Diurnal Cortisol Interacts With Stressful Events to Prospectively Predict Depressive Symptoms in Adolescent Girls

Abstract

Purpose The aim of present study was to test the diathesis-stress model of depression using baseline cortisol, prospective assessment of depression symptoms, and stressful life events. Methods The sample consisted of 527 adolescent girls aged 13.5 – 15.5 years without major depressive disorder (MDD). At baseline, saliva samples were collected at waking, 30 minutes after waking, and 8 pm on three consecutive days. Diurnal cortisol was indexed by cortisol awakening response (CAR) and area under the curve (AUCg). Stressful events during the preceding interval and current depressive symptoms were assessed 18-months following baseline. Results Stressful events and the interaction of CAR or AUCg with stressful events predicted depressive symptoms at 18-months, even after controlling for baseline depressive symptoms. Specifically, in the face of high levels of stress, baseline blunted CAR or smaller AUCg were associated with future depressive symptoms. This was more apparent for CAR than AUCg. The effect was reversed at low levels of stress, with heightened CAR associated with more severe depressive symptoms. Conclusions Blunted CAR and less daily cortisol output at baseline appear to accentuate the depressogenic effects of stressful events after 18 months, consistent with the diathesis stress model of HPA axis function in depression.

Positive memory specificity reduces adolescent vulnerability to depression

“…We have previously demonstrated that in this sample, high morning cortisol predicts conversion to major depression only in boys with high subclinical depressive symptoms 17 , and similar results have been obtained in adolescent girls 27 . Here, we find that positive memory specificity is associated with reduced morning cortisol over time, thus potentially regulating an important physiological vulnerability marker of depression (note that this effect is present for both genders; see Supplementary Results).…”

Positive memory specificity is associated with reduced vulnerability to depression

“…Morning cortisol is a physiological marker of vulnerability to depression; high morning cortisol is associated with familial risk for 9 , onset 6,8 , presence 7 and history of 7 major depression. Recently, morning cortisol was shown to interact with stressful life events leading to more depressive symptoms in adolescent girls 26 . Recalling positive memories, in contrast, has been shown to dampen the cortisol response to stress 4 .…”

Cortisol awakening response and additive serotonergic genetic risk interactively predict depression in two samples: The 2019 Donald F. Klein Early Career Investigator Award Paper

“…We found that the CAR remained a significant predictor for 2.5 years in a sample followed for 4 years (Vrshek‐Schallhorn et al, ). (Several studies that found nonsignificant results for CAR's prospective effect have aimed to predict depression or its symptoms either at a single point or over a timespan beyond which CAR would be expected to remain predictive; Carnegie et al, ; LeMoult, Ordaz, Kircanski, Singh, & Gotlib, ; Schuler et al, . )…”