Adverse childhood experiences and personality functioning interact substantially in predicting depression, anxiety, and somatization

Abstract

Etiological theories on the development of psychopathology often incorporate adverse childhood experiences (ACE) as an important contributing factor. Recent studies suggest personality functioning (PF; i.e., stability of the self and interpersonal relationships) as an important transdiagnostic construct that could be useful in better understanding when persons with ACE do (not) develop psychopathological symptoms. A representative sample of N = 2363 was assessed by questionnaires on ACE, PF (Level of Personality Functioning Scale—Brief Form 2.0), and current symptoms of depression, anxiety, and somatization (Brief Symptom Inventory 18). The interaction between ACE and PF on symptoms was investigated using multiple group models and Bayesian structural equation modeling. ACE were positively associated with psychopathology and PF impairments. The interaction effect between ACE and PF explained incremental variance in current symptoms, ranging from 26% for somatization to 49% for depression with the complete model explaining up to 91% of the latent variance in psychopathology. Our findings indicate a diathesis–stress model with PF as a resource or resilience that may buffer against the development of symptoms in the face of adversity. Treatments of depression and anxiety targeting self and interpersonal functioning therefore may lead to improvements in resilience and relapse prevention. [Correction added on 15 March 2023, after first online publication: Level of Personality Functioning Scale—Brief Form has been replaced to Level of Personality Functioning Scale—Brief Form 2.0 ]

Examining childhood experiences and personality functioning as potential predictors for the speed of recovery during psychotherapy of patients with anxiety disorders

“…Our findings are partially consistent with the recent study by Kerber et al. (2023), in which ACEs and personality functioning were examined as predictors of anxiety symptoms, depressiveness, and somatization ( 36 ). In this cross-sectional study, while it was shown that ACEs were positively associated with psychopathology, an association between ACEs and impairments of personality functioning was also found.…”

“…Aside from the findings that both ACEs and personality functioning are each associated with treatment outcome in psychotherapy, ACEs have repeatedly been linked to personality functioning ( 23 , 31 – 35 ). For example, it was found that the interaction between ACE and personality functioning predicts psychopathology, including anxiety symptoms ( 36 ). Assessing a heterogeneous sample of psychotherapy patients, Kindermann et al.…”

Adverse childhood experiences lead to slower symptom improvement during psychotherapy of patients with anxiety disorders

“…However, we found no direct effects of personality functioning on improvement rate in psychotherapy. Our ndings are partially consistent with the recent study by Kerber et al (2023), in which ACEs and personality functioning were examined as predictors of anxiety symptoms, depressiveness, and somatization [36]. In this cross-sectional study, while it was shown that ACEs were positively associated with psychopathology, an association between ACEs and impairments of personality functioning was also found.…”

Examining the role of personality functioning in a hierarchical taxonomy of psychopathology using two years of ambulatory assessed data

“…Unlike personality traits, which describe how individuals are, personality functioning (PF) focuses on basic psychological capacities individuals possess in perception, regulation, communication, and relationship formation to interact with themselves and the social world [18]. This de nition of PF draws on objects relations and mentalization theories [14], which postulate that de cits in regulating the self and relationships (i.e., low levels of PF) are a result of adverse geneenvironment interactions in early childhood and predispose individuals to psychopathology in general [19]. Empirically, PF shows less longitudinal stability in mean levels compared to personality traits, except for neuroticism [20], which overlaps signi cantly with PF [21] and appears more responsive to clinical interventions than other traits [22].…”