Recurrence of MDD: A prospective study of personality pathology and cognitive distortions.

Abstract

Major depressive disorder (MDD) is characterized by a high risk of recurrence, especially among individuals whose initial episode occurs during adolescence. Identifying predictors of recurrence of MDD among young samples is therefore of paramount clinical importance. Survival analytic models were used to evaluate the effects of dysfunctional cognitions and Axis II personality pathology on MDD recurrence in a sample of 130 previously, but not currently, depressed young adults. Participants were initially assessed for depression, dysfunctional attitudes, and personality pathology during their first semester in college and then reevaluated via the Longitudinal Interval Follow-up Evaluation interview every 6 months for 18 months. Baseline level of depressive symptoms significantly (HR-1.07, p = .002) predicted recurrence of MDD. In the survival analyses with baseline level of depression serving as a current mood state covariate, overall personality pathology (HR-1.04, p < .05), but not cognitive distortions, uniquely predicted MDD recurrence. In similar analyses, none of the specific DSM-IV personality disorder cluster scores uniquely predicted recurrence. We discussed the theoretical, empirical, and clinical implications of these findings, and we noted the limitations of the study.

Comparing chronic interpersonal and noninterpersonal stress domains as predictors of depression recurrence in emerging adults

“…Due to the known relationship of subsyndromal depressive symptoms and MDD recurrence (Craighead et al, 2011; Judd, Akiskal, & Paulus, 1997), baseline BDI was entered as a static, or time-fixed, covariate in all survival analyses, to control for the relationships of baseline depressive symptoms and MDD recurrence and baseline depressive symptoms and chronic stress generation (Hammen, 2005). Additionally, it was important to include this covariate because it predicted censoring due to drop-out.…”

“…The screening survey asked participants if they had experienced a depressive episode during high school and if they were currently in treatment for depression. Respondents were asked to return the survey only if they believed they had experienced a previous depressive episode (for a detailed description of sampling and recruitment, see Craighead et al, 2011. All enrolled participants met DSM-IV diagnosis of at least one past episode of major depressive disorder (MDD), but they had recovered from depression when they enrolled in the project.…”

“…Similarly, greater personality disorder symptoms are consistently associated with greater rates of MDD recurrence and decreased time between MDEs (Hart, Craighead, & Craighead, 2001; Ilardi et al, 1997; Skodol et al, 2011). A previous report from the study’s larger parent project indicated that residual subsyndromal levels of depressive symptoms and total personality pathology predicted greater recurrence of MDD (Craighead, Sheets, Craighead, & Madsen, 2011). The present study aimed to identify how chronic stress uniquely impacts depression beyond these predictors, so baseline subclinical depressive symptoms, dysfunctional cognitions, and personality pathology were covariates in all models.…”

Predictors of remission in depression to individual and combined treatments (PReDICT): study protocol for a randomized controlled trial

“…Prior research suggests that personality variables, including personality disorders (PDs), predict the longitudinal course of MDD in treatment-seeking patients [117,118], although data on personality predictors of response to specific treatments are sparse [119]. Perhaps the central question at the heart of current research on the classification of personality pathology, which bears on predictors of treatment outcome, is how best to conceptualize personality: as categorical PDs; as sums of numbers of PDs or PD criteria met [117]; as dimensional representations of syndromes (for example, personality prototypes, for which patients can vary in the degree to which they match a given diagnosis [120]); or as dimensional traits (for example, neuroticism, emotional dysregulation, or emotional avoidance) [121,122].…”

Evaluation of the Unique and Specific Contributions of Dimensions of the Triple Vulnerability Model to the Prediction of DSM-IV Anxiety and Mood Disorder Constructs

“…The scale reliability estimate (Cronbach’s α) of the first factor was .92 (Sexton & Dugas, (2009). In accord with prior research (e.g., Alloy et al, 2006; Craighead, Sheets, Craighead, & Madsen, 2011; Rogers et al, 2009), the DAS total score was used as the indicator of depressogenic cognitions and maladaptive beliefs (average α across studies = .90).…”