High multisystem stress response is concordant with perceived arousal and predicts future depressive symptoms in the Tracking Adolescents' Individual Lives Survey.

Depressive disorders increase in prevalence during adolescence and profoundly impact psychosocial functioning and quality of life. Adverse childhood experiences (ACEs) and family history of depression may increase the risk for depressive disorders through altered physiological stress response. In a sample of 508 participants without prior depressive symptoms from the Tracking Adolescents' Individual Lives Survey (42% female, 58% male sex-assigned-at-birth; mean age = 16.05, SD = 0.56), we investigated longitudinal relationships between ACEs, family history, psychophysiological response to a standardized psychosocial stressor, and subsequent depressive symptoms. Latent profile analysis was used to identify stress response patterns across the hypothalamic-pituitary-adrenal axis, autonomic nervous system, and perceived arousal. With generalized linear mixed modelling, we tested whether associations between ACEs and family history, and future depression varied by group. We identified four stress response patterns: low response, autonomic-reciprocal response, autonomic-coactivated response, and HPA-dominant response. Perceived arousal was concordant with physiological stress, indicating that the Self-Assessment Manikin could provide a useful proxy of stress response when physiological assessment is not feasible. Adolescents with heightened HPA response and autonomic coactivation had significantly higher future depressive symptoms compared with adolescents with autonomic reciprocity, suggesting that higher environmental sensitivity and lack of response coordination may be vulnerability factors for depressive symptoms. However, associations between ACEs, family history, and future depressive symptoms did not vary across stress response profiles. Limitations include single-time-point assessment of dynamic stress response systems and low power to detect moderation effects. Future studies could employ repeatable paradigms to capture how stress response systems develop and impact future mental health.