Prospective Relations Between Cortical Thickness and Change in Internalizing Symptoms Are Moderated by Chronic Stress Exposure in Adolescents With Depression and Anxiety

Brain structural alterations have been associated with internalizing symptoms concurrently. Less is known about whether these alterations relate to change in internalizing psychopathology during adolescence, a sensitive period for the effects of stress on neurodevelopment and internalizing symptoms. We examined whether cortical thickness (CT) was prospectively related to change in an internalizing factor in 203 adolescents (ages 14–17) with depression and/or anxiety diagnoses or no diagnosis from the Boston Adolescent Neuroimaging of Depression and Anxiety study. We conducted residualized-change-regression models to determine whether baseline CT was associated with 1-year change in internalizing-factor scores and whether exposure to chronic stress moderated these relations. Lower bilateral temporal pole and left insula CT were associated with 1-year increases in internalizing-factor scores and were moderated by chronic stress. These novel results identify specific features of cortical structure that might contribute to worsening depression and anxiety, particularly in adolescents with high chronic stress.