Journal of Abnormal Child Psychology

, Volume 47, Issue 8, pp 1391–1399 | Cite as

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

  • Shimrit DachesEmail author
  • Vera Vine
  • Charles J. George
  • Maria Kovacs


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.


Stress reactivity Adversity Depression Respiratory sinus arrhythmia High-risk offspring 



This study was supported by the National Institute of Mental Health Grant numbers: RO1 MH085722 and T32 MH018951, Rockville, MD.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that there is no potential or actual conflict of interest.


  1. Badanes, L. S., Watamura, S. E., & Hankin, B. L. (2011). Hypocortisolism as a potential marker of allostatic load in children: Associations with family risk and internalizing disorders. Development and Psychopathology, 23(3), 881–896.PubMedPubMedCentralCrossRefGoogle Scholar
  2. Beardslee, W., Versage, E., & Giadstone, T. (1998). Children of affectively ill parents: A review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry, 37(11), 1134–1141.PubMedCrossRefGoogle Scholar
  3. Berntson, G. G., Bigger, J. T., Jr., Eckberg, D. L., Grossman, P., Kaufmann, P. G., Malik, M., et al. (1997). Heart rate variability: Origins, methods, and interpretive caveats. Psychophysiology, 34(6), 623–648.PubMedCrossRefGoogle Scholar
  4. Bodner, T. E. (2016). Tumble graphs: Avoiding misleading end point extrapolation when graphing interactions from a moderated multiple regression analysis. Journal of Educational and Behavioral Statistics, 41(6), 593–604.CrossRefGoogle Scholar
  5. Bouma, E. M. C., Ormel, J., Verhulst, F. C., & Oldehinkel, A. J. (2008). Stressful life events and depressive problems in early adolescent boys and girls: The influence of parental depression, temperament and family environment. Journal of Affective Disorders, 105(1), 185–193.PubMedCrossRefGoogle Scholar
  6. Chapman, D. P., Whitfield, C. L., Felitti, V. J., Dube, S. R., Edwards, V. J., & Anda, R. F. (2004). Adverse childhood experiences and the risk of depressive disorders in adulthood. Journal of Affective Disorders, 82(2), 217–225.PubMedCrossRefGoogle Scholar
  7. Downey, G., & Coyne, J. C. (1990). Children of depressed parents: An integrative review. Psychological Bulletin, 108(1), 50–76.PubMedCrossRefGoogle Scholar
  8. Duan, H., Wang, L., Zhang, L., Liu, J., Zhang, K., & Wu, J. (2015). The relationship between cortisol activity during cognitive task and posttraumatic stress symptom clusters. PLoS One, 10(12), 1–13.CrossRefGoogle Scholar
  9. Ellis, B. J., & Boyce, W. T. (2008). Biological sensitivity to context. Current Directions in Psychological Science, 17(3), 183–187.CrossRefGoogle Scholar
  10. Ellis, B. J., & Boyce, W. T. (2011). Differential susceptibility to the environment: Toward an understanding of sensitivity to developmental experiences and context. Development and Psychopathology, 23(1), 1–5.PubMedCrossRefGoogle Scholar
  11. El-Sheikh, M., & Whitson, S. A. (2006). Longitudinal relations between marital conflict and child adjustment: Vagal regulation as a protective factor. Journal of Family Psychology, 20(1), 30–39.PubMedCrossRefGoogle Scholar
  12. Engert, V., Efanov, S. I., Dedovic, K., Duchesne, A., Dagher, A., & Pruessner, J. C. (2010). Perceived early-life maternal care and the cortisol response to repeated psychosocial stress. Journal of Psychiatry and Neuroscience, 35(6), 370–377.PubMedCrossRefGoogle Scholar
  13. Forbes, E. E., Miller, A., Cohn, J. F., Fox, N. A., & Kovacs, M. (2005). Affect-modulated startle in adults with childhood-onset depression: Relations to bipolar course and number of lifetime depressive episodes. Psychiatry Research, 134(1), 11–25.PubMedCrossRefGoogle Scholar
  14. Gentzler, A. L., Santucci, A. K., Kovacs, M., & Fox, N. A. (2009). Respiratory sinus arrhythmia reactivity predicts emotion regulation and depressive symptoms in at-risk and control children. Biological Psychology, 82(2), 156–163.PubMedPubMedCentralCrossRefGoogle Scholar
  15. Gentzler, A. L., Rottenberg, J., Kovacs, M., George, C. J., & Morey, J. N. (2012). Atypical development of resting respiratory sinus arrhythmia in children at high risk for depression. Developmental Psychobiology, 54(5), 556–567.PubMedCrossRefGoogle Scholar
  16. Gerra, G., Zaimovic, A., Zambelli, U., Timpano, M., Reali, N., Bernasconi, S., & Brambilla, F. (2000). Neuroendocrine responses to psychological stress in adolescents with anxiety disorder. Neuropsychobiology, 42(2), 82–92.PubMedCrossRefGoogle Scholar
  17. Goodman, S. H., & Gotlib, I. H. (1999). Risk for psychopathology in the children of depressed mothers: A developmental model for understanding mechanisms of transmission. Psychological Review, 106(3), 458–490.PubMedCrossRefGoogle Scholar
  18. Goodman, S. H., Rouse, M. H., Connell, A. M., Broth, M. R., Hall, C. M., & Heyward, D. (2011). Maternal depression and child psychopathology: A meta-analytic review. Clinical Child and Family Psychology Review, 14(1), 1–27.PubMedCrossRefGoogle Scholar
  19. Graziano, P., & Derefinko, K. (2013). Cardiac vagal control and children’s adaptive functioning: A meta-analysis. Biological Psychology, 94(1), 22–37.PubMedPubMedCentralCrossRefGoogle Scholar
  20. Green, J. G., McLaughlin, K. A., Berglund, P. A., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2010). Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication I: Associations with first onset of DSM-IV disorders. Archives of General Psychiatry, 67(2), 113–123.PubMedPubMedCentralCrossRefGoogle Scholar
  21. Hamilton, J. L., & Alloy, L. B. (2016). Atypical reactivity of heart rate variability to stress and depression across development: Systematic review of the literature and directions for future research. Clinical Psychology Review, 50(1), 67–79.PubMedPubMedCentralCrossRefGoogle Scholar
  22. Hankin, B. L. (2015). Depression from childhood through adolescence: Risk mechanisms across multiple systems and levels of analysis. Current Opinion in Psychology, 4, 13–20.PubMedPubMedCentralCrossRefGoogle Scholar
  23. Harkness, K. L., Stewart, J. G., & Wynne-Edwards, K. E. (2011). Cortisol reactivity to social stress in adolescents: Role of depression severity and child maltreatment. Psychoneuroendocrinology, 36(2), 173–181.PubMedCrossRefGoogle Scholar
  24. Heim, C., & Nemeroff, C. B. (1999). The impact of early adverse experiences on brain systems involved in the pathophysiology of anxiety and affective disorders. Biological Psychiatry, 46(11), 1509–1522.PubMedCrossRefGoogle Scholar
  25. Holterman, L. A., Murray-Close, D. K., & Breslend, N. L. (2016). Relational victimization and depressive symptoms: The role of autonomic nervous system reactivity in emerging adults. International Journal of Psychophysiology, 110(1), 119–127.PubMedCrossRefGoogle Scholar
  26. Kaffman, A., & Meaney, M. J. (2007). Neurodevelopmental sequelae of postnatal maternal care in rodents: Clinical and research implications of molecular insights. Journal of Child Psychology and Psychiatry, 48(3–4), 224–244.PubMedCrossRefGoogle Scholar
  27. Katz, L. F., & Gottman, J. M. (1997). Buffering children from marital conflict and dissolution. Journal of Clinical Child Psychology, 26(2), 157–171.PubMedCrossRefGoogle Scholar
  28. Lupien, S. J., McEwen, B. S., Gunnar, M. R., & Heim, C. (2009). Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nature Reviews Neuroscience, 10(6), 434–445.PubMedCrossRefGoogle Scholar
  29. Lutgendorf, S. K., Kreder, K. J., Rothrock, N. E., Ratliff, T. L., & Zimmerman, B. (2000). Stress and symptomatology in patients with interstitial cystitis: A laboratory stress model. The Journal of Urology, 164(4), 1265–1269.PubMedCrossRefGoogle Scholar
  30. Malcarne, V. L., Hamilton, N. A., Ingram, R. E., & Taylor, L. (2000). Correlates of distress in children at risk for affective disorder: Exploring predictors in the offspring of depressed and nondepressed mothers. Journal of Affective Disorders, 59(1), 243–251.PubMedCrossRefGoogle Scholar
  31. Mayer, L., Lopez-Duran, N. L., Kovacs, M., George, C. J., Baji, I., Kapornai, K., et al. (2009). Stressful life events in a clinical sample of depressed children in Hungary. Journal of Affective Disorders, 115(1), 207–214.PubMedCrossRefGoogle Scholar
  32. Maziade, M., Roy, M., Fournier, J., Cliche, D., Mérette, C., Caron, C., et al. (1992). Reliability of best-estimate diagnosis in genetic linkage studies of major psychoses: Results from the Quebec pedigree studies. The American Journal of Psychiatry, 149(12), 1674–1686.PubMedCrossRefGoogle Scholar
  33. McCann, B. S., Carter, J., Vaughan, M., Raskind, M., Wilkinson, C. W., & Veith, R. C. (1993). Cardiovascular and neuroendocrine responses to extended laboratory challenge. Psychosomatic Medicine, 55(6), 497–504.PubMedCrossRefGoogle Scholar
  34. McLaughlin, K. A., Alves, S., & Sheridan, M. A. (2014). Vagal regulation and internalizing psychopathology among adolescents exposed to childhood adversity. Developmental Psychobiology, 56(5), 1036–1051.PubMedCrossRefGoogle Scholar
  35. McLaughlin, K. A., Sheridan, M. A., Tibu, F., Fox, N. A., Zeanah, C. H., & Nelson, C. A. (2015). Causal effects of the early caregiving environment on development of stress response systems in children. Proceedings of the National Academy of Sciences, 112(18), 5637–5642.CrossRefGoogle Scholar
  36. Miller, A., Fox, N. A., Cohn, J. F., Forbes, E. E., Sherrill, J. T., & Kovacs, M. (2002). Regional patterns of brain activity in adults with a history of childhood-onset depression: Gender differences and clinical variability. American Journal of Psychiatry, 159(6), 934–940.PubMedCrossRefGoogle Scholar
  37. Morris, M. C., Ciesla, J. A., & Garber, J. (2010). A prospective study of stress autonomy versus stress sensitization in adolescents at varied risk for depression. Journal of Abnormal Psychology, 119(2), 341–354.PubMedPubMedCentralCrossRefGoogle Scholar
  38. Obradović, J., Bush, N. R., & Boyce, W. T. (2011). The interactive effect of marital conflict and stress reactivity on externalizing and internalizing symptoms: The role of laboratory stressors. Development and Psychopathology, 23(1), 101–114.PubMedCrossRefGoogle Scholar
  39. Ouellet-Morin, I., Wong, C. C., Danese, A., Pariante, C. M., Papadopoulos, A. S., Mill, J., & Arseneault, L. (2013). Increased serotonin transporter gene (SERT) DNA methylation is associated with bullying victimization and blunted cortisol response to stress in childhood: A longitudinal study of discordant monozygotic twins. Psychological Medicine, 43(9), 1813–1823.PubMedCrossRefGoogle Scholar
  40. Porges, S. W. (1995). Cardiac vagal tone: A physiological index of stress. Neuroscience and Biobehavioral Reviews, 19, 225–233.PubMedCrossRefGoogle Scholar
  41. Porges, S. W. (2007). The polyvagal perspective. Biological Psychology, 74(2), 116–143.PubMedCrossRefGoogle Scholar
  42. Sherrill, J. T., & Kovacs, M. (2000). Interview schedule for children and adolescents (ISCA). Journal of the American Academy of Child and Adolescent Psychiatry, 39(1), 67–75.PubMedCrossRefGoogle Scholar
  43. Stange, J. P., Hamilton, J. L., Olino, T. M., Fresco, D. M., & Alloy, L. B. (2017). Autonomic reactivity and vulnerability to depression: A multi-wave study. Emotion, 17(4), 602–615.PubMedCrossRefGoogle Scholar
  44. Steinberg, L., & Avenevoli, S. (2000). The role of context in the development of psychopathology: A conceptual framework and some speculative propositions. Child Development, 71(1), 66–74.PubMedCrossRefGoogle Scholar
  45. Stroop, J. R. (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology, 18, 643–662.CrossRefGoogle Scholar
  46. Tottenham, N., Tanaka, J. W., Leon, A. C., McCarry, T., Nurse, M., Hare, T. A., et al. (2009). The NimStim set of facial expressions: Judgments from untrained research participants. Psychiatry Research, 168(3), 242–249.PubMedPubMedCentralCrossRefGoogle Scholar
  47. von Klitzing, K., Perren, S., Klein, A. M., Stadelmann, S., White, L. O., Groeben, M., et al. (2012). The interaction of social risk factors and HPA axis dysregulation in predicting emotional symptoms of five- and six-year-old children. Journal of Psychiatric Research, 46, 290–297.CrossRefGoogle Scholar
  48. Whitson, S. A., & El-Sheikh, M. (2003). Marital conflict and health: Processes and protective factors. Aggression and Violent Behavior, 8(3), 283–312.CrossRefGoogle Scholar
  49. Williams, J. M. G., Mathews, A., & MacLeod, C. (1996). The emotional Stroop task and psychopathology. Psychological Bulletin, 120(1), 3–24.PubMedCrossRefGoogle Scholar
  50. Woodruff, R. S. (1971). A simple method for approximating the variance of a complicated estimate. Journal of the American Statistical Association, 66(334), 411–414.CrossRefGoogle Scholar
  51. Yaroslavsky, I., Rottenberg, J., & Kovacs, M. (2014). Atypical patterns of respiratory sinus arrhythmia index an endophenotype for depression. Development and Psychopathology, 26, 1337–1352.PubMedPubMedCentralCrossRefGoogle Scholar
  52. Yeung, W. J., Linver, M. R., & Brooks–Gunn, J. (2002). How money matters for young children's development: Parental investment and family processes. Child Development, 73(6), 1861–1879.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Shimrit Daches
    • 1
    • 2
    Email author
  • Vera Vine
    • 2
  • Charles J. George
    • 3
  • Maria Kovacs
    • 2
  1. 1.Department of PsychologyBar-Ilan UniversityRamat GanIsrael
  2. 2.Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghUSA
  3. 3.University of Pittsburgh Medical CenterPittsburghUSA

Personalised recommendations