Impact of Early-Life Stress and Resilience on Patients with Major Depressive Disorder
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Purpose: Early-life stress (ELS) has a long-lasting effect on affective function and may entail an increased risk for major depressive disorder (MDD). However, resilience can play a protective role against developing psychopathology. In this study, we investigated the relationships of depressive symptoms with ELS and resilience in MDD. Materials and Methods: Twenty-six patients with MDD as well as age- and gender-matched healthy controls were included in this study. Each subject was assessed concerning ELS, resilience, and depressive symptom severity with self-report questionnaires. Independent samples t-test and Mann-Whitney test were performed to compare ELS and resilience between the patient and control groups. Spearman correlation analyses and linear regression analysis were conducted to investigate significant ELS and resilience factors associated with depressive symptoms. Results: In the MDD patient group, subjects reported greater exposure to inter-parental violence, and five factor scores on the resilience scale were significantly lower in comparison to the control group. In linear regression analysis, in regards to resilience, depressive symptom score was significantly associated with self-confidence and self-control factors; however, ELS demonstrated no significant association with depressive symptoms. Conclusion: Among resilience factors, self-confidence and self-control may ameliorate depressive symptoms in MDD. ELS, including inter-parental violence, physical abuse and emotional abuse, might be a risk factor for developing depression. Assessment of early-life stress and intervention programs for increasing resilience capacity would be helpful in treating MDD.
Abstract
Purpose: Early-life stress (ELS) has a long-lasting effect on affective function and may entail an increased risk for major depressive disorder (MDD). However, resilience can play a protective role against developing psychopathology. In this study, we investigated the relationships of depressive symptoms with ELS and resilience in MDD. Materials and Methods: Twenty-six patients with MDD as well as age- and gender-matched healthy controls were included in this study. Each subject was assessed concerning ELS, resilience, and depressive symptom severity with self-report questionnaires. Independent samples t-test and Mann-Whitney test were performed to compare ELS and resilience between the patient and control groups. Spearman correlation analyses and linear regression analysis were conducted to investigate significant ELS and resilience factors associated with depressive symptoms. Results: In the MDD patient group, subjects reported greater exposure to inter-parental violence, and five factor scores on the resilience scale were significantly lower in comparison to the control group. In linear regression analysis, in regards to resilience, depressive symptom score was significantly associated with self-confidence and self-control factors; however, ELS demonstrated no significant association with depressive symptoms. Conclusion: Among resilience factors, self-confidence and self-control may ameliorate depressive symptoms in MDD. ELS, including inter-parental violence, physical abuse and emotional abuse, might be a risk factor for developing depression. Assessment of early-life stress and intervention programs for increasing resilience capacity would be helpful in treating MDD.
참고문헌 (30)
- Pechtel P, "Effects of early life stress on cognitive and affective function: an integrated review of human literature", sychopharmacology, 214, pp.55~70 (2011)
- Heim C, "The link between childhood trauma and depression: insights from HPA axis studies in humans", Psychoneuroendocrinology, 33, pp.693~710 (2008)
- McCauley J, "Clinical characteristics of women with a history of childhood abuse: unhealed wounds", JAMA, 277, pp.1362~1368 (1997)
- Edwards VJ, "Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: results from the adverse childhood experiences study", Am J Psychiatry, 160, pp.1453~1460 (2003)
- Dube SR, "Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the Adverse Childhood Experiences Study", JAMA, 286, pp.3089~3096 (2001)
- Block J, "IQ and ego-resiliency : conceptual and empirical connections and separateness", J Pers Soc Psychol, 70, pp.349~361 (1996)
- Masten AS, "Resilience and development: contributions from the study of children who overcome adversity", Dev Psychopathol, 2, pp.425~444 (1990)
- Southwick SM, "The psychobiology of depression and resilience to stress: implications for prevention and treatment", Annu Rev Clin Psychol, 1, pp.255~291 (2005)
- Han OS, "Korean version of Structured Clinical Interview for DSM-IV" (2000), Hana Medical Publishing Company
- Oh HJ., "Effects of chldhood abuse and exposure to parental violence on problem in drinking in later life (In Korean)", 석사, pp.2004
- Straus MA, "Measuring intrafamily conflict and violence: the conflict tactics (CT) scales", J Marriage Fam, 41, pp.75~88 (1979)
- Jang HJ, "The development of a child abuse assessment scale (In Korean)", 박사, pp.1998
- Connor KM, "Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC)", Depress Anxiety, 18, pp.76~82 (2003)
- Hyun-Sook Baek, "Reliability and Validity of the Korean Version of the Connor-Davidson Resilience Scale", PSYCHIATRY INVESTIGATION, 7(2), pp.109~115 (2010), 대한신경정신의학회
- Rhee MK, "A standardization study of Beck Depression Inventory I - Korean version (K-BDI): reliability and factor analysis", Korean J Psychopathol, 4, pp.77~95 (1995)
- Roustit C, "Exposure to interparental violence and psychosocial maladjustment in the adult life course: advocacy for early prevention", J Epidemiol Community Health, 63, pp.563~568 (2009)
- Rees CA, "Understanding emotional abuse", Arch Dis Child, 95, pp.59~67 (2010)
- Shen AC., "Long-term effects of interparental violence and child physical maltreatment experiences on PTSD and behavior problems: a national survey of Taiwanese college students", Child Abuse Negl, 33, pp.148~160 (2009)
- Boxer P, "Effects of multiple maltreatment experiences among psychiatrically hospitalized youth", Child Abuse Negl, 32, pp.637~647 (2008)
- Cicchetti D, "The role of self-organization in the promotion of resilience in maltreated children", Dev Psychopathol, 9, pp.797~815 (1997)
- Egeland B, "Resilience as process", Dev Psychopathol, 5, pp.517~528 (1993)
- Montpetit MA, "Resilience-as-process: negative affect, stress, and coupled dynamical systems", Psychol Aging, 25, pp.631~640 (2010)
- Gillham JE, "School-based prevention of depressive symptoms: a randomized controlled study of the effectiveness and specificity of the Penn Resiliency Program", J Consult Clin Psychol, 75, pp.9~19 (2007)
- Burt DB, "Depression and memory impairment: a meta-analysis of the association, its pattern, and specificity", Psychol Bull, 117, pp.285~305 (1995)
- Gara MA, "Perception of self and other in major depression", J Abnorm Psychol, 102, pp.93~100 (1993)
- Breslau N, "A second look at comorbidity in victims of trauma: the posttraumatic stress disorder-major depression connection", Biol Psychiatry, 48, pp.902~909 (2000)
- Brown GW, "Clinical and psychosocial origins of chronic depressive episodes. I: a community survey", Br J Psychiatry, 165, pp.447~456 (1994)
- Chapman DP, "Adverse childhood experiences and the risk of depressive disorders in adulthood", J Affect Disord, 82, pp.217~225 (2004)
- Kendler KS, "The prediction of major depression in women: toward an integrated etiologic model", Am J Psychiatry, 150, pp.1139~1148 (1993)
- Nelson EC, "Association between self-reported childhood sexual abuse and adverse psychosocial outcomes: results from a twin study", Arch Gen Psychiatry, 59, pp.139~145 (2002)