Unpacking affect maintenance and its association with depressive symptoms: integrating positive and negative affects.

ABSTRACTDepression is associated with increased maintenance of negative affect (NA) and reduced - blunted and short-lived - maintenance of positive affect (PA). Studies have focused on factors associated with the maintenance of NA, specifically, the emotion regulation strategy of brooding and the capacity to hold negative affective experiences in working memory (WM). Despite its theoretical importance, less attention has been given to factors associated with the maintenance of PA in depression. This study aims to synthesise factors playing a role in the maintenance of both NA and PA. Specifically, we used self-reported assessment of PA and NA regulation and performance-based measures of NA and PA processing in WM to predict depressive symptoms severity. Participants (N = 219) completed the Affective Maintenance Task (AMT, Mikels et al., 2008), which provided performance-based measures of PA and NA maintenance, and filled out questionnaires assessing brooding, positive rumination and depressive severity. Brooding, positive rumination and AMT-based measures of positive (but not negative) affective information processing were independently associated with depressive symptoms. We highlight the unique contributions of PA processing, as well as of self-reported emotion regulation strategies in understanding depression maintenance.

Metabolic syndrome among young adults at high and low familial risk for depression.

BACKGROUND: Our study examined whether the early-onset depression phenotype among young adults (probands) is associated with the metabolic syndrome (MetS) and its components, and if MetS characterizes unaffected but high-risk siblings of probands. METHODS: We studied three groups of young adults (Mage = 25 years, s.d. = 3.84 years): probands with histories of childhood onset depression - i.e. early-onset phenotype - (n = 293), their unaffected siblings (high-risk siblings, n = 273), and healthy controls (n = 171). Participants completed a full psychiatric interview, physical and laboratory assessments, and self-rating scales. MetS was defined using the criteria of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (). RESULTS: Early-onset depression phenotype and being a high-risk sibling were associated with higher MetS composite scores relative to that of controls, but did not differ from one another. With regard to MetS components: Probands and siblings had similarly larger waist circumference and lower HDL than did controls, while siblings and controls had lower triglyceride levels than did probands but did not differ from one another. Groups did not differ on glucose levels and SBP. CONCLUSIONS: Our study extends the literature on the association between MetS and depression and underscores the importance of depression phenotypes: failure to account for the clinical heterogeneity of depression may partly underlie the inconsistent findings regarding its relation to MetS. The results also suggest that, in depression-prone populations, MetS may predate and possibly function as a risk factor for eventual depression.

Economic Choice and Heart Rate Fractal Scaling Indicate That Cognitive Effort Is Reduced by Depression and Boosted by Sad Mood.

BACKGROUND: People with depression typically exhibit diminished cognitive control. Control is subjectively costly, prompting speculation that control deficits reflect reduced cognitive effort. Evidence that people with depression exert less cognitive effort is mixed, however, and motivation may depend on state affect. METHODS: We used a cognitive effort discounting task to measure propensity to expend cognitive effort and fractal structure in the temporal dynamics of interbeat intervals to assess on-task effort exertion for 49 healthy control subjects, 36 people with current depression, and 67 people with remitted depression. RESULTS: People with depression discounted more steeply, indicating that they were less willing to exert cognitive effort than people with remitted depression and never-depressed control subjects. Also, steeper discounting predicted worse functioning in daily life. Surprisingly, a sad mood induction selectively boosted motivation among participants with depression, erasing differences between them and control subjects. During task performance, depressed participants with the lowest cognitive motivation showed blunted autonomic reactivity as a function of load. CONCLUSIONS: Discounting patterns supported the hypothesis that people with current depression would be less willing to exert cognitive effort, and steeper discounting predicted lower global functioning in daily life. Heart rate fractal scaling proved to be a highly sensitive index of cognitive load, and data implied that people with lower motivation for cognitive effort had a diminished physiological capacity to respond to rising cognitive demands. State affect appeared to influence motivation among people with current depression given that they were more willing to exert cognitive effort following a sad mood induction.

Successful implementation of cognitive reappraisal: effects of habit and situational factors.

Reappraisal is an adaptive emotion regulation strategy associated with favourable mental health outcomes. It is unclear whether the adaptive outcomes of habitual reappraisal are associated with better implementation of reappraisal when faced with negative affective situations. The current study aimed to examine whether habitual reappraisal predicts the implementation of instructed reappraisal and to evaluate the potential moderating effects of situational factors, namely - emotional intensity and reappraisal affordance. To address this question, 100 participants reported their habitual reappraisal tendency and were asked to imagine themselves in different hypothetical interpersonal situations. Participants rated emotional intensity levels and reappraisal affordance for each situation, followed by instructions to implement reappraisal. Implementation success was measured by self-reported affect pre-and-post-implementation. Results indicated that habitual reappraisal was associated with greater reappraisal implementation success. While higher intensity scores predicted greater reappraisal implementation success, intensity did not moderate the association between habitual reappraisal and reappraisal implementation success. Reappraisal affordance did not predict reappraisal implementation success, nor did it moderate the association between habitual reappraisal and reappraisal implementation success. Our findings suggest that individual-centred factors play a significant role in reappraisal implementation success, while the effects of situation-centred factors demand further investigation.

Age related sex differences in maladaptive regulatory responses to sadness: A study of youths at high and low familial risk for depression.

Offspring of parents with depression histories are at increased risk of developing depression and also report maladaptive ways of self-regulating sadness. Maladaptive regulation of sadness tends to be more prevalent among females than males and has been proposed as one explanation of sex differences in depression rates that emerge around mid-adolescence. However, there is scant information about the age at which the sex differences in maladaptive regulatory responses become evident and whether such age-related sex differences vary depending on depression risk. The present study examined two samples aged 8-18 years: 86 offspring of emotionally healthy parents and 98 offspring of parents with depression histories. Subjects were clinically assessed and provided self-reports of maladaptive responses to sadness. In the combined samples, sex differences in maladaptive responses were significant at age 12.5 years and older ages (i.e., chronologically earlier than the documented emergence of sex differences in depression). While in the high-risk group, sex differences in maladaptive regulatory responses were significant at 12.11 years of age and older, in the low-risk group there was no age at which sex differences were significant. Our findings support the possible mechanistic role of maladaptive emotion regulation in the emergence of sex disparities in depression rates and have implications for prevention.

Personalized cognitive training: Protocol for individual-level meta-analysis implementing machine learning methods.

Accumulating evidence suggests that cognitive training may enhance well-being. Yet, mixed findings imply that individual differences and training characteristics may interact to moderate training efficacy. To investigate this possibility, the current paper describes a protocol for a data-driven individual-level meta-analysis study aimed at developing personalized cognitive training. To facilitate comprehensive analysis, this protocol proposes criteria for data search, selection and pre-processing along with the rationale for each decision. Twenty-two cognitive training datasets comprising 1544 participants were collected. The datasets incorporated diverse training methods, all aimed at improving well-being. These training regimes differed in training characteristics such as targeted domain (e.g., working memory, attentional bias, interpretation bias, inhibitory control) and training duration, while participants differed in diagnostic status, age and sex. The planned analyses incorporate machine learning algorithms designed to identify which individuals will be most responsive to cognitive training in general and to discern which methods may be a better fit for certain individuals.

Sympathetic arousal during the processing of dysphoric affect by youths at high and low familial risk for depression.

Youths at high risk for depression have been shown to have problems in repairing their own sad mood. Given that sympathetic arousal has been implicated both in the experience and regulation of affect, an atypical pattern of arousal may be one of the factors that contribute to mood repair problems. In the current study, we measured sympathetic arousal of never-depressed youths at high (n = 56) and low (n = 67) familial risk for depression during sad mood induction and instructed mood repair. Sympathetic arousal was indexed by skin conductance level (SCL) and cardiac pre-ejection period (PEP); mood repair outcome was indexed by self-rated affect. High-risk youths demonstrated increased SCL during sadness induction, which persisted during mood repair; low-risk youths evidenced increased SCL only during mood repair. Shortened PEP was evident only among high-risk youths and only during mood repair. Furthermore, shortened PEP during mood induction predicted less successful mood repair in the low-risk but not in the high-risk group. The findings suggest that: (a) depression-prone youths differ from control peers in patterns of sympathetic responses to emotional stimuli, which may impair their ability to relieve sadness, and (b) activation patterns differ across subsystems (SCL vs. PEP) of sympathetic activity, in conjunction with depression risk status.

Cardiac vagal control mediates the relation between past depression and blood pressure several years later among young adults.

Depression has been associated with high blood pressure (BP). However, the mechanisms of the relation between depression and high BP are unclear. We therefore examined whether impaired cardiac vagal control, indexed as low levels of resting respiratory sinus arrhythmia (RSA), serves as a route from depression to high BP. The sample included 125 subjects with histories of depression (probands), 123 never depressed siblings of probands (high-risk siblings), and 156 controls. Resting RSA was assessed at Time 1 (T1) along with BP when subjects were adolescents (Mage  = 16.3 years); systolic and diastolic BP (SBP and DBP) were measured again at Time 2 (T2) when subjects were young adults (Mage  = 22.3 years). Linear mixed-effects models were used to examine the group differences in resting RSA and T2 BP outcomes and to test for RSA mediation of the relation between depression (history or being at high risk) and BP. Resting RSA was lower among probands than controls but was similar among high-risk siblings and controls, while the subject groups did not differ in T2 SBP or DBP. Controlling for T1 BP, depression history indirectly affected T2 DBP (but not SBP) through resting RSA. The findings suggest that, although the direct detrimental effects of depression on BP are not yet evident in young adulthood, among those with depression histories, impaired cardiac vagal control appears to serve as a mechanism of elevated DBP.

The persistence of hedonically-based mood repair among young offspring at high- and low-risk for depression.

The aim of the present study was to examine whether offspring at high and low familial risk for depression differ in the immediate and more lasting behavioural and physiological effects of hedonically-based mood repair. Participants (9- to 22-year olds) included never-depressed offspring at high familial depression risk (high-risk, n = 64), offspring with similar familial background and personal depression histories (high-risk/DEP, n = 25), and never-depressed offspring at low familial risk (controls, n = 62). Offspring provided affect ratings at baseline, after sad mood induction, immediately following hedonically-based mood repair, and at subsequent, post-repair epochs. Physiological reactivity, indexed via respiratory sinus arrhythmia (RSA), was assessed during the protocol. Following mood induction and mood repair, high- and low-risk (control) offspring reported comparable changes in levels of sadness and RSA. However, sadness increased among high-risk offspring following the post-repair epoch, whereas low-risk offspring maintained mood repair benefits. High-risk/DEP offspring also reported higher levels of sadness following the post-repair epoch than did low-risk offspring. Change in RSA did not differ across the three offspring groups. Self-ratings confirm that one source of difficulty associated with depression risk is diminished ability to maintain hedonically-based mood repair gains, which were not apparent at the physiological level.

Autonomic correlates of lifetime suicidal thoughts and behaviors among adolescents with a history of depression.

Suicidal thoughts and behaviors (STBs) have been associated with emotion dysregulation and atypical responses to affective and stressful stimuli. To investigate the psychophysiology involved, we measured changes in respiratory sinus arrhythmia (RSA) and cardiac pre-ejection period (PEP; indexing parasympathetic and sympathetic functioning, respectively) in response to stressful- and sadness-eliciting laboratory probes. Our sample included adolescents with a history of depression and STBs (n = 177), adolescents with a history of depression but no history of STBs (n = 47), and healthy controls (n = 175). The outcome of interest was the most severe form of clinician-rated STBs across the subject's lifetime. In partial support of our hypotheses, during the stressful task, adolescents with a history of depression and STBs did not evidence the RSA decrease that was exhibited by controls and displayed greater PEP shortening compared to ever-depressed adolescents with no lifetime STBs. No group differences were found in either RSA or PEP reactivity to the sadness-eliciting stimulus. As expected, severity of STBs was positively correlated with the extent of PEP shortening during the stressful task. The results suggest that adolescents with a history of depression and STBs experience blunted parasympathetic responses to stress along with compensatory efforts. Our findings contribute to a better understanding of STBs among youths and underscore that future studies should examine physiological risk factors for these psychopathological outcomes.

Adversity and Depression: The Moderating Role of Stress Reactivity among High and Low Risk Youth.

Adverse life events have been causally linked to depression among youth at high risk for depression. But given that not all high-risk youth develop depression following adversity, individual differences in various processes, including physiological reactivity to stress, are likely to be at play. This longitudinal prospective study tested the hypothesis that, among high-risk youth exposed to adversities, extent of physiological reactivity to laboratory stress (indexed as respiratory sinus arrhythmia; RSA) would predict subsequent depressive symptoms. Subjects were youth at high (n = 80) and low (n = 74) familial risk for depression. At Time 1 (T1), RSA was assessed during a cognitive stress task. At Time 2 (T2) about 2 years later, parents reported on adversities experienced by their offspring during the interim. At T1 and T2, youth received a diagnostic evaluation, which included assessment of their depressive symptoms. The three-way interaction of group-X-adversities-X-RSA predicted T2 depressive symptoms (controlling for T1 depressive symptoms). This interaction was mostly driven by the moderating effect of RSA among high-risk youth, such that adversities predicted higher depressive symptoms for those who displayed greater RSA reactivity to stress. Among low-risk youth, an inverse marginal moderating effect of RSA was found, such that adversities tended to predict depressive symptoms for those who displayed blunted RSA reactivity to stress. Thus, high physiological stress reactivity appears to be an additional risk factor for depressive symptoms only among youth at elevated risk for such outcomes, and should be taken into consideration in efforts to prevent depression in these populations.

Family functioning as perceived by parents and young offspring at high and low risk for depression.

BACKGROUND: Family dysfunction has been proposed as one of the environmental mechanisms whereby risk of depression is transmitted from mothers to their children. Using our sample of offspring at high and low familial risk for depression, we hypothesized that: a) high-risk offspring (n = 79) and their mothers will report more extensive family dysfunction than low-risk offspring (n = 82) and their mothers, b) family dysfunction will predict the extent of offspring's depressive symptoms, and c) family dysfunction will mediate the impact of mother's depression on offspring's depressive symptoms. METHODS: The study enrolled 161 offspring of parents who, in a previous study, were ascertained to have either childhood onset mood disorder or no history of a major psychiatric disorder. Parents completed questionnaires and a clinical interview about themselves, their offspring, and the family, while offspring also completed questionnaires about themselves and the family. RESULTS: We found support for all three hypotheses. The significant indirect effect between maternal depression and offspring depressive symptoms was driven primarily by offspring's, but not mothers', reports of family dysfunction. LIMITATIONS: Although our assessment of mother's early history of depression was done in a previous study, it is important to note that our results do not inform about causality because of the present study's cross-sectional nature. CONCLUSIONS: The results highlight the importance of detecting and treating family dysfunction, particularly via offspring report, as one way to lower the risk of depression transmission from mothers to their children.

Childhood adversity predicts reduced physiological flexibility during the processing of negative affect among adolescents with major depression histories.

BACKGROUND: Adversity during early development has been shown to have enduring negative physiological consequences. In turn, atypical physiological functioning has been associated with maladaptive processing of negative affect, including its regulation. The present study therefore explored whether exposure to adverse life events in childhood predicted maladaptive (less flexible) parasympathetic nervous system functioning during the processing of negative affect among adolescents with depression histories. METHODS: An initially clinic-referred, pediatric sample (N=189) was assessed at two time points. At Time 1, when subjects were 10.17years old (SD=1.42), on average, and were depressed, parents reported on adverse life events the offspring experienced up to that point. At Time 2, when subjects were 17.18years old (SD=1.28), and were remitted from depression, parents again reported on adverse life events in their offspring's lives for the interim period. At time 2, subjects' parasympathetic nervous system functioning (quantified as respiratory sinus arrhythmia) also was assessed at rest, during sad mood induction, and during instructed mood repair. RESULTS: Extent of adverse life events experienced by T1 (but not events occurring between T1 and T2) predicted less flexible RSA functioning 7years later during the processing of negative affect. Adolescents with more extensive early life adversities exhibited less vagal withdrawal following negative mood induction and tended to show less physiological recovery following mood repair. CONCLUSIONS: Early adversities appear to be associated with less flexible physiological regulatory control during negative affect experience, when measured later in development. Stress-related autonomic dysfunction in vulnerable youths may contribute to the unfavorable clinical prognosis associated with juvenile-onset depression.

Rumination: Cognitive consequences of training to inhibit the negative.

BACKGROUND AND OBJECTIVES: To explore cognitive factors in ruminative thinking, we assessed the effect of a single-session of inhibition training on subsequent biases in attention and interpretation. METHODS: We randomly assigned participants to either inhibit or attend to negative stimuli. Inhibition was assessed by using assessment trials embedded throughout the training, and interpretation bias was assessed following the training. RESULTS: Trait rumination moderated training effects on both measures. Low ruminators in the inhibition-training condition maintained their level of inhibition of negative stimuli, but those in the attention-training condition showed a non-significant trend for decreased inhibition. Participants also showed a transfer-congruent tendency in interpretation bias, with reduced bias by those trained to inhibit negative stimuli, compared to those trained to attend to negative stimuli. In contrast, high ruminators in the inhibition training condition showed a training-incongruent decrease in inhibition of negative stimuli, but no change in inhibition when trained to attend to negative stimuli. No effects of the training on interpretation bias were observed among high ruminators. Finally, the training did not affect subsequent measures of mood or state rumination, even when trait rumination scores were taken into account. LIMITATIONS: This study used a single session of inhibition training rather than a multi-session training, and this may explain the null effects among high ruminators. CONCLUSIONS: Findings highlight the critical role that trait rumination plays in moderating the effect of inhibition training. Our results suggest that inhibition training may provide an effective technique to change inhibition bias and later interpretation bias.

Brooding moderates the link between reappraisal and inhibition of negative information.

The ability to inhibit negative information is associated with emotion regulation (ER). Reduced inhibition of negative information characterises poor ER, which in turn plays a critical role in psychopathology. People engage in multiple ER strategies; some are harmful and others are helpful. However, the interaction between harmful and helpful ER strategies and its link to inhibition of negative information have not been explored. This study examined the joint association between reappraisal, an adaptive ER strategy, and brooding, a maladaptive ER strategy, with inhibition of negative information. Participant's high (N = 81) and low (N = 47) in brooding completed a measure of habitual reappraisal as well as the negative affective priming task, a measure of inhibition bias. As predicted, reappraisal was positively linked with the ability to inhibit negative content. However, this link was moderated by brooding and was found only among low brooders but not among high brooders. The implications of these findings to theories of ER are discussed.