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Mechanisms underlying the comorbidity between depressive and addictive disorders in adolescents: interactions between stress and HPA activity.

ABSTRACT: OBJECTIVE:Depression may be a precursor to substance use disorder in some youngsters, and substance abuse might complicate the subsequent course of depression. This study examined whether hypothalamic-pituitary-adrenal (HPA) activity and stressful life experiences are related to the development of substance use disorder in depressed and nondepressed adolescents, and whether substance use disorder predicts a worsening course of depression. METHOD:Urinary-free cortisol was measured for 3 nights in 151 adolescents with no prior history of substance use disorder (55 depressed, 48 at high risk for depression, and 48 normal subjects). Information was obtained on recent stressful life experiences. The participants were followed for up to 5 years to assess the onset of substance use disorder, course of depression, and stressful experiences. The relationships among depression, cortisol as a measure of HPA activity, stressful experiences, and substance use disorder were examined. RESULTS:Elevated cortisol was associated with onset of substance use disorder. Stressful life experiences moderated this relationship. Cortisol and stress accounted for the effects of a history or risk of depression on the development of substance use disorder. Substance use disorder was associated with higher frequency of subsequent depressive episodes. CONCLUSIONS:Higher cortisol prior to the onset of substance use disorder may indicate vulnerability to substance use disorder. Stressful experiences increase the risk for substance use disorder in such vulnerable youth. The high prevalence of substance use disorders in depressed individuals may be explained, in part, by high levels of stress and increased HPA activity.

SUBMITTER: Rao U

PROVIDER: S-EPMC2770585 | biostudies-literature | 2009 Mar

REPOSITORIES: biostudies-literature

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Mechanisms underlying the comorbidity between depressive and addictive disorders in adolescents: interactions between stress and HPA activity.

Rao Uma U Hammen Constance L CL Poland Russell E RE

The American journal of psychiatry 20090217 3

<h4>Objective</h4>Depression may be a precursor to substance use disorder in some youngsters, and substance abuse might complicate the subsequent course of depression. This study examined whether hypothalamic-pituitary-adrenal (HPA) activity and stressful life experiences are related to the development of substance use disorder in depressed and nondepressed adolescents, and whether substance use disorder predicts a worsening course of depression.<h4>Method</h4>Urinary-free cortisol was measured ...[more]

PMID: 19223436

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Project description:BACKGROUND AND AIMS:To determine whether transdiagnostic risk, represented as elevations in one high-risk personality trait, interacts with behavior-specific risk, represented as elevated expectancies for reinforcement from either drinking or smoking, to account partly for early adolescent drinking and smoking behavior. DESIGN:Multiple regression analysis. SETTING:Twenty-three public schools in two school systems in the United States. PARTICIPANTS:A sample of 1897 adolescents tested in the spring of 5th, 6th, 7th, 8th and 9th grades. MEASUREMENTS:Transdiagnostic risk was measured as negative urgency, the tendency to act rashly when distressed, using the UPPS-P child version. Drinking-specific and smoking-specific risk were measured as expectancies for reinforcement from drinking and smoking, using the Memory Model-Based Expectancy Questionnaire (alcohol) and the Adolescent Smoking Consequences Questionnaire (smoking). FINDINGS:There was consistent concurrent prediction from the interactions of (a) negative urgency and alcohol reinforcement expectancies to early adolescent drinking and (b) negative urgency and smoking reinforcement expectancies to early adolescent smoking, above and beyond prediction from the main effects of those variables. In each case, expectancies were more predictive at higher levels of negative urgency. Incremental R2 values for main effects ranged from 0.07 to 0.26, and for interactions ranged from 0.01 to 0.03. Prospectively, the main effects predicted subsequent behavior but the interaction effects did not, except in one case. CONCLUSIONS:Among elementary and high school students in the United States, the joint effects of negative urgency and behavior-specific expectancies help to explain drinking and smoking behavior. Joint elevations on the trait and the learning variable account for drinking and smoking behavior beyond the main effects of each predictor. However, there is reason to doubt whether the joint effects predict subsequent increases in drinking and smoking beyond the main effects of those variables.

Project description:AimTo gain insight into the relations between protective/risk family interactions and depressive symptoms in adolescent boys and girls.MethodA self-reported cross-sectional survey was conducted on a representative sample of 1191 secondary school students (617 girls and 574 boys) aged from 14 to 19 years, with a median of 16, from all secondary schools in the Primorsko-goranska County, Croatia in January and February 2010. Students reported their depressive symptoms, perceptions about the relationship with their mother and father, family activities, and parents' conflict resolution strategies. Data were analyzed by hierarchical multiple regression to calculate the effects of family supportive and harmful interactions on depressive symptoms in girls and boys.ResultsDepressive symptoms were reported often and very often by 19.1% of girls and 15.8% of boys. Girls' assessment of the family relations was significantly more positive than boys', including the assessment of family activities, constructive family conflict resolution, or father's and mother's warmth and affection. Multiple correlation analysis revealed that the examined family variables accounted for 16.3% of the variance of depressive symptoms in boys and for 17.2% in girls. Hierarchical multiple regression analysis showed a difference in the relation of family variables and depressive symptoms between boys and girls. Depressive symptoms in girls were more linked to the lack of protective family factors (9.9% of the explained variance in girls vs. 5.5% in boys), while depressive symptoms in boys were more linked to the existence of harmful family factors (10.8% of the explained variance in boys vs.7.3% in girls).ConclusionFamily activities and the father's warmth and affection have a higher significance for girls than for boys, while destructive parental conflict and the mother's aggression and hostility are equally significant for both girls and boys. These results indicate the targets for family-based preventive and intervention programs for depression in adolescents.

Dataset Information

Mechanisms underlying the comorbidity between depressive and addictive disorders in adolescents: interactions between stress and HPA activity.

Publications

Mechanisms underlying the comorbidity between depressive and addictive disorders in adolescents: interactions between stress and HPA activity.

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