Early temperamental and neurocognitive risk factors may play a role in future anxiety and depression

Early temperamental and neurocognitive risk factors may play a role in future anxiety and depression

A recent imaging study led by a scientist at the University of Texas at Dallas has identified early risk factors linked to children's temperament and a neural process that could predict whether a person might develop depression and anxiety in adolescence and early adulthood.

The study, published Oct. 26 in JAMA Psychiatry, followed a cohort of 165 people from 4 months old between 1989 and 1993 to age 26.

Dr. Alva Tang, assistant professor of psychology in the School of Behavioral and Brain Sciences and corresponding author of the study, found that people who are more inhibited in early childhood and also don't tend to respond to potential rewards like adolescents are more prone to developing depression later in life, more so than anxiety.

“The results highlight different mechanisms in the brain and relate them to who is at higher risk for developing various mental health problems,” said Tang, who conducted the research at the University of Maryland, College Park before coming to UT Dallas in August. “These results could inform the development of prevention-focused treatments tailored to the individual.”

When babies are exposed to new objects, people, or situations, some respond positively and approach them without fear, while others respond with caution or avoidance. This distinction defines uninhibited versus inhibited behavior.

We know that inhibited children are more likely to have anxiety disorders later in life, particularly social anxiety, which begins in late childhood through adolescence. Less is known about depression, which generally occurs later in young adulthood. But we know that people who have had an anxiety disorder are 50% to 60% more likely to suffer from depression later in life, so inhibited children should also be at higher risk for depression.”

Dr. Alva Tang, Assistant Professor of Psychology, Department of Behavioral and Brain Sciences

Tang's research is unique for its characterization of the subjects' early temperamental risks and the protracted period over which they were studied.

"To show a link to increases in depressive symptoms over time, we need to follow subjects over decades, as full-blown syndromes usually do not appear until young adulthood," she said.

As young children, subjects were categorized as either inhibited or uninhibited. As adolescents, they underwent functional MRIs while performing a task to measure their brain's response in anticipation of rewards -; in this case try to win money.

"We looked at the ventral striatum, a brain region that has been well studied in understanding depression in adults, to see whether it is related to maladaptive processing in the brain's reward centers," Tang said.

Some study participants showed a blunted response in this brain region in response to possible monetary rewards.

The researchers found that the association between inhibition at ages 14 to 24 months and worsening depressive symptoms at ages 15 to 26 only existed among those who also showed attenuated activity in the ventral striatum as adolescents. There was no similar association with anxiety.

"We found that behavioral inhibition is associated with worsening depressive symptoms into adulthood. This supports the contention that this temperament has a stronger association with the development of anxiety in adolescence, but is more strongly associated with depression in adulthood. However, not all inhibited children develop anxiety or depression," Tang said. "Particularly the inhibited children, who have blunted striatal activity were more likely to be depressed in young adulthood.”

Tang said her previous research has linked anxiety to neural networks and processes subserving attention and executive functions, while current work highlights reward and motivation centers in the brain linked to depression.

“This study is novel because it can separate different types of brain correlates for these different diseases,” she said.

There are already interventions for socially anxious and behaviorally disordered children that improve social and cognitive skills, Tang said. Additional interventions for these children could target motivational deficits, for example by teaching them to actively create conditions in which they can engage socially with their peers and seek positive experiences.

"This, in turn, could reduce the likelihood of developing depression resulting from not being socially engaged or missing opportunities for positive experiences," she said.

She said future studies could examine the effectiveness of programs that target maladaptive reward processing in anxious adolescents to reduce the risk of later depression.

Anxiety and depression are complex conditions that can be triggered by a variety of factors -; Genetics, environment and others, Tang said.

“Here we show strong evidence that both early temperamental risk factors and maladaptive neurocognitive processing of rewards are involved in the development of depression.”

Additional authors of the article include researchers at the Intramural Research Program of the National Institute of Mental Health in Bethesda, Maryland, as well as scientists at Pennsylvania State University, University College London, the University of California, Davis, and the University of Maryland, College Park.

Source:

University of Texas at Dallas

Reference:

Tang, A., et al. (2022) Striatal anticipatory reward activity as a moderator of the association between early behavioral inhibition and changes in anxiety and depressive symptoms from adolescence to adulthood. JAMA Psychiatry. doi.org/10.1001/jamapsychiatry.2022.3483.

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