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Maladaptive mood repair, atypical respiratory sinus arrhythmia, and risk of a recurrent major depressive episode among adolescents with prior major depression

Published online by Cambridge University Press:  20 May 2016

M. Kovacs ,
I. Yaroslavsky ,
J. Rottenberg ,
C. J. George ,
E. Kiss ,
K. Halas ,
R. Dochnal ,
I. Benák ,
I. Baji  and
A. Vetró
...Show all authors
M. Kovacs*
Affiliation:
University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
I. Yaroslavsky
Affiliation:
Cleveland State University, OH, USA
J. Rottenberg
Affiliation:
University of South Florida, FL, USA
C. J. George
Affiliation:
University of Pittsburgh Medical Center, PA, USA
E. Kiss
Affiliation:
Szeged University, Hungary
K. Halas
Affiliation:
Szeged University, Hungary
R. Dochnal
Affiliation:
Szeged University, Hungary
I. Benák
Affiliation:
Szeged University, Hungary
I. Baji
Affiliation:
Szeged University, Hungary
A. Vetró
Affiliation:
Szeged University, Hungary
A. Makai
Affiliation:
Szeged University, Hungary
K. Kapornai
Affiliation:
Szeged University, Hungary
*
*Address for correspondence: M. Kovacs, Ph.D., University of Pittsburgh School of Medicine, WPIC, 3811 O'Hara Street, Pittsburgh, PA 15213, USA. (Email: kovacs@pitt.edu)
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Abstract

Background

Because depressive illness is recurrent, recurrence prevention should be a mainstay for reducing its burden on society. One way to reach this goal is to identify malleable risk factors. The ability to attenuate sadness/dysphoria (mood repair) and parasympathetic nervous system functioning, indexed as respiratory sinus arrhythmia (RSA), are impaired during depression and after it has remitted. The present study therefore tested the hypothesis that these two constructs also may mirror risk factors for a recurrent major depressive episode (MDE).

Method

At time 1 (T1), 178 adolescents, whose last MDE had remitted, and their parents, reported on depression and mood repair; youths’ RSA at rest and in response to sad mood induction also were assessed. MDE recurrence was monitored until time 2 (T2) up to 2 years later. Mood repair at T1 (modeled as a latent construct), and resting RSA and RSA response to sadness induction (RSA profile), served to predict onset of first recurrent MDE by T2.

Results

Consistent with expectations, maladaptive mood repair predicted recurrent MDE, above and beyond T1 depression symptoms. Further, atypical RSA profiles at T1 were associated with high levels of maladaptive mood repair, which, in turn, predicted increased risk of recurrent MDE. Thus, maladaptive mood repair mediated the effects of atypical RSA on risk of MDE recurrence.

Conclusions

This study documented that a combination of behavioral and physiological risk factors predicted MDE recurrence in a previously clinically referred sample of adolescents with depression histories. Because mood repair and RSA are malleable, both could be targeted for modification to reduce the risk of recurrent depression in youths.

Keywords

Adolescentsemotion regulationmood repairrecurrent major depressionrespiratory sinus arrhythmia
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 10 , July 2016 , pp. 2109 - 2119
Copyright
Copyright © Cambridge University Press 2016 

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