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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    • "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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    • "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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