Stress reactivity moderates the association between stressful life events and depressive symptoms in adolescents: Results from a population-based study

Background: A large body of evidence links stressful life events with depression. However, little is understood about the role of perceived impact in this association.

Methods: We performed regression analysis to investigate whether self-reported stress reactivity (derived by regressing the impact-weighted life event score on the unweighted score) moderated the association between stressful life events and depressive symptoms in adolescents from the Avon Longitudinal Study of Parents and Children cohort (n = 4791), controlling for age at outcome, sex, ethnicity, and maternal education. Depressive symptoms were assessed using the self-report Short Mood and Feelings Questionnaire (score range 0-26) at 16 years of age. Adolescents also reported on their exposure to 23 possible stressful life events since age 12 and their impact, which were used to define stress reactivity groups using a residual regression approach.

Results: We identified a moderating effect of stress reactivity. Adolescents with high stress reactivity showed a stronger association between the number of stressful life events and depressive symptoms than adolescents with low (b = 0.32, 95 % CI = 0.13, 0.50, p < 0.001) or typical (b = 0.44, 95 % CI = 0.28, 0.60, p < 0.001) stress reactivity.

Limitations: Limitations include the use of retrospective life event measures and limited generalisability of findings to other population-based, high-risk, or clinical samples.

Conclusions: When resources are limited, interventions should prioritise individuals with high stress reactivity who have experienced multiple stressful life events, as these individuals may be at greater risk for depression.