Social connection is the strongest protective factor for depression
August 14, 2020
Science Daily/Massachusetts General Hospital
Researchers from Massachusetts General Hospital (MGH) have identified a set of modifiable factors from a field of over 100 that could represent valuable targets for preventing depression in adults. In a study published in The American Journal of Psychiatry, the team named social connection as the strongest protective factor for depression, and suggested that reducing sedentary activities such as TV watching and daytime napping could also help lower the risk of depression.
"Depression is the leading cause of disability worldwide, but until now researchers have focused on only a handful of risk and protective factors, often in just one or two domains," says Karmel Choi, PhD, investigator in the Department of Psychiatry and the Harvard T.H. Chan School of Public Health, and lead author of the paper. "Our study provides the most comprehensive picture to date of modifiable factors that could impact depression risk."
To that end, researchers took a two-stage approach. The first stage drew on a database of over 100,000 participants in the UK Biobank -- a world-renowned cohort study of adults -- to systematically scan a wide range of modifiable factors that might be associated with the risk of developing depression, including social interaction, media use, sleep patterns, diet, physical activity, and environmental exposures. This method, known as an exposure-wide association scan (ExWAS), is analogous to genome-wide association studies (GWAS) that have been widely used to identify genetic risk factors for disease. The second stage took the strongest modifiable candidates from ExWAS and applied a technique called Mendelian randomization (MR) to investigate which factors may have a causal relationship to depression risk. MR is a statistical method that treats genetic variation between people as a kind of natural experiment to determine whether an association is likely to reflect causation rather than just correlation.
This two-stage approach allowed the MGH researchers to narrow the field to a smaller set of promising and potentially causal targets for depression. "Far and away the most prominent of these factors was frequency of confiding in others, but also visits with family and friends, all of which highlighted the important protective effect of social connection and social cohesion," points out Jordan Smoller, MD, ScD associate chief for research in the MGH Department of Psychiatry, and senior author of the study. "These factors are more relevant now than ever at a time of social distancing and separation from friends and family." The protective effects of social connection were present even for individuals who were at higher risk for depression as a result of genetic vulnerability or early life trauma.
On the other hand, factors associated with depression risk included time spent watching TV, though the authors note that additional research is needed to determine if that risk was due to media exposure per se or whether time in front of the TV was a proxy for being sedentary. Perhaps more surprising, the tendency for daytime napping and regular use of multivitamins appeared to be associated with depression risk, though more research is needed to determine how these might contribute.
The MGH study demonstrates an important new approach for evaluating a wide range of modifiable factors, and using this evidence to prioritize targets for preventive interventions for depression. "Depression takes an enormous toll on individuals, families, and society, yet we still know very little about how to prevent it," says Smoller. "We've shown that it's now possible to address these questions of broad public health significance through a large-scale, data-based approach that wasn't available even a few years ago. We hope this work will motivate further efforts to develop actionable strategies for preventing depression." The study's two-stage approach could also be used to inform the prevention of other health conditions.
https://www.sciencedaily.com/releases/2020/08/200814131007.htm
Increased attention to sad faces predicts depression risk in teenagers
July 28, 2020
Science Daily/Binghamton University
Teenagers who tend to pay more attention to sad faces are more likely to develop depression, but specifically within the context of stress, according to new research from Binghamton University, State University of New York.
Researchers at Binghamton University, led by graduate student Cope Feurer and Professor of Psychology Brandon Gibb, aimed to examine whether attentional biases to emotional stimuli, assessed via eye tracking, serve as a marker of risk for depression for teenagers.
"Although previous studies from the lab have examined who is most likely to show biased attention to sad faces and whether attention to sad faces is associated with risk for depression, the current study is the first to look at whether these attention biases impact how teenagers respond to stress, both in the lab and in the real world," said Feurer.
Biased attention to sad faces is associated with depression in adults and is hypothesized to increase depression risk specifically in the presence, but not absence, of stress by modulating stress reactivity. However, few studies have tested this hypothesis, and no studies have examined the relation between attentional biases and stress reactivity during adolescence, despite evidence that this developmental window is marked by significant increases in stress and depression risk.
Seeking to address these limitations, the new study examined the impact of adolescents' sustained attention to facial displays of emotion on individual differences in both mood reactivity to real-world stress and physiological reactivity to a laboratory-based stressor. Consistent with vulnerability-stress models of attention, greater sustained attention to sad faces was associated with greater depressive reactions to real-world stress.
"If a teenager has a tendency to pay more attention to negative stimuli, then when they experience something stressful they are likely to have a less adaptive response to this stress and show greater increases in depressive symptoms," said Feurer. "For example, if two teenagers both have a fight with a friend and one teenager spends more time paying attention to negative stimuli (i.e., sad faces) than the other, then that teenager may show greater increases in depressive symptoms in response to the stressor, potentially because they are paying more attention to the stressor and how the stressor makes them feel."
The researchers believe that the biological mechanism behind this finding lies in the brain's ability to control emotional reactivity.
"Basically, if the brain has difficulty controlling how strongly a teenager responds to emotions, this makes it harder for them to look away from negative stimuli and their attention gets 'stuck,'" said Feurer. "So, when teenagers who tend to pay more attention to sad faces experience stress, they may respond more strongly to this stress, as they have difficulty disengaging their attention from negative emotions, leaving these teens at increased risk for depression."
"This is also why we believe that findings were stronger for older than younger adolescents. Specifically, the brain becomes more effective at controlling emotional reactivity as teens get older, so it may be that being able to look away from negative stimuli doesn't protect against the impact of stress until later adolescence."
There is increasing research showing that the way teenagers pay attention to emotional information can be modified through intervention, and that changing attention biases can reduce risk for depression. The current study highlights attention toward sad faces as a potential target for intervention, particularly among older teenagers, said Feurer.
The researchers recently submitted a grant that would let them look at how these attention biases change across childhood and adolescence.
"This will help us better understand how this risk factor develops and how it increases risk for depression in youth," said Gibb. "Hopefully, this will help us to develop interventions to identify risk for these types of biases so that they can be mitigated before they lead to depression."
https://www.sciencedaily.com/releases/2020/07/200728130837.htm
Anger more harmful to health of older adults than sadness
Associated with increased inflammation, which can lead to chronic disease
May 9, 2019
Science Daily/American Psychological Association
Anger may be more harmful to an older person's physical health than sadness, potentially increasing inflammation, which is associated with such chronic illnesses as heart disease, arthritis and cancer, according to new research published by the American Psychological Association.
"As most people age, they simply cannot do the activities they once did, or they may experience the loss of a spouse or a decline in their physical mobility and they can become angry," said Meaghan A. Barlow, MA, of Concordia University, lead author of the study, which was published in Psychology and Aging. "Our study showed that anger can lead to the development of chronic illnesses, whereas sadness did not."
Barlow and her co-authors examined whether anger and sadness contributed to inflammation, an immune response by the body to perceived threats, such as infection or tissue damage. While inflammation in general helps protect the body and assists in healing, long-lasting inflammation can lead to chronic illnesses in old age, according to the authors.
The researchers collected and analyzed data from 226 older adults ages 59 to 93 from Montreal. They grouped participants as being in early old age, 59 to 79 years old, or advanced old age, 80 years old and older.
Over one week, participants completed short questionnaires about how angry or sad they felt. The authors also measured inflammation from blood samples and asked participants if they had any age-related chronic illnesses.
"We found that experiencing anger daily was related to higher levels of inflammation and chronic illness for people 80 years old and older, but not for younger seniors," said study co-author Carsten Wrosch, PhD, also of Concordia University. "Sadness, on the other hand, was not related to inflammation or chronic illness."
Sadness may help older seniors adjust to challenges such as age-related physical and cognitive declines because it can help them disengage from goals that are no longer attainable, said Barlow.
This study showed that not all negative emotions are inherently bad and can be beneficial under certain circumstances, she explained.
"Anger is an energizing emotion that can help motivate people to pursue life goals," said Barlow. "Younger seniors may be able to use that anger as fuel to overcome life's challenges and emerging age-related losses and that can keep them healthier. Anger becomes problematic for adults once they reach 80 years old, however, because that is when many experience irreversible losses and some of life's pleasures fall out of reach."
The authors suggested that education and therapy may help older adults reduce anger by regulating their emotions or by offering better coping strategies to manage the inevitable changes that accompany aging.
"If we better understand which negative emotions are harmful, not harmful or even beneficial to older people, we can teach them how to cope with loss in a healthy way," said Barlow. "This may help them let go of their anger."
https://www.sciencedaily.com/releases/2019/05/190509092729.htm
Teens who can describe negative emotions can stave off depression
June 28, 2019
Science Daily/University of Rochester
Teenagers who can describe their negative emotions in precise and nuanced ways are better protected against depression than their peers who can't. That's the conclusion of a new study about negative emotion differentiation, or NED -- the ability to make fine-grained distinctions between negative emotions and apply precise labels -- published in the journal Emotion.
"Adolescents who use more granular terms such as 'I feel annoyed,' or 'I feel frustrated,' or 'I feel ashamed' -- instead of simply saying 'I feel bad' -- are better protected against developing increased depressive symptoms after experiencing a stressful life event," explains lead author Lisa Starr, an assistant professor of psychology at the University of Rochester.
Those who score low on negative emotion differentiation tend to describe their feelings in more general terms such as "bad" or "upset." As a result, they are less able to benefit from useful lessons encoded in their negative emotions, including the ability to develop coping strategies that could help them regulate how they feel.
"Emotions convey a lot of information. They communicate information about the person's motivational state, level of arousal, emotional valence, and appraisals of the threatening experience," says Starr. A person has to integrate all that information to figure out -- "am I feeling irritated," or "am I feeling angry, embarrassed, or some other emotion?"
Once you know that information you can use it to help determine the best course of action, explains Starr: "It's going to help me predict how my emotional experience will unfold, and how I can best regulate these emotions to make myself feel better."
The team found that a low NED strengthens the link between stressful life events and depression, leading to reduced psychological well-being.
By focusing exclusively on adolescence, which marks a time of heightened risk for depression, the study zeroed in on a gap in the research to date. Prior research suggests that during adolescence a person's NED plunges to its lowest point, compared to that of younger children or adults. It's exactly during this developmentally crucial time that depression rates climb steadily.
Previous research had shown that depression and low NED were related to each other, but the research designs of previous studies did not test whether a low NED temporally preceded depression. To the researchers, this phenomenon became the proverbial chicken-and-egg question: did those youth who showed signs of significant depressive symptoms have a naturally low NED, or was their NED low as a direct result of their feeling depressed?
The team, made up of Starr, Rachel Hershenberg, an assistant professor of psychiatry at Emory University, and Rochester graduate students Zoey Shaw, Irina Li, and Angela Santee, recruited 233 mid-adolescents in the greater Rochester area with an average age of nearly 16 (54 percent of them female) and conducted diagnostic interviews to evaluate the participants for depression.
Next, the teenagers reported their emotions four times daily over the period of seven days. One and a half years later, the team conducted follow-up interviews with the original participants (of whom 193 returned) to study longitudinal outcomes.
The researchers found that youth who are poor at differentiating their negative emotions are more susceptible to depressive symptoms following stressful life events. Conversely, those who display high NED are better at managing the emotional and behavioral aftermath of being exposed to stress, thereby reducing the likelihood of having negative emotions escalate into a clinically significant depression over time.
Depression ranks among the most challenging public health problems worldwide. As the most prevalent mental disorder, it not only causes recurring and difficult conditions for sufferers, but also costs the U.S. economy tens of billions of dollars each year and has been identified by the World Health Organization as the number one cause of global burden among industrialized nations. Particularly depression in adolescent girls is an important area to study, note the researchers, as this age brings a surge in depression rates, with a marked gender disparity that continues well into adulthood.
Adolescent depression disrupts social and emotional development, which can lead to a host of negative outcomes, including interpersonal problems, reduced productivity, poor physical health, and substance abuse. Moreover, people who get depressed during adolescence are more likely to become repeatedly depressed throughout their life span, says Starr. That's why mapping the emotional dynamics associated with depression is key to finding effective treatments.
"Basically you need to know the way you feel, in order to change the way you feel," says Starr. "I believe that NED could be modifiable, and I think it's something that could be directly addressed with treatment protocols that target NED."
The team's findings contribute to a growing body of research that tries to make inroads in the fight against rising rates of adolescent depression, suicidal thoughts, and suicide. According to the most recent CDC data, about 17 percent of high school students nationwide say they have thought of suicide, more than 13 percent said they actually made a suicide plan, and 7.4 percent attempted suicide in the past year.
"Our data suggests that if you are able to increase people's NED then you should be able to buffer them against stressful experiences and the depressogenic effect of stress," says Starr.
https://www.sciencedaily.com/releases/2019/06/190628120447.htm