Liu Qimin, Cole David, Tran Tiffany, Quinn Meghan, McCauley Elisabeth, Diamond Guy, Garber Judy
Department of Psychology and Human Development, Vanderbilt University, USA.
Department of Psychological Sciences, College of William & Mary, USA.
Dev Psychopathol. 2023 May 23:1-10. doi: 10.1017/S0954579423000500.
Traditionally, depression phenotypes have been defined based on differences that distinguish between subgroups of individuals expressing distinct depressive symptoms often from cross-sectional data. Alternatively, depression phenotypes can be defined based on differences, differentiating between transitory states of distinct symptoms profiles that a person transitions into or out of over time. Such within-person phenotypic states are less examined, despite their potential significance for understanding and treating depression.
The current study used intensive longitudinal data of youths ( = 120) at risk for depression. Clinical interviews (at baseline, 4, 10, 16, and 22 months) yielded 90 weekly assessments. We applied a multilevel hidden Markov model to identify intraindividual phenotypes of weekly depressive symptoms for at-risk youth.
Three intraindividual phenotypes emerged: a low-depression state, an elevated-depression state, and a cognitive-physical-symptom state. Youth had a high probability of remaining in the same state over time. Furthermore, probabilities of transitioning from one state to another did not differ by age or ethnoracial minority status; girls were more likely than boys to transition from a low-depression state to either the elevated-depression state or the cognitive-physical symptom state. Finally, these intraindividual phenotypes and their dynamics were associated with comorbid externalizing symptoms.
Identifying these states as well as the transitions between them characterizes how symptoms of depression change over time and provide potential directions for intervention efforts.
传统上，抑郁表型是根据区分表达不同抑郁症状的个体亚组之间的差异来定义的，这些差异通常来自横断面数据。或者，抑郁表型也可以根据差异来定义，即区分一个人随着时间推移进入或脱离的不同症状谱的短暂状态。尽管这些个体内部的表型状态对理解和治疗抑郁症具有潜在意义，但对其研究较少。
本研究使用了有抑郁风险的青少年（n = 120）的密集纵向数据。临床访谈（在基线、4、10、16和22个月时）产生了90次每周评估。我们应用了多层次隐马尔可夫模型来识别有风险青少年每周抑郁症状的个体内表型。
出现了三种个体内表型：低抑郁状态、高抑郁状态和认知-身体症状状态。随着时间的推移，青少年保持在同一状态的可能性很高。此外，从一种状态转变为另一种状态的概率在年龄或种族少数群体身份上没有差异；女孩比男孩更有可能从低抑郁状态转变为高抑郁状态或认知-身体症状状态。最后，这些个体内表型及其动态变化与共病的外化症状有关。
识别这些状态以及它们之间的转变，能够描述抑郁症状如何随时间变化，并为干预措施提供潜在方向。
