Early life stress is associated with youth-onset depression for some types of stress but not others

July 15, 2020

Science Daily/Elsevier

A study in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), published by Elsevier, reports that individuals exposed to early life stress (ELS) were more likely to develop a major depressive disorder (MDD) in childhood or adolescence than individuals who had not been exposed to ELS.

Examining the association between eight different types of ELS and youth-onset depression, the authors found that while some types of ELS (e.g., poverty) were not associated with MDD, other types of stress, including emotional abuse, were associated more strongly with MDD than a broader assessment of ELS.

"Researchers have documented that early life stress increases the risk for developing depression in adulthood. We wanted to know the degree to which it was associated with depression earlier in life -- specifically during childhood or adolescence," said lead author Joelle LeMoult, PhD, a researcher at the University of British Columbia, Vancouver, Canada. "Given that earlier onsets of depression often mean a more recurrent course across the lifespan. We found that exposure to early life stress more than doubled the likelihood someone will develop youth-onset depression.

"These findings indicate that there is a narrow window between adversity and depression during which we have the opportunity to intervene."

The findings are based on a meta-analysis of data from 62 journal articles and over 44,000 unique participants. Studies that assessed early life stress and the presence or absence of MDD before the age of 18 years were also included.

Compared to youth who were not exposed to ELS, youth who were exposed to ELS were 2.5 times more likely to develop MDD (OR=2.50; 95% CI [2.08, 3.00]).

The authors also conducted eight additional meta-analyses to examine the association between different types of ELS and a diagnosis of MDD during childhood or adolescence. Sexual abuse, physical abuse, death of a family member, domestic violence, and emotional abuse were associated with significantly higher risk for youth-onset MDD; in contrast, poverty, illness/injury, and exposure to a natural disaster were not.

Several variables moderated the association between ELS and youth-onset MDD. For example, studies that used interview-based assessments or included larger sample sizes reported stronger associations between ELS and depression.

Taken together, findings provide evidence that the adverse effects of ELS on risk for MDD manifests early in development, before adulthood, and varies by type of ELS. Further, findings support recommendations to use best-practice methods in early life stress research.

https://www.sciencedaily.com/releases/2020/07/200715142326.htm

People with anxiety may strategically choose worrying over relaxing

September 30, 2019

Science Daily/Penn State

Relaxing is supposed to be good for the body and soul, but people with anxiety may actively resist relaxation and continue worrying to avoid a large jump in anxiety if something bad does happen, according to Penn State research.

In a new study, the researchers found that people who were more sensitive to shifts in negative emotion -- quickly moving from a relaxed state to one of fear, for example -- were more likely to feel anxious while being led through relaxation exercises.

Michelle Newman, professor of psychology, said the results could help benefit people who experience "relaxation-induced anxiety," a phenomenon that occurs when people actually become more anxious during relaxation training.

"People may be staying anxious to prevent a large shift in anxiety, but it's actually healthier to let yourself experience those shifts," Newman said. "The more you do it, the more you realize you can do it and it's better to allow yourself to be relaxed at times. Mindfulness training and other interventions can help people let go and live in the moment."

Hanjoo Kim, a graduate student in psychology, said the study also sheds light on why relaxation treatments designed to help people feel better can potentially cause more anxiety.

"People who are more vulnerable to relaxation-induced anxiety are often the ones with anxiety disorders who may need relaxation more than others," Kim said. "And of course, these relaxation techniques were meant to help, not make someone more anxious. Our findings will hopefully serve as a cornerstone for providing better care for these populations."

Newman said that while researchers have known about relaxation-induced anxiety since the 1980s, the specific cause of this phenomenon has remained unknown. When Newman developed the contrast avoidance theory in 2011, she thought the two concepts might be connected.

"The theory revolves around the idea that people may make themselves anxious intentionally as a way to avoid the letdown they might get if something bad were to happen," Newman said. "This isn't actually helpful and just makes you more miserable. But, because most of the things we worry about don't end up happening, what's reinforced in the brain is, 'I worried and it didn't happen so I should continue worrying.'"

For this study, the researchers recruited 96 college students. Participants included 32 people with generalized anxiety disorder, 34 people with major depressive disorder and 30 controls with neither disorder.

When the participants arrived at the lab, the researchers led them through relaxation exercises before having them watch videos that may elicit fear or sadness. The participants then answered a list of questions designed to measure how sensitive they were to changes in their emotional state. For example, some people may be uncomfortable with the negative emotions incited by the videos right after relaxing, while others might find the relaxation session helpful in dealing with those emotions.

Next, the researchers led the participants through a relaxation session once more before having them fill out a second survey. These questions were designed to measure the participants' anxiety during the second relaxation session.

After analyzing the data, the researchers found that people with generalized anxiety disorder were more likely to be sensitive to sharp spikes in emotion, like going from feeling relaxed to feeling scared or stressed. Additionally, this sensitivity was linked to feeling anxious during sessions intended to induce relaxation.

The researchers found similar results in people with major depressive disorder, although the effect wasn't as strong.

Kim said he hopes the results -- recently published in the Journal of Affective Disorders -- may help clinicians provide better care for people with anxiety.

"Measuring relaxation-induced anxiety and implementing exposure techniques targeting the desensitization of negative contrast sensitivity may help patients reduce this anxiety," Kim said. "Also, it would be important to examine relaxation-induced anxiety in other disorders, such as panic disorder and persistent mild depression."

https://www.sciencedaily.com/releases/2019/09/190930114737.htm

Childhood trauma has lasting effect on brain connectivity in patients with depression

April 8, 2019

Science Daily/University of Pennsylvania School of Medicine

A study lead by Penn Medicine researchers found that childhood trauma is linked to abnormal connectivity in the brain in adults with major depressive disorder (MDD). The paper, published this week in Proceedings of the National Academy of Sciences (PNAS), is the first data-driven study to show symptom-specific, system-level changes in brain network connectivity in MDD.

"With estimates of approximately 10 percent of all children in the United States having been subjected to child abuse, the significance of child maltreatment on brain development and function is an important consideration," said Yvette I. Sheline, MD, McLure professor of Psychiatry, Radiology, and Neurology, and director of the Center for Neuromodulation in Depression and Stress (CNDS) in the Perelman School of Medicine at the University of Pennsylvania. "This study not only confirms the important relationship between childhood trauma and major depression, but also links patients' experiences of childhood trauma with specific functional brain network abnormalities. This suggests a possible environmental contributor to neurobiological symptoms."

MDD is a common mental disorder characterized by a variety of symptoms -- including persistently depressed mood, loss of interest, low energy, insomnia or hypersomnia, and more. These symptoms impair daily life and increase the risk of suicide. In addition, experiences of childhood trauma, including physical, sexual, or emotional abuse, as well as physical or emotional neglect, have been associated with the emergence and persistence of depressive and anxiety disorders. However, the neurobiological mechanisms underlying MDD are still largely unknown.

To address this challenge, a team led by Sheline utilized functional magnetic resonance imaging (fMRI) to investigate the brain networks and patterns that underlie the disorder. Researchers compared brain activity in 189 participants with MDD to activity of 39 healthy controls. First author Meichen Yu, a post-doctoral fellow in the CNDS, conducted statistical analyses to determine the associations between temporal correlations in connectivity within and between 10 well-established, large-scale resting state networks (RSNs) and clinical measures, including both past history of trauma and current clinical symptoms, such as depression, anxiety, suicidality. These symptoms were measured by 213 item-level survey questions.

The authors found that in patients with MDD, while the strongest correlations were with childhood trauma, abnormal network connectivity was also associated with current symptoms of depression. Even though participants in this study were not selected as participants based on a history of trauma, and the brain imaging took place decades after trauma occurred, prior trauma was evident in abnormal functional connectivity.

"These results suggest that resting-state network connectivity may point to some of the brain mechanisms underlying the symptoms of major depressive disorder," Sheline explains. "It may have the potential to serve as an effective biomarker, aiding in the development of depression biotypes and opening up the possibility of targeted diagnosis."

https://www.sciencedaily.com/releases/2019/04/190408161610.htm