Adolescent stress experience–expression–physiology correspondence: Links to depression, self-injurious thoughts and behaviors, and frontolimbic neural circuity

Background: Dysregulated stress responsivity is implicated in adolescent risk for depression and self-injurious thoughts and behaviors (STBs). However, studies often examine levels of the stress response in isolation, precluding understanding of how coordinated disturbance across systems confers risk. The current study utilized a novel person-centered approach to identify stress correspondence profiles and linked them to depressive symptoms, STBs, and neural indices of self-regulatory capacity. Method: Adolescents with and without a major depressive disorder diagnosis (N = 162, M_age = 16.54, SD = 1.96, 72.8% White, 66.5% female) completed the Trier Social Stress Test (TSST), questionnaires, and clinical interviews. Stress experience (self-report), expression (observed), and physiology (salivary cortisol) were assessed during the experimental protocol. Adolescents also underwent a magnetic resonance imaging scan. Results: Multitrajectory modeling revealed four profiles. High Experience–High Expression–Low Physiology (i.e., lower stress correspondence) adolescents were more likely to report depressive symptoms, lifetime nonsuicidal self-injury, and suicidal ideation relative to all other subgroups reflecting higher stress correspondence: Low Experience–Low Expression–Low Physiology, Moderate Experience–Moderate Expression–Moderate Physiology, High Experience–High Expression–High Physiology. High Experience–High Expression–Low Physiology adolescents also exhibited less positive amygdala–ventromedial prefrontal cortex resting state functional connectivity relative to Moderate Experience–Moderate Expression–Moderate Physiology. Limitations: Data were cross-sectional, precluding inference about our profiles as etiological risk factors or mechanisms of risk. Conclusions: Findings illustrate meaningful heterogeneity in adolescent stress correspondence with implications for multimodal, multilevel assessment and outcome monitoring in depression prevention and intervention efforts.