In Search of HPA Axis Dysregulation in Child and Adolescent Depression

Dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis in adults with major depressive disorder is among the most consistent and robust biological findings in psychiatry. Given the importance of the adolescent transition to the development and recurrence of depressive phenomena over the lifespan, it is important to have an integrative perspective on research investigating the various components of HPA axis functioning among depressed young people. The present narrative review synthesizes evidence from the following five categories of studies conducted with children and adolescents: (1) those examining the HPA system’s response to the dexamethasone suppression test (DST); (2) those assessing basal HPA axis functioning; (3) those administering corticotropin-releasing hormone (CRH) challenge; (4) those incorporating psychological probes of the HPA axis; and (5) those examining HPA axis functioning in children of depressed mothers. Evidence is generally consistent with models of developmental psychopathology that hypothesize that atypical HPA axis functioning precedes the emergence of clinical levels of depression and that the HPA axis becomes increasingly dysregulated from child to adult manifestations of depression. Multidisciplinary approaches and longitudinal research designs that extend across development are needed to more clearly and usefully elucidate the role of the HPA axis in depression

A kid-friendly tool to assess rumination in children and early adolescents: relationships with mother psychopathology and family functioning

The early identification of ruminative processes in children and early adolescents is particularly important to prevent the development of a stable ruminative style in later stages of development. The present study first aimed at validating a child-friendly tool, Kid Rumination Interview (KRI), to be used in a sample aged 7–12 years (n = 100; 50% females). Second, we hypothesized that maternal depression, family functioning and participants’ emotion regulation skills would be associated with children’ levels of rumination. Factor analysis on KRI scores yielded two main factors: personal life-related rumination and school-related rumination. Older and female participants showed higher tendencies to ruminate about school issues compared to their younger and male counterparts. A low-to-moderate correlation emerged between school-related rumination and child/early adolescent’s emotion regulation capacities. Mothers’ depressive rumination and mothers’ depressive symptoms were positively associated with children/early adolescents’ rumination about personal life and rumination about school issues. Conversely, an adequate and positive family functioning was negatively correlated with both school-related rumination and rumination about personal life. Hierarchical regression analyses pointed to a crucial role of maternal rumination and familiar rigidity in both types of rumination. Personal life-related rumination was also specifically predicted by maternal depression and family enmeshment, whereas school-related rumination was significantly associated with children/early adolescents’ emotional control and gender. Overall, the KRI appears as a promising tool to assess rumination in children/early adolescents. Results suggests partially different pathways to specific forms of ruminative thoughts