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Background: There is a sharp increase in depression in females in mid-adolescence, but we do not understand why. Cognitive theories suggest that people with depression have negative biases in recalling self-referential information. We tested whether recall biases were more negative in girls in early and mid-adolescence and were associated with depressive symptoms., Methods: 315 young and 263 mid-adolescents (11-12 and 13-15 years) completed a surprise test, assessing recall of social evaluation about the self (self-referential) or another person (other-referential). The short Mood and Feelings Questionnaire measured depressive symptoms. We tested the effects of condition (self-referential/other-referential), valence (positive/negative), gender, and age group on correct recall (hits) and associations with depressive symptoms., Results: There was no evidence for gender or age differences in positive or negative self-referential recall. Self-referential positive hits were negatively associated with depressive symptoms (adjusted coefficient=-0.38, 95% CI=-0.69-0.08, p=0.01). Self-referential negative hits were positively associated with depressive symptoms (adjusted coefficient=0.45, 95% CI=0.15-0.75, p=0.003), and this association was stronger in females (adjusted interaction p=0.04)., Limitations: The reliability and validity of the recall task are unknown. We cannot provide evidence of a causal effect of recall on depressive symptoms in this cross-sectional study., Conclusions: Adolescents who recalled more self-referential negative and fewer self-referential positive words had more severe depressive symptoms. Females did not demonstrate more recall biases, but the association between self-referential negative hits and depressive symptoms was stronger in females. Negative self-referential recall may be a risk factor for depressive symptoms and is a good candidate for longitudinal studies., (Copyright © 2020. Published by Elsevier B.V.)

Objective: Cognitive theories suggest people with depression interpret self-referential social information negatively. However, it is unclear whether these biases precede or follow depression. We investigated whether facial expression recognition was associated with depressive symptoms cross-sectionally and longitudinally., Methods: Prospective cohort study of people who had visited UK primary care in the past year reporting depressive symptoms (n = 509). Depressive symptoms were measured using the Patient Health Questionnaire (PHQ-9) at four time-points, 2 weeks apart. A computerised task assessed happy and sad facial expression recognition at three time-points (n = 505 at time 1). The unbiased hit rate measured ability to recognise emotions accounting for any general tendency to identify the emotion when it was not present., Results: The sample included the full range of depressive symptom severity, with 45% meeting diagnostic criteria for depression. There was no evidence that happy or sad unbiased hit rates were associated with concurrent or subsequent depressive symptoms. There was weak evidence that, for every additional face incorrectly classified as happy, concurrent PHQ-9 scores reduced by 0.05 of a point (95% CI = -0.10 to 0.002, p = 0.06 after adjustment for confounders). This association was strongest for more ambiguous facial expressions (interaction term p<0.001)., Limitations: This was an observational study with relatively short follow-up (6 weeks) and small changes in depressive symptoms and emotion recognition. Only 7% of invited patients consented to participate., Conclusions: Reduced misclassifications of ambiguous faces as happy could be a state marker of depression, but was not associated with subsequent depressive symptoms. Future research should focus on the interpretation of ambiguous social information., (Copyright © 2019. Published by Elsevier B.V.)