- Pain catastrophising is indirectly associated with depressive severity via anxiety, highlighting anxiety mediated processes in adolescent MDD.
- Adolescents with MDD show increased delta and theta power and altered microstate dynamics, including greater microstate B involvement and reduced microstate D persistence.
- EEG informed path models link microstate features to the pain catastrophising anxiety depressive severity pathway, endorsing dynamic EEG markers for further investigation.
Ann N Y Acad Sci. 2026 Oct;1564(1):e70421. doi: 10.1111/nyas.70421.
ABSTRACT
Adolescent major depressive disorder (MDD) is characterized by altered processing and regulation of negative emotional and bodily experiences. Pain lies at the interface of sensory and cognitive-affective processing, encompassing both perceptual sensitivity and appraisal of pain-related experiences. Yet, how pain catastrophizing, a pain-specific cognitive-affective pattern characterized by rumination, magnification, and helplessness, relates to depressive severity and neurophysiological dynamics during adolescence remains poorly understood. In this cross-sectional case-control study, we recruited 140 participants aged 12-23 years with and without MDD and investigated behavioral and electrophysiological correlates of pain-related cognitive-affective dysregulation using clinical assessments and resting-state electroencephalography (EEG). Structural equation modeling revealed a significant indirect association between pain catastrophizing and depressive severity through anxiety, highlighting anxiety-related processes within this relationship. Compared with healthy controls, adolescents with MDD exhibited increased δ- and θ-band power and altered EEG microstate dynamics, characterized by greater temporal involvement of microstate B, reduced temporal persistence of microstate D, and increased bidirectional B-C transitions. EEG-informed path models further linked microstate features to the indirect relationship between pain catastrophizing, anxiety, and depressive severity. Together, these findings identify convergent behavioral and neurophysiological correlates of pain-related cognitive-affective dysregulation and highlight dynamic EEG features for further investigation in adolescent MDD.
PMID:42848743 | DOI:10.1111/nyas.70421
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