An Emotion Recognition-Awareness Vulnerability Hypothesis for Depression in Adolescence: A Systematic Review.

In this systematic review, we examined the evidence for an adolescent emotion recognition-awareness vulnerability to depression. The current review provided a qualitative synthesis of the emotion recognition (26 studies) and emotion awareness (38 studies) literatures for adolescent depression and was grounded within the framework of affective social competence (Halberstadt et al. in Soc Dev 10:79-119, 2001). It was hypothesized that deficits or difficulties in recognizing emotions in others and in being aware of emotions within the self would increase vulnerability to depression for adolescents. There was limited evidence to support a general emotion recognition vulnerability due to heterogeneous research designs and inconsistencies across studies; however, three emerging trends in specific recognition deficits associated with adolescent depression were identified: sensitivity to sadness, under-perceiving happiness, and over-perceiving anger. In contrast, there was robust support for an emotion awareness vulnerability to depression from cross-sectional, longitudinal, and longitudinal onset studies. When recognition and awareness are considered together, this review indicated that deficits in emotion awareness may exacerbate difficulties with emotion recognition during stressful or emotionally evocative contexts. This review highlighted the need for future investigations into emotion recognition and emotion awareness deficits in relation to adolescent depression using methodological innovations and longitudinal, clinical designs.