Objective. This study investigated whether low reward responsiveness marks vulnerability for developing depression in a large cohort of never-depressed 16-year-old adolescents who completed a reward task and were subsequently followed for 9 years, during which onset of depression was assessed. Method. Data were collected as part of the TRacking Adolescents’ Individual Lives Survey (TRAILS), an ongoing prospective cohort study. Reward responsiveness was assessed by the spatial orienting task at 16 years and depression was assessed at 19 years by the World Health Organization Composite International Diagnostic Interview and at 25 years by the Lifetime Depression Assessment Self-Report. Participants who completed the reward task at 16 years, had no previous onset of depression, and were assessed on depression onset at 19 and/or 25 years were included in the present study (N = 531; 81 became depressed during follow-up). Results. Difficulties in shifting attention from expected non-reward to expected reward and from expected punishment to expected non-punishment at 16 years predicted depression during follow-up. This was found only at an automatic level of information processing. Conclusion. The findings suggest that decreased reward responsiveness at 16 years marks vulnerability for depression. Prevention programs may aim at increasing at-risk adolescents’ responsiveness to cues for potential rewards, particularly in situations in which they are focused on negative experiences.
Importance. Oral contraceptives have been associated with an increased risk of subsequent clinical depression in adolescents. However, the association of oral contraceptive use with concurrent depressive symptoms remains unclear. Objectives. To investigate the association between oral contraceptive use and depressive symptoms and to examine whether this association is affected by age and which specific symptoms are associated with oral contraceptive use. Design, Setting, and Participants. Data from the third to sixth wave of the prospective cohort study Tracking Adolescents' Individual Lives Survey (TRAILS), conducted from September 1, 2005, to December 31, 2016, among females aged 16 to 25 years who had filled out at least 1 and up to 4 assessments of oral contraceptive use, were used. Data analysis was performed from March 1, 2017, to May 31, 2019. Exposure. Oral contraceptive use at 16, 19, 22, and 25 years of age. Main Outcomes and Measures. Depressive symptoms were assessed by the DSM-IV-oriented affective problems scale of the Youth (aged 16 years) and Adult Self-Report (aged 19, 22, and 25 years). Results. Data from a total of 1010 girls (743-903 girls, depending on the wave) were analyzed (mean [SD] age at the first assessment of oral contraceptive use, 16.3 [0.7]; (mean [SD] age at the final assessment of oral contraceptive use, 25.6 [0.6] years). Oral contraceptive users particularly differed from nonusers at age 16 years, with nonusers having a higher mean (SD) socioeconomic status (0.17 [0.78] vs -0.15 [0.71]) and more often being virgins (424 of 533 [79.5%] vs 74 of 303 [24.4%]). Although all users combined (mean [SD] ages, 16.3 [0.7] to 25.6 [0.6] years) did not show higher depressive symptom scores compared with nonusers, adolescent users (mean [SD] age, 16.5 [0.7] years) reported higher depressive symptom scores compared with their nonusing counterparts (mean [SD] age, 16.1 [0.6] years) (mean [SD] score, 0.40 [0.30] vs 0.33 [0.30]), which persisted after adjustment for age, socioeconomic status and ethnicity (β coefficient for interaction with age, -0.021; 95% CI, -0.038 to -0.005; P = .0096). Adolescent contraceptive users particularly reported more crying (odds ratio, 1.89; 95% CI, 1.38-2.58; P < .001), hypersomnia (odds ratio, 1.68; 95% CI, 1.14-2.48; P = .006), and more eating problems (odds ratio, 1.54; 95% CI, 1.13-2.10; P = .009) than nonusers. Conclusions and Relevance. Although oral contraceptive use showed no association with depressive symptoms when all age groups were combined, 16-year-old girls reported higher depressive symptom scores when using oral contraceptives. Monitoring depressive symptoms in adolescents who are using oral contraceptives is important, as the use of oral contraceptives may affect their quality of life and put them at risk for nonadherence.
A prominent hypothesis within the field of psychiatry is that the manifestation of psychopathology changes from non-specific to specific as illness severity increases. Using a transdiagnostic network approach, we investigated this hypothesis in four independent groups with increasing psychopathology severity. We investigated whether symptom domains became more interrelated and formed more clusters as illness severity increased, using empirical tests for two network characteristics: global network strength and modularity-based community detection. Four severity groups, ranging from subthreshold psychopathology to having received a diagnosis and treatment, were derived with a standardized diagnostic interview conducted at age 18.5 (n = 1933; TRAILS cohort). Symptom domains were assessed using the Adult Self Report (ASR). Pairwise comparisons of the symptom networks across groups showed no difference in global network strength between severity groups. Similar number and type of communities detected in the four groups exceeded the more minor differences across groups. Common clusters consisted of domains associated with attention deficit hyperactivity disorder (ADHD) and combined depression and anxiety domains. Based on the strength of symptom domain associations and symptom clustering using a network approach, we found no support for the hypothesis that the manifestation of psychopathology along the severity continuum changes from non-specific to specific.
Introduction. Several statistical methods are available to identify developmental trajectory classes, but it is unclear which method is most suitable. The aim of this study was to determine whether latent class analysis, latent class growth analysis or growth mixture modeling was most appropriate for identifying developmental trajectory classes. Methods. We compared the three methods in a simulation study in several scenarios, which varied regarding e.g. sample size and degree of separation between classes. The simulation study was replicated with a real data example concerning anxiety/depression symptoms measured over 6 time points in the Tracking Adolescent Individuals’ Lives Survey (TRAILS, N = 2227). Results. Growth mixture modeling was least biased or equally biased compared to latent class analysis and latent class growth analysis in all scenarios. In TRAILS, the shapes of the trajectories were rather similar over the three methods, but class sizes differed slightly. A 4-class growth mixture model performed best, based on several fit indices, interpretability and clinical relevance. Conclusions. Growth mixture modeling seems most suitable to identify developmental trajectory classes. Copyright © 2020 Elsevier B.V.