Adverse life events and cognitive-personality characteristics in the prediction of major depression and antidepressant response

Objective: Stressful life events are known to precipitate major depression. However. it remains unclear why some individuals who experience adverse ev ents develop depression whereas others do not, and how the occurrence of li fe events affects treatment outcome. Emerging models posit that the effect of adverse life events varies by cognitive-personality style. This study ex amines the direct and interactive effects of stressful life events and cogn itive-personality style in predicting 1) episode onset in patients with DSM -IV unipolar depression versus community comparison subjects and 2) depress ive symptom severity at the completion of a 6-week standard antidepressant regimen. Method: Multivariate models were used to test the effects of adverse life e vents. cognitive-personality style, and the congruence of event type (inter personal versus achievement) with cognitive-personality style on depressive onset and treatment outcome in 43 patients with major depression and 43 he althy comparison subjects. Cognitive-personality characteristics were asses sed by using Beck's measures of sociotropy (interpersonal dependency) and a utonomy (need for independence and control). Results: Adverse life events, sociotropy, and an autonomy factor need for c ontrol were each significantly related to depressive onset and predicted gr oup status for 88% of the subjects. Event types affected outcome differentl y. and specific life event types interacted with cognitive-personality styl es 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 depressi on. however, cognitive-personality characteristics also confer susceptibili ty to depression. Better outcome is associated with occurrence of adverse i nterpersonal events (e.g., death of a loved one) rather than adverse achiev ement events (e.g., loss of job) and occurs when the event type is congruen t with cognitive-personality style.