Macrostructural Brain Morphology as Moderator of the Relationship Between Pandemic-Related Stress and Internalizing Symptomology During COVID-19 in High-Risk Adolescents

McKinley Pawlak; Jennifer Kemp; Signe Bray; Sneha Chenji; Melanie Noel; Kathryn A Birnie; Frank P MacMaster; Jillian Vinall Miller; Daniel C Kopala-Sibley

doi:10.1016/j.bpsc.2024.07.002

Macrostructural Brain Morphology as Moderator of the Relationship Between Pandemic-Related Stress and Internalizing Symptomology During COVID-19 in High-Risk Adolescents

Biol Psychiatry Cogn Neurosci Neuroimaging. 2024 Jul 15:S2451-9022(24)00190-3. doi: 10.1016/j.bpsc.2024.07.002. Online ahead of print.

Authors

McKinley Pawlak¹, Jennifer Kemp², Signe Bray³, Sneha Chenji⁴, Melanie Noel⁵, Kathryn A Birnie⁶, Frank P MacMaster⁷, Jillian Vinall Miller⁸, Daniel C Kopala-Sibley⁹

Affiliations

¹ Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Alberta Children Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Alberta, Canada. Electronic address: mckinley.pawlak@ucalgary.ca.
² Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Alberta, Canada.
³ Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Alberta Children Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Child and Adolescent Imaging Research Program, University of Calgary, Calgary, Alberta, Canada; Department of Radiology, University of Calgary, Calgary, Alberta, Canada; Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.
⁴ Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
⁵ Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Alberta Children Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
⁶ Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Alberta Children Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Alberta, Canada; Department of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
⁷ Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; IWK Health, Halifax, Nova Scotia, Canada.
⁸ Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Alberta Children Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Calgary, Alberta, Canada.
⁹ Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Alberta Children Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Alberta, Canada; Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.

PMID: 39019399
DOI: 10.1016/j.bpsc.2024.07.002

Abstract

Background: According to person-by-environment models, individual differences in traits may moderate the association between stressors and the development of psychopathology; however, findings in the literature have been inconsistent and little literature has examined adolescent brain structure as a moderator of the effects of stress on adolescent internalizing symptoms. The COVID-19 pandemic presented a unique opportunity to examine the associations between stress, brain structure, and psychopathology. Given links of cortical morphology with adolescent depression and anxiety, the current study investigated whether cortical morphology moderated the relationship between stress from the COVID-19 pandemic and the development of internalizing symptoms in familial high-risk adolescents.

Methods: Prior to the COVID-19 pandemic, 72 adolescents (27 male) completed a measure of depressive and anxiety symptoms and underwent magnetic resonance imaging. T1-weighted images were acquired to assess cortical thickness and surface area. Approximately 6 to 8 months after COVID-19 was declared a global pandemic, adolescents reported their depressive and anxiety symptoms and pandemic-related stress.

Results: Adjusting for pre-pandemic depressive and anxiety symptoms and stress, increased pandemic-related stress was associated with increased depressive but not anxiety symptoms. This relationship was moderated by cortical thickness and surface area in the anterior cingulate and cortical thickness in the medial orbitofrontal cortex such that increased stress was only associated with increased depressive and anxiety symptoms among adolescents with lower cortical surface area and higher cortical thickness in these regions.

Conclusions: Results further our understanding of neural vulnerabilities to the associations between stress and internalizing symptoms in general and during the COVID-19 pandemic in particular.

Keywords: Anxiety; COVID-19 pandemic; Cortical surface area; Cortical thickness; Depression; Stress.