Disentangling the causal inter-relationship between negative life events and depressive symptoms in women: A longitudinal twin study

Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, Maastricht, The Netherlands.
Psychological Medicine (Impact Factor: 5.94). 01/2012; 42(9):1801-14. DOI: 10.1017/S003329171100300X
Source: PubMed


Negative life events are strongly associated with the development of depression. However, the etiologic relationship between life events and depression is complex. Evidence suggests that life events can cause depression, and depression increases the risk for life events. Additionally, third factors influencing both phenotypes may be involved. In this work we sought to disentangle these relationships using a genetically informative longitudinal design.
Adult female twins (n=536, including 281 twin pairs) were followed up for measurements of negative life event exposure and depressive symptoms. Four follow-ups were completed, each approximately 3 months apart. Model fitting was carried out using the Mx program.
The best-fitting model included causal paths from life events to depressive symptoms for genetic and shared environmental risk factors, whereas paths from depressive symptoms to life events were apparent for shared environmental factors. Shared latent influence on both phenotypes was found for individual-specific effects.
Life events and depressive symptoms have complex inter-relationships that differ across sources of variance. The results of the model, if replicated, indicate that reducing life event exposure would reduce depressive symptoms and that lowering depressive symptoms would decrease the occurrence of negative life events.

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Available from: Marieke Wichers, Oct 06, 2015
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    • "Although the link between stressors and negative health outcomes is not completely understood, some authors have proposed mechanisms to explain this association. One possible explanation is that the influence of such events on physical health is mediated by the development of depressive and other psychiatric symptoms [3,35]. However, the presence of major depressive disorder did not influence this association, suggesting that other mechanisms of association may be present. "
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    ABSTRACT: BACKGROUND: Stress is a typical migraine trigger. However, the impact of negative life events on migraine activity is poorly studied. The aim of this study is to investigate the association between negative life events and migraine using data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline assessment. METHODS: ELSA-Brasil is a multicenter cohort study conducted in six Brazilian cities. Baseline assessment included validated questionnaires for headache classification and the occurrence of five pre-specified negative life events (financial hardship, hospitalization other than for childbirth, death of a close relative, robbery and end of a love relationship), focusing on a 12-month period before evaluation. We built crude and adjusted logistic regression models to study the association between the occurrences of negative life events and migraine diagnosis and activity. RESULTS: We included 4,409 individuals with migraine and 4,457 participants without headache (reference). After adjustment for age, sex, race, income and educational level, we found that the occurrence of a negative life event (Odds ratio = 1.31; 95% confidence interval = 1.19-1.45) was associated with migraine. However, after stratifying with subgroup analyses, only financial hardship (Odds ratio = 1.65; 95% confidence interval = 1.47-1.87) and hospitalization (Odds ratio = 1.47; 95% confidence interval = 1.25-1.72) were independently associated with migraine. Further adjustment for a current major depression episode and report of religious activity did not significantly change the results. Considering migraine frequency as (a) less than once per month, (b) once per month to once per week, or (c) more than once per week, financial hardship and hospitalization remained significantly associated with migraine in all episode frequency strata, with higher odds ratios for higher frequencies in adjusted models. We also observed a significant association between the death of a close relative and the highest migraine frequency stratum (Odds ratio = 1.38; 95% confidence interval = 1.09-1.75) in full-adjusted model. CONCLUSIONS: The occurrence of financial hardship and hospitalization had a direct and independent association with migraine diagnosis and frequency. The death of a close relative was also independently associated with the highest migraine frequency stratum.
    BMC Public Health 07/2014; 14(678). DOI:10.1186/1471-2458-14-678 · 2.26 Impact Factor
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    • "First, the cross-sectional design of the study precludes any conclusions about the direction of effects. It has to be noted, however, that a recent longitudinal twin study showed that the relationship between ALE and depressive reaction is precisely bidirectional and suggested that reducing life event exposure would reduce depressive symptoms and lowering depressive symptoms would decrease the occurrence of ALE [26]. Also, problems in data interpretation may arise from the use of retrospective self-reports. "
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    ABSTRACT: Consistent with cognitive views of depression, we aimed to investigate the mediating role of personal goals in the relationship between stressful events and distinct patterns of depressive symptoms in a nonclinical sample. Participants identified a dysphoric episode that occurred in the previous year by reporting the severity of 12 depressive symptoms and their plausible cause. A goal taxonomy was used to determine how much the event interfered with the achievement of a series of personal goals. After controlling for age and current level of depression, the patterns of symptoms differed based on the triggering events. The relationship between sadness and affective losses was partially mediated by the personal goal of lovableness, and success was a partial mediator in the association between an event of failure and symptoms of worthlessness and anhedonia. Although the cross-sectional design of the study does not allow for conclusions on the direction of effects, findings suggest the importance of motivational factors in the development of specific patterns of depressive symptoms to adverse events. Assuming a continuum from low mood to clinical depression, treatment models could benefit from a precise identification of the specific stressors that initiate depressive behaviour and the personal meaning assigned to those events.
    The Scientific World Journal 12/2012; 2012:810341. DOI:10.1100/2012/810341 · 1.73 Impact Factor
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    ABSTRACT: BACKGROUND: Prospective studies measuring first-incidence of DSM-IV mood, anxiety and substance use disorders in the general population are rare. We assessed these incidence rates in the Dutch population; and identified baseline sociodemographic, physical and psychopathological variables, and negative changes in sociodemographics and physical health between baseline and follow-up, as determinants of first-onset main categories of disorders. METHOD: Data are from NEMESIS-2, a representative face-to-face survey including 5303 subjects aged 18-64 interviewed twice (2007-2009; 2010-2012) with the CIDI3.0. RESULTS: In three years, 8.86% of adults without prior psychopathology experienced any mental disorder, corresponding with 3.09 cases per 100 person-years. Incidence was highest for anxiety (1.69 per 100 person-years) and mood disorder (1.65), and lowest for substance use disorder (0.97). For the separate disorders, incidence was highest for major depression (1.58), specific phobia (0.79) and alcohol abuse (0.73). For mood and anxiety disorder, incidence rate was higher among women and for substance use disorder it was higher among men. Age was inversely related to all disorder categories. Changes in sociodemographics, like no longer living with a partner and decrease in income, were stronger determinants than the corresponding sociodemographics. Incident mood disorder was predicted by baseline anxiety and substance use disorder, incident anxiety disorder by mood and substance use disorder, and incident substance use disorder by adultADHD. LIMITATIONS: Validity of lifetime diagnoses can be questioned because of difficulty of accurate recall. Only determinants of categories of disorders were studied, due to low numbers of incident cases of most separate disorders. CONCLUSION: First-onset of mental disorders in a 3-year period is not an uncommon phenomenon. Results about determinants of incident disorders are important for prevention and early intervention initiatives aimed at reducing burden of mental disorders.
    Journal of Affective Disorders 02/2013; 149(1-3). DOI:10.1016/j.jad.2013.01.009 · 3.38 Impact Factor
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