H017 Associations between stress and externalizing problems in youth at risk for Huntington disease

<h3>Background</h3> Children at risk for Huntington disease (HD) face significant stress while growing up in families impacted by HD. However, we do not fully understand the sources of stress in this population or the association between stress and psychological symptoms. <h3>Aims</h3> The aims of this study were to understand the types and characteristics of stressors experienced by youth at risk for HD vs. controls and to examine the correlations between stress and affective symptoms. <h3>Methods</h3> Thirty adolescents at-risk for HD (Mage 13.7, SD 2.9) and 52 healthy controls (Mage 12.5, SD 2.1) completed the Stress and Adversity Inventory (STRAIN) and the Youth Self Report (YSR). t-tests were used to compare scores on STRAIN and YSR subscales between at-risk and control participants. Bivariate correlations were performed to examine the relationship between stress and affective symptoms. <h3>Results</h3> At-risk participants scored significantly higher than controls on all core subscales of the STRAIN (Table 1) and on the Anxious/Depressed (MHD 59.4, MHC 55.8, p = 0.04), Attention Problems (MHD 62.7, MHC 57.3, p = 0.006), Internalizing Problems (MHD 57.8, MHC 53.4, p = 0.06), and Total Problems (MHD 58.5, MHC 52.8, p = 0.01) subscales of the YSR. While stress correlated primarily with internalizing problems in controls, at-risk adolescents showed stronger correlations between stress and externalizing problems, including rule-breaking and aggressive behavior (Figure 1). <h3>Conclusions</h3> These results demonstrate that youth at risk for HD experience significantly greater stress than their peers and are more likely to develop externalizing problems when exposed to stress.