The onset of depression and depressive symptoms spikes during adolescence, and the prevalence of depression in adolescents appears to be increasing over time (Daly, 2022). In previous research, we found that greater integration of an allostatic interoceptive system (AIS), a brain system involved in the predictive regulation of the body, prospectively predicted more depressive symptoms in adolescents two years later, mediated by a greater tendency to ruminate (Frye et al., 2025). This pattern of brain organization may reflect excessive internal focus. Here, we examine the potential moderating effect of emotional awareness on the relationship between AIS integration and prospective depression symptoms. Specifically, using data from a larger longitudinal study of adolescents beginning in 6th -8th grade, we test whether trait emotional clarity or emotional attention moderates the relationship between AIS global efficiency during a resting-state fMRI scan and prospective depressive symptoms assessed an average of two years later (N = 117, 55% female, Minitial age= 12.99, Mage at follow−up= 14.74). We found that for adolescents who paid little attention to their emotions, greater AIS integration was related to lower prospective depressive symptoms, whereas for adolescents who paid above-average attention to their emotions, greater AIS integration was related to greater prospective depressive symptoms. These findings contribute to an emerging understanding of the role of the allostatic-interoceptive system in depression in adolescents by showing that the relationship between system integration and prospective depressive symptoms differs depending on adolescents’ emotional attention.
