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Stress Sensitization and Adolescent Depressive Severity as a Function of Childhood Adversity: A Link to Anxiety Disorders

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Abstract

The goal of the present study was to determine whether exposure to adversity in childhood contributes to a differential threshold at which stressful life events provoke depressive reactions in adolescence. In addition, to address empirical and conceptual questions about stress effects, the moderating effect of anxiety disorder history was also explored. This examination was conducted in a sample of 816 children of depressed and nondepressed mothers, who were followed from birth to age 15. Information on adversities experienced in childhood was collected both from mothers during the first five years of their youth’s life and from the youths themselves at age 15, and included information on the mother’s relationship with her partner, maternal psychopathology, as well as youth-reported abuse. Results indicated that youths with both greater exposure to adversity in childhood and a history of an anxiety disorder displayed increased depressive severity following low levels of episodic stress compared to youths with only one or neither of these risk factors. The results are speculated to reflect the possibility that early anxiety disorders associated with exposure to adversity in childhood may be a marker of dysregulated stress responses, and may help to account for the comorbidity of depression and anxiety in some individuals.

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Notes

  1. It was decided not to exclude the 29 mothers who were missing DAS data for three or four time points because analyses indicated that they were not a random subsample, differing significantly in depression history (χ 2 (1, N = 816) = 4.04, p < .05) and their youths’ reports of total episodic stress (t(814) = 2.233, p < .05). Therefore, a conservative method of imputation of the missing DAS scores was used that consisted of assigning them the mean of the total sample.

  2. Final analyses excluding those 25 youths whose mothers were missing data points in the computation of the “mother-reported adversities” variable were largely the same. The 3-way interaction of childhood adversity, total episodic stress, and anxiety history remained highly significant (b = −.06, t(743) = −2.93, p < .005).

  3. Reliability of the dating of maternal diagnoses in the first 5 years was examined in the following ways: Mothers’ contemporaneous self-reports of depression on the DSSI were averaged across the 4 waves of MUSP in the first 5 years of the child’s life. Mothers who met DSM criteria for a depressive diagnosis in the first five years of the child’s life endorsed significantly more depressive symptoms than did mothers who did not meet criteria over that time period (t(810) = 7.052, p < .0001).

    Mothers’ self-reports of anxiety on the DSSI were also averaged across the 4 waves of MUSP. Mothers who met criteria for an anxiety disorder in the first five years of the child’s life reported significantly more anxious symptoms than did mothers who did not meet criteria over that time period (t(813) = 4.393, p < .0001).

    At the fourth wave of data collection in MUSP, mothers reported on both the frequency with which they drank alcohol since the time of their child’s birth and the amount of alcohol they consumed at those times. Mothers who met diagnostic criteria for alcohol abuse in the first five years of the child’s life reported greater frequency of consuming alcohol (t(811) = 4.413, p < .0001) and greater amount of alcohol consumed (t(811) = 4.095, p < .0001) than did mothers who did not meet criteria over that time period.

    Finally, at the fourth wave of data collection in MUSP, mothers also reported on the frequency with which they used any “sedatives, sleeping pills, tranquillizers, anti-depressants, or other drugs” to help them relax in the last week. Mothers who met criteria for substance abuse in the first five years of the child’s life reported greater frequency of using drugs to help them relax than did mothers who did not meet criteria over that time period (t(804) = 2.589, p < .01).

  4. Eleven youths were missing BDI scores, thus, depressive severity component scores could not be computed for these individuals. An additional 29 youths did not have family income information available. These 40 youths did not differ from the remainder of the sample in terms of any of the relevant study variables (p = ns) and were omitted from remaining analyses. Thus, the sample size for final analyses was 776.

  5. Results of simple slope analyses indicated that depressive severity differed by level of recent stress among youths with a history of an anxiety disorder and low adversity in childhood (b = .11, t(764) = 2.76, p < .01) and among youths without a history of an anxiety disorder and high adversity in childhood (b = .04, t(764) = 3.31, p < .001). Both indicated higher levels of recent stress predicting higher depressive severity. Depressive severity did not differ by level of recent stress among youths with a history of an anxiety disorder and high adversity in childhood (b = .02, t(764) = .95, p = .35, ns) nor among youths without a history of an anxiety disorder and low adversity in childhood (b = .01, t(764) = .99, p = .32, ns).

    Depressive severity differed by level of childhood adversity among youths with a history of an anxiety disorder and low recent stress (b = .11, t(764) = 2.76, p < .01), among youths without a history of an anxiety disorder and low recent stress (b = .11, t(764) = 2.067, p < .05), and among youths without a history of an anxiety disorder and high recent stress (b = .21, t(764) = 4.50, p < .001), each indicating higher levels of childhood adversity predicting higher depressive severity. Depressive severity did not differ by level of childhood adversity among youths with a history of an anxiety disorder and high levels of recent stress, (b = .02, t(764) = .96, p = .72, ns).

    Finally, depressive severity differed by anxiety history status among youths with high childhood adversity and low recent stress (b = .47, t(764) = 2.96, p < .01), among youths with high childhood adversity and high recent stress (b = .33, t(764) = 2.536, p < .05), and among youths with low childhood adversity and high recent stress (b = .66, t(764) = 2.94, p < .01), each indicating higher depressive severity among those with a history of anxiety disorder than among those without an anxiety disorder history. Depressive severity did not differ as a function of anxiety disorder history among youths with low childhood adversity and low recent stress (b = −.15, (t(764) = −.752, p = .45, ns).

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Authors and Affiliations

  1. Department of Psychology, University of California, Los Angeles, USA

    Emmanuel P. Espejo, Constance L. Hammen & Nicole P. Connolly

  2. Emory University, Atlanta, Georgia, USA

    Patricia A. Brennan

  3. University of Queensland, Brisbane, Australia

    Jake M. Najman & William Bor

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  1. Emmanuel P. Espejo
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  2. Constance L. Hammen
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Correspondence to Emmanuel P. Espejo.

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Espejo, E.P., Hammen, C.L., Connolly, N.P. et al. Stress Sensitization and Adolescent Depressive Severity as a Function of Childhood Adversity: A Link to Anxiety Disorders. J Abnorm Child Psychol 35, 287–299 (2007). https://doi.org/10.1007/s10802-006-9090-3

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