepancy between subjective and team-rated threat) was generated. A 2-factor (Internalizing and Externalizing) latent variable model provided an excellent fit to the diagnostic correlations. After adjusting for the covariation between the factors, adolescents' threat overestimation prospectively predicted higher standing on Internalizing, whereas threat underestimation prospectively predicted elevations on Externalizing. Cross-sectional analyses replicated this pattern in early adulthood. Appraisals were not related to the residual portions of any diagnosis in the latent variable model, suggesting that the transdiagnostic dimensions mediated the connections between stress appraisal bias and disorder entities. We discuss implications for enhancing the efficiency of emerging research on the stress response and speculate how these findings, if replicated, might guide refinements to psychological treatments for stress-linked disorders. (PsycINFO Database Record

Children of parents with a history of depression: The impact of a preventive intervention on youth social problems through reductions in internalizing problems

The current investigation examined if changes in youth internalizing problems as a result of a family group cognitive behavioral (FGCB) preventive intervention for families with a parent with a history of depression had a cascade effect on youth social problems over 24 months and the bidirectional nature of these effects. One hundred eighty families with a parent with a history of major depressive disorder (M age = 41.96; 88.9% mothers) and a youth age 9 to 15 years (49.4% females; M age = 11.46) participated. Findings from a panel model indicated that, compared to a minimum intervention condition, the FGCB intervention significantly reduced youth internalizing problems at 12 months that in turn were associated with lower levels of social problems at 18 months. Similarly, the FGCB intervention reduced internalizing problems at 18 months, which were associated with fewer social problems at 24 months. Changes in social problems were not related to reductions in subsequent internalizing problems. The findings suggest that reductions in youth internalizing problems can lead to lower levels of social problems. Youth social problems are difficult to change; therefore, targeting internalizing problems may be an effective way to reduce the social problems of children of parents with a history of depression.

A Daily Diary Investigation of the Influence of Early Family Adversity on Social Functioning during the Transition to Adulthood

Early life stressors are associated with maladaptive social functioning in childhood and adolescence, but it is unclear whether and how the negative interpersonal effects of stress persist into adulthood. Daily diary surveys were used to examine young adults' social behavior and mood reactivity to social stressors as a function of experiences of early family adversity. Stressful early family environments predicted more daily reassurance seeking, but not aggression, withdrawal, or positive social behavior. Early family adversity also moderated the within-person effects of social stressors on next-day mood, such that individuals with high levels of adversity had elevated next-day negative affect in response to higher than average social stress. Findings highlight the enduring impact of early adversity on social development, with implications for developing targeted policies and interventions.

A developmentally informed perspective on the relation between stress and psychopathology: when the problem with stress is that there is not enough

A common tenet of several prominent theories of stress and psychopathology (e.g., stress exposure) is that experiencing high rates of life stressors is associated with greater risk for negative mental health outcomes. Although there has been substantial empirical support for this position, another possibility that has received considerably less attention to date is that early life stressors may share a curvilinear rather than monotonic relation with psychological well-being. In what has been termed the "steeling effect," "stress inoculation," and "antifragility," exposure to moderate stressors early in life may confer resilience to potential detrimental effects of later stressors. An interesting implication of this model is that low levels of early life stressors, relative to normatively moderate rates, may be associated with greater sensitivity to future stressors. The present article reviews preliminary evidence consistent with this possibility, drawing on behavioral and neurobiological studies in animal models, and the more modest literature on neurocognitive, psychological, and psychophysiological functioning in humans. Limitations of the clinical literature and possible directions for future research are discussed, including naturalistic longitudinal studies with clinical outcomes, and for research examining moderators and mechanisms, across multiple levels of analysis (e.g., cognitive, immunological, and neurobiological).

Peer Victimization Mediates the Impact of Maternal Depression on Risk for Suicidal Ideation in Girls but not Boys: A Prospective Study

Although children of depressed mothers are at an increased risk for suicidal thinking, little is known about the potential mechanisms by which this occurs. The present study is the first to our knowledge to utilize a prospective design with the goal of examining whether the impact of maternal depression on children's risk for suicidal ideation is mediated by children's levels of overt and relational peer victimization. Participants were 203 mother-child pairs recruited from the community. The age range of the children was 8 to 14 years old (50.2 % girls). Mothers either met criteria for a major depressive disorder (MDD) during their child's lifetime (n = 96) or had no lifetime diagnosis of any DSM-IV mood disorder and no current Axis I diagnosis (n = 107). At the baseline assessment, diagnostic interviews were used to assess mothers' and children's histories of MDD and children completed a self-report measure of peer victimization. Follow-up assessments were conducted at 6, 12, 18, and 24 months after the initial assessment during which time interviewers assessed for the occurrence of suicidal ideation in the children. Utilizing a mediated moderation model, we found significant indirect pathways from maternal depression to children's suicidal ideation through both relational and overt forms of peer victimization among girls, but not among boys. The current study suggests that peer victimization may constitute one of the potential mechanisms by which daughters of depressed mothers are at increased risk for suicidal thinking.

Pathways maintaining physical health problems from childhood to young adulthood: The role of stress and mood

OBJECTIVE

Poor physical health in childhood is associated with a variety of negative health-related outcomes in adulthood. Psychosocial pathways contributing to the maintenance of physical health problems from childhood to young adulthood remain largely unexamined, despite evidence that factors such as negative mood and stress impact physical health.

DESIGN

The current study tested the direct and indirect effects of ongoing health, chronic stress, health-related chronic stress, and depressive symptoms at age 20 on the link between health problems in childhood and young adulthood (age 21) in a longitudinal sample (n = 384).

MAIN OUTCOME MEASURES

The hypotheses were tested using a multiple mediation path analysis framework; the primary outcome measure was a composite index of health status markers in young adulthood.

RESULTS

The proposed model provided an adequate fit for the data, with significant total indirect effects of the four mediators and significant specific indirect effects of health-related chronic stress and depressive symptoms in maintaining health problems from childhood into young adulthood.

CONCLUSIONS

Health problems are maintained from early childhood into young adulthood in part through psychosocial mechanisms. Depressive symptoms and health-related chronic stress have significant, unique effects on the relationship between health problems in early childhood and young adulthood.

Sensitizing effect of early adversity on depressive reactions to later proximal stress: Moderation by polymorphisms in serotonin transporter and corticotropin releasing hormone receptor genes in a 20-year longitudinal study

Previous research supports gene-environment interactions for polymorphisms in the corticotropin hormone receptor 1 gene (CRHR1) and the serotonin transporter gene linked polymorphic region (5-HTTLPR) in predicting depression, but it has rarely considered genetic influences on stress sensitization processes, whereby early adversities (EA) increase depressive reactivity to proximal stressors later in life. The current study tested a gene-environment-environment interaction (G × E × E; specifically, gene-EA-proximal stress interaction) model of depression in a 20-year longitudinal study. Participants were assessed prospectively for EA up to age 5 and recent chronic stress and depressive symptoms at age 20 and genotyped for CRHR1 single nucleotide polymorphism rs110402 and 5-HTTLPR. EA predicted stronger associations between recent chronic stress and depression, and the effect was moderated by genes. CRHR1 A alleles and 5-HTTLPR short alleles were associated with greater stress sensitization (i.e., greater depressive reactivity to chronic stress for those also exposed to high levels of EA). The results are consistent with the notion that EA exposure results in neurobiological and cognitive-emotional consequences (e.g., altered hypothalamic-pituitary-adrenal axis functioning), leading to emotional distress in the face of recent stressors among those with certain genetic characteristics, although further research is needed to explore explanatory mechanisms.

Genetic moderation of the association between adolescent romantic involvement and depression: Contributions of serotonin transporter gene polymorphism, chronic stress, and family discord

Studies support a link between adolescent romantic involvement and depression. Adolescent romantic relationships may increase depression risk by introducing chronic stress, and genetic vulnerability to stress reactivity/emotion dysregulation may moderate these associations. We tested genetic moderation of longitudinal associations between adolescent romantic involvement and later depressive symptoms by a polymorphism in the serotonin transporter linked polymorphic region gene (5-HTTLPR) and examined contributory roles of chronic stress and family discord. Three hundred eighty-one youth participated at ages 15 and 20. The results indicated that 5-HTTLPR moderated the association between age 15 romantic involvement and age 20 depressive symptoms, with strongest effects for short homozygotes. Conditional process analysis revealed that chronic stress functioned as a moderated mediator of this association, fully accounting for the romantic involvement-depression link among short/short genotypes. Also, romantic involvement predicted later depressive symptoms most strongly among short-allele carriers with high family discord. The results have important implications for understanding the romantic involvement-depression link and the behavioral and emotional correlates of the 5-HTTLPR genotype.

Externalizing disorders in adolescence mediate the effects of maternal depression on substance use disorders

Maternal depression has been linked to increased risk of substance use disorders (SUDs) in offspring. Cross-sectional studies have identified relationships among maternal depression, externalizing disorders and SUDs, but no longitudinal examination of causality has been undertaken. In order to address this gap in the literature, depression and externalizing disorders at or prior to age 15 were tested as mediators of the relationship between maternal depression and SUDs diagnosed between ages 16 and 20 in a sample of 702 Australian youth (363 women) using path models. Mothers' and fathers' substance diagnoses and earlier onset of substance abuse in youth were controlled for in all analyses. Consistent with previous work, maternal depression predicted SUDs between ages 16 and 20. An indirect effect of maternal depression through youth externalizing disorders diagnosed by age 16 was detected for alcohol and cannabis use disorders, but not drug disorders. Early adolescent depression was not a mediator of the relationship between maternal depression and any of the substance outcomes measured. To our knowledge, this study is the first to examine depression and externalizing disorders in early adolescence as mediators of the effect of maternal depression on psychopathology in later adolescence. Further work is needed to understand how family environment and genetic factors may explain the mediation by externalizing disorders.

Social stress and the oxytocin receptor gene interact to predict antisocial behavior in an at-risk cohort

Polymorphisms in the oxytocin receptor gene are commonly associated with prosocial behaviors in the extant literature, yet their role in antisocial behaviors has rarely been explored, particularly during the transition from adolescence to early adulthood. We examined a prospective cohort (N = 404), collecting youth, mother, and clinician reports of conduct-disordered and antisocial behavior at ages 15 and 20. The oxytocin receptor gene rs53576 polymorphism was hypothesized to interact with social stress to predict antisocial outcomes. Structural equation modeling results revealed a significant main effect at age 15 (p = .025); those with the G allele exhibited higher levels of conduct problems. Structural equation modeling revealed a significant Gene × Environment interaction at age 20 (p = .029); those with the G allele who experienced high social stress exhibited higher levels of antisocial behavior. Heterozygous (AG) grouping models were compared, and parameter estimations supported G dominant groupings. These novel findings suggest that rs53576 polymorphisms may influence social salience and contribute to risk for antisocial outcomes, particularly under conditions of high social stress.

Close Friends' Psychopathology as a Pathway From Early Adversity to Young Adulthood Depressive Symptoms

Past research has highlighted the negative impact of early adverse experiences on childhood social functioning, including friendship selection, and later mental health. The current study explored the long-term effects of early adversity on young adults' close friends' psychological symptoms and the impact of these close friendships on later depressive symptoms. A prospective longitudinal design was used to examine 816 youth from a large community-based sample, who were followed from birth through age 25. Participants' mothers provided contemporaneous information about adversity exposure up to age 5, and participants completed questionnaires about their own depressive symptoms at age 20 and in their early 20s. Youth also nominated a best friend to complete questionnaires about his or her own psychopathology at age 20. Individuals who experienced more early adversity by age 5 had best friends with higher rates of psychopathology at age 20. Moreover, best friends' psychopathology predicted target youth depressive symptoms 2 to 5 years later. Results indicate that early adversity continues to affect social functioning throughout young adulthood and that best friendships marked by elevated psychopathology in turn negatively affect mental health. Findings have implications for clinical interventions designed to prevent the development of depressive symptoms in youth who have been exposed to early adversity.

Prevalence and correlates of depressive symptoms and resiliency among African American women in a community-based primary health care center

The purpose of this cross-sectional pilot study was to determine the prevalence and correlates of depressive symptoms and resiliency among 290 African American women (AAW) in a community-based primary health care center. Descriptive statistics, Pearson product-moment correlation, and logistic regression analyses were conducted. Findings indicate that depressive symptoms are experienced by 49% of the participants, while 10% indicated a history of suicidal ideation. Participants had moderately high resiliency scores that had a statistically significant inverse relationship with depressive symptoms. This suggests that resiliency is potentially a protective factor for depressive symptoms. Depressive symptoms were positively correlated with participants' diagnosis of at least one chronic disease. The strongest predictors of depressive symptoms were previous diagnoses of a mental health condition and unemployment. This study identifies risk and potential protective factors for depression among a clinic sample of AAW.

The association of ADHD and depression: mediation by peer problems and parent-child difficulties in two complementary samples

Children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for the development of depression, with evidence that peer and academic difficulties mediate predictions of later depression from ADHD. In the present study, we hypothesized that parent-child relationship difficulties may be an additional potential mediator of this association. Academic, peer, and parent-child functioning were tested as mediators of the association of attention problems and depression in two distinctly different yet complementary samples. Study 1 was a cross-sectional sample of 5- to 10-year-old children (N = 230) with and without ADHD. Study 2 was a prospective longitudinal sample of 472 youth, followed prospectively from birth to age 20 years, at risk for depression. Despite differences in age, measures, and designs, both studies implicated peer and parent-child problems as unique mediators of depressive symptoms, whereas academic difficulties did not uniquely mediate the ADHD-depression association. Furthermore, inattention symptoms, but not hyperactivity, predicted depressive symptoms via the disruption of interpersonal functioning. The inclusion of oppositional defiant disorder into models impacted results and supported its independent role in parent-child problems. Implications include support for interventions that target interpersonal competence, which may effectively reduce the risk of depression among children with ADHD.

Serotonin transporter gene as a predictor of stress generation in depression

Research suggests that a polymorphism in the promoter region of the serotonin transporter promoter (5-HTTLPR) interacts with stressful life events to predict depressive onset, with short (s) allele presence associated with greater susceptibility to stressors. However, this research has not considered that depressed individuals often actively generate stressful contexts. Furthermore, little is known about the genetic basis of stress generation. The current study explored the role of 5-HTTLPR genotype in stress generation in a longitudinal sample of 381 adolescents, oversampled for maternal depression, assessed at ages 15 and 20. Genotype did not correlate directly with number or ratings of stressful life events. However, 5-HTTLPR genotype interacted with depression at age 15 to predict dependent stressful events at age 20. Specifically, participants with one or more s alleles showed a stronger association between age 15 depression and age 20 dependent and interpersonal events than long allele homozygotes. Results imply that the 5-HTTLPR genotype predicts reciprocal associations between stress and depression, indicating a more complex relationship between stress, depression, and their genetic underpinnings than previously suggested.

Youth depression and early childrearing: stress generation and intergenerational transmission of depression

OBJECTIVE

Broadening the concept of stress generation beyond acute life events, the current study explores predictors of the creation of stressful environments-specifically, selection into early childrearing by age 20. It was predicted that youth with early onset depressive disorders would be at higher risk for early childrearing accompanied by greater depression and parenting maladjustment. Additional analyses tested hypotheses about the roles of interpersonal vulnerability and intergenerational transmission of depression and examined gender differences.

METHOD

A community sample of 706 adolescents and their mothers were studied at ages 15 and 20. The sample was originally selected to oversample families with depressed mothers.

RESULTS

Results confirmed the hypotheses for women but not men: Young women with depression by age 15 were at greater risk for interpersonal difficulties at age 15 and early childrearing, accompanied by further depression and parenting dysfunction at age 20. The effects of (grand)maternal depression were evident in predicting youth early onset depression and interpersonal difficulties, as well as higher rates of depression among their daughters who had children by age 20.

CONCLUSIONS

The study expands the definition of stress generation to include the role of past depression and other risk factors as predictors of selection into a stressful childrearing environment. The findings also describe aspects of the intergenerational transmission of depression. The results highlight potentially important targets for interventions in young women to prevent recurrence of major depression and parenting dysfunction.

Interactions between the COMT Val108/158Met polymorphism and maternal prenatal smoking predict aggressive behavior outcomes

The purpose of the current study is to examine the moderating influence of the catechol O methyltransferase gene (COMT) on the maternal prenatal smoking/offspring externalizing disorder relationship. The sample consisted of 430 young adults born between 1981 and 1984 at the Mater Misericordiae Mother's Hospital in Brisbane, Australia, as well as their mothers and peers. Mothers reported their prenatal smoking status during pregnancy, and genetic data was obtained from the youth at a later follow-up in adulthood. The outcome measures in this study were mother and teacher reports of youth attention problems and aggression at age 15, and youth, mother and peer reports of youth attention problems and aggression at age 20 (combined to create latent factors of attention problems and aggression at each age). The COMT Val108/158Met polymorphism (rs4680) significantly interacted with maternal cigarette smoking during pregnancy to predict youth aggressive behavior at ages 15 and 20. This gene-environment interaction was not significant for youth attention problems.

Mediators of aggression among young adult offspring of depressed mothers

The current article explores the connection between maternal depression and offspring aggression during the transition to adulthood, expanding the scope of prior research on this topic. Both family-level factors (including parent-child relationship quality and maternal romantic relationship quality) and youth factors (including depression history and social functioning in midadolescence) were tested as potential mediators in a longitudinal community sample of 710 youth at ages 15 and 20. The results suggest that maternal depression confers a risk for higher levels of aggressive behavior by offspring at age 20. Structural equation models suggested that the association between maternal depression and youth aggression is fully mediated by youth history of depression by midadolescence, even when accounting for the stability of aggression between ages 15 and 20. Parent-child relationship quality, youth social functioning, and maternal relationship quality were not unique mediators of this association. Limitations and implications are discussed.

Patterns of adolescent depression to age 20: the role of maternal depression and youth interpersonal dysfunction

Considerable research has focused on youth depression, but further information is needed to characterize different patterns of onset and recurrence during adolescence. Four outcome groups by age 20 were defined (early onset-recurrent, early-onset-desisting, later-onset, never depressed) and compared on three variables predictive of youth depression: gender, maternal depression, and interpersonal functioning. Further, it was hypothesized that the association between maternal depression and youth depression between 15 and 20 is mediated by early-onset depression and interpersonal dysfunction by age 15. Eight hundred sixteen community youth selected for depression risk by history (or absence) of maternal depression were interviewed at age 15, and 699 were included in the 5-year follow-up. Controlling for gender, early onset and interpersonal dysfunction mediated the link between maternal depression and late adolescent major depression. Different patterns for males and females were observed. For males maternal depression's effect was mediated by early onset but not interpersonal difficulties, while for females maternal depression's effect was mediated by interpersonal difficulties but not early onset. Maternal depression did not predict first onset of major depression after age 15. The results suggest the need for targeting the impact of maternal depression's gender-specific effects on early youth outcomes, and also highlight the different patterns of major depression in youth and their likely implications for future course of depression.

Early adversity and the prospective prediction of depressive and anxiety disorders in adolescents

The current study was a prospective exploration of the specificity of early childhood adversities as predictors of anxiety and depressive disorders in adolescents. Participants were 816 adolescents (414 males, 402 females) with diagnostic information collected at age 15; information on early adversities had been collected from the mothers during pregnancy, at birth, age 6 months, and age 5 years for a related study. Adolescents with "pure" anxiety disorders were compared with adolescents with "pure" depressive disorders (major depressive disorder, dysthymia), and these groups were compared to never-ill controls. Analyses controlled for gender and maternal depression and anxiety disorders. Results indicated that adolescents with anxiety disorders were more likely than depressed youth to have been exposed to various early stressors, such as maternal prenatal stress, multiple maternal partner changes, and more total adversities, whereas few early childhood variables predicted depressive disorders. Even when current family stressors at age 15 were controlled, early adversity variables again significantly predicted anxiety disorders. Results suggest that anxiety disorders may be more strongly related to early stress exposure, while depressive disorders may be related to more proximal stressors or to early stressors not assessed in the current study.

Maternal Depression and Anxiety and Infant Development: A Comparison of Foreign-Born and Native-Born Mothers

Studies that investigate infant and/or child development in families of depressed or anxious mothers do not include samples of foreign-born non-English-speaking mothers. This article describes a pilot study investigating infant development, maternal depression, and anxiety in comparison samples of native-born and foreign-born mothers and children from Vietnam, Laos (Hmong), and the Democratic Republic of Congo. Maternal depression and anxiety were measured with the Hopkins Symptom Checklist-25, and the developmental status of children 0-25 months of age was measured with the Denver II. Foreign-born mothers were more anxious than native-born mothers. Non-English-speaking foreign-born mothers were clinically depressed (1.83) and moderately anxious (1.62). Infants of native-born mothers and English-speaking foreign-born mothers performed better on the Denver II than children of foreign-born non-English-speaking mothers. Infants and toddlers of non-English-speaking mothers appear to be at high risk for delays during their first 25 months of life. Public health nurses need to advocate for appropriate interpreter services and mental health resources for non-English-speaking mothers of young children. Developmental screening should reflect cultural variations in parental expectations of how and when children meet developmental milestones. Replication studies and investigation about the long-term development of this high-risk group of children are needed.

Cognitive moderators of the longitudinal association between peer rejection and adolescent depressive symptoms

This longitudinal study examined peer rejection as a predictor of adolescent depressive symptoms during the critical developmental period associated with substantial increases in the prevalence of girls' depression. In a sample of 158 adolescents aged 15-17 years, a peer nomination, sociometric assessment was conducted to examine adolescents' peer status at an initial time point, along with self-report measures of depressive symptoms, depressogenic attributions, and peer importance. Adolescents completed a second measure of depressive symptoms 17 months later. Results were consistent with integrated cognitive vulnerability-stress and cognitive dissonance models, particularly for girls. Specifically, peer rejection was a significant prospective predictor of depressive symptoms when combined with high levels of importance ascribed to peer status and high levels of adolescents' depressogenic attributional styles.