Neurophysiological Indices of Emotion Processing Predict the Impact of COVID-19 Pandemic-Related Stress on Internalizing Symptoms

• In Event: Family functioning and child mental health in the COVID-19 pandemic: Implications for risk, resilience, and recovery

Abstract

Exposure to stressful events related to the COVID-19 pandemic have been associated with substantial increases in the prevalence of depression and anxiety, raising questions about vulnerabilities that make some individuals more susceptible to experiencing internalizing symptoms following stress exposure. The present prospective longitudinal studies examined changes in internalizing symptoms from pre- to post-pandemic onset, differences in the frequencies of exposure to pandemic-related stressful events, and whether neurophysiological indices of emotional reactivity and regulation moderated the impact of stress associated with the pandemic on internalizing symptom changes in adolescent and emerging adult samples. Emotion reactivity and regulation were indexed by the late-positive potential (LPP), an event-related potential reflecting the sustained processing of motivationally salient stimuli. Emerging adults (N = 75; age 18-22) initially completed measures of internalizing symptoms and an interpersonal emotional images task while electroencephalogram was recorded pre-pandemic and were re-contacted post-pandemic onset in May 2020 to complete measures of exposure to pandemic-related stressful events and current internalizing symptoms. Adolescents (N = 48; age 14-17) at varying risk for depression completed pre-pandemic assessments involving diagnostic interviews and self-reports of internalizing symptoms, as well as an interpersonal emotional images task and emotion regulation task while electroencephalogram was recorded. Similarly, the adolescents were re-contacted post-pandemic onset in May 2020 to complete follow-up measures of internalizing symptoms and exposure to pandemic-related stressful events.
Results indicated that emerging adults experienced significant increases in symptoms of depression and traumatic intrusions from pre- to post-pandemic onset. While there was an overall trend for increases in depressive symptoms in the adolescent sample, distinct patterns emerged based on depression status pre-pandemic. Adolescents diagnosed with clinical depression pre-pandemic experienced significant decreases in depression whereas adolescents without a depressive disorder pre-pandemic experienced significant increases in depressive symptoms. Additionally, both adolescents and emerging adults experienced significant decreases in social anxiety symptoms from pre- to post-pandemic onset. Multiple linear regression analyses were conducted to test the main and interactive effects of pandemic-related stress exposure and LPP amplitudes to emotional stimuli during passive viewing and cognitive reappraisal. Furthermore, in the emerging adult sample significant interactions between LPP reactivity to positive interpersonal stimuli and interpersonal stress emerged in the prediction of post-pandemic internalizing symptoms controlling for baseline symptoms. Under high exposure to interpersonal stressors, reduced LPPs predicted increases in depressive symptoms while enhanced LPPs predicted increases in traumatic intrusions (Figure 1). A similar pattern of results emerged in the adolescent sample for LPP reactivity to positive stimuli, with additional evidence of an interaction effect between LPP amplitudes during reappraisal and total pandemic-related stress, such that impaired emotion regulation ability indexed by larger LPPs during reappraisal in combination with high overall stress exposure predicted increases in depressive symptoms (Figure 2). These findings highlight the mental health impacts of the COVID-19 pandemic on adolescents and emerging adults, as well as a potential biomarker of vulnerability to stress.

Authors

• Lindsay Dickey, Vanderbilt University
  Presenting Author

• Resh Gupta, Vanderbilt University
  Non-Presenting Author

• Autumn Kujawa, Vanderbilt University
  Non-Presenting Author