Quantifying the Effect of Abuse on Major Depressive Disorder

Abuse early in life is among the many factors definitively linked with depression later in life. But a study in BMC Psychiatry is among the first to report a relationship between childhood abuse, personality, adulthood life stresses and the severity of depression in depressed patients.

The onset, progression, and prognosis of major depressive disorder (MDD) is often driven by many different, sometimes inter-related factors, including a little bit of nature (genetics), a little bit of nurture (environment), and a good deal of personality. Among the environmental factors known to be related to depression are maltreatment, parenting, life stress, and poverty. Childhood abuse is considered to be critical for the development of depression and to have long-term negative effects on mental and physical conditions, including increasing the risk for psychiatric diseases such as MDD in adulthood.

The current used structural equation modeling (SEM) to infer the causal relationship between variables for 113 newly diagnosed, untreated patients with MDD, ranging in age from 25 to 75. Patients completed the Beck Depression Inventory-II (BDI-II), the Neuroticism Extroversion Openness Five Factor Inventory (NEO-FFI), the Child Abuse and Trauma Scale (CATS), and the Life Experiences Survey (LES), which are self-report scales. The researchers developed the SEM based on previous research and the chronological order in which patients experienced the variables that can impact development of MDD.

The researchers found that childhood abuse directly predicted the severity of depression and indirectly predicted the severity of depression through the mediation of personality. Negative life change score of the LES was affected by childhood abuse, however it did not predict the severity of depression.

The purpose of this present study was to identify how childhood abuse, personality, and stress of life events predicted symptoms of depression. We used SEM and evaluated and compared the effects of multiple factors on the severity of depression in MDD patients. Results indicated three important findings. Firstly, childhood abuse directly predicted the severity of depression. Secondly, childhood abuse predicted the severity of depression indirectly through the mediation of personality. Thirdly, the negative life change score of the LES was affected by childhood abuse; however, the negative life change score of the LES did not predict the severity of depression.

“This is the first report of a relationship between multiple factors, including childhood abuse, personality, and stress of life events, and the severity of depression in MDD patients,” the study authors note. “Correlation analysis also indicated that MDD patients showed a weak, but a positive correlation between neglect, punishment, and emotional childhood was directly and indirectly associated with the severity of depression symptoms in adulthood. These previous findings were reinforced by current findings.”

Limitations of the study include the possibility of age and memory biases related to childhood trauma. Secondly, according to the authors, SEM is a hypothesis modeling technique and not a technique for causal modeling. Therefore, it is possible that there are more appropriate models that include other variables.