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Relationship between personality and psychopathology in a longitudinal community study: a test of the predisposition model

Published online by Cambridge University Press:  16 March 2016

M. P. Hengartner*
Affiliation:
Department of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
V. Ajdacic-Gross
Affiliation:
Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
C. Wyss
Affiliation:
Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
J. Angst
Affiliation:
Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
W. Rössler
Affiliation:
Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of São Paulo, São Paulo, Brazil
*
*Address for correspondence: M. P. Hengartner, Ph.D., Department of Applied Psychology, Zurich University of Applied Sciences (ZHAW), PO Box 707, CH-8037 Zurich, Switzerland. (Email: [email protected])

Abstract

Background

Mounting evidence supports the notion that personality is crucial in the aetiopathology of common mental disorders, but studies that allow for aetiological conclusions are lacking. The aim of the present study was thus to provide a test of the predisposition model.

Method

We analysed data from the Zurich Cohort Study, a 30-year longitudinal epidemiological community study of an adult cohort (n = 591) from 1979 to 2008. Personality was assessed in 1988 with an established personality questionnaire, and psychopathology through seven semi-structured interviews between 1979 and 2008.

Results

On the basis of personality assessment from 1988, used as predictor of subsequent psychopathology (1993–2008), while adjusting for sex and prior mental disorders (1979–1988), neuroticism related significantly with future major depression episodes [odds ratio (OR) = 1.41], anxiety disorders (OR = 1.32) and depression treatment use (OR = 1.41). When participants with a past 10-year history (i.e. 1979–1988) of either major depression, anxiety disorder or depression treatment use were excluded, neuroticism in 1988 still significantly predicted first incidence (i.e. 1993–2008) of major depression episodes (OR = 1.53) and depression treatment use (OR = 1.84).

Conclusions

The present study provides compelling evidence that the personality trait of neuroticism constitutes an independent risk factor for subsequent major depression episodes and use of respective professional treatments, which serves as a proxy for particularly severe and impairing depression episodes. We therefore advocate that personality traits could provide clinically useful prognostic information when considered carefully.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2016 

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References

Alonso, J, Angermeyer, MC, Bernert, S, Bruffaerts, R, Brugha, TS, Bryson, H, de Girolamo, G, Graaf, R, Demyttenaere, K, Gasquet, I, Haro, JM, Katz, SJ, Kessler, RC, Kovess, V, Lépine, JP, Ormel, J, Polidori, G, Russo, LJ, Vilagut, G, Almansa, J, Arbabzadeh-Bouchez, S, Autonell, J, Bernal, M, Buist-Bouwman, MA, Codony, M, Domingo-Salvany, A, Ferrer, M, Joo, SS, Martínez-Alonso, M, Matschinger, H, Mazzi, F, Morgan, Z, Morosini, P, Palacín, C, Romera, B, Taub, N, Vollebergh, WA; ESEMeD/MHEDEA 2000 Investigators, European Study of the Epidemiology of Mental Disorders (ESEMeD) Project (2004). Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatrica Scandinavica 109, 2127.CrossRefGoogle Scholar
Angst, J, Clayton, P (1986). Premorbid personality of depressive, bipolar, and schizophrenic patients with special reference to suicidal issues. Comprehensive Psychiatry 27, 511532.Google Scholar
Angst, J, Dobler-Mikola, A, Binder, J (1984). The Zurich Study – a prospective epidemiological study of depressive, neurotic and psychosomatic syndromes. I. Problem, methodology. European Archives of Psychiatry and Neurological Sciences 234, 1320.Google Scholar
Angst, J, Gamma, A, Neuenschwander, M, Ajdacic-Gross, V, Eich, D, Rössler, W, Merikangas, KR (2005). Prevalence of mental disorders in the Zurich Cohort Study: a twenty year prospective study. Epidemiologia e Psichiatria Sociale 14, 6876.Google Scholar
Angst, J, Paksarian, D, Cui, L, Merikangas, KR, Hengartner, MP, Ajdacic-Gross, V, Rössler, W (2016). The epidemiology of common mental disorders from age 20 to 50: results from the prospective Zurich cohort Study. Epidemiology and Psychiatric Sciences 25, 2432.Google Scholar
Barlow, DH, Sauer-Zavala, S, Carl, JR, Bullis, JR, Ellard, KK (2014). The nature, diagnosis, and treatment of neuroticism: back to the future. Clinical Psychological Science 2, 344365.Google Scholar
Bogg, T, Roberts, BW (2013). The case for conscientiousness: evidence and implications for a personality trait marker of health and longevity. Annals of Behavioral Medicine 45, 278288.Google Scholar
Caspi, A, Houts, RM, Belsky, DW, Goldman-Mellor, SJ, Harrington, H, Israel, S, Meier, MH, Ramrakha, S, Shalev, I, Poulton, R, Moffitt, TE (2014). The p factor: one general psychopathology factor in the structure of psychiatric disorders? Clinical Psychological Science 2, 119137.Google Scholar
Clark, LA (2005). Temperament as a unifying basis for personality and psychopathology. Journal of Abnormal Psychology 114, 505521.Google Scholar
Connor-Smith, JK, Flachsbart, C (2007). Relations between personality and coping: a meta-analysis. Journal of Personality and Social Psychology 93, 10801107.Google Scholar
Cramer, V, Torgersen, S, Kringlen, E (2006). Personality disorders and quality of life. A population study. Comprehensive Psychiatry 47, 178184.Google Scholar
Cuijpers, P, Smit, F, Penninx, BW, de Graaf, R, ten Have, M, Beekman, AT (2010). Economic costs of neuroticism: a population-based study. Archives of General Psychiatry 67, 10861093.CrossRefGoogle Scholar
De Fruyt, F, Van Leeuwen, K, Bagby, RM, Rolland, JP, Rouillon, F (2006). Assessing and interpreting personality change and continuity in patients treated for major depression. Psychological Assessment 18, 7180.Google Scholar
De Graaf, R, Bijl, RV, Ravelli, A, Smit, F, Vollebergh, WA (2002). Predictors of first incidence of DSM-III-R psychiatric disorders in the general population: findings from the Netherlands Mental Health Survey and Incidence Study. Acta Psychiatrica Scandinavica 106, 303313.Google Scholar
Depla, MF, ten Have, ML, van Balkom, AJ, de Graaf, R (2008). Specific fears and phobias in the general population: results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Social Psychiatry and Psychiatric Epidemiology 43, 200208.Google Scholar
Derogatis, LR (1977). Symptom Checklist 90, R-Version Manual I: Scoring, Administration, and Procedures for the SCL-90. Johns Hopkins Press: Baltimore, MD.Google Scholar
Dunn, G, Pickles, A, Tansella, M, Vazquez-Barquero, JL (1999). Two-phase epidemiological surveys in psychiatric research. British Journal of Psychiatry 174, 95100.Google Scholar
Eich, D, Ajdacic-Gross, V, Condrau, M, Huber, H, Gamma, A, Angst, J, Rössler, W (2003). The Zurich Study: participation patterns and Symptom Checklist 90-R scores in six interviews, 1979–99. Acta Psychiatrica Scandinavica Supplement 108, 1114.Google Scholar
Eysenck, SBG, Eysenck, HJ (1975). Manual of the EPQ (Eysenck Personality Questionnaire). Educational and Industrial Testing Service: San Diego, CA.Google Scholar
Fahrenberg, J, Hampel, R, Selg, H (1984). Das Freiburger Persönlichkeitsinventar FPI. Revidierte Fassung FPI-R und teilweise geänderte Fassung FPI-A1, 4. revidierte Auflage. Hogrefe: Göttingen.Google Scholar
Fahrenberg, J, Hampel, R, Selg, H (2001). Das Freiburger Persönlichkeitsinventar FPI. Handanweisung, 7. überarbeitete und neunormierte Auflage. Hogrefe: Göttingen.Google Scholar
Fanous, AH, Neale, MC, Aggen, SH, Kendler, KS (2007). A longitudinal study of personality and major depression in a population-based sample of male twins. Psychological Medicine 37, 11631172.Google Scholar
Genetics of Personality Consortium, de Moor, MH, van den Berg, SM, Verweij, KJ, Krueger, RF, Luciano, M, Arias Vasquez, A, Matteson, LK, Derringer, J, Esko, T, Amin, N, Gordon, SD, Hansell, NK, Hart, AB, Seppälä, I, Huffman, JE, Konte, B, Lahti, J, Lee, M, Miller, M, Nutile, T, Tanaka, T, Teumer, A, Viktorin, A, Wedenoja, J, Abecasis, GR, Adkins, DE, Agrawal, A, Allik, J, Appel, K, Bigdeli, TB, Busonero, F, Campbell, H, Costa, PT, Davey Smith, G, Davies, G, de Wit, H, Ding, J, Engelhardt, BE, Eriksson, JG, Fedko, IO, Ferrucci, L, Franke, B, Giegling, I, Grucza, R, Hartmann, AM, Heath, AC, Heinonen, K, Henders, AK, Homuth, G, Hottenga, JJ, Iacono, WG, Janzing, J, Jokela, M, Karlsson, R, Kemp, JP, Kirkpatrick, MG, Latvala, A, Lehtimäki, T, Liewald, DC, Madden, PA, Magri, C, Magnusson, PK, Marten, J, Maschio, A, Medland, SE, Mihailov, E, Milaneschi, Y, Montgomery, GW, Nauck, M, Ouwens, KG, Palotie, A, Pettersson, E, Polasek, O, Qian, Y, Pulkki-Råback, L, Raitakari, OT, Realo, A, Rose, RJ, Ruggiero, D, Schmidt, CO, Slutske, WS, Sorice, R, Starr, JM, St Pourcain, B, Sutin, AR, Timpson, NJ, Trochet, H, Vermeulen, S, Vuoksimaa, E, Widen, E, Wouda, J, Wright, MJ, Zgaga, L, Porteous, D, Minelli, A, Palmer, AA, Rujescu, D, Ciullo, M, Hayward, C, Rudan, I, Metspalu, A, Kaprio, J, Deary, IJ, Räikkönen, K, Wilson, JF, Keltikangas-Järvinen, L, Bierut, LJ, Hettema, JM, Grabe, HJ, van Duijn, CM, Evans, DM, Schlessinger, D, Pedersen, NL, Terracciano, A, McGue, M, Penninx, BW, Martin, NG, Boomsma, DI (2015). Meta-analysis of genome-wide association studies for neuroticism, and the polygenic association with major depressive disorder. JAMA Psychiatry 72, 642650.Google Scholar
Goodwin, RD, Hoven, CW, Lyons, JS, Stein, MB (2002). Mental health service utilization in the United States. The role of personality factors. Social Psychiatry and Psychiatric Epidemiology 37, 561566.CrossRefGoogle Scholar
Griffith, JW, Zinbarg, RE, Craske, MG, Mineka, S, Rose, RD, Waters, AM, Sutton, JM (2010). Neuroticism as a common dimension in the internalizing disorders. Psychological Medicine 40, 11251136.CrossRefGoogle Scholar
Harris, JM, Cherkas, LF, Kato, BS, Heiman, JR, Spector, TD (2008). Normal variations in personality are associated with coital orgasmic infrequency in heterosexual women: a population-based study. Journal of Sexual Medicine 5, 11771183.Google Scholar
Hasin, DS, Fenton, MC, Skodol, AE, Krueger, RF, Keyes, KM, Geier, T, Greenstein, E, Blanco, C, Grant, BF (2011). Personality disorders and the 3-year course of alcohol, drug, and nicotine use disorders. Archives of General Psychiatry 68, 11581167.CrossRefGoogle Scholar
Hengartner, MP (2015). The detrimental impact of maladaptive personality on public mental health: a challenge for psychiatric practice. Frontiers in Psychiatry 6, 87.Google Scholar
Hengartner, MP, Ajdacic-Gross, V, Rodgers, S, Müller, M, Rössler, W (2014 a). The joint structure of normal and pathological personality: further evidence for a dimensional model. Comprehensive Psychiatry 55, 667674.Google Scholar
Hengartner, MP, Angst, F, Ajdacic-Gross, V, Rössler, W, Angst, J (2016). Treated versus non-treated subjects with depression from a 30-year cohort study: prevalence and clinical covariates. European Archives of Psychiatry and Clinical Neuroscience 266, 173180.Google Scholar
Hengartner, MP, De Fruyt, F, Rodgers, S, Müller, M, Rössler, W, Ajdacic-Gross, V (2014 b). An integrative examination of general personality dysfunction in a large community sample. Personality and Mental Health 8, 276289.CrossRefGoogle Scholar
Hengartner, MP, Müller, M, Rodgers, S, Rössler, W, Ajdacic-Gross, V (2014 c). Interpersonal functioning deficits in association with DSM-IV personality disorder dimensions. Social Psychiatry and Psychiatric Epidemiology 49, 317325.Google Scholar
Hettema, JM, Neale, MC, Myers, JM, Prescott, CA, Kendler, KS (2006). A population-based twin study of the relationship between neuroticism and internalizing disorders. American Journal of Psychiatry 163, 857864.Google Scholar
Kendler, KS, Gatz, M, Gardner, CO, Pedersen, NL (2006). Personality and major depression: a Swedish longitudinal, population-based twin study. Archives of General Psychiatry 63, 11131120.Google Scholar
Kendler, KS, Kuhn, J, Prescott, CA (2004). The interrelationship of neuroticism, sex, and stressful life events in the prediction of episodes of major depression. American Journal of Psychiatry 161, 631636.Google Scholar
Kessler, RC, Chiu, WT, Demler, O, Merikangas, KR, Walters, EE (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 617627.Google Scholar
Kessler, RC, Wang, PS (2008). The descriptive epidemiology of commonly occurring mental disorders in the United States. Annual Review of Public Health 29, 115129.Google Scholar
Khan, AA, Jacobson, KC, Gardner, CO, Prescott, CA, Kendler, KS (2005). Personality and comorbidity of common psychiatric disorders. British Journal of Psychiatry 186, 190196.Google Scholar
Klein, DN, Kotov, R, Bufferd, SJ (2011). Personality and depression: explanatory models and review of the evidence. Annual Review of Clinical Psychology 7, 269295.Google Scholar
Kotov, R, Gamez, W, Schmidt, F, Watson, D (2010). Linking “big” personality traits to anxiety, depressive, and substance use disorders: a meta-analysis. Psychological Bulletin 136, 768821.Google Scholar
Krueger, RF (1999). Personality traits in late adolescence predict mental disorders in early adulthood: a prospective-epidemiological study. Journal of Personality 67, 3965.Google Scholar
Krueger, RF, Eaton, NR (2010). Personality traits and the classification of mental disorders: toward a more complete integration in DSM-5 and an empirical model of psychopathology. Personality Disorders 1, 97118.CrossRefGoogle Scholar
Lahey, BB (2009). Public health significance of neuroticism. American Psychologist 64, 241256.Google Scholar
Leeners, B, Hengartner, MP, Rössler, W, Ajdacic-Gross, V, Angst, J (2014). The role of psychopathological and personality covariates in orgasmic difficulties: a prospective longitudinal evaluation in a cohort of women from age 30 to 50. Journal of Sexual Medicine 11, 29282937.Google Scholar
Lorenzo-Luaces, L (2015). Heterogeneity in the prognosis of major depression: from the common cold to a highly debilitating and recurrent illness. Epidemiology and Psychiatric Sciences 24, 466472.CrossRefGoogle Scholar
Macare, C, Bates, TC, Heath, AC, Martin, NG, Ettinger, U (2012). Substantial genetic overlap between schizotypy and neuroticism: a twin study. Behavior Genetics 42, 732742.Google Scholar
Markon, KE, Krueger, RF, Watson, D (2005). Delineating the structure of normal and abnormal personality: an integrative hierarchical approach. Journal of Personality and Social Psychology 88, 139157.Google Scholar
Moffitt, TE, Caspi, A, Taylor, A, Kokaua, J, Milne, BJ, Polanczyk, G, Poulton, R (2010). How common are common mental disorders? Evidence that lifetime prevalence rates are doubled by prospective versus retrospective ascertainment. Psychological Medicine 40, 899909.Google Scholar
Morey, LC, Hopwood, CJ, Markowitz, JC, Gunderson, JG, Grilo, CM, McGlashan, TH, Shea, MT, Yen, S, Sanislow, CA, Ansell, EB, Skodol, AE (2012). Comparison of alternative models for personality disorders, II: 6-, 8- and 10-year follow-up. Psychological Medicine 42, 17051713.Google Scholar
Morey, LC, Shea, MT, Markowitz, JC, Stout, RL, Hopwood, CJ, Gunderson, JG, Grilo, CM, McGlashan, TH, Yen, S, Sanislow, CA, Skodol, AE (2010). State effects of major depression on the assessment of personality and personality disorder. American Journal of Psychiatry 167, 528535.CrossRefGoogle Scholar
Ormel, J, Oldehinkel, AJ, Vollebergh, W (2004). Vulnerability before, during, and after a major depressive episode: a 3-wave population-based study. Archives of General Psychiatry 61, 990996.Google Scholar
Parker, G (2005). Beyond major depression. Psychological Medicine 35, 467474.Google Scholar
Pearlin, LI, Schooler, C (1978). The structure of coping. Journal of Health and Social Behavior 19, 221.Google Scholar
Quilty, LC, De Fruyt, F, Rolland, JP, Kennedy, SH, Rouillon, PF, Bagby, RM (2008). Dimensional personality traits and treatment outcome in patients with major depressive disorder. Journal of Affective Disorders 108, 241250.Google Scholar
Rössler, W, Ajdacic-Gross, V, Müller, M, Rodgers, S, Haker, H, Hengartner, MP (2015). Assessing sub-clinical psychosis phenotypes in the general population – a multidimensional approach. Schizophrenia Research 161, 194201.Google Scholar
Samuel, DB, Widiger, TA (2008). A meta-analytic review of the relationships between the five-factor model and DSM-IV-TR personality disorders: a facet level analysis. Clinical Psychology Review 28, 13261342.Google Scholar
Skodol, AE, Geier, T, Grant, BF, Hasin, DS (2014). Personality disorders and the persistence of anxiety disorders in a nationally representative sample. Depression and Anxiety 31, 721728.Google Scholar
Skodol, AE, Grilo, CM, Keyes, KM, Geier, T, Grant, BF, Hasin, DS (2011). Relationship of personality disorders to the course of major depressive disorder in a nationally representative sample. American Journal of Psychiatry 168, 257264.Google Scholar
Soskin, DP, Carl, JR, Alpert, J, Fava, M (2012). Antidepressant effects on emotional temperament: toward a biobehavioral research paradigm for major depressive disorder. CNS Neuroscience and Therapeutics 18, 441451.Google Scholar
Spek, V, Nyklicek, I, Cuijpers, P, Pop, V (2008). Predictors of outcome of group and Internet-based cognitive behavior therapy. Journal of Affective Disorders 105, 137145.Google Scholar
Tackett, JL, Lahey, BB, van Hulle, C, Waldman, I, Krueger, RF, Rathouz, PJ (2013). Common genetic influences on negative emotionality and a general psychopathology factor in childhood and adolescence. Journal of Abnormal Psychology 122, 11421153.Google Scholar
Takayanagi, Y, Spira, AP, Roth, KB, Gallo, JJ, Eaton, WW, Mojtabai, R (2014). Accuracy of reports of lifetime mental and physical disorders: results from the Baltimore Epidemiological Catchment Area study. JAMA Psychiatry 71, 273280.Google Scholar
Tang, TZ, DeRubeis, RJ, Hollon, SD, Amsterdam, J, Shelton, R, Schalet, B (2009). Personality change during depression treatment: a placebo-controlled trial. Archives of General Psychiatry 66, 13221330.Google Scholar
ten Have, M, Oldehinkel, A, Vollebergh, W, Ormel, J (2005). Does neuroticism explain variations in care service use for mental health problems in the general population? Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Social Psychiatry and Psychiatric Epidemiology 40, 425431.Google Scholar
Turiano, NA, Whiteman, SD, Hampson, SE, Roberts, BW, Mroczek, DK (2012). Personality and substance use in midlife: conscientiousness as a moderator and the effects of trait change. Journal of Research in Personality 46, 295305.Google Scholar
Tyrer, P (2015). Personality dysfunction is the cause of recurrent non-cognitive mental disorder: a testable hypothesis. Personality and Mental Health 9, 17.Google Scholar
Tyrer, P, Reed, GM, Crawford, MJ (2015). Classification, assessment, prevalence, and effect of personality disorder. Lancet 385, 717726.Google Scholar
Van Os, J, Jones, PB (2001). Neuroticism as a risk factor for schizophrenia. Psychological Medicine 31, 11291134.Google Scholar
Widiger, TA (2011). Personality and psychopathology. World Psychiatry 10, 103106.Google Scholar
Zeger, SL, Liang, KY, Albert, PS (1988). Models for longitudinal data: a generalized estimating equation approach. Biometrics 44, 10491060.Google Scholar
Zhang, J, Yu, KF (1998). What's the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. JAMA 280, 16901691.Google Scholar