Reactivity to Interpersonal Conflict: A Correlate of Non‐Remission in Childhood Depression—Evidence Across Modalities and Time Scales

Depression is often a relapsing disorder that can start as early as preschool. In adults and adolescents, family and peer criticism/conflict and rejection sensitivity are associated with recurrence. However, it is not yet clear whether similar factors are associated with relapse among early adolescent youth who experience depression starting in preschool. The current study used data from a unique longitudinal study, which began at preschool age and included 161 youth. It oversampled for those with preschool‐onset major depressive disorder (PO‐MDD) and included community controls (CCs). When the youth were 7–12 years old, we administered diagnostic interviews and weekly surveys over 1 year. These measures were repeated at ages 8–15, along with ecological momentary assessment (EMA) three to four times a day for 8 days, and an event‐related potential (ERP) task assessing neural reactivity to social feedback. We assessed whether youth with a history of PO‐MDD who were experiencing depression in adolescence (i.e., non‐remitted youth [NRY]) versus those who were not (i.e., remitted youth [RY]) and/or CCs experienced greater family/peer criticism/conflict and sensitivity to interpersonal stress. Across multiple time scales (weekly and daily), NRY experienced greater parent and peer criticism/conflict and were more reactive to such criticism/conflict than RY and CCs. Further, in weekly surveys, NRY displayed a stronger association between experiencing interpersonal criticism/conflict and depression compared to CCs, with a similar trend compared to RY. In momentary assessments, NRY showed a longer‐lasting association between family conflict and both negative affect (NA) and connectedness than RY. In addition, neural measures indicated a stronger response to negative social feedback among NRY. Taken together, these data identify potential interpersonal treatment targets for youth with early‐onset depression who continue to experience depression into adolescence. Trial Registration: ClinicalTrials.gov identifier: NCT02076425