Prospective associations of low positive emotionality with first onsets of depressive and anxiety disorders: Results from a 10-wave latent trait-state modeling study.

Abstract

Unipolar depressive disorders and anxiety disorders co-occur at high rates and can be difficult to distinguish from one another. Cross-sectional evidence has demonstrated that whereas all these disorders are characterized by high negative emotion, low positive emotion shows specificity in its associations with depressive disorders, social anxiety disorder, and possibly generalized anxiety disorder. However, it remains unknown whether low positive emotionality, a personality trait characterized by the tendency to experience low positive emotion over time, prospectively marks risk for the initial development of these disorders. We aimed to help address this gap. Each year for up to 10 waves, participants (n = 627, mean age = 17 years at baseline) completed self-report measures of mood and personality and a structured clinical interview. A latent trait-state decomposition technique was used to model positive emotionality and related personality traits over the first 3 years of the study. Survival analyses were used to test the prospective associations of low positive emotionality with first onsets of disorders over the subsequent 6-year follow-up among participants with no relevant disorder history. The results showed that low positive emotionality was a risk marker for depressive disorders, social anxiety disorder, and generalized anxiety disorder, although evidence for its specificity to these disorders versus the remaining anxiety disorders was inconclusive. Additional analyses revealed that the risk effects were largely accounted for by the overlap of low positive emotionality with neuroticism. The implications for understanding the role of positive emotionality in depressive disorders and anxiety disorders are discussed.