4.7 Article

Are childhood and adult life adversities differentially associated with specific symptom dimensions of depression and anxiety? Testing the tripartite model

Journal

JOURNAL OF AFFECTIVE DISORDERS
Volume 146, Issue 2, Pages 238-245

Publisher

ELSEVIER
DOI: 10.1016/j.jad.2012.09.011

Keywords

Depression; Anxiety; Symptom dimensions; Childhood trauma; Life event; Tripartite model

Funding

  1. Geestkracht program of the Netherlands Organisation for Health Research and Development (ZonMw) [10-000-1002]
  2. VU University Medical Center
  3. GGZ in Geest
  4. Arkin
  5. Leiden University Medical Center
  6. GGZ Rivierduinen
  7. University Medical Center Groningen
  8. University of Groningen
  9. Lentis
  10. GGZ Friesland
  11. GGZ Drenthe
  12. Scientific Institute for Quality of Care (IQ Healthcare)
  13. Netherlands Institute for Health Services Research (NIVEL)
  14. Netherlands Institute of Mental Health and Addiction (Trimbos)

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Background: Different types of adverse events may have general or specific effects on depression and anxiety symptomatology. We examined the effects of adversities on the dimensions of the tripartite model: general distress, anhedonic depression and anxious arousal. Methods: Data were from 2615 individuals from the Netherlands Study for Depression and Anxiety (NESDA), with or without depressive or anxiety disorders. We analysed associations of childhood trauma, childhood life events (childhood trauma interview), and recent life events (List of Threatening Events Questionnaire, LTE-Q) with anhedonic depression, anxious arousal, and general distress (assessed by the adapted Mood and Anxiety Symptoms Questionnaire, MASQ-D30). Results: We controlled for co-occurrence of adversities. Regarding childhood trauma, only emotional neglect was associated with all three symptom dimensions. Psychological and sexual abuse were associated with general distress and anxious arousal, whereas physical abuse was associated only with anxious arousal. Particularly strong associations were seen for emotional neglect with anhedonic depression and for sexual abuse with anxious arousal. Childhood life events showed no associations with symptom dimensions. The recent life events 'Serious problems with friend', 'Serious financial problems', and 'Becoming unemployed' were associated with all three dimensions. The recent life event 'death of parent/child/sibling' was associated with anxious arousal. Several associations remained significant when controlled for current diagnosis of depression or anxiety. Limitations: Our cross-sectional analyses do not allow for causal interpretation. Conclusions: Distinct childhood traumas had different effects on the symptom dimensions, whereas most recent adult life events were associated with all three symptom dimensions. Our observations help to understand the often reported associations of these adversities with depressive and anxiety symptomatology. In addition, symptom dimensions of the tripartite model were shown to capture effects of adverse events on top of those captured by diagnostic categories. (c) 2012 Elsevier B.V. All rights reserved.

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