Threat exposure moderates associations between neural and physiological indices of emotion reactivity in adolescent females.

Early life adversity (ELA) characterized by threat (e.g., abuse, witnessing violence) impacts neural and physiologic systems involved in emotion reactivity; however, research on how threat exposure impacts the interplay between these systems is limited. This study investigates ELA characterized by threat as a potential moderator of the association between (a) neural activity during a negative image processing fMRI task and (b) cortisol production following a modified Trier Social Stress Test (TSST). The sample is comprised of 117 young adolescent females (Mage = 11.90 years, SD = 1.69) at elevated risk for internalizing problems. Whole-brain analyses revealed a positive association between cortisol production and increased right lateral orbitofrontal cortex activity during the emotion reactivity task. In moderation models, threat exposure interacted with bilateral amygdala activation (b = -3.34, p = 0.021) and bilateral hippocampal activation (b = -4.14, p = 0.047) to predict cortisol response to the TSST. Specifically, participants with low, but not high, levels of threat exposure demonstrated a positive association between cortisol production and neural activity in these regions, while no significant association emerged for participants with high threat exposure. Findings contribute to the growing field of research connecting physiological and neural emotion processing and response systems, suggesting that dimensions of ELA may uniquely disrupt associations between neural activation and cortisol production.

Why Suicide? Suicide Propinquity and Adolescent Risk for Suicidal Thoughts and Behaviors.

Suicide represents an international public health concern, and for adolescents aged 14 to 18 in the United States, is the third leading cause of death (Centers for Disease Control and Prevention. 2021 Youth Risk Behavior Survey Data. Available at: www.cdc.gov/yrbs . Accessed on August 30, 2023.). In response to this alarming rate, as well as the relative lack of meaningful progress in the prediction and prevention of suicidal thoughts and behaviors (STB) over the past decades (see Franklin et al., 2017), recent reviews of the suicide literature have advocated for the adoption of novel frameworks and theoretical reexamination of the processes that confer risk for suicide. Currently, the majority of suicide theories emphasize distal factors associated with suicide risk, but these factors also generalize to other types of psychopathology and do not answer the fundamental question of "why suicide?" vs. other maladaptive outcomes. In an effort to address this gap and build off existing theoretical and empirical science from various disciplines, the current theoretical paper will explore the concept of suicide propinquity, the degree of closeness and identification with STB, as a potential moderator of the link between psychological distress and suicide. Specifically, this paper: (1) provides context within the existing theories of suicide, highlighting gaps that might otherwise be explained by propinquity; (2) discusses historical and scientific evidence of suicide phenomena that support the existence of propinquity; (3) explores potential processes of how propinquity may confer risk for STB in adolescence; and (4) suggests future directions for research to examine adolescent suicide from a propinquity perspective.

Does Psychological Flourishing Have the Potential to Mitigate Self-Injurious Thoughts and Behaviors? A Preliminary Analysis of the Protective Influence of Flourishing.

AIM: The purpose of this article was to examine whether psychological flourishing, a multi-dimensional construct of well-being, has the potential to play a preventative role in suicidal and nonsuicidal thoughts and actions. METHODS: This two-part study utilized cross-sectional survey data from college students across the United States, assessing levels of psychological distress, loneliness, and psychological flourishing. Frequencies of suicidal ideation, intent, previous suicidal attempts, and nonsuicidal self-injury (NSSI) were also assessed. Data collected in 2019 were used for Study 1 (n = 38,679) and data collected in 2020 were used for Study 2 (n = 50,307). RESULTS: Psychological flourishing is significantly inversely related to suicide and NSSI risk when controlling for loneliness and psychological distress. There were two-way interactions between flourishing and distress, whereby under conditions of high distress, the inverse effect of flourishing on suicidal ideation, intent, and attempts and NSSI was more pronounced. These results were consistent across both studies. Subgroup analyses revealed similar results regardless of participants' race, sexual orientation, and gender identity. CONCLUSION: Inverse associations between flourishing and self-injurious thoughts and behaviors suggest that flourishing may buffer risk of suicide and NSSI, and these findings may have important implications for developing evidence-based therapeutic interventions. Additional research, including longitudinal and clinical work, is warranted.

An RDoC-based approach to adolescent self-injurious thoughts and behaviors: The interactive role of social affiliation and cardiac arousal.

Recent theoretical models have posited that increases in self-injurious thoughts and behaviors (SITBs) during adolescence may be linked to failures in biological stress regulation in contexts of social stress. However, there is a lack of data examining this hypothesis during the transition to adolescence, a sensitive period of development characterized by changes across socioaffective and psychophysiological domains. Building on principles from developmental psychopathology and the RDoC framework, the present study used a longitudinal design in a sample of 147 adolescents to test whether interactions among experiences of social (i.e., parent and peer) conflict and cardiac arousal (i.e., resting heart rate) predicted adolescents' engagement in SITBs (i.e., nonsuicidal self-injury, NSSI; and suicidal ideation; SI) across 1-year follow-up. Prospective analyses revealed that adolescents experiencing a combination of greater peer, but not family, conflict and higher cardiac arousal at baseline showed significant longitudinal increases in NSSI. In contrast, social conflict did not interact with cardiac arousal to predict future SI. Findings indicate that greater peer-related interpersonal stress in adolescents may increase risk for future NSSI among youth with physiological vulnerabilities (i.e., higher resting heart rate) that may be markers of maladaptive stress responses. Future research should examine these processes at finer timescales to elucidate whether these factors are proximal predictors of within-day SITBs.

Interpersonal Life Stress and Inflammatory Reactivity as Prospective Predictors of Suicide Attempts in Adolescent Females.

Adolescents' suicidal behavior frequently is preceded by interpersonal stress, but not all who experience distress attempt to end their lives. Recent theories have posited individual differences in stress-related inflammatory reactivity may be associated with psychopathology risk; this study examined inflammatory reactivity as a moderator of the prospective association between interpersonal stress and adolescents' suicidal behavior. Participants included 157 at-risk adolescent females (ages 12 to 16 years) and assessed individual differences in proinflammatory cytokine responses to a brief laboratory-based social stressor, both interpersonal and non-interpersonal life events, and suicidal behavior over an 18-month follow-up period. Measuring levels of the key proinflammatory cytokines interleukin-1ß (IL-1ß), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) before and after an experimentally-induced social stressor, results revealed that blunted cytokine reactivity heightened the effect of high interpersonal stress exposure on risk for suicidal behaviors over the subsequent 9 months. Significant effects were not revealed for non-interpersonally themed stress. Finding highlight the urgent need for more research examining inflammation reactivity among adolescents.

Measuring peer influence susceptibility to alcohol use: Convergent and predictive validity of a new analogue assessment.

Research on peer socialization rarely examines individual differences in adolescents' susceptibility to peer influence, perhaps because few theories or methods have elucidated how susceptibility is operationalized. This study offers a new analogue measure of peer influence susceptibility in adolescence that is adapted from sociological theory. A preliminary examination of this new paradigm included the study of individual differences in susceptibility to peer influence, convergent validity correlates, and predictive validity by examining decision-making on the task as a moderator of the prospective association between friends' and adolescents' engagement in one form of real-world risk taking. Participants included 714 adolescents (54% female; 46.1% White, 20.9% Black, 24.2% Hispanic/Latinx, 6.2% mixed race or other) aged 15-18 years (M=16.1). Participants completed the Peer Analogue Susceptibility Task, peer nominations, and self-report measures at Time 1, and repeated an assessment of their own alcohol use one year later. Participants' friends also reported their own alcohol use. Results indicated concurrent associations with peer influence susceptibility, rejection sensitivity, perceived importance of peer status, peer-nominated popularity, and self-reported resistance to peer influence. Furthermore, among adolescents demonstrating average and high levels of peer influence susceptibility on the task, greater perceived alcohol use among friends was associated with their own alcohol use one year later. Findings offer preliminary evidence for the convergent and predictive validity of a new approach to study peer influence susceptibility.

Advances in Research on Adolescent Suicide and a High Priority Agenda for Future Research.

Suicide is the second leading cause of death for adolescents in the United States, yet remarkably little is known regarding risk factors for suicidal thoughts and behaviors (STBs), relatively few federal grants and scientific publications focus on STBs, and few evidence-based approaches to prevent or treat STBs are available. This "decade in review" article discusses five domains of recent empirical findings that span biological, environmental, and contextual systems and can guide future research in this high priority area: (1) the role of the central nervous system; (2) physiological risk factors, including the peripheral nervous system; (3) proximal acute stress responses; (4) novel behavioral and psychological risk factors; and (5) broader societal factors impacting diverse populations and several additional nascent areas worthy of further investigation.

Determinants of Excessive Reassurance-Seeking: Adolescents' Internalized Distress, Friendship Conflict, and Inhibitory Control as Prospective Predictors.

Substantial research suggests that excessive reassurance-seeking behavior is associated with exacerbations in depressive symptoms and later interpersonal rejection, yet remarkably few studies have examined predictors of this maladaptive social behavior. This study proposed and examined a diathesis stress model suggesting that beyond the effects of prior internalized distress, a combination of poor inhibitory control and dyadic friendship conflict may be especially relevant predictors of adolescents' excessive reassurance-seeking behavior. Longitudinal associations were examined in a sample of 865 adolescents (54.5% female, 22.2% African American, 23.1% Latinx) who completed self-reported measures of depressive rumination/intrusive thoughts, depressive symptoms, loneliness, friendship conflict, and a performance-based measure of inhibitory control at baseline, as well as a measure of excessive reassurance-seeking at baseline and 2 years later. Results initially revealed a prospective effect of depressive rumination/intrusive thoughts on later excessive reassurance-seeking, consistent with prior work. Final results yielded only a significant interaction effect, revealing that higher levels of friendship conflict coupled with low levels of inhibitory control were associated longitudinally with higher levels of excessive reassurance-seeking. Findings suggest that inhibitory control may moderate the association between adolescents' interpersonal conflict and their excessive reassurance-seeking.