What biological, cognitive, emotional, and social factors predict the emergence of affective disorders in adolescents as they transition to early adulthood? This William T. Grant Scholar award funded a longitudinal study of adolescents that examined how changes in each of these areas, independently and in conjunction with one another, are related to the emergence of symptoms and diagnoses of affective disorders, specifically major depression. Adam focused on the effects of everyday stress (e.g., marital conflict between parents, negative emotional connections with parents, lack of positive social networks) on stress hormone activity; the role of sleep timing and quality in the development of affective disorders; and differences in self-reported daily experiences between depressed and non-depressed adolescents. Her sample consisted of 200 ethnically and socioeconomically diverse 16- and 17-year-olds from Evanston, Illinois, and Santa Monica, California. The students were tracked until they were 20 or 21 as part of this grant (data collection is ongoing), and they participated in cortisol sampling and sleep quality measurement each year. Findings showed that youth with concurrent diagnoses of anxiety and depression had higher evening cortisol and less pronounced declines in cortisol across the day (flatter diurnal cortisol slopes), due to an increased number of life stresses and negative emotions. Chronic negative experiences and emotions (such as encountering a large number of stressful life events in the past year, and chronic feelings of loneliness) are associated with poorly regulated basal cortisol levels, and increased cortisol reactivity to moments of negative emotion and loneliness. Adam suggests that over time, the wear and tear of chronic stress, negative emotion, and depression contribute to impaired functioning of the biological stress systems that are typically supposed to help us cope with daily stress. Findings also suggested that youth with exaggerated patterns of cortisol response at baseline were found to be more vulnerable to new onsets of major depressive disorder over time. Youth who had a larger rise in cortisol in the 30 minutes immediately after awakening (known as the cortisol awakening response) are more likely to be diagnosed with a mood disorder over the subsequent three years. Adam has also found that low hours of sleep predict the presence of a flatter diurnal cortisol rhythm, a pattern which has been associated with a variety of health risks, including increased risk for cardiovascular disease.
What biological, cognitive, emotional, and social factors predict the emergence of affective disorders in adolescents as they transition to early adulthood?