J Psychiatr Res
· 2026 Aug · PMID 42019363
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Obsessive-compulsive disorder (OCD) is a heterogenous chronic psychiatric illness which significantly impacts quality of life. The aim of the current study was to investigate the distinct associations of trial-by-trial,...Obsessive-compulsive disorder (OCD) is a heterogenous chronic psychiatric illness which significantly impacts quality of life. The aim of the current study was to investigate the distinct associations of trial-by-trial, high-power, transient burst-like oscillatory events within the autogenous-reactive obsessions (AO-RO) subtype taxonomy to further characterize the neural underpinnings of heterogenous obsessive-compulsive symptom profiles. An analogue sample of 83 young adults completed 5 min of eyes-closed resting-state EEG. The rate, power, duration, and frequency-span of transient oscillatory bursts were calculated within each frequency band (i.e., delta/theta, alpha, beta) for 19 electrodes across the scalp. The severity of AO and RO, as primary outcome measures, was indexed using the Revised Obsessive Intrusion Inventory (ROII). Greater AO severity was primarily associated with longer alpha burst duration in the left occipital region, whereas greater RO severity was primarily associated with an increased rate of beta bursts in the right parietal region. This suggests that during rest AO is more strongly associated with a neural index of overactive attentional control for unwanted stimuli (i.e., relating to internally unprovoked mental intrusions eliciting internal conflict), whereas RO is more strongly associated with a neural index of overactive motor initiation (i.e., relating to externally provoked mental intrusions eliciting a motor response). The results of the current study provide novel insight into the neural underpinnings of the AO-RO taxonomy which may assist in characterizing the heterogeneity seen throughout OCD.
Satoh M, Hirakawa H, Eto M
… +5 more, Kawano N, Sakai A, Akase M, Kohno K, Terao T
J Psychiatr Res
· 2026 Aug · PMID 42008902
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INTRODUCTION: Self-compassion involves providing oneself with support during times of suffering or distress. It plays a significant role in an individual's life and mental well-being. This study aims to examine how affec...INTRODUCTION: Self-compassion involves providing oneself with support during times of suffering or distress. It plays a significant role in an individual's life and mental well-being. This study aims to examine how affective temperament and parental bonding styles impact self-compassion in healthy participants. METHODS: This study investigated the effects of affective temperament and parental bonding style on self-compassion using data from 107 healthy participants. Multiple regression analyses were conducted using the stepwise method, with the total Self-Compassion Scale (SCS) scores as the dependent variable and relevant potential factors, including affective temperament and parental bonding styles, as independent variables. Additionally, subclass analyses were conducted, wherein similar multiple regression analyses were performed with the positive subscales of SCS (self-kindness, common humanity, mindfulness) and the negative subscales of SCS (self-judgment, isolation, over-identification) individually allocated to dependent factors in each model using the relevant potential factors. RESULTS: Total SCS scores were significantly and positively associated with hyperthymic temperament and significantly and negatively associated with anxious temperament and maternal overprotection. Subclass analyses revealed that the positive SCS subscales were significantly associated with affective temperaments but not parental bonding styles, with relatively small adjusted R2 values. Conversely, negative SCS subscales were significantly associated with affective temperaments and maternal overprotection, showing relatively large adjusted R2 values. CONCLUSIONS: These findings suggest that self-compassion may be positively associated with hyperthymic temperament and negatively associated with anxious temperament and maternal overprotection in healthy participants.
Chen P, Li Y, Cuthbertson CC
… +2 more, Clifford JS, Yang Z
J Psychiatr Res
· 2026 Aug · PMID 41996755
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OBJECTIVE: National life course studies examining the interplay between genetic risk, parental substance abuse, and lifelong depression are lacking, despite the need for individualized interventions. This study investiga...OBJECTIVE: National life course studies examining the interplay between genetic risk, parental substance abuse, and lifelong depression are lacking, despite the need for individualized interventions. This study investigates how the interaction between polygenic risk for depression and childhood exposure to parental substance abuse is associated with depression trajectories from mid-to late adulthood. METHOD: Data from 14 waves (1994-2020) of the Health and Retirement Study included 7512 participants of European ancestry aged 51-90 years. Primary predictors were childhood parental substance abuse, polygenic depression-risk scores, and their interaction. Growth-curve linear mixed models estimated depressive symptoms (Center for Epidemiologic Studies-Depression [CES-D] scale, standardized) trajectories, and logistic mixed-effects models applied to binary probable clinical depression. RESULTS: Higher polygenic risk scores were associated with elevated depressive symptoms (β = 0.074; 95% CI = 0.058-0.090) and greater odds of probable clinical depression (OR = 1.38; 95% CI = 1.28-1.49). Childhood parental substance abuse was also associated with higher depression risk (OR = 1.61; 95% CI = 1.32-1.96). A significant gene × environment interaction revealed that the adverse effect of parental substance abuse on depressive trajectories was amplified among individuals with high genetic risk (P < 0.05), particularly in the mid-fifties and mid-sixties. CONCLUSIONS: Findings underscore the importance of considering both genetic susceptibility and early-life adversity in understanding lifelong depression. Individualized prevention and intervention strategies may be critical for those with elevated genetic risk who experienced parental substance abuse, with potential to mitigate the progression of depression into later life. Since our analyses were restricted to participants of European genetic ancestry to minimize population stratification in polygenic score estimation, this may limit the generalizability of findings to other ancestral groups.
J Psychiatr Res
· 2026 Aug · PMID 41996754
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Eating behavior patterns are influenced by multiple neurocognitive processes, including executive, emotional, and social functioning. However, their relative associations, particularly among healthy individuals without e...Eating behavior patterns are influenced by multiple neurocognitive processes, including executive, emotional, and social functioning. However, their relative associations, particularly among healthy individuals without eating disorders, remain unclear. This study investigated the relationships between eating behavior patterns and executive function, social functioning, and emotional states in young adults. This cross-sectional study included 101 healthy young adults aged 20-30 years, recruited from a student population between March 2025 and July 2025. Eating behavior patterns, executive function, social functioning, and emotional states were assessed using validated questionnaires and neurocognitive tasks. Partial correlation and hierarchical regression analyses were conducted. Female participants scored higher than males on measures of binge eating, food-cue reactivity, decision-making, social functioning, and emotional distress. Eating behavior patterns, except for emotional undereating and satiety responsiveness, showed stronger associations with executive function. Reward sensitivity and hypervigilance were associated with food addiction. Food fussiness was linked to reduced cognitive flexibility. Sensory sensitivity, stereotyped behaviors, and social stress symptoms were associated with multiple eating-related measures. Eating behavior patterns in young adults were associated with executive, social, and emotional processes. These findings should be interpreted as exploratory and associative, given the cross-sectional and non-clinical nature of the sample. The results provide preliminary, associative insights into the relationships between executive flexibility, social functioning, emotional regulation, and eating behavior patterns. Future research in larger and clinical samples is warranted.
Peng P, Chen Z, Ren S
… +12 more, He Y, Li J, Liao A, Zhao L, Shao X, Chen S, He R, Liang Y, Tan Y, Chen X, Tang J, Liao Y
J Psychiatr Res
· 2026 Aug · PMID 41996753
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BACKGROUND: Sleep problems have often been conceptualized as a correlate or consequence of Internet Gaming Disorder (IGD), but longitudinal evidence suggests the association may be bidirectional. This study examined reci...BACKGROUND: Sleep problems have often been conceptualized as a correlate or consequence of Internet Gaming Disorder (IGD), but longitudinal evidence suggests the association may be bidirectional. This study examined reciprocal associations between sleep problems and IGD, tested emotional problems and resilience as mediators, and explored sex differences among Chinese adolescents. METHOD: A three-wave school-based study was conducted among 20,137 adolescents at baseline (T1, November 2020), with follow-ups at 1 year (T2) and 2 years (T3). Sleep problems, emotional problems, resilience, and IGD were assessed using validated self-report measures. Cross-lagged panel models (CLPMs) were used to estimate reciprocal longitudinal associations and indirect effects. RESULTS: Sleep problems and IGD showed significant bidirectional longitudinal associations, with a small to moderate effect size. In the CLPM, sleep problems were associated with higher subsequent IGD (β = 0.033-0.055), and IGD was associated with higher subsequent sleep problems (β = 0.039-0.061). Significant indirect effects were observed from T1 sleep problems to T3 IGD through T2 emotional problems (β = 0.006, 95% CI = 0.003-0.009) and T2 resilience (β = 0.003, 95% CI = 0.001-0.005). Sex differences were evident: the emotional problems pathway was significant only in boys, whereas the resilience pathway was significant only in girls. CONCLUSIONS: Sleep problems and IGD are reciprocally related over time. Emotional problems and resilience represent distinct longitudinal pathways linking sleep problems to later IGD, with sex-specific patterns. Adolescent sleep health may be a relevant target for early prevention of IGD.
BACKGROUND: Cultural contexts, such as whether one's immediate environment is ethnoracially congruent, are known to influence emotional expression, emotional experience, motivation, and social behavior in healthy individ...BACKGROUND: Cultural contexts, such as whether one's immediate environment is ethnoracially congruent, are known to influence emotional expression, emotional experience, motivation, and social behavior in healthy individuals. However, it is unclear whether such cultural factors play a role in state exacerbations in negative symptoms that occur in schizophrenia (SZ). AIMS: The current study combined GPS data, environmental geocoding, and ecological momentary assessment (EMA) to test the hypothesis that ethnoracial incongruence encountered in daily-life situations predicts state increases in negative symptoms in SZ. METHOD: Participants included outpatients with SZ (n = 37) and healthy controls (CN: n = 41) with marginalized ethnoracial identities who completed EMA and passive digital phenotyping recordings. Geolocation was used to pair participant GPS location at the time of completing EMA symptom surveys with geocoded measures of that location's ethnoracial density based on government census records. Ethnoracial congruence was determined in relation to the match between a participant's identified ethnoracial identity and the ethnoracial density of their location at the time of EMA survey. RESULTS: Results indicated that ethnoracially incongruent contexts were associated with state increases in negative symptoms in individuals with SZ, but not CN. CONCLUSIONS: These findings suggest that interactions between one's own ethnoracial identity and the ethnoracial context of the current environment contributes to negative symptom exacerbations in SZ. Identity factors are not typically considered in the assessment and treatment of negative symptoms in SZ, but it would be beneficial to do so.
BACKGROUND: Intermittent theta-burst stimulation (iTBS) is an established neuromodulation treatment for major depressive disorder (MDD). However, its clinical effectiveness in patients with comorbid neurodevelopmental di...BACKGROUND: Intermittent theta-burst stimulation (iTBS) is an established neuromodulation treatment for major depressive disorder (MDD). However, its clinical effectiveness in patients with comorbid neurodevelopmental disorders, particularly autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), remains insufficiently understood despite their high prevalence and distinct neurocognitive and sensory profiles. METHODS: This retrospective cohort study analyzed real-world registry data from three TMS clinics in Tokyo. All participants met DSM-5 criteria for MDD, and ASD/ADHD diagnoses were confirmed by board-certified psychiatrists. Patients received left-DLPFC iTBS using the Beam F3 method. Primary outcomes included percentage changes in Montgomery-Åsberg Depression Rating Scale (MADRS) and Hamilton Depression Rating Scale (HAMD-17) scores, response and remission rates, and adverse events. Group differences were examined using t-tests, ANOVA, chi-square tests, and multivariable regression adjusting for demographic and treatment-related covariates. RESULTS: Patients without neurodevelopmental comorbidities demonstrated significantly greater symptom improvement and higher remission rates than those with ASD/ADHD (TD vs. neurodiverse). These differences persisted after covariate adjustment, indicating an independent effect of neurodevelopmental status. Baseline MADRS severity consistently predicted poorer outcomes across all models. Sensitivity analyses confirmed attenuated improvement in each neurodiverse subgroup. Findings for the ASD/ADHD subgroup were exploratory. Neurodiverse patients also reported higher rates of stimulation-site pain, although no serious adverse events occurred. CONCLUSIONS: iTBS is effective for MDD in routine clinical practice; however, its therapeutic impact appears moderately reduced in patients with ASD and/or ADHD. These findings underscore the need for individualized neuromodulation strategies and further investigation into neurobiological and sensory factors contributing to treatment heterogeneity.
BACKGROUND: White matter microstructure abnormalities have been widely observed in schizophrenia, closely associated with clinical symptoms and cognitive deficits. While various alterations have been suggested, the natur...BACKGROUND: White matter microstructure abnormalities have been widely observed in schizophrenia, closely associated with clinical symptoms and cognitive deficits. While various alterations have been suggested, the nature of their specific patterns and underlying processes remains unclear. Thus, this study aims to identify these patterns and explore their associations with polygenic burden, cognition, and clinical symptoms. METHODS: 336 participants (133 first-episode schizophrenia [FES], 49 unaffected siblings [SB], and 154 healthy controls [HC]) underwent MRI scanning, clinical and cognitive assessments, and genetic sequencing. DTI preprocessing was performed using the FMRIB Software Library. Group comparisons for fractional anisotropy (FA), radial diffusivity (RD), axial diffusivity (AD), mean diffusivity (MD) and mode of anisotropy (MO), and correlation analysis between white matter abnormalities and PRS, clinical symptoms, and cognitive features were conducted. RESULTS: Two patterns of reduced FA with differing radial features in FES were observed: 1) "FA + RD" pattern with reduced FA and increased RD, including fornix, left stria terminalis, left posterior corona radiata, left retrolenticular part of the internal capsule, and left cerebral peduncle; 2) "FA-only" pattern with reduced FA but normal RD, including left superior fronto-occipital fasciculus, left cingulate gyrus, left posterior thalamic radiation, left superior longitudinal fasciculus, left inferior cerebellar peduncle, bilateral sagittal stratum, bilateral superior corona radiata, and genu of the corpus callosum. FA of the white matter skeleton was negatively correlated with PRS, clinical symptoms, and duration of illness, but positively correlated with cognitive features. In addition, SB showed reduced FA in left sagittal stratum, left posterior thalamic radiation, and left superior longitudinal fasciculus. CONCLUSION: Our study observed two diffusion patterns of reduced FA with different radial features, of which the abnormalities were associated with polygenic burden, clinical symptoms and cognitive deficits. However, further direct evidence is required to validate and extend these findings.
Crocin, a water-soluble carotenoid known for its therapeutic potential in anxiety disorders, exhibits a range of beneficial properties such as anti-inflammatory, neuroprotective, and anti-anxiety effects. Despite its doc...Crocin, a water-soluble carotenoid known for its therapeutic potential in anxiety disorders, exhibits a range of beneficial properties such as anti-inflammatory, neuroprotective, and anti-anxiety effects. Despite its documented efficacy, the precise mechanism behind its anxiolytic action remains incompletely understood. Given crocin's known interaction with NMDA receptors within the glutamatergic system-particularly in cognitive processes-this study aimed to investigate its interplay with NMDA receptor modulators in regulating anxiety-related behaviors in male mice under an acute restraint stress (ARS) model. Mice were implanted with guide cannulas for intracerebroventricular (i.c.v.) drug administration and subjected to 4 h of immobilization to induce ARS. Anxiety was assessed using the elevated plus maze (EPM), which revealed that stressed mice displayed increased anxiogenic behaviors, reflected by reduced percentages of open arm time (%OAT) and open arm entries (%OAE). Additionally, ARS led to a rise in dark cell count in hippocampal CA1 and prefrontal cortical regions. Administration of NMDA (0.5 μg/mouse, i.c.v.) intensified anxiety-like behavior, whereas both D-AP5 (an NMDA antagonist; 0.5 μg/mouse, i.c.v.) and crocin (50 mg/kg, intraperitoneal (i.p.)) attenuated it. A sub-effective dose of NMDA (0.25 μg/mouse) counteracted the anxiolytic effects of crocin across multiple doses, while a sub-threshold dose of D-AP5 (0.25 μg/mouse) enhanced crocin-induced anxiety reduction. Synergistic anxiolytic effects between crocin and D-AP5 were observed in both stressed and non-stressed mice. These findings strongly indicate that crocin modulates anxiety-related behavior, at least partially, via interaction with NMDA receptors.
OBJECTIVE: To investigate demographic and clinical correlates of alcohol dependence in obsessive-compulsive disorder (OCD). METHODS: A total of 1222 OCD-affected adults were included in the analyses. We compared demograp...OBJECTIVE: To investigate demographic and clinical correlates of alcohol dependence in obsessive-compulsive disorder (OCD). METHODS: A total of 1222 OCD-affected adults were included in the analyses. We compared demographic and clinical features in those with and without a history of alcohol dependence and used logistic regression models to assess the relationship between alcohol dependence and history of OCD treatment. RESULTS: One hundred sixty-four participants (13%) had a lifetime history of DSM-IV alcohol dependence. Those with alcohol dependence were older and less likely to have a college degree. The lifetime prevalences of DSM-IV mood disorders, anxiety disorders, bulimia, post-traumatic stress disorder, and substance dependence were significantly greater in those with alcohol dependence. Those with alcohol dependence were significantly less likely to have received treatment with serotonin reuptake inhibitors (SRIs/SSRIs) and, if they had received treatment, less likely to report a good treatment response. CONCLUSION: Alcohol dependence is relatively prevalent in individuals with OCD and is associated with poorer response to SSRI treatment. The findings suggest the clinical importance of evaluating alcohol dependence in OCD patients and considering its potential impact on treatment response.
Being overweight is commonly observed in patients with major depressive disorder (MDD). However, the relationship between body weight and treatment outcomes in MDD is less clear. In this context, we examined the associat...Being overweight is commonly observed in patients with major depressive disorder (MDD). However, the relationship between body weight and treatment outcomes in MDD is less clear. In this context, we examined the association between BMI and treatment outcomes in patients treated with escitalopram with and without adjunctive aripiprazole. We tested this association using data from the Canadian Biomarker Integration Network in Depression-1 (CAN-BIND-1). The sample consisted of 180 participants who were treated with escitalopram for 8 weeks, followed by 8 more weeks of treatment with escitalopram alone (for responders) or escitalopram plus aripiprazole (for non-responders). Punishment/reward sensitivity and physical activity were also explored. Logistic regression analysis was used to examine the association between BMI, being overweight, and treatment response or remission after 8 or 16 weeks of treatment. BMI, being overweight, physical activity, behavioral inhibition, and behavioral activation were not associated with treatment outcomes. We also reviewed the recent literature on BMI, obesity, and antidepressant treatment outcomes, which showed mixed findings. Our results, which showed a lack of association between BMI and treatment outcomes, add to this complexity of the relationship between body weight and treatment outcomes in MDD. Larger studies with more diverse samples are needed to validate these results.
Edgar EV, Reid L, Marco L
… +4 more, Sawada Y, Ibrahim K, Bloch MH, Crowley MJ
J Psychiatr Res
· 2026 Jul · PMID 41931984
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Biased self-referential processing is a component of both depression and anxiety. Although research on self-referential processing in relation to depression and anxiety shows a consistent direction, studies differ widely...Biased self-referential processing is a component of both depression and anxiety. Although research on self-referential processing in relation to depression and anxiety shows a consistent direction, studies differ widely in methodology and sample compositions, varying the magnitudes of findings. We conducted a systematic review and meta-analysis to assess whether mean differences in self-referential processing or continuous relations between self-referential processing and anxiety/depression, differed as a function of sample composition, assessment type, score calculation method, or mood induction use. We included all studies reporting a mean difference in positive versus negative self-referential and/or a continuous relation between self-referential processing and symptoms of depression/anxiety. Standardized mean differences and Fisher's z correlation coefficients were calculated through random-effect meta-analyses. Sample composition and score calculation method emerged as robust moderators of the standardized mean difference between positive and negative self-trait endorsement and the magnitude of the correlation between negative self-trait endorsement and symptoms of depression. We highlight several avenues for future research.
This longitudinal study employed Ecological Momentary Assessment (EMA) to investigate the dynamic relationship between emotional instability and suicidal ideation (SI) in adolescents with depression. Thirty adolescents (...This longitudinal study employed Ecological Momentary Assessment (EMA) to investigate the dynamic relationship between emotional instability and suicidal ideation (SI) in adolescents with depression. Thirty adolescents (15 males, 15 females; aged 13-18 years) diagnosed with depression underwent repeated assessments of emotional states and SI using the three-item Suicidal Ideation Scale and the Positive and Negative Affect Schedule (PANAS) during hospitalization. Results indicated that state-level positive emotions (e.g., interest, activity) were significantly associated with reduced SI, whereas acute negative emotions (e.g., anxiety, irritability) predicted increased suicidal risk. Notably, daily emotional stability-operationalized as the within-day standard deviation of emotional states-showed no direct correlation with SI. This finding highlights the primacy of momentary emotional fluctuations over trait-like stability in influencing acute suicidal risk. These results underscore the importance of real-time emotion regulation in suicide prevention for adolescent depression. Future research should expand sample sizes and incorporate socio-cultural factors to deepen the understanding of this complex relationship.
BACKGROUND: Artificial intelligence (AI) increasingly supports medical diagnosis, interventions, and clinical decision-making. In various domains of human communication, AI systems based on large language models offer ef...BACKGROUND: Artificial intelligence (AI) increasingly supports medical diagnosis, interventions, and clinical decision-making. In various domains of human communication, AI systems based on large language models offer effective tools for conducting interviews, supportive dialogue, and engaging in problem-focused discussions with healthy individuals and clinical patients. In contemporary clinical settings, interactions between psychiatrists and patients are increasingly complemented by AI; however, the position of this new agent within the therapeutic triad largely depends on patients' attitudes towards AI technologies. OBJECTIVE: The study aimed at two primary objectives: (1) to examine how clinically relevant adaptive and maladaptive personality traits are associated with positive and negative attitudes toward AI, and (2) to evaluate these attitudes among patients diagnosed with anxiety, depression, bipolar disorder, and schizophrenia. METHODS: This multicenter study used the General Attitudes Toward Artificial Intelligence Scale to examine how social adaptation and maladaptation are associated with a broad set of standardized measures, including the DSM-5 Personality Inventory, Schizotypal Traits Questionnaire, Anxiety Sensitivity Index, and Self-Concept Clarity Scale, in psychiatric patients and healthy participants. RESULTS: Patients with schizophrenia and bipolar disorder showed a more positive attitude toward AI use than those with depression and anxiety disorders. A negative attitude towards AI was associated with affective, cognitive, and behavioral vulnerability. This included elevated levels of negative affectivity, detachment, disinhibition, psychoticism, and anxiousness, as well as higher scores on schizotypal traits and reduced self-coherence. CONCLUSION: Patients' symptomatology and diagnostic profiles significantly shape their attitudes toward artificial intelligence, influencing their acceptance or rejection of AI-assisted interventions.
AIM: Hikikomori is a state of prolonged social isolation in which individuals remain at home and disengage from work, school, and other activities. This preliminary study investigated the correspondence between self-repo...AIM: Hikikomori is a state of prolonged social isolation in which individuals remain at home and disengage from work, school, and other activities. This preliminary study investigated the correspondence between self-reported scores on the Hikikomori Functional Assessment Scale (HFAS) and independently collected interview-based ratings. Consistency was evaluated at two retrospectively defined time points: the participant-designated peak period of hikikomori (Peak) and the time of assessment (Current). METHODS: A total of 16 participants (6 men and 10 women; mean age = 40.2 years) completed the HFAS and a semi-structured interview for both time points. Interviewers were masked to questionnaire responses. Data were analysed using Wilcoxon signed-rank tests and Kendall's τ correlations with Bayes factors. RESULTS: Social negative reinforcement showed moderate to strong correspondence between methods at both time points (Peak: τ = 0.50, BF = 8.9; Current: τ = 0.50, BF = 8.6). Intrapersonal negative reinforcement indicated weak to moderate correlations and evidence at Peak (τ = 0.40, BF = 3.0) but not at Current (τ = 0.07, BF = 0.5). Intrapersonal positive reinforcement exhibited only anecdotal evidence of association at either time point (Peak: τ = 0.27, BF = 1.1; Current: τ = 0.27, BF = 1.0). CONCLUSIONS: These findings provide preliminary support for the HFAS as a practical tool for identifying socially avoidant contingencies relevant to early intervention, underscoring the need for further research with larger, prospective samples.
BACKGROUND: Attentional bias to facial expressions has been suggested as a novel, promising mechanism explaining the effect of adverse childhood experiences (ACEs) on depression, but the direct eye-tracking evidence, esp...BACKGROUND: Attentional bias to facial expressions has been suggested as a novel, promising mechanism explaining the effect of adverse childhood experiences (ACEs) on depression, but the direct eye-tracking evidence, especially regarding a key period of adolescence and dimensional effects of ACEs, remains rare. OBJECTIVE: Relying on eye-tracking approach, this study systematically examined the extent to which attentional bias to facial expressions may help explain the association between ACEs and adolescent major depressive disorder (MDD). METHOD: Adolescents with MDD (N = 24, M = 17.71 ± 1.60 years; 75.0 % female) and healthy control (N = 49, M = 18.67 ± .66 years; 77.6 % female) were recruited respectively. An eye-tracking free viewing task was administered to assess orientation and maintenance bias to facial expressions (i.e. happy, sad, angry and neutral). ACEs were retrospectively reported by participants. RESULTS: After controlling for age, reduced maintenance bias to happiness significantly mediated the association between ACEs and adolescent MDD (OR = 1.48 [1.02, 2.15], p = .041). Such mediation effect was observed for both the threat and deprivation dimensions of ACEs (for threat: OR = 1.75 [1.11, 2.76], p = .015; for deprivation: OR = 5.97 [1.38, 25.66], p = .016). In contrast, orientation bias to any facial expressions did not exert this mediation effect. CONCLUSION: The reduced maintenance bias to happy faces, reflecting blunted (social) reward processing, may serve as a potential pathway linking ACEs as well as threat or deprivation experiences to adolescent MDD.