Stressful Life Events, Depression, and the Moderating Role of Psychophysiological Reactivity in Patients with Pediatric Inflammatory Bowel Disease

Overview

Journal J Psychosom Res

Specialty Psychiatry

Date 2020 Dec 15

PMID 33321262

Citations 3

Authors

Grace K Cushman

Sharon Shih

Mary Gray Stolz

Rebecca C Hinrichs

Tanja Jovanovic

Jennifer L Lee

Subra Kugathasan

Bonney Reed

Affiliations

Soon will be listed here.

Abstract

Objective: The development of depressive symptoms in youth with IBD is a concerning disease complication, as higher levels of depressive symptoms have been associated with poorer quality of life and lower medication adherence. Previous research has examined the association between disease activity and depression, but few studies have examined individual differences in experience of stressful life events in relation to depressive symptoms. The purpose of the current study is to examine the relation between stressful life events and depression within pediatric IBD and to determine whether individual differences in stress response moderates this association.

Methods: 56 youth ages 8-17 years old diagnosed with IBD completed questionnaires about their depressive symptoms and history of stressful life events. We assessed skin conductance reactivity (SCR) to a stressful task as an index of psychophysiological reactivity.

Results: Stressful life events (r = 0.36, p = .007) were positively related to depressive symptoms. Youth who demonstrated a greater maximum SC level during the IBD-specific stress trial compared to baseline (n = 32) reported greater depressive symptoms. For these same participants, the relationship between stressful life events and depressive symptoms depended on SCR F(3, 28) = 4.23, p = .01, such that at moderate and high levels of SCR, a positive relationship between stressful life events and depressive symptoms was observed.

Conclusions: The relationship between stressful life events and depressive symptoms in youth with IBD may depend on individual differences in processing stress, such that risk may increase with greater psychophysiological reactivity.

Citing Articles

Prospective Measurement of Skin Conductance Response during Trauma Interview Predicts Future PTSD Severity in Trauma Exposed Children.

Basarkod S, Valbrun S, Wiltshire C, France J, Davie W, Winters S J Mood Anxiety Disord. 2024; 7.

PMID: 38559776 PMC: 10976609. DOI: 10.1016/j.xjmad.2024.100061.

Negative caregiving and stress reactivity moderate the relation between early life stress and externalizing in adolescence.

Buthmann J, Miller J, Chahal R, Berens A, Gotlib I Dev Psychobiol. 2022; 64(7):e22327.

PMID: 36282754 PMC: 9608333. DOI: 10.1002/dev.22327.

Associations between children's trauma-related sequelae and skin conductance captured through mobile technology.

Wiltshire C, Wanna C, Stenson A, Minton S, Reda M, Davie W Behav Res Ther. 2022; 150:104036.

PMID: 35078028 PMC: 8887191. DOI: 10.1016/j.brat.2022.104036.

References

Sexton K, Walker J, Graff L, Bernstein M, Beatie B, Miller N . Evidence of Bidirectional Associations Between Perceived Stress and Symptom Activity: A Prospective Longitudinal Investigation in Inflammatory Bowel Disease. Inflamm Bowel Dis. 2017; 23(3):473-483. DOI: 10.1097/MIB.0000000000001040. View

Szigethy E, Levy-Warren A, Whitton S, Bousvaros A, Gauvreau K, Leichtner A . Depressive symptoms and inflammatory bowel disease in children and adolescents: a cross-sectional study. J Pediatr Gastroenterol Nutr. 2004; 39(4):395-403. DOI: 10.1097/00005176-200410000-00017. View

Stapersma L, van den Brink G, Szigethy E, Escher J, Utens E . Systematic review with meta-analysis: anxiety and depression in children and adolescents with inflammatory bowel disease. Aliment Pharmacol Ther. 2018; 48(5):496-506. DOI: 10.1111/apt.14865. View

McQuaid E, Fritz G, Nassau J, Lilly M, Mansell A, Klein R . Stress and airway resistance in children with asthma. J Psychosom Res. 2000; 49(4):239-45. DOI: 10.1016/s0022-3999(00)00173-2. View

Griffin M, Resick P, Galovski T . Does physiologic response to loud tones change following cognitive-behavioral treatment for posttraumatic stress disorder?. J Trauma Stress. 2012; 25(1):25-32. PMC: 3336195. DOI: 10.1002/jts.21667. View

Kappelman M, Crandall W, Colletti R, Goudie A, Leibowitz I, Duffy L . Short pediatric Crohn's disease activity index for quality improvement and observational research. Inflamm Bowel Dis. 2010; 17(1):112-7. PMC: 2998542. DOI: 10.1002/ibd.21452. View

El-Sheikh M . The role of emotional responses and physiological reactivity in the marital conflict-child functioning link. J Child Psychol Psychiatry. 2005; 46(11):1191-9. DOI: 10.1111/j.1469-7610.2005.00418.x. View

GANGULI S, Kamath M, Redmond K, Chen Y, Irvine E, Collins S . A comparison of autonomic function in patients with inflammatory bowel disease and in healthy controls. Neurogastroenterol Motil. 2007; 19(12):961-7. DOI: 10.1111/j.1365-2982.2007.00987.x. View

Pinquart M, Shen Y . Depressive symptoms in children and adolescents with chronic physical illness: an updated meta-analysis. J Pediatr Psychol. 2010; 36(4):375-84. DOI: 10.1093/jpepsy/jsq104. View

10.

El-Sheikh M . Children's skin conductance level and reactivity: are these measures stable over time and across tasks?. Dev Psychobiol. 2007; 49(2):180-6. DOI: 10.1002/dev.20171. View

11.

Hyams J, Ferry G, Mandel F, GRYBOSKI J, Kibort P, Kirschner B . Development and validation of a pediatric Crohn's disease activity index. J Pediatr Gastroenterol Nutr. 1991; 12(4):439-47. View

12.

Harris P, Taylor R, Minor B, Elliott V, Fernandez M, ONeal L . The REDCap consortium: Building an international community of software platform partners. J Biomed Inform. 2019; 95:103208. PMC: 7254481. DOI: 10.1016/j.jbi.2019.103208. View

13.

Greenley R, Hommel K, Nebel J, Raboin T, Li S, Simpson P . A meta-analytic review of the psychosocial adjustment of youth with inflammatory bowel disease. J Pediatr Psychol. 2010; 35(8):857-69. PMC: 3107587. DOI: 10.1093/jpepsy/jsp120. View

14.

Pellissier S, Dantzer C, Canini F, Mathieu N, Bonaz B . Psychological adjustment and autonomic disturbances in inflammatory bowel diseases and irritable bowel syndrome. Psychoneuroendocrinology. 2009; 35(5):653-62. DOI: 10.1016/j.psyneuen.2009.10.004. View

15.

Malaty H, Fan X, Opekun A, Thibodeaux C, Ferry G . Rising incidence of inflammatory bowel disease among children: a 12-year study. J Pediatr Gastroenterol Nutr. 2009; 50(1):27-31. DOI: 10.1097/MPG.0b013e3181b99baa. View

16.

Burke P, Kocoshis S, Chandra R, Whiteway M, Sauer J . Determinants of depression in recent onset pediatric inflammatory bowel disease. J Am Acad Child Adolesc Psychiatry. 1990; 29(4):608-10. DOI: 10.1097/00004583-199007000-00015. View

17.

Hommel K, Greenley R, Maddux M, Gray W, Mackner L . Self-management in pediatric inflammatory bowel disease: A clinical report of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr. 2013; 57(2):250-7. PMC: 3723797. DOI: 10.1097/MPG.0b013e3182999b21. View

18.

Schuman S, Graef D, Janicke D, Gray W, Hommel K . An exploration of family problem-solving and affective involvement as moderators between disease severity and depressive symptoms in adolescents with inflammatory bowel disease. J Clin Psychol Med Settings. 2013; 20(4):488-96. PMC: 4048997. DOI: 10.1007/s10880-013-9368-x. View

19.

Diefenbach K, Breuer C . Pediatric inflammatory bowel disease. World J Gastroenterol. 2006; 12(20):3204-12. PMC: 4087963. DOI: 10.3748/wjg.v12.i20.3204. View

20.

Sawczenko A, Sandhu B, Logan R, Jenkins H, Taylor C, Mian S . Prospective survey of childhood inflammatory bowel disease in the British Isles. Lancet. 2001; 357(9262):1093-4. DOI: 10.1016/s0140-6736(00)04309-9. View