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Explication of the Relationship between Depressive Symptoms, Stress, and Health Behaviors in Young Adults
Get PDFThe current project aimed to clarify several aspects of the relationship between depressive symptoms, stress, and health behaviors among young adults. A large body of research supports bidirectional relationships between depression and poor physical health outcomes, and health behaviors such as substance use, physical inactivity, and poor sleep may serve as modifiable links between depression and physical health. It is particularly important to improve understanding of these processes in young adulthood, a crucial period in the development of physical and mental health. The current study sought, in part, to clarify the relative and interactive effects of chronic, acute, and daily stress in influencing health behaviors and subsequent mood. Results from Study 1 demonstrated that chronic stress, but not acute stress, predicted increased depressive symptoms several years later in part through maladaptive health behaviors, especially poor sleep, among young adults. Results from Study 2 demonstrated that depressive symptoms, chronic stress, and daily stress, but not acute stress, were associated with higher levels of daily maladaptive health behavior engagement in college students. Contrary to Study 2 hypotheses, youth with elevated depressive symptoms were not more likely to respond to stress with maladaptive health behaviors than youth without elevated depressive symptoms. Results from Study 2 also indicated that fluctuations in daily affect mediated the effects of depressive symptoms on daily maladaptive health behavior engagement, and that individuals endorsing beliefs about the stress-relieving properties of exercise and alcohol consumption (but not smoking and eating) were likelier to engage in these behaviors when facing stress. Together, the current results indicate that chronic stress, depressive symptoms, and daily stress are associated with maladaptive health behavior engagement among young adults. Furthermore, fluctuations in daily affect and beliefs about health behavior engagement may serve as fruitful targets of interventions aimed to ameliorate the deleterious effects of stress and depression on health behaviors
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The Role of Puberty in the Development of Depressive Symptoms into Young Adulthood
Get PDFIn addition to the biological and hormonal changes that characterize puberty, the pubertal transition is accompanied by significant psychological and social challenges. Research has established that pubertal experiences can lead to psychopathology among youth, with most studies examining the role of pubertal timing relative to peers. However, less is known about the mechanisms through which off-time development contributes to psychopathology, the impact of characteristics of puberty other than timing, and the influence of pubertal processes on mental health beyond adolescence. The present dissertation sought to explore these issues via three related studies. Given the marked increase in rates of depression during adolescence as well as the emergence of a gender disparity in depression prevalence that persists into adulthood, the dissertation focused on the association between pubertal experiences and depressive symptoms. Study 1 utilized a large, community sample to test four psychosocial mechanisms that have been proposed to account for the link between off-time development and depressive symptoms among youth. The results supported the stage termination, personal accentuation, and contextual amplification hypotheses among females, but did not support any hypotheses among males. Study 2 further explored contextual amplification by assessing which types of environmental stress exacerbate the effects of off-time development. Chronic interpersonal stressors interacted with pubertal timing among females while dependent episodic stressful events were associated with the highest level of depressive symptoms among early-maturing males. Study 3 examined whether pubertal synchrony, the degree to which various markers of puberty mature simultaneously, was associated with depression among females. Evidence suggested that asynchronous development led to the highest levels of depressive symptoms in young adulthood, particularly among late-maturing girls. Together, the results of the dissertation indicate that females are particularly vulnerable to the influence of pubertal experiences on mental health and suggest several mechanisms through which puberty influences depression among females. Males appear to be less likely to react to variations in pubertal timing by becoming depressed. The findings suggest several pathways for future research including the integration of proposed biological and psychosocial mechanisms and the continued exploration of pubertal processes as a contributor to the gender gap in depression prevalence
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Depression and Mate Selection During the Transition to Adulthood
Get PDFThere is considerable research demonstrating the link between depression and interpersonal stress. This literature has included support for the phenomenon of stress generation, or the tendency for individuals with depression histories to have higher levels of stress in their lives, particularly interpersonal stressors, even after depression remits. Currently missing from the existing literature, but supported by multiple psychological theories and research on constructs related to depression, is the possibility that individuals prone to depression may self-select into maladaptive romantic partnerships that promote stress and exacerbate depression. The current project sought to explore whether depression portends risk for choosing romantic partners with higher levels of psychopathology or disordered personality traits. This question was explored in two complementary studies. Study 1 utilized a longitudinal, community sample of 252 individuals followed from birth to early adulthood with romantic partners at age 20. Results indicated that individuals with higher levels of depressive symptoms at age 15 had romantic partners by age 20 with higher levels of personality disorder symptoms. Insecure attachment mediated this relationship. Partner personality pathology, in turn, marginally predicted increases in depressive symptoms 2 to 5 years later. Study 2 explored the role of depression in the mate selection process by using a mock online dating laboratory paradigm in which college-aged women rated hypothetical romantic partners based on fabricated dating profiles. Some profiles included antisocial personality disorder traits. Results revealed that current depressive symptoms and major depression history indirectly predicted lower initial interest in "antisocial" profiles via lower self-esteem and lower perceived similarity to these individuals, respectively. However, when participants were later asked to imagine that an "antisocial" individual was interested in dating them, depressive symptoms predicted greater positive change in interest in this individual and a greater likelihood of changing an initial refusal to date this individual to a positive response. Findings from both studies indicate that depression plays a role in the mate selection process and can have detrimental consequences. Future research would benefit from further exploring mediators of the relationship between depression and choosing problematic partners and the role of partner characteristics in the cycle of stress and depression
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A Hierarchical-Spectrum Model of Mental Disorders: Genetic, Developmental, and Interpersonal Perspectives
Get PDFThe current project aimed to determine whether a recently developed explanatory model for comorbidity patterns--labeled the Hierarchical-Spectrum Model (HSM)--could serve as a useful organizing framework for research on psychopathology. The HSM accounts for the high co-occurrence of depressive and anxiety disorders by representing them as facets of an overarching Internalizing dimension; likewise, the substance use and antisocial behavior disorders are represented as facets of an Externalizing dimension. In latent variable modeling terms, the HSM parses the shared and unique variance of disorders into transdiagnostic latent factors (i.e., Internalizing and Externalizing dimensions) and diagnosis-specific residuals, respectively. This project integrated the HSM quantitative structure with prominent genetic and psychosocial theories of psychopathology. Results from Study 1 demonstrated that the relationship of early environmental adversity with psychopathology in young adulthood is partly mediated by the transdiagnostic dimensions. At the same time, early adversity was associated with several residual variances of the HSM, signaling the presence of diagnosis-specific pathways from early adversity to mental disorder. Study 2 conceptualized the stress generation hypothesis, which posits that people with a history of depression, relative to their never-depressed counterparts, experience more stressful life events dependent at least in part on their own behavior, through the lens of the HSM. Results revealed stress generating effects of the Internalizing and Externalizing dimensions, suggesting that the stress generation phenomenon is not specific to any one diagnostic category. Yet, the diagnosis-specific components of major depression and dysthymia also contributed to stress generation over and above the effects of the transdiagnostic dimensions, suggesting there is some pathology unique to depression that confers vulnerability to stress exposure. In Study 3, a daily diary methodology was used to examine day-to-day fluctuations of HSM symptoms. Consistent with expectations, elevated daily stress levels predicted increases in both Internalizing and Externalizing symptoms. Further, a widely studied polymorphism in the serotonin transporter gene (5-HTTLPR) moderated the relationship between daily stress and Internalizing, but not Externalizing, symptoms. Together, the current findings suggest that the HSM has the potential to be a useful framework for research, treatment, and classification in clinical psychology
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Genetic Underpinnings of the Relationships Among Stress, Inflammation, and Depression
Get PDFIncreases in pro-inflammatory cytokines, the immunological response to pathogens, have been observed in close to one third of patients with major depression. Further, interpersonal stressors, the most potent and well-established risk for depression, have also been found to elicit pro-inflammatory cytokines. Thus, inflammation may represent a biological response to stress that heightens the risk of depression. A better understanding of the relationships among stress, depression and inflammation has the potential to shed light on the cycle of stress and depression, as well as the increased prevalence of inflammatory illness in depressed patients, which is of growing concern in our aging population. This dissertation sought to confirm that among young, healthy adults, depressive symptoms tend to develop before, and contribute to elevations in pro-inflammatory cytokines, and to determine whether functional variation in immunological genes would create susceptibility to depression and inflammation in response to stress, and/or create susceptibility to inflammation following an elevation in depressive symptoms. The dissertation explored these questions in a pair of longitudinal cohort studies, the first of which followed Australian youth with a high prevalence of familial risk for depression from ages 15 to 20, and included assessments of depressive symptoms, stress exposure and genotypic information for a trio of immunological genes. Exposure to interpersonal stress was moderated by variation at IL6 and IL1β, so that -174C allele carriers at IL6, and -511C carriers at IL1β had greater depressive symptoms in response to stress, while neither of these genotypes affected the prediction of depressive symptoms from exposure to non-interpersonal stressors, such as finances and work. TNF genotype was not a moderator of either type of stress exposure. In the second dissertation study, the prediction of growth in depressive symptoms and C-reactive protein (CRP) from childhood stress exposure, and potential moderation of these paths by IL6 genotype, was examined in 4,276 participants in the Coronary Artery Risk Development Study of Young Adults. Stress exposure in the childhood home was predictive of depressive symptoms at age 30, which were in turn associated with slight, but significant growth in CRP between age 32 and age 50. African Americans in this sample showed a unique moderating effect of IL6 genotype, so that the relationship between stress and CRP was significant among G allele carriers, but not among African American CC homozygotes, or among Caucasians, regardless of genotype. Taken together, the two dissertation studies suggest that genetic variation at IL6 may contribute to increases in depressive symptoms and CRP following interpersonal stress exposure. Further, although a strong relationship from stress exposure to depression was observed in both study populations, a direct relationship between stress and CRP was not found. Instead, stress led to depression which in turn predicted CRP, and this effect was more pronounced in Caucasians
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Early Adversity, Social Functioning, Mood, and Physical Health: Developmental and Daily Process Approaches
Get PDFExposure to early stressful experiences has been associated with a variety of poor health outcomes in adolescence and adulthood (Felitti et al., 1998; Repetti, Taylor, & Seeman, 2002; Springer, Sheridan, Kuo, & Carnes, 2007). The current project was designed to explore specific psychosocial and biological mechanisms through which early adversity might prospectively shape physical health in adulthood. Study 1 used longitudinal data from a community sample to show that cumulative experiences of early adversity, as measured by contemporaneous maternal report, predicted poor self-reported and interviewer-rated physical health in young adults. Results suggested that early adverse experiences led to ongoing stress in social and nonsocial (e.g., academic) contexts, which in turn portended poor health. Elevated depressive symptoms accounted, in large part, for the effects of ongoing social stress on later risk for poor health. Study 2, using a subset of the Study 1 sample, showed that individuals who experienced early adversity tended to have higher depressive symptoms partially as a result of close friendships with individuals with mental health problems. Study 3 examined the day-to-day dynamics of interpersonal and biological mechanisms of the effects of early adversity on physical health in a sample of college students. Results suggested that young adults who have experienced stressful family environments reported more instances of reassurance-seeking, aggression, and withdrawal on a day-to-day basis. In addition, early adversity predicted higher daily reports of negative affect. Together, these findings support the notion that early adversity can have a long-lasting impact on patterns of psychological, social, and biological functioning, and that early adversity and ongoing stress might contribute to poor physical health in part through their effects on social relationships and mood. Results have implications for the development of targeted interventions designed to prevent the long-term emotional and physical consequences of early life stress
Epidemiology of Depression
No full textEpidemiological evidence shows that major depressive disorder (MDD) is a commonly occurring, seriously impairing, and often undertreated disorder. MDD occurs in the context of a very high prevalence of depressed mood and a high prevalence of subsyndromal depressive episodes. MDD is often recurrent and is typically comorbid with other mental disorders that are usually temporally primary in the sense that first lifetime onset of MDD usually occurs after the onset of at least one other lifetime comorbid disorder. Future efforts such as the NIMH RDoC initiative will be needed to identify the neural circuitry, disease mechanisms, and critical periods underlying depression—information essential to improving our current diagnostic, therapeutic, and prevention strategies. Progress in these areas is sorely needed, as evidenced by the structural impairments that occur subsequent to the onset of MDD, including low educational attainment, poor marital outcomes, and poor socioeconomic outcomes. The day-to-day role impairments that occur in conjunction with MDD include poor performance in both productive and social roles. Increased efforts are needed to document the cost-effectiveness of expanded depression treatment and of treatment-quality improvement initiatives. Because employers play such a large part in driving health insurance benefit design in the United States, it is especially important to document the return on investment of expanded depression outreach and treatment from the employer perspective. We also need to expand research on modifiable barriers to help seeking for depression and to evaluate the effectiveness of systematic depression screening and outreach programs designed to increase the proportion of people with depression who seek treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved
Epidemiology of Depression
No full textEpidemiological evidence shows that major depressive disorder (MDD) is a commonly occurring, seriously impairing, and often undertreated disorder. MDD occurs in the context of a very high prevalence of depressed mood and a high prevalence of subsyndromal depressive episodes. MDD is often recurrent and is typically comorbid with other mental disorders that are usually temporally primary in the sense that first lifetime onset of MDD usually occurs after the onset of at least one other lifetime comorbid disorder. Future efforts such as the NIMH RDoC initiative will be needed to identify the neural circuitry, disease mechanisms, and critical periods underlying depression—information essential to improving our current diagnostic, therapeutic, and prevention strategies. Progress in these areas is sorely needed, as evidenced by the structural impairments that occur subsequent to the onset of MDD, including low educational attainment, poor marital outcomes, and poor socioeconomic outcomes. The day-to-day role impairments that occur in conjunction with MDD include poor performance in both productive and social roles. Increased efforts are needed to document the cost-effectiveness of expanded depression treatment and of treatment-quality improvement initiatives. Because employers play such a large part in driving health insurance benefit design in the United States, it is especially important to document the return on investment of expanded depression outreach and treatment from the employer perspective. We also need to expand research on modifiable barriers to help seeking for depression and to evaluate the effectiveness of systematic depression screening and outreach programs designed to increase the proportion of people with depression who seek treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved
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