Personality, stressful life events, and treatment response in major depression.

Abstract

Major Depression (MD) currently affects over 17 million individuals in North America (Greenberg et al., 2003). Identifying factors predictive of MD treatment response is important for developing more efficacious treatments and better understanding MD vulnerability. The goal of the present study was to examine the main and interactive effects of personality and stressful life events as predictors of MD treatment response.One hundred and thirty-one clinically depressed participants were randomly assigned to either 16-weeks of cognitive behavioural therapy (CBT), interpersonal psychotherapy (IPT), or pharmacotherapy (PT). Personality in the form of trait self-criticism, neediness, and connectedness was assessed at pre and post-treatment using the Depressive Experiences Questionnaire (DEQ; Blatt et al., 1976). Stressful life events experienced during treatment were assessed using the Life Events and Difficulties Schedule (LEDS; Bifulco et al., 1989). Results revealed that amongst individuals scoring lower in pretreatment self-criticism, higher pre-treatment connectedness predicted superior treatment response. As well, amongst individuals scoring lower in pre-treatment neediness, higher pre-treatment connectedness predicted superior treatment response. In terms of personality change, both a reduction in neediness and a reduction in self-criticism over the course of treatment predicted superior treatment response. A personality × stressful life event interaction was also found such that amongst those experiencing a stressful life event during treatment, higher scores on pre-treatment self-criticism predicted poor treatment response. These results suggest that personality and stressful life events play an important role in the treatment of MD. Limitations and clinical implications are discussed.iii Acknowledgements

Impact of childhood adversities on the short-term course of illness in psychotic spectrum disorders

“…For instance, patients with a dual diagnosis, especially dependency on alcohol or other substances, could benefit from programs that integrate childhood experiences. Studies suggest that patients with adverse childhood experiences benefit from additional cognitive behavioral therapy (Nemeroff et al, 2003;Bulmash et al, 2009;Lewis et al, 2010). As shown for treatment of chronic depression integration of childhood adversities in treatment strategies should improve outcomes of schizophrenia patients with high levels of early life stress (McCullough, 2003).…”

Therapist's Autonomy Support and Patient's Self-Criticism Predict Motivation during Brief Treatments for Depression

“…The investigation was conducted in an outpatient mood disorders clinic of a large university-affiliated psychiatric hospital. Other articles derived from this study are Bulmash, Harkness, Bagby, and Stewart (2009) ;Marshall, Zuroff, McBride, and Bagby (2008); Quilty, McBride, and Bagby (2008); and Zuroff et al (2007).…”

Fears of Compassion in a Depressed Population Implication for Psychotherapy

“…Selfcriticism is of course the opposite of self-compassion, especially when associated with feelings of anger and contempt for the self [42,43,61,62]. Self-criticism has long been linked to increased vulnerability to psychopathology [63] and poor recovery [64]. There is an important link between fears of compassion and internal feelings of hostility towards the self and self-criticism [51,52].…”

“…There is an important link between fears of compassion and internal feelings of hostility towards the self and self-criticism [51,52]. Self-critical individuals often struggle with standard therapies [64,65] and have become a focus for compassion focused therapy [13,14]. A series of studies have shown that shame-prone and self-critical individuals tend to come from more difficult attachment backgrounds and have problematic attachment strategies which can interfere with being open to affiliative and compassionate feelings [34].…”