Abstract
Background: Depressive disorder is one of the main health problems worldwide. Many risk factors have been associated with this pathology. However, while the association between risks factors and adult depression is well established, the mechanisms behind its impact remains poorly understood. A possible, yet untested explanation is the mediating impact of levels of personality functioning, i.e., impairments with regard to self and interpersonal.Method: Around 162 patients were assessed at the beginning of their therapy, with regard to risk factors, such as sociodemographic, physical, hereditary (Information Form), and adverse childhood experiences (ACE; CTQ). Depressive symptoms (Beck Depression Inventory, BDI) and personality functioning (OPD-SQ) were also measured. Associations between the related variables as well as other possible covariates were examined by means of zero-order correlations and bootstrapping-based mediation analysis.Results: Of all the risk factors taken into account, level of education and physical illness were associated with depression. On the other hand, the most significant predictor of depressive symptomatology was ACE, and this relationship was mediated by personality functioning. This indicates that patients presenting adverse childhood experiences are more likely to develop deficiencies in personality functioning, which in turn increases their likelihood of developing depressive symptomatology.Conclusion: These results reaffirm the importance of incorporating risk and vulnerability factors such as personality functioning in understanding depression.
Highlights
Mood disorders, such as depression, can be disruptive to daily functioning and well-being (Malinowski et al, 2017)
The existence of adverse childhood experiences (ACE) was associated with depressive symptomatology with a moderate to large effect, showing that people who had ACE report higher levels of depressive symptomatology than those subjects who did not have this type of experiences
When exploring the relationships between personality functioning and risk factors according to the ANOVA, only ACE were associated with personality functioning, with a moderate to large effect size
Summary
Mood disorders, such as depression, can be disruptive to daily functioning and well-being (Malinowski et al, 2017). What is usually described as “depression” is a heterogeneous construct (Fried and Nesse, 2015), which does point toward different symptom profiles, and to a thorough assessment of the impact of risk factors and vulnerabilities. This is of practical relevance, as different pathways to the development and course of depression may interact with the selection of treatments that suits the patient best (De la Parra et al, 2017), and identify strategies for relapse prevention (Ingram and Price, 2010). A possible, yet untested explanation is the mediating impact of levels of personality functioning, i.e., impairments with regard to self and interpersonal
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