Can personality assessment predict future depression? A twelve-month follow-up of 631 subjects

doi:10.1016/j.jad.2005.12.034

Journal of Affective Disorders

Volume 92, Issue 1, May 2006, Pages 35-44

https://doi.org/10.1016/j.jad.2005.12.034 Get rights and content

Abstract

Background

Personality assessment provides a description of a person's fundamental emotional needs and of the higher cognitive processes that modulate thoughts, feelings, and behavior. Prior studies by us examined personality and mood at the same time. Assessing personality may allow prediction of mood changes over time in a longitudinal study, as described in earlier prospective studies by Paula Clayton and others.

Method

A group of 631 adults representative of the general population completed the Temperament and Character Inventory (TCI) and Center for Epidemiological Studies depression scale (CES-D) at baseline and one year later.

Results

TCI scores at baseline accounted for gender differences in levels of depression. TCI personality scores were strongly stable (range in r = .78 to .85 for each of seven dimensions) whereas mood was only moderately stable (r = .62) over the twelve-month follow-up. Baseline personality scores (particularly high Harm Avoidance and low Self-Directedness) explained 44% of the variance in the change in depression. Baseline levels and changes in Harm Avoidance and Self-Directedness explained 52% of the variance in the change in depression at follow-up.

Limitations

The follow-up sample was representative of the target population except for slightly lower Novelty Seeking scores.

Clinical relevance

Observable personality levels strongly predict mood changes. Personality development may reduce vulnerability to future depression.

Section snippets

Sample

We attempted to study a stratified random sample of 1000 noninstitutionalized adults, 18 years of age or older, who lived in the greater metropolitan area of St. Louis, Missouri in June 1994 and to follow them up twelve months later. The Washington University Human Subjects Committee approved the study methods. Potential participants initially were identified at random from standard telephone lists and asked if they were willing to participate in a questionnaire survey of depression,

Results

The levels of depressive symptoms, as measured by CES-D scores, are summarized for men and for women in Table 1. Women more often had CES-D scores of 21 or more than did men (18% versus 13%), as expected from previous community surveys. There were also strong differences in personality between men and women: women were higher than men in Harm Avoidance, Reward Dependence, and Cooperativeness (Table 2).

The observed gender differences in personality accounted for the observed differences in CES-D

Discussion

Our findings indicate that TCI Harm Avoidance is a marker of emotional vulnerability to depression. In contrast, TCI Self-Directedness is a marker of executive functions that protect a person from depression. As a result, individuals with depression are likely to be both anxiety-prone (i.e., high in Harm Avoidance) and immature (i.e., low in Self-Directedness and Cooperativeness) (see Table 7). In prior work, we showed that depression and these same personality variables were correlated at the

Acknowledgment

We thank Dr. Richard Hudgens for his valuable comments on an earlier draft.

References (52)

J. Angst et al.
Premorbid personality of depressive, bipolar, and schizophrenic patients with special reference to suicidal issues
Comprehensive Psychiatry
(1986)
C. Bayon et al.
Dimensional assessment of personality in an outpatient sample: relations of the systems of Millon and Cloninger
Journal of Psychiatric Research
(1996)
C.M. Bulik et al.
Predictors of 1-year treatment outcome in Bulimea Nervosa
Comprehensive Psychiatry
(1998)
C.R. Cloninger et al.
Measurement of temperament and character in mood disorders: a model of fundamental states as personality types
Journal of Affective Disorders
(1998)
N.A. Gillespie et al.
The genetic and environmental relationship between Cloninger's dimensions of temperament and character
Personality and Individual Differences
(2003)
P.R. Joyce et al.
Temperament predicts clomipramine and desipramine response in major depression.
Journal of Affective Disorders
(1994)
P.R. Joyce et al.
Borderline personality disorder in major depression: differential drug response, and 6-month outcome
Comprehensive Psychiatry
(2003)
Y. Osher et al.
TPQ in euthymic manic-depressive patients
Journal of Psychiatric Research
(1996)
Y. Osher et al.
Low persistence in euthymic manic-depressive patients: a replication
Journal of Affective Disorders
(1999)
J. Pujol et al.
Anatomical variability of the anterior cingulate gyrus and basic dimensions of human personality
NeuroImage
(2002)

M.B. Tome et al.

Serotonergic autoreceptor blockade in the reduction of antidepressant latency: personality and response to paroxetine and pindolol

Journal of Affective Disorders

(1997)

H.S. Akiskal et al.

Switching from ‘unipolar’ to bipolar II. An 11-year prospective study of clinical and temperamental predictors in 559 patients

Archives of General Psychiatry

(1995)

P.J. Clayton

Mortality and morbidity in the first year of widowhood

Archives of General Psychiatry

(1974)

C.R. Cloninger

A unified biosocial theory of personality and its role in the development of anxiety states

Psychiatric Developments

(1986)

C.R. Cloninger

A new conceptual paradigm from genetics and psychobiology for the science of mental health

Australian and New Zealand Journal of Psychiatry

(1999)

C.R. Cloninger

Biology of personality dimensions

Current Opinion in Psychiatry

(2000)

C.R. Cloninger

A practical way to diagnose personality disorder: a proposal

Journal of Personality Disorders

(2000)

C.R. Cloninger

Functional neuroanatomy and brain imaging of personality and its disorders

C.R. Cloninger

Implications of comorbidity for the classification of mental disorders: the need for a psychobiology of coherence

C.R. Cloninger

Feeling Good: the Science of Well Being

(2004)

C.R. Cloninger et al.

Personality disorders

C.R. Cloninger et al.

Diagnosis and prognosis in schizophrenia

Archives of General Psychiatry

(1985)

C.R. Cloninger et al.

The tridimensional personality questionnaire: U.S. normative data

Psychological Reports

(1991)

C.R. Cloninger et al.

A psychobiological model of temperament and character

Archives of General Psychiatry

(1993)

C.R. Cloninger et al.

The Temperament and Character Inventory: a Guide to its Development and Use

(1994)

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^☆: Supported in part by grants from the National Institutes of Health MH-60879, MH-62130, AA-840314.

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Research reportCan personality assessment predict future depression? A twelve-month follow-up of 631 subjects☆

Abstract

Background

Method

Results

Limitations

Clinical relevance

Section snippets

Sample

Results

Discussion

Acknowledgment

Comprehensive Psychiatry

Journal of Psychiatric Research

Comprehensive Psychiatry

Journal of Affective Disorders

Personality and Individual Differences

Journal of Affective Disorders

Comprehensive Psychiatry

Journal of Psychiatric Research

Journal of Affective Disorders

NeuroImage

Journal of Affective Disorders

Switching from ‘unipolar’ to bipolar II. An 11-year prospective study of clinical and temperamental predictors in 559 patients

Archives of General Psychiatry

Mortality and morbidity in the first year of widowhood

Archives of General Psychiatry

A unified biosocial theory of personality and its role in the development of anxiety states

Psychiatric Developments

A new conceptual paradigm from genetics and psychobiology for the science of mental health

Australian and New Zealand Journal of Psychiatry

Biology of personality dimensions

Current Opinion in Psychiatry

A practical way to diagnose personality disorder: a proposal

Journal of Personality Disorders

Functional neuroanatomy and brain imaging of personality and its disorders

Implications of comorbidity for the classification of mental disorders: the need for a psychobiology of coherence

Feeling Good: the Science of Well Being

Personality disorders

Diagnosis and prognosis in schizophrenia

Archives of General Psychiatry

The tridimensional personality questionnaire: U.S. normative data

Psychological Reports

A psychobiological model of temperament and character

Archives of General Psychiatry

The Temperament and Character Inventory: a Guide to its Development and Use

Research report
Can personality assessment predict future depression? A twelve-month follow-up of 631 subjects☆