Whereas there is extensive research on factors that contribute to vulnerability for depression and anxiety, research on how to promote mental health or offset risk effects in individuals likely to develop these disorders is lacking. Resilience models focus on risk, resource, and protective factors and their relationships. The current longitudinal study evaluated whether extraversion and interpersonal support functioned in resource or protective roles in relation to unipolar mood disorder (UMD), anxiety disorder (AD), and comorbid diagnoses. Data from 534 adolescents over a 3-year period were examined in a series of survival analyses to predict future disorder onset. The linear effect of extraversion significantly interacted with neuroticism predicting UMD diagnoses with extraversion conferring protection and introversion conferring risk at high levels of neuroticism. The quadratic effect of extraversion significantly interacted with neuroticism predicting AD and comorbid diagnoses such that extraversion escalated risk for diagnoses at high levels of neuroticism. The quadratic effect of extraversion was significant in comorbidity models, demonstrating increased risk as one progresses from slight extraversion to extreme introversion, independent of neuroticism. Interpersonal support significantly predicted UMD, AD, and comorbid diagnoses in an approximately linear fashion. Specificity tests indicated that these effects remained when including the other diagnosis in each model. Findings suggest the value of attending to extraverted traits and encouraging social connection regardless of risk status in prevention and treatment approaches.
Limitations of this study include small sample size and absence of high lethality suicide attempts in the depressed attempter group. No trait-like binding correlations with past suicide attempt or current depression were observed. Given the heterogeneity of nonfatal suicidal behavior, a larger sample study emphasizing higher lethality suicide attempts may find the serotonin biological phenotype seen in suicide decedents.
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