Adverse life events and cognitive-personality characteristics in the prediction of major depression and antidepressant response
Adverse life events and cognitive-personality characteristics in the prediction of major depression and antidepressant response
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DOI：
10.1176/appi.ajp.157.6.896
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发表时间：
2000-06-01
影响因子：
17.7
通讯作者：
Jacobs, SC
中科院分区：
文献类型：
--
作者：
Mazure, CM;Bruce, ML;Jacobs, SC
目的：应激性生活事件是抑郁症的诱因。然而.目前尚不清楚为什么有些经历过不良事件的人会患上抑郁症，而另一些人则不会，以及生活事件的发生如何影响治疗结果。新兴的模型认为，不良生活事件的影响因认知人格风格而异。本研究探讨了压力性生活事件和认知人格风格在预测1）DSM-IV型单相抑郁症患者与社区对照受试者发作和2）完成6周标准抗抑郁剂治疗方案后抑郁症状严重程度方面的直接和交互作用。在43例重性抑郁症患者和43例健康对照者中，探讨了认知-人格风格、事件类型（人际与成就）与认知-人格风格的一致性对抑郁发作和治疗结果的影响。认知人格特征进行了评估，使用贝克的措施sociotropy（人际依赖）和自主性（需要独立和控制）。结果：不良生活事件，sociotropy，和一个自主性因素需要控制显着相关的抑郁发作和预测组状态的88%的受试者。事件类型对结局的影响不同。特定生活事件类型与认知人格风格在预测治疗反应方面相互作用。多变量模型预测outcome.Conclusions的方差占65%：不良生活事件是预测抑郁症的一个有效因素。然而，认知人格特征也赋予抑郁症的易感性。更好的结果与不良人际事件的发生有关（例如，所爱的人的死亡）而不是不利的成就事件（例如，失业），并且当事件类型与认知人格风格一致时发生。
Objective: Stressful life events are known to precipitate major depression. However. it remains unclear why some individuals who experience adverse events develop depression whereas others do not, and how the occurrence of life events affects treatment outcome. Emerging models posit that the effect of adverse life events varies by cognitive-personality style. This study examines the direct and interactive effects of stressful life events and cognitive-personality style in predicting 1) episode onset in patients with DSM-IV unipolar depression versus community comparison subjects and 2) depressive symptom severity at the completion of a 6-week standard antidepressant regimen.Method: Multivariate models were used to test the effects of adverse life events. cognitive-personality style, and the congruence of event type (interpersonal versus achievement) with cognitive-personality style on depressive onset and treatment outcome in 43 patients with major depression and 43 healthy comparison subjects. Cognitive-personality characteristics were assessed by using Beck's measures of sociotropy (interpersonal dependency) and autonomy (need for independence and control).Results: Adverse life events, sociotropy, and an autonomy factor need for control were each significantly related to depressive onset and predicted group status for 88% of the subjects. Event types affected outcome differently. and specific life event types interacted with cognitive-personality styles in predicting response to treatment. A multivariate model accounted for 65% of the variance in predicting outcome.Conclusions: Adverse life events are a potent factor in predicting depression. however, cognitive-personality characteristics also confer susceptibility to depression. Better outcome is associated with occurrence of adverse interpersonal events (e.g., death of a loved one) rather than adverse achievement events (e.g., loss of job) and occurs when the event type is congruent with cognitive-personality style.