Neural markers of emotion regulation difficulties moderate effects of COVID‐19 stressors on adolescent depression

Abstract

Background Stressful events, such as those imposed by the COVID‐19 pandemic, are associated with depression risk, raising questions about processes that make some people more susceptible to the effects of stress on mental health than others. Emotion regulation may be a key process, but methods for objectively measuring emotion regulation abilities in youth are limited. We leveraged event‐related potential (ERP) measures and a longitudinal study of adolescents oversampled for depression and depression risk to examine emotion regulation difficulties as prospective predictors of depressive symptoms in response to pandemic‐related stress. Methods Before the pandemic, adolescents with (n = 28) and without (n = 34) clinical depression (N = 62 total) completed an explicit emotion regulation task while ERP data were recorded and measures of depressive symptoms. Adolescents were re‐contacted during the pandemic to report on COVID‐19 related stressful events and depressive symptoms (n = 48). Results Adolescents who had never experienced a depressive episode showed an increase in depressive symptoms during the pandemic, but adolescents who were clinically depressed before the pandemic did not exhibit significant changes in symptoms. Neural markers of emotion regulation abilities interacted with pandemic‐related stressful events to predict depressive symptoms during the pandemic, such that stressors predicted increases in depressive symptoms only for adolescents with greater difficulty modulating responses to negative images before the pandemic. Conclusions Results provide insight into adolescent mental health during the COVID‐19 pandemic and highlight the role of emotion regulatory brain function in risk and resilience for depression.

Early executive control buffers risk for adolescent psychopathology during the COVID‐19 pandemic

“…Consistent with emerging research, COVID‐related stress uniquely predicted adolescent internalizing problems during the first 6 months of the pandemic after controlling for prepandemic symptom levels. Further, consistent with our hypothesis and recent longitudinal work exploring neural markers of EC before the pandemic (Chahal et al, 2021; Gupta et al, 2022), the effect of COVID‐related stress on internalizing problems was stronger to the extent that preschool EC was lower. That is, the strength of the association between COVID‐related stress and internalizing problems significantly weakened and became statistically nonsignificant as preschool EC increased.…”

“…Relatedly, adolescents reporting moderate to high COVID‐related distress experienced significantly greater increases in internalizing symptoms during the first few months of the pandemic (Magson et al, 2021). Further, recent longitudinal studies exploring neural markers of EC demonstrate that deficits before the onset of COVID‐19 are associated with increased adolescent psychopathology during the pandemic after controlling for prepandemic symptom levels (Chahal et al, 2021; Gupta et al, 2022). Taken together, this research suggests that EC and COVID‐related stress play an important role in determining adolescent psychopathology amid the pandemic; however, to our knowledge, there are no studies examining how early EC interacts with pandemic‐related stress to predict increases in adolescent psychopathology.…”

Neural Predictors of Improvement With Cognitive Behavioral Therapy for Adolescents With Depression: An Examination of Reward Responsiveness and Emotion Regulation

“…2 . To assess the temporal dynamics of emotion regulation and given prior research showing the LPP is composed of several distinct but overlapping positivities (Foti et al, 2009 ; Pegg et al, 2019 ), the LPP was scored across three time windows: 400-1000 ms, 1000-3500 ms, and 3500-6000 ms, consistent with prior research (Gupta et al, 2022 ). Spearman-Brown coefficients for split-half reliabilities for the full LPP window (400-6000 ms) were acceptable to good (0.58-0.74 across electrode poolings and conditions), but reliability varied across the time course of the LPP (reliabilities across frontal sites for reappraisal in the middle and late window and the neutral condition in the late window ranged from 0.53-0.58; all other time windows, conditions, and poolings ranged from 0.65-0.81).…”

Reduced reward responsiveness and depression vulnerability: Consideration of social contexts and implications for intervention

“…I was first introduced to EEG/ERP methods as a post‐baccalaureate research assistant working with Dr. Koraly Pérez‐Edgar and have spent the past 15 years applying these methods to better understand depression risk and intervention. EEG/ERPs show promise for characterizing a range of RDoC constructs and depression vulnerabilities, including processing of negative emotional stimuli (Dickey et al., 2021) and emotion regulation abilities (Gupta et al., 2022), but I focus this review on reward responsiveness—a key component of RDoC's positive valence systems—and connections with social processes. A simplified conceptual model of the development of low reward responsiveness, associations with depression risk, and potential windows for intervention is presented in Figure 1.…”