4 89 Neural and affective responses to prolonged eye contact with parents and unfamiliar others in depressed and non-depressed adolescents Sixty-three HC and 22 DEP adolescents participated in the fMRI part of the study. Four HCs were excluded; n = 3 due to scanner artefacts and n = 1 due to an (a posteriori discovered) depression score in the clinical range according to the Patient Health Questionnaire (i.e., PHQscore of 18), which was preregistered as an exclusion criterion. Three DEP adolescents were excluded; n = 1 due to scanner artefacts, n = 1 due to claustrophobia, and n = 1 due to distress related to exposure to participants’ own videos. This resulted in a final sample of n = 59 HC and n = 19 DEP adolescents performing the eye contact task in the MRI scanner (see Table 4.1 for demographics and clinical characteristics). Details on the full study procedure can be found in Supplement S4.1. The study was approved by the medical ethical committee of the Leiden University Medical Centre (LUMC; P17.241) and was performed in accordance with the declaration of Helsinki and the Dutch Medical Research Involving Human Subjects Act (WMO). Eye contact task To assess neural and affective responses to prolonged eye contact, adolescents performed the “eye contact task” (see Wever et al. (2022) and Figure 4.1 for an overview of the task). During this task adolescents were shown pre-recorded videos of their parent, an unfamiliar peer, an unfamiliar adult, and themselves; all facing the camera. Each video contained a single target who looked straight into the camera (direct gaze) or averted their gaze to the left side of the camera (averted gaze), resulting in eight distinct conditions: Gaze direction (2 levels: Direct gaze, averted gaze) × target (4 levels: Parent, unfamiliar child, unfamiliar adult, self). See Supplement S4.2 for details about preparation and presentation of the videos. We simultaneously recorded eye movements during the task using an eye-tracker. While in the scanner, adolescents were instructed to make eye contact with the targets in the videos. Each trial started with a fixation cross (2-5 s), after which they were presented with a video of one of the targets in one of the gaze directions for 16-38 s. The gender of the unfamiliar peer was matched to adolescents’ own gender and the gender of the unfamiliar adult was matched to the gender of their parent in the task. After watching a video of their parent, an unfamiliar peer, and an unfamiliar adult, adolescents were asked to answer three questions; (1) “How connected do you feel with this person at this moment?”, (2) “How do you feel about this person at this moment?”, and (3) “How do you feel at this moment?”. After the videos of themselves, adolescents only reported on their mood (question 3). Adolescents answered the questions on a Likert scale ranging from 1 (not at all/very negative) to 7 (very much/very positive) and were instructed to answer and confirm the question within 8 s. The questions were selfpaced and participants could press any button to display a box around the middle option, and then press the button corresponding to their right index (to go left) and right middle finger (to go right) to move the box to their preferred answer. They could confirm their answer by pressing
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