Mood repair via attention refocusing or recall of positive autobiographical memories by adolescents with pediatric‐onset major depression

Abstract

Background Impaired emotion regulation is increasingly recognized as a core feature of depressive disorders. Indeed, currently and previously depressed adults both report greater problems in attenuating sadness (mood repair) in daily life than healthy controls. In contrast, studies of various strategies to attenuate sad affect have mostly found that currently or previously depressed adults and controls were similarly successful at mood repair in the laboratory. But few studies have examined mood repair among depression-prone youths or the effects of trait characteristics on mood repair outcomes in the laboratory. Methods Adolescents, whose first episode of major depressive disorder (MDD) had onset at age 9, on average (probands), and were either in remission or depressed, and control peers, watched a sad film clip. Then, they were instructed to engage in re-focusing attention (distraction) or recalling happy memories. Using affect ratings provided by the youths, we tested two developmentally informed hypotheses about whether the subject groups would be similarly able to attenuate sadness via the two mood repair strategies. We also explored if self-reported habitual (trait) mood repair influenced laboratory performance. Results Contrary to expectations, attention re-focusing and recall of happy memories led to comparable mood benefits across subjects. Control adolescents reported significantly greater reductions in sadness than did depressed (Cohen’s d=.48) or remitted (Cohen’s d=.32) probands, regardless of mood repair strategy, while currently depressed probands remained the saddest after mood repair. Habitual mood repair styles moderated the effects of instructed (state) mood repair in the laboratory. Conclusions Whether depressed or in remission, adolescents with MDD histories are not as efficient at mood repair in the laboratory as controls. But proband-control group differences in mood repair outcomes were modest in scope, suggesting that the abilities that subserve affect regulation have been preserved in probands to some degree. Further information about the nature of mood repair problems among youths with depression histories would help to better understand the clinical course of MDD and to design personalized interventions for depression.

Atypical patterns of respiratory sinus arrhythmia index an endophenotype for depression

“…We use data from matched sibling pairs from the Program Project, who also participated in a subsequent psychophysiological study (see Kovacs et al, 2014; Rottenberg et al, 2014; Tamás et al, 2007). Subjects were 279 school-age youths ( N = 147 proband–sibling pairs; some probands had multiple siblings) in Hungary.…”

“…Adolescents also completed various other questionnaires (Kovacs et al, 2014). Parents also reported on their child’s psychotropic medication use.…”

“…During the course of an experimental protocol, subjects were hooked up to physiological monitors and completed several stress reactivity (psychology and physical) and positive mood induction tasks. For this article, we used data from the portion of the protocol that included a 3-min paced breathing task and sad mood induction via a 2-min clip from the The Champ (dubbed in Hungarian) described elsewhere (Kovacs et al, 2014). This clip has been extensively used in emotion research with both pediatric and adult samples (e.g., Gross & Levenson, 1995; Rottenberg, Gross, Wilhelm, Najmi, & Gotlib, 2002), and it was also pilot tested with Hungarian youth (see Kovacs et al, 2014).…”

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

“…The Time 1 (T1) assessments were part of a genetic investigation in a national sample of clinically referred children in Hungary, recruited through 23 child mental health clinical sites. At T1, probands were 7- to 14-years old and met DSM-IV (American Psychiatric Association [APA] 1994) criteria for a depressive disorder, as determined via a stringent series of research diagnostic interviews (for details, see Tamás et al, 2007; Kovacs et al, 2015). …”

“…The procedures have been described in detail elsewhere (e.g., Kiss et al, 2007; Tamás et al, 2007). At T2, participants completed again a full psychosocial evaluation and an experimental protocol with psychophysiological recording (also noted in Kovacs et al, 2015, and below).…”