Developmental depression in adolescents: a potential sub- type based on neural correlates and comorbidity
Abstract
Diagnosis of depression has low reliability (kappa = 0.28) due to "covert heterogeneity," making the identification of sub-types a focus of research. Very high rates of moderate or sub-threshold depression among adolescents (35-45 % beyond the 20-25 % with MDD), prompt consideration of a potential sub-type of moderate sub-threshold depression, linked to adolescent development. Previously, developmental depression (DD) has been proposed as sub-type of moderate depression that is a normative developmental process of spiritual individuation, the integration of existential and spiritual experience. DD as a potential sub-type is supported both by clinical observation and by an emerging body of research identifying a common physiology to underlie both depression and spirituality (neurotransmitters, structural MRI and long-term clinical course), as well as research showing a surge of spirituality in adolescence (concomitant with window of risk of depression). We test for unique patterns of comorbidity and neural correlates as support for a sub-type. Based upon existing literature, we propose that DD will be (1) associated with the unique neural correlate of increased volume in the occipital region and (2) co-morbid with symptoms of affected regulation and processing. A sample of 125 adolescents (64 girls and 61 boys; ages 15-19 years) from the larger National Institute of Health Magnetic Resonance Imaging (MRI) Study of Normal Brain Development (Evans in Neuroimage 30(1):184-202, 2006) was assessed using the Cloninger Self-Transcendence Scale to examine correlates of sub-threshold mild to moderate symptoms of depression. Findings lend support to the possibility of a DD. Sub-threshold depression was associated with greater volume in the occipital region, as well as comorbidity with symptoms of affected regulation and processing (mania, ADHD, anxiety). By contrast, in adolescents with a low level of transcendence, sub-threshold depression was associated with conduct disorder and heavy substance use, both of which previous research have found to be associated with low levels of personal spirituality.
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A greater constellation of factors are implicated in youth despair beyond agency or mastery, including attachment disruptions, hormonal-related coping/emotional dysregulation challenges, and emerging spiritual individuation.
“Taken together, these modest findings are not surprising, given that a greater constellation of factors are implicated in youth despair beyond agency or mastery, including attachment disruptions (Stoddard et al., 2011), hormonal-related coping/emotional dysregulation challenges (Ho et al., 2022), and emerging spiritual individuation (Miller and Barton, 2015).”
From A hope intervention for adolescents: a randomized controlled trial delivered by paraprofessionals (2025) · cites this paper as Miller and Barton, 2015
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- Authors
- Miller, L., & Barton, Y. A.
- Affiliations
- Columbia University (US)
- Corresponding author
- Miller, Lisa
- ORCID
- Miller, Lisa
- Venue
- Journal of Religion and Health
- Published
- 2015-04-16
- Volume
- 54
- Issue
- 3
- Pages
- 817-828
- ISSN
- 0022-4197 (ISSN-L)
- 1573-6571
- OpenAlex
- W2077712585
- Cited by
- 9
- References
- 31
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2022: 2 · 2021: 1 · 2020: 1 · 2017: 1
- FWCI
- 0.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Religion and Health (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- Topics
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- adolescent depression, subthreshold depression, spirituality, self-transcendence, neural correlates, comorbidities, conduct disorder, substance use, attention deficit hyperactivity disorder, anxiety, mania, adolescent brain development
- MeSH terms
- Adolescent, Mental Disorders, Brain, Brain Mapping, Depressive Disorder, Female, Humans, Magnetic Resonance Imaging, Male, Organ Size, Reproducibility of Results, Comorbidity, Spirituality
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