Refining the Candidate Environment: Interpersonal Stress, the Serotonin Transporter Polymorphism, and Gene-Environment Interactions in Major Depression

Family dysfunction, stressful life events, and mental health problems across development in the offspring of parents with an affective disorder

BACKGROUND

Offspring of parents with affective disorders (OAD) are at risk of developing a wide range of mental disorders. Deficits in the rearing environment and high levels of stress are well-known risk factors for negative outcomes in OAD. Building on prior research, we aim to examine the longitudinal relationships between family dysfunction, stressful life events, and mental health in OAD and control offspring of parents with no affective disorder. In the present study, we hypothesized that high levels of family dysfunction would be associated with more internalizing and externalizing problems across time in OAD than in controls, and that family dysfunction would mediate the relationship between stressful life events in adolescence and poor mental health in adulthood, particularly in OAD.

METHODS

As part of the TRacking Adolescents' Lives Survey (TRAILS), 2230 participants (51% female, Mage = 11.1 years, SD = 0.6, at baseline) and their parents completed measures across six time points, spanning 15 years. Mental health, family dysfunction, and stressful life events were assessed with the Youth and Adult Self-Report, Family Assessment Device, and an in-house measure, respectively.

RESULTS

Multi-group structured equation modeling revealed that family dysfunction was linked to internalizing and externalizing problems in OAD, but not controls, across time. Risk status did not moderate family dysfunction's mediation of the relationship between stressful life events and negative outcomes in adulthood.

CONCLUSIONS

OAD show high sensitivity to dysfunction in the rearing environment across childhood and adolescence, which supports the use of family based interventions to prevent the development of mental disorders in high-risk youth.

The effects of childhood maltreatment, recent interpersonal and noninterpersonal stress, and HPA-axis multilocus genetic variation on prospective changes in adolescent depressive symptoms: A multiwave longitudinal study

Based on a multiwave, two-year prospective design, this study is the first to examine the extent to which multilocus hypothalamic-pituitary-adrenal axis (HPA axis)-related genetic variants, childhood maltreatment, and recent stress jointly predicted prospective changes in adolescent depressive symptoms. A theory-driven multilocus genetic profile score (MGPS) was calculated to combine the effects of six common polymorphisms within HPA-axis related genes (CRHR1, NR3C1, NR3C2, FKBP5, COMT, and HTR1A) in a sample of Chinese Han adolescents (N = 827; 50.2% boys; Mage = 16.45 ± 1.36 years). The results showed that the three-way interaction of HPA-axis related MGPS, childhood maltreatment and recent interpersonal, but not noninterpersonal, stress significantly predicted prospective changes in adolescent depressive symptoms. For adolescents with high but not low HPA-axis related MGPS, exposure to severe childhood maltreatment predisposed individuals more vulnerable to recent interpersonal stress, exhibiting greater prospective changes in adolescent depressive symptoms. The findings provide preliminary evidence for the cumulative risk mechanism regarding gene-by-environment-by-environment (G × E1 × E2) interactions that underlie the longitudinal development of adolescent depressive symptoms and show effects specific to interpersonal stress.

Effects of serotonin transporter and receptor polymorphisms on depression

INTRODUCTION

Serotonin is highly implicated in the regulation of emotional state and the execution of cognitive tasks, so much so that the serotonin transporter genes (5-HTT, SLC6A4) and the serotonin receptor genes (HTR1A, HTR1B, HTR2A) have become the perfect candidates when studying the effects that these genes and their polymorphic variations have on depression characteristics.

OBJECTIVE

A review of research reports that have studied the effects of variations in the serotonin transporter and receptor genes on different clinical features of depression.

METHODS

A search of the Scopus, Web of Science and PubMed databases was conducted using the keywords ("depression" AND "polymorphism").

CONCLUSIONS

According to the review of 54 articles, the short allele of the 5-HTTLPR polymorphism was found to be the most reported risk factor related to the development of depression and its severity. Variations in the genes studied (SLC6A4, HTR1A, HTR2A) can generate morphological alterations of brain structures.

Positive and Negative Life Events in Association with Psychopathology: An Examination of Sex Differences in Early Adolescence

Negative life events (NLEs) are associated with psychopathology in older adolescents and adults, particularly for women. However, less is known about the association between positive life events (PLEs) and psychopathology. This study examined associations between NLEs, PLEs, and their interaction, and sex differences in associations between PLEs and NLEs on internalizing and externalizing psychopathology. Youth completed interviews about NLEs and PLEs. Parents and youth reported on youth internalizing and externalizing symptoms. NLEs were positively associated with youth-reported depression and anxiety and parent-reported youth depression. Female youth had stronger positive associations between NLEs and youth-reported anxiety than male youth. Interactions between PLEs and NLEs were non-significant. Findings for NLEs and psychopathology are extended to earlier in development.

Chronic restraint stress-induced depression-like behavior is mediated by upregulation of melanopsin expression in C57BL/6 mice retina

BACKGROUND

Depression is associated with circadian disturbances in which melanopsin was a key mechanism. Further studies have demonstrated that melanopsin gene variations are associated with some depressive disorders and aberrant light can impair mood through melanopsin-expressing retinal ganglion cells (mRGCs). The goal of this study was to explore the direct relationship between depression and melanopsin.

METHODS

Adult C57BL/6 male mice were physically restrained for 16 h in a 50-ml polypropylene centrifuge tube and all behavioral tests were performed after CRS treatment. Western blot analysis and immunofluorescence were used to detect melanopsin expression in the retina of C57BL/6 mice. And we observed the change of the electrophysiological function and release of glutamate of mRGCs.

RESULTS

The melanopsin expression upregulate in mRGCs of chronic restraint stress (CRS)-treating mice which exhibit depression-like behavior. The frequency of blue light-induced action potentials and light-induced glutamate release mediated by melanopsin also increase significantly. This change of melanopsin is mediated by the CRS-induced glucocorticoid.

CONCLUSIONS

CRS may induce the depression-like behavior in mice via glucocorticoid-melanopsin pathway. Our findings provide a novel mechanistic link between CRS-induced depression and melanopsin in mice.

Additive serotonergic genetic sensitivity and cortisol reactivity to lab-based social evaluative stress: Influence of severity across two samples

Prior work demonstrates that an additive serotonergic multilocus genetic profile score (MGPS) predicts amplified risk for depression following significant life stress, and that it interacts with elevations in the cortisol awakening response to predict depression. The serotonin system and HPA-axis have bidirectional influence, but whether this MGPS predicts acute cortisol reactivity, which might then serve as a mechanism for depression, is unknown. Our prior work suggests that depression risk factors predict blunted cortisol reactivity to explicit negative evaluative lab-based stress. Thus, we hypothesized that a 4-variant serotonergic MGPS (three SNPs from the original 5-variant version plus 5HTTLPR) would predict blunted cortisol reactivity to explicit negative evaluative stress versus a control. In Sample 1, growth curve modeling showed that the MGPS predicted heightened cortisol reactivity (p = 0.0001) in an explicitly negative evaluative Trier Social Stress Test variant (TSST) versus a control condition among non-depressed emerging adults (N = 152; 57% female). In Sample 2, 125 males completed the Socially Evaluative Cold Pressor Test (SECPT), an ambiguously negative evaluative manipulation; findings displayed a similar pattern but did not reach statistical significance (ps.075-.091). A participant-level meta-analysis of the two samples demonstrated a significant effect of negative evaluation severity, such that the MGPS effect size on reactivity increased linearly from control to SECPT to an explicitly negative evaluative TSST. Findings indicate that this MGPS contributes to sensitivity to social threat and that cortisol dysregulation in the context of social stress may be one mechanism by which this MGPS contributes to depression.

Effects of Serotonin Transporter and Receptor Polymorphisms on Depression

INTRODUCTION

Serotonin is highly implicated in the regulation of emotional state and the execution of cognitive tasks, so much so that the serotonin transporter genes (5-HTT, SLC6A4) and the serotonin receptor genes (HTR1A, HTR1B, HTR2A) have become the perfect candidates when studying the effects that these genes and their polymorphic variations have on depression characteristics.

OBJECTIVE

A review of research reports that have studied the effects of variations in the serotonin transporter and receptor genes on different clinical features of depression.

METHODS

A search of the Scopus, Web of Science and PubMed databases was conducted using the keywords ("depression" AND "polymorphism").

CONCLUSIONS

According to the review of 54 articles, the short allele of the 5-HTTLPR polymorphism was found to be the most reported risk factor related to the development of depression and its severity. Variations in the genes studied (SLC6A4, HTR1A, HTR2A) can generate morphological alterations of brain structures.

The Interplay of Chronic Interpersonal Stress and Rumination on Nonsuicidal Self-Injury in Youth

Nonsuicidal self-injury (NSSI) describes deliberate self-destructive behaviors without the intention to die. Little is known about what factors contribute to NSSI especially among youth. The current study tested two conceptual models for how chronic interpersonal stress and rumination may contribute to NSSI engagement across 18 months in a community sample of youth: (1) a mediation pathway based on the Emotional Cascade Model (i.e., stress contributes to rumination and then to subsequent NSSI), and (2) a moderation model based on the cognitive vulnerability-stress framework (i.e., rumination moderates the relation between stress and NSSI). 516 youth aged 7-16 (M_age = 12.0; 56% female; 90% Non-Hispanic or Non-Latinx) reported on ongoing interpersonal stress occurring between T1-T2 (every 6 months from T1 to 12 months) via the Youth Life Stress Interview, rumination via the Children's Response Styles Questionnaire (at T1 and 18 months later, T2), and NSSI engagement every six months from 18 to 36 months (T2-T3) via the Self-Injurious Thoughts and Behaviors Interview. Interpersonal stress predicted later rumination (b = .43, p < .01), rumination forecasted later NSSI occurrence (OR = 1.06, p < .01), and mediation was supported via a significant indirect effect of interpersonal stress on NSSI through rumination (b = .03, 95% CI = .01, .07). Rumination did not significantly moderate the relation between stress and NSSI. The prospective relation between chronic interpersonal stress and NSSI engagement was partly explained by rumination, aligning with the Emotional Cascade Model's prediction that rumination contributes to NSSI. Youth may conduct NSSI to interrupt rumination elicited by chronic interpersonal stress.

Stress and Psychological Distress in Emerging Adulthood: A Gender Analysis

Emerging adulthood is a critical period of life that entails many life transitions in living arrangements, relationships, education and employment, which can generate stress and psychological distress in the emerging adult. The aim of the present study was to assess the relevance of stress, coping styles, self-esteem and perceived social support in the distress of emerging adult women and men. The sample consists of 4816 people (50% females) from the Spanish general population, ranging in age from 18 to 29 years old. All participants were assessed through questionnaires and scales that assess psychological distress, stress, coping styles, self-esteem and social support. Women scored higher than men in psychological distress, chronic stress, minor daily hassles, emotional coping style and social support, whereas men scored higher than women in rational and detachment coping styles and in self-esteem. Psychological distress was significantly predicted in women and men by high emotional coping style, lower self-esteem, high number of life events, and less social support. Another statistically significant predictor in men was less detachment coping style, whereas in women it was high chronic stress. The results of this research are relevant to healthcare professionals interested in improving the mental health of the emerging adult.

Five-year prospective neuroticism-stress effects on major depressive episodes: Primarily additive effects of the general neuroticism factor and stress

The past decades of research on predictors of depression have frequently emphasized interactive diathesis-stress questions: What kinds of vulnerabilities under stressful circumstances increase risk of developing depression? This study addresses 3 theoretically important gaps in our knowledge regarding diathesis-stress models of depression: the role of temperament (neuroticism), interactive versus additive effects of neuroticism-stress relationships, and effects of stressor characteristics (acute vs. chronic, major vs. minor events, interpersonal vs. noninterpersonal content). We addressed these gaps in the prediction of major depressive episodes (MDEs) in a sample of high schoolers (n = 559) oversampled for high neuroticism and assessed for presence of MDEs annually for 5 years. Survival analyses provided relatively consistent support for the main effects of the broad vulnerability factor of the general neuroticism factor, acute stressors, and chronic stressors in the prediction of MDEs. In contrast, the majority of our analyses failed to support interactive neuroticism-stress accounts of MDE risk. Integrating our results with the extant literature reinforces the notion that both the general neuroticism factor and stress prospectively predict depressive disorders and highlight that their main effects are significantly larger than their interaction. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Stress sensitization to depression following childhood adversity: Moderation by HPA axis and serotonergic multilocus profile scores

Childhood adversity appears to sensitize youth to stress, increasing depression risk following stressful life events occurring throughout the lifespan. Some evidence suggests hypothalamic-pituitary-adrenal (HPA) axis-related and serotonergic genetic variation moderates this effect, in a "gene-by-environment-by-environment" interaction (G × E × E). However, prior research has tested single genetic variants, limiting power. The current study uses a multilocus genetic profile score (MGPS) approach to capture polygenic risk relevant to HPA axis and serotonergic functioning. Adolescents (N = 241, Mage = 15.90) completed contextual-threat-based interviews assessing childhood adversity and acute life events, and diagnostic interviews assessing depression. Established MGPSs indexed genetic variation linked to HPA axis (10 single nucleotide polymorphisms [SNPs]) and serotonergic (five SNPs) functioning. Results showed significant MGPS × Childhood Adversity × Recent Life Stress interactions predicting depression for both HPA axis and serotonergic MGPSs, with both risk scores predicting stronger Childhood Adversity × Recent Stress interactions. Serotonergic genetic risk specifically predicted sensitization to major interpersonal stressors. The serotonergic MGPS G × E × E was re-tested in an independent replication sample of early adolescent girls, with comparable results. Findings support the notion that genetic variation linked to these two neurobiological symptoms alters stress sensitization, and that gene-by-environment (G × E) interactions may be qualified by environmental exposures occurring at different points in development.

Parental Depressive Symptoms Potentiate the Effect of Youth Negative Mood Symptoms on Gene Expression in Children with Asthma

Depressive symptoms in parents and in youths have been found to relate to disease comorbidity processes in children, including greater disease-related impairment and poorer clinical outcomes. The current study sought to assess whether coming from a family characterized by more depressive symptoms on average would potentiate the effects of changes in youths' own negative mood on the expression of two receptor genes relevant to asthma that are the primary targets of asthma medication, such that the combination of low child negative mood in the context of greater parental depressive symptoms would relate to the lowest levels of gene expression. One-hundred-twenty youths with diagnosed asthma and their parents participated every 6 months for 2 years. Parents reported on their depressive symptoms, children reported negative mood symptoms, and youths completed blood draws from which expression of Glucocorticoid Receptor (GR) and Beta2 Adrenergic Receptor (β₂-AR) genes was extracted. Multilevel linear modeling revealed significant interactions between average levels of parental depressive symptoms and changes in youths' negative mood symptoms predicting gene expression, such that youths expressed significantly less GR and β₂-AR during times when they experienced more negative mood symptoms, but this was only true if they came from families with higher levels of average parental depressive symptoms. The current study identifies novel and biologically-proximal molecular signaling patterns that connect depressive symptoms to pediatric asthma while also highlighting the important role of family environment for biological processes that may operate within depression comorbidity.

Serotonergic multilocus genetic variation moderates the association between major interpersonal stress and adolescent depressive symptoms: Replication and candidate environment specification

Serotonin-linked genetic risk and stressful life event (SLE) interaction research has been criticized for using single genetic variants with inconsistent replicability. A recent study showed that a multilocus genetic profile score (MGPS) capturing additive risk from five serotonin-linked polymorphisms moderated the association between major interpersonal SLEs and depression, but no subsequent replication attempts have been reported. Moreover, major interpersonal SLEs have been suggested as "candidate environments" for this MGPS, but it has never been demonstrated that gene-environment interactions (G × Es) for major interpersonal SLEs are significantly stronger than for other contexts. Adolescents (N = 241) completed contextual-threat life stress interviews and clinical interviews assessing depressive symptoms, and provided DNA. MGPS intensified the major interpersonal stress-depression association; the interaction accounted for 4% of depressive symptom variance. Genetic moderation was statistically unique to major interpersonal stress versus other environments. Extending previous findings, results support an MGPS approach and underscore the cruciality of the G × E candidate environment.

The cortisol awakening response (CAR) interacts with acute interpersonal stress to prospectively predict depressive symptoms among early adolescent girls

The cortisol awakening response (CAR) has been shown to prospectively predict depression, but it remains unresolved whether a greater CAR predicts risk independently of subsequent acute stress, or whether greater CAR indicates increased vulnerability to subsequent acute stress. Further, no prior work has evaluated whether the CAR increases vulnerability to certain types of acute stress, but not others, in predicting depression. To address these gaps, we investigated whether the CAR predicted depressive symptoms alone and in interaction with acute interpersonal stress in a one-year longitudinal study of 86 early adolescent girls with no history of diagnosable depression. To index the CAR, adolescents collected saliva at waking and 30-minutes past waking for 3 days; compliance with the sampling protocol was electronically monitored. Diagnostic and objective contextual stress interviews were used to quantify acute stress in the 2-months prior to worst depressive symptom onset during the follow-up. Supporting hypotheses, results indicated that greater CAR predicted greater depressive symptoms, and interacted with acute interpersonal stress in predicting depressive symptoms. Further, the CAR interacted with acute dependent (i.e., at least partially arising from the person's behavior) interpersonal stress in predicting depressive symptoms. In contrast, the CAR did not interact with acute non-interpersonal stress nor acute interpersonal independent (i.e., fateful) stress in predicting depressive symptoms. These results further refine circumstances in which the CAR is predictive of depressive symptoms among early adolescent girls, and highlight the importance of focusing on etiologically relevant stress when testing interactions between physiological stress indicators and environmental stress.

Cortisol awakening response and additive serotonergic genetic risk interactively predict depression in two samples: The 2019 Donald F. Klein Early Career Investigator Award Paper

BACKGROUND

The serotonin system and hypothalamic pituitary-adrenal (HPA)-axis are each implicated in the pathway to depression; human and animal research support these systems' cross-talk. Our work implicates a 5-variant additive serotoninergic multilocus genetic profile score (MGPS) and separately the cortisol awakening response (CAR) in the prospective prediction of depression; other work has shown that the serotonin transporter polymorphism 5HTTLPR predicts CAR and interacts with the CAR to predict depression.

METHODS

We tested the hypothesis that a 6-variant MGPS (original plus 5HTTLPR) would interact with CAR to predict prospective depressive episode onsets in 201 emerging adults using four annual follow-up interviews. We also tested whether MGPS predicted CAR. We attempted replication of significant findings in a sample of 77 early adolescents predicting depression symptoms.

RESULTS

In sample 1, MGPS did not significantly predict CAR. MGPS interacted with CAR to predict depressive episodes; CAR slopes for depression steepened as MGPS increased, for risk or protection. No single variant accounted for results, though CAR's interactions with 5HTTLPR and the original MGPS were both significant. In sample 2, the 6-variant MGPS significantly interacted with CAR to predict depression symptoms.

CONCLUSIONS

Higher serotonergic MGPS appears to sensitize individuals to CAR level-for better and worse-in predicting depression.

Prospective Relations between Parents' Depressive Symptoms and Children's Attributional Style

Children of parents with depression are at increased risk for developing psychopathology. The purpose of the current longitudinal study was to examine the dynamic relations between parents' depressive symptoms and children's cognitions, specifically their attributions for the causes of life events. Participants were 227 parent-child dyads with one parent (M_age = 42.19, SD = 6.82; 76% female) and one child (M_age = 12.53, SD = 2.33; 53% female) per family. Parents either were diagnosed with a current major depressive disorder (n= 129; 72.9% female) or were lifetime-free of mood disorders (n= 98; 79.6% female). The Beck Depression Inventory-II was used to obtain a dimensional measure of parents' depressive symptoms, and the Children's Attributional Style Questionnaire-Revised was used to assess children's attributions of negative and positive events. Evaluations were conducted 5 times across 22 months. We used latent difference score (LDS) modeling to examine the relations between changes in parents' depressive symptoms and changes in children's attributional style over time. The final model provided a close fit to the data: χ²(30) = 35.22, p = .24; comparative fit index = .995, root mean square error of approximation = .028, 90% confidence interval (CI) [.000, .060], standardized root mean square residual = .024. Parents' levels of depressive symptoms significantly predicted the worsening of children's attributions (i.e., becoming more pessimistic) over the 22 months, whereas children's attributions did not significantly predict changes in parents' depressive symptoms at the next time point. Preventive interventions should aim to both reduce parents' depression and teach children strategies for examining the accuracy of their beliefs regarding the causes of life events.

HPA-axis multilocus genetic variation moderates associations between environmental stress and depressive symptoms among adolescents

Research suggests that genetic variants linked to hypothalamic-pituitary-adrenal (HPA)-axis functioning moderate the association between environmental stressors and depression, but examining gene–environment interactions with single polymorphisms limits power. The current study used a multilocus genetic profile score (MGPS) approach to measuring HPA-axis–related genetic variation and examined interactions with acute stress, chronic stress, and childhood adversity (assessed using contextual threat interview methods) with depressive symptoms as outcomes in an adolescent sample (ages 14–17, N = 241; White subsample n = 192). Additive MGPSs were calculated using 10 single nucleotide polymorphisms within HPA-axis genes (CRHR1, NR3C2, NR3C1, FKBP5). Higher MGPS directly correlated with adolescent depressive symptoms. Moreover, MGPS predicted stronger associations between acute and chronic stress and adolescent depressive symptoms and also moderated the effect of interpersonal, but not noninterpersonal, childhood adversity. Gene–environment interactions individually accounted for 5%–8% of depressive symptom variation. All results were retained following multiple test correction and stratification by race. Results suggest that using MGPSs provides substantial power to examine gene–environmental interactions linked to affective outcomes among adolescents.

The Development of Latent Dimensions of Psychopathology across Early Childhood: Stability of Dimensions and Moderators of Change

Recent research has described the structure of psychopathology as including one general and multiple specific factors, and this structure has been found in samples across development. However, little work has examined whether this structure is consistent across time, particularly in young children, within the same sample. Further, few studies have examined factors that influence the magnitude of the stability of latent dimensions of psychopathology. In the present study, we examine these issues in a community sample of 545 children assessed at ages 3 and 6. In addition, we explored child temperament, parental history of psychopathology, and parenting behaviors as potential moderators of the longitudinal stability of latent dimensions of psychopathology. We found that the same bifactor model structure identified at age 3 provided an adequate fit to the data at age 6. Further, our model revealed significant homotypic stability of the general, internalizing, and externalizing specific factors. We also found evidence of differentiation of psychopathology over time with the general factor at age 3 predicting the externalizing factor at age 6. However, we failed to identify moderators of the longitudinal associations between psychopathology latent factors. Overall, our results bolster support for the bifactor structure of psychopathology, particularly in early childhood.

Cultural Genomics: Promises and Challenges

In this article, we attempt to integrate recent advances in our understanding of the relations between culture and genes into an emerging field—cultural genomics—and discuss its promises and theoretical and methodological challenges. We first provide a brief review of previous conceptualizations about the relations between culture and genes and then argue that recent advances in molecular evolution research has allowed us to reframe the discussion away from parallel genetic and cultural evolution to focus on the interactions between the two. After outlining the key issues involved in cultural genomics (unit of analysis, timescale, mechanisms, and direction of influence), we provide examples of research for the different levels of interactions between culture and genes. We then discuss ideological, theoretical, and methodological challenges in cultural genomics and propose tentative solutions.

Trait rumination and response to negative evaluative lab-induced stress: neuroendocrine, affective, and cognitive outcomes

Theoretical models of depression posit that, under stress, elevated trait rumination predicts more pronounced or prolonged negative affective and neuroendocrine responses, and that trait rumination hampers removing irrelevant negative information from working memory. We examined several gaps regarding these models in the context of lab-induced stress. Non-depressed undergraduates completed a rumination questionnaire and either a negative-evaluative Trier Social Stress Test (n = 55) or a non-evaluative control condition (n = 69), followed by a modified Sternberg affective working memory task assessing the extent to which irrelevant negative information can be emptied from working memory. We measured shame, negative and positive affect, and salivary cortisol four times. Multilevel growth curve models showed rumination and stress interactively predicted cortisol reactivity; however, opposite predictions, greater rumination was associated with blunted cortisol reactivity to stress. Elevated trait rumination interacted with stress to predict augmented shame reactivity. Rumination and stress did not significantly interact to predict working memory performance, but under control conditions, rumination predicted greater difficulty updating working memory. Results support a vulnerability-stress model of trait rumination with heightened shame reactivity and cortisol dysregulation rather than hyper-reactivity in non-depressed emerging adults, but we cannot provide evidence that working memory processes are critical immediately following acute stress.

Honoring the Past, Envisioning the Future: ABCT's 50th Anniversary Presidential Address

The theme of the Association for Behavioral and Cognitive Therapies (ABCT) 50^th Anniversary was to honor the past and envision the future. From the wisdom, foresight, and determination of the pioneers of our organization, and the continuous upholding of the scientific method over the last 50 years, cognitive behavioral therapy (CBT) has become the most empirically supported psychological treatment for a wide array of mental health problems. Yet, we still have a long way to go. This address outlines a vision for the future of CBT, which involves greater collaborative science, with all minds working together on the same problem, and greater attention to the risk factors and critical processes that underlie psychopathology and explain treatment change. Such knowledge generation can inform the development of new, more efficient and more effective therapies that are tailored with more precision to the needs of each person. Latest technologies provide tools for a precision focus while at the same time increasing the reach of our treatments to the many for whom traditional therapies are unavailable. Our impact will be greatly enhanced by large samples with common methods and measures that inform a precision approach. We have come a long way since ABCT was founded in 1966, and we are poised to make even larger strides in our mission to enhance health and well-being by harnessing science, our major guiding principle.

Gene-environment interactions between stress and 5-HTTLPR in depression: A meta-analytic update

BACKGROUND

Meta-analyses have yielded contradictory findings concerning the role of 5-HTTLPR in interaction with stress (GxE) in depression. The current meta-analysis investigates if these contradictory findings are a result of differences between studies in methodological approaches towards the assessment of stress and depression.

METHODS

After performing a systematic database search (February to December 2016), first, a meta-analysis was used to investigate the total effect size and publication bias. Second, stratified meta-analyses were used to investigate the potential moderating influence of different methodological approaches on heterogeneity of study findings. Third, a meta-regression was used to investigate the combined influence of the methodological approaches on the overall effect size.

RESULTS

Results showed a small but significant effect of 5-HTTLPR in interaction with stress in the prediction of depression (OR[95%CI] = 1.18[1.09; 1.28], n = 48 effect sizes from 51 studies, totaling 51,449 participants). There was no evidence of publication bias. Heterogeneity of effect sizes was a result of outliers and not due to different methodological approaches towards the assessment of stress and depression. Yet, there was some evidence that studies adopting a categorical and interview approach to the assessment of stress report higher GxE effects, but further replication of this finding is needed.

LIMITATIONS

A large amount of heterogeneity (i.e., 46%) was not explained by the methodological factors included in the study and there was a low response rate of invited studies.

CONCLUSIONS

The current meta-analysis provides new evidence for the robustness of the interaction between stress and 5-HTTLPR in depression.

Translational Functional Neuroimaging in the Explanation of Depression

Translation as a notion and procedure is deeply embodied in medical science and education. Translation includes the possibility to translate data across disciplines to improve diagnosis and treatment procedures. The evidence accumulated using translation serves as a vehicle for reification of medical diagnoses. There are promising, established post hoc correlations between the different types of clinical tools (interviews and inventories) and neuroscience. The various measures represent statistical correlations that must now be integrated into diagnostic standards and procedures but this, as a whole, is a step forward towards a better understanding of the mechanisms underlying psychopathology in general and depression in particular. Here, we focus on functional magnetic resonance imaging studies using a trans-disciplinary approach and attempt to establish bridges between the different fields. We will selectively highlight research areas such as imaging genetics, imaging immunology and multimodal imaging, as related to the diagnosis and management of depression.

Additive genetic risk from five serotonin system polymorphisms interacts with interpersonal stress to predict depression

Behavioral genetic research supports polygenic models of depression in which many genetic variations each contribute a small amount of risk, and prevailing diathesis-stress models suggest gene-environment interactions (G×E). Multilocus profile scores of additive risk offer an approach that is consistent with polygenic models of depression risk. In a first demonstration of this approach in a G×E predicting depression, we created an additive multilocus profile score from 5 serotonin system polymorphisms (1 each in the genes HTR1A, HTR2A, HTR2C, and 2 in TPH2). Analyses focused on 2 forms of interpersonal stress as environmental risk factors. Using 5 years of longitudinal diagnostic and life stress interviews from 387 emerging young adults in the Youth Emotion Project, survival analyses show that this multilocus profile score interacts with major interpersonal stressful life events to predict major depressive episode onsets (hazard ratio [HR] = 1.815, p = .007). Simultaneously, there was a significant protective effect of the profile score without a recent event (HR = 0.83, p = .030). The G×E effect with interpersonal chronic stress was not significant (HR = 1.15, p = .165). Finally, effect sizes for genetic factors examined ignoring stress suggested such an approach could lead to overlooking or misinterpreting genetic effects. Both the G×E effect and the protective simple main effect were replicated in a sample of early adolescent girls (N = 105). We discuss potential benefits of the multilocus genetic profile score approach and caveats for future research.

Future Research Directions in the Positive Valence Systems: Measurement, Development, and Implications for Youth Unipolar Depression

The Positive Valence Systems (PVS) have been introduced by the National Institute of Mental Health as a domain to help organize multiple constructs focusing on reward-seeking behaviors. However, the initial working model for this domain is strongly influenced by adult constructs and measures. Thus, the present review focuses on extending the PVS into a developmental context. Specifically, the review provides some hypotheses about the structure of the PVS, how PVS components may change throughout development, how family history of depression may influence PVS development, and potential means of intervening on PVS function to reduce onsets of depression. Future research needs in each of these areas are highlighted.

Gene-Environment Interplay in the Context of Romantic Relationships

A growing body of research supports an important role for genetic factors on intimate, romantic relationships. In this article, we review research that has examined the interplay between genetic and environmental influences on romantic relationships and the associations between relationship outcomes and important individual differences related to relationships. We first elaborate on how behavioral genetic and molecular genetic methods can be used to understand the etiology of relationship outcomes. We then review empirical studies that have examined gene-environment correlations and gene-by-environment interactions in predicting romantic relationship outcomes (e.g., relationship formation, relationship quality and functioning, relationship dissolution) and their association with the physical health, mental health, and well-being of relationship partners.

Testing Specificity: Associations of Stress and Coping with Symptoms of Anxiety and Depression in Youth

Research has documented the co-occurrence of symptoms of anxiety and depression across the lifespan, suggesting that these symptoms share common correlates and etiology. The present study aimed to examine potential specific and/or transdiagnostic correlates of symptoms of anxiety and depression in at-risk youth. The present study examined youth stress associated with parental depression and youth coping as potential correlates of symptoms of anxiety and depression in a sample of children of depressed parents. One hundred eighty parents with a history of depression and their children ages 9-15 completed measures assessing youths' stress associated with parental depression (RSQ), symptoms of anxiety and depression (YSR and CBCL), and coping (RSQ). The results support the hypothesis that secondary control coping is a transdiagnostic correlate of symptoms of anxiety and depression in youth. Youth stress related to parental depression and primary control coping were specific correlates of youth depressive symptoms and not anxiety symptoms. Disengagement coping was not a significant correlate of symptoms of anxiety or depression in youth. Results suggest that there are both transdiagnostic and specific correlates of symptoms of anxiety and depression in youth. The current study provides evidence to suggest specific types of stress and strategies to cope with this stress demonstrate specificity to symptoms of anxiety and depression in high-risk offspring of depressed parents. These findings highlight the importance of understanding the relationship between stress, coping, and symptoms to inform prevention and treatment research.

Interaction of CD38 Variant and Chronic Interpersonal Stress Prospectively Predicts Social Anxiety and Depression Symptoms Over Six Years

Variation in the CD38 gene, which regulates secretion of the neuropeptide oxytocin, has been associated with several social phenotypes. Specifically, rs3796863 A allele carriers have demonstrated increased social sensitivity. In 400 older adolescents, we used trait-state-occasion modeling to investigate how rs3796863 genotype, baseline ratings of chronic interpersonal stress, and their gene-environment (GxE) interaction predicted trait social anxiety and depression symptoms over six years. We found significant GxE effects for CD38 A-carrier genotypes and chronic interpersonal stress at baseline predicting greater social anxiety and depression symptoms. A significant GxE effect of smaller magnitude was also found for C/C genotype and chronic interpersonal stress predicting greater depression; however, this effect was small compared to the main effect of chronic interpersonal stress. Thus, in the context of chronic interpersonal stress, heightened social sensitivity associated with the rs3796863 A allele may prospectively predict risk for social anxiety and (to a lesser extent) depression.

Depression from childhood into late adolescence: Influence of gender, development, genetic susceptibility, and peer stress

Depression is a debilitating mental illness with clear developmental patterns from childhood through late adolescence. Here, we present data from the Gene Environment Mood (GEM) study, which used an accelerated longitudinal cohort design with youth (N = 665) starting in 3rd, 6th, and 9th grades, and a caretaker, who were recruited from the general community, and were then assessed repeatedly through semistructured diagnostic interviews every 6 months over 3 years (7 waves of data) to establish and then predict trajectories of depression from age 8 to 18. First, we demonstrated that overall prevalence rates of depression over time, by age, gender, and pubertal status, in the GEM study closely match those trajectories previously obtained in past developmental epidemiological research. Second, we tested whether a genetic vulnerability-stress model involving 5-HTTLPR and chronic peer stress was moderated by developmental factors. Results showed that older aged adolescents with SS/SL genotype, who experienced higher peer chronic stress over 3 years, were the most likely to be diagnosed with a depressive episode over time. Girls experiencing greater peer chronic stress were the most likely to develop depression. This study used repeated assessments of diagnostic interviewing in a moderately large sample of youth over 3 years to show that depression rates increase in middle to late adolescence, or postpubertally, and that the gender difference in depression emerges earlier in adolescence (age 12.5), or postpubertally. Additionally, genetically susceptible older adolescents who experience chronic peer stress were the most likely to become depressed over time.

Chronic and episodic interpersonal stress as statistically unique predictors of depression in two samples of emerging adults

Few studies comprehensively evaluate which types of life stress are most strongly associated with depressive episode onsets, over and above other forms of stress, and comparisons between acute and chronic stress are particularly lacking. Past research implicates major (moderate to severe) stressful life events (SLEs), and to a lesser extent, interpersonal forms of stress; research conflicts on whether dependent or independent SLEs are more potent, but theory favors dependent SLEs. The present study used 5 years of annual diagnostic and life stress interviews of chronic stress and SLEs from 2 separate samples (Sample 1 N = 432; Sample 2 N = 146) transitioning into emerging adulthood; 1 sample also collected early adversity interviews. Multivariate analyses simultaneously examined multiple forms of life stress to test hypotheses that all major SLEs, then particularly interpersonal forms of stress, and then dependent SLEs would contribute unique variance to major depressive episode (MDE) onsets. Person-month survival analysis consistently implicated chronic interpersonal stress and major interpersonal SLEs as statistically unique predictors of risk for MDE onset. In addition, follow-up analyses demonstrated temporal precedence for chronic stress; tested differences by gender; showed that recent chronic stress mediates the relationship between adolescent adversity and later MDE onsets; and revealed interactions of several forms of stress with socioeconomic status (SES). Specifically, as SES declined, there was an increasing role for noninterpersonal chronic stress and noninterpersonal major SLEs, coupled with a decreasing role for interpersonal chronic stress. Implications for future etiological research were discussed.

Depression from childhood through adolescence: Risk mechanisms across multiple systems and levels of analysis

This paper selectively reviews recent research, especially in the last two years (2012-2014) in preschool, child, and adolescent depression. In particular, attention is paid to developmental epidemiology as well as risk factors and processes that contribute to depression trajectories over time. Emphasis is placed on a developmental psychopathology perspective in which risks are instantiated across multiple systems and levels of analysis, including genetics, stress contexts and processes, biological stress mechanisms, temperament, emotion, reward, cognitive factors and processes, and interpersonal influences. These risks dynamically transact over time, as they emerge and stabilize into relatively trait-like vulnerabilities that confer risk for the increasing rates of depression observed in adolescence. Overall, this summary illustrates that considerable progress has been made recently in understanding the complex developmental processes contributing to depression. Finally, a few gaps are highlighted as opportunities for future research.

Impact of coping with interpersonal stress on the risk of depression in a Japanese sample: a focus on reassessing coping

Reassessing coping, a concept first proposed in Asia, refers to efforts to wait patiently for an appropriate opportunity to act or for a change or improvement in a situation, and can be observed in individuals facing stressful relationship events. The main purpose of the present study was to determine if reassessing coping would be associated with a lower risk of depression. The author examined the relationships between depression risk using the Center for Epidemiologic Studies Depression Scale (CES-D) and coping strategies for interpersonal stressors, including reassessing coping, in a sample of 1,912 Japanese college students. In our sample, the proportions of women and men with depressive symptoms were 55.28% (95% confidence intervals (CIs) [52.35, 58.20]) and 46.08% (95% CIs [42.63, 49.52]), respectively, using the conventional CES-D cut-off score of 16. A multivariate logistic regression analysis revealed that reassessing coping was significantly associated with a lower risk of depression (OR = 0.92, 95% CIs [0.89, 0.95]), after adjusting for gender. Distancing coping (strategies to actively damage, disrupt, or dissolve a stressful relationship) and constructive coping (strategies to improve, maintain, or sustain a relationship without irritating others) were significantly associated with a greater depression risk. Reassessing coping for interpersonal stressors was associated with a low risk of depression among Japanese college students.

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.

Serotonin promoter polymorphism (5-HTTLPR) predicts biased attention for emotion stimuli: Preliminary evidence of moderation by the social environment

A number of studies have found an association between attentional bias for negative stimuli and variation in the serotonin transporter promoter region polymorphism (5-HTTLPR). The current project examined whether a positive social environment mitigates this association. More specifically, we examined the relationship between attentional bias on the dot-probe task, variation in the 5-HTTLPR and current social support among a community sample of adults (N=216). Consistent with prior research, the S/L_G homozygotes were more likely than the other genotype groups to have a negative attention bias. However, social support moderated the association between 5-HTTLPR variation and attentional bias. The S/L_G homozygote group was particularly likely to exhibit greater attentional bias towards negative stimuli at low levels of social support. However, as social support improved, negative attention bias decreased. Findings suggest that supportive environments may attenuate genetic associations with negative attention bias.

Psychological distress following marital separation interacts with a polymorphism in the serotonin transporter gene to predict cardiac vagal control in the laboratory

Marital separation is linked to negative mental and physical health; however, the strength of this link may vary across people. This study examined changes in respiratory sinus arrhythmia (RSA), used to assess cardiac vagal control, in recently separated adults (N = 79; M time since separation = 3.5 months). When reflecting on the separation, self-reported psychological distress following the separation interacted with a polymorphism in the serotonin transporter gene (5-HTTLPR) and a relevant single nucleotide polymorphism (SNP), rs25531, to predict RSA. Among people reporting emotional difficulties after the separation, those who were homozygous for the short allele had lower RSA levels while reflecting on their relationship than other genotypes. The findings, although limited by the relatively small sample size, are discussed in terms of how higher-sensitivity genotypes may interact with psychological responses to stress to alter physiology.

Cortisol responses to chronic stress in adult macaques: moderation by a polymorphism in the serotonin transporter gene

Accumulating evidence has shown that a polymorphism in the promoter region of the serotonin transporter gene (5-HTTLPR) moderates the association between stress and depressive symptoms. However, the exact etiologies underlying this moderation are not well understood. Here it is reported that among adult female rhesus macaques, an orthologous polymorphism (rh5-HTTLPR) exerted an influence on cortisol responses to chronic stress. It was found that females with two copies of the short allele were associated with increased cortisol responses to chronic stress in comparison to their counterparts who have one or two copies of the long allele. In the absence of stress, no differences related to genotype were observed in these females. This genetic moderation was found without a genetic influence on exposure to stressful situations. Rather it was found to be a genetic modulation of cortisol responses to chronic stress. These findings indicate that the rh5-HTTLPR polymorphism is closely related to hypothalamus-pituitary-adrenal (HPA) axis reactivity, which may increase susceptibility to depression in females with low serotonin transporter efficiency and a history of stress.

Comparing chronic interpersonal and noninterpersonal stress domains as predictors of depression recurrence in emerging adults

Understanding how persistent interpersonal difficulties distinctly affect the course of major depressive disorder (MDD) during emerging adulthood is critical, given that early experiences impact future coping resources and functioning. Research on stress and MDD has mostly concentrated on stressful life events, while chronic stress largely has not been explored. The present study examined interpersonal (intimate relationship, close friendships, social life, family relationships) and noninterpersonal (academic, work, financial, personal health, and family members' health) domains of chronic stress as time-varying predictors of depressive recurrence in emerging adults. Baseline assessments identified previously depressed emerging adults (N = 119), who subsequently completed 6-month, 12-month and 18-month follow-up interviews to determine chronic stress experiences and onset of new major depressive episodes. Survival analyses indicated that time-varying total chronic stress and chronic interpersonal stress predicted higher risk for depression recurrence; however, chronic noninterpersonal stress was not associated with recurrence. Intimate relationship stress, close friendship stress, family relationship stress, personal health, and family members' health independently predicted MDD recurrence, over and above well-established depression risk factors of dysfunctional cognitions and personality disorder symptoms. Evidence that interpersonal stress could have substantial impact on course of depression is consistent with theories of emerging adulthood, a time when young people are individuating from the family and experiencing significant social transition.

Diurnal cortisol rhythms in youth from risky families: effects of cumulative risk exposure and variation in the serotonin transporter gene-linked polymorphic region (5-HTTLPR) [corrected]

Building on research on cumulative risk and psychopathology, this study examines how cumulative risk exposure is associated with altered diurnal cortisol rhythms in an ethnically diverse, low-income sample of youth. In addition, consistent with a diathesis-stress perspective, this study explores whether the effect of environmental risk is moderated by allelic variation in the promoter region of the serotonin transporter gene-linked polymorphic region (5-HTTLPR). Results show that youth with greater cumulative risk exposure had flatter diurnal cortisol slopes, regardless of 5-HTTLPR genotype. However, the association of cumulative risk with average cortisol output (area under the curve [AUC]) was moderated by the 5-HTTLPR genotype. Among youth homozygous for the long allele, greater cumulative risk exposure was associated with lower cortisol AUC, driven by significant reductions in cortisol levels at waking. In contrast, there was a trend-level association between greater cumulative risk and higher cortisol AUC among youth carrying the short allele, driven by a trend-level increase in bedtime cortisol levels. Findings are discussed with regard to the relevance of dysregulated diurnal cortisol rhythms for the development of psychopathology and the implications of genetically mediated differences in psychophysiological adaptations to stress.