Center for Anxiety & Related Disorders, Department of Psychology, Boston University, Boston, MA 02215-2013, USA.
J Abnorm Psychol. 2011 Nov;120(4):844-56. doi: 10.1037/a0023035. Epub 2011 Mar 7.
The direct and interactive effects of neuroticism and stressful life events (chronic and episodic stressors) on the severity and temporal course of depression symptoms were examined in 826 outpatients with mood and anxiety disorders, assessed on 3 occasions over a 1-year period (intake and 6- and 12-month follow-ups). Neuroticism, chronic stress, and episodic stress were uniquely associated with intake depression symptom severity. A significant interaction effect indicated that the strength of the effect of neuroticism on initial depression severity increased as chronic stress increased. Although neuroticism did not have a significant direct effect on the temporal course of depression symptoms, chronic stress significantly moderated this relationship such that neuroticism had an increasingly deleterious effect on depression symptom improvement as the level of chronic stress over follow-up increased. In addition, chronic stress (but not episodic stress) over follow-up was uniquely predictive of less depression symptom improvement. Consistent with a stress generation framework, however, initial depression symptom severity was positively associated with chronic stress during follow-up. The results are discussed in regard to diathesis-stress conceptual models of emotional disorders and the various roles of stressful life events in the onset, severity, and maintenance of depressive psychopathology.
本研究在 826 名心境和焦虑障碍门诊患者中，考察了神经质和压力性生活事件（慢性和发作性压力源）对抑郁症状严重程度和时间进程的直接和交互影响，这些患者在 1 年的时间内接受了 3 次评估（入组时和 6 个月及 12 个月的随访）。神经质、慢性压力和发作性压力与入组时的抑郁症状严重程度呈独立相关。一个显著的交互效应表明，神经质对初始抑郁严重程度的影响强度随着慢性压力的增加而增加。虽然神经质对抑郁症状的时间进程没有显著的直接影响，但慢性压力显著调节了这种关系，即随着随访中慢性压力水平的升高，神经质对抑郁症状改善的不利影响越来越大。此外，随访中的慢性压力（而非发作性压力）对抑郁症状改善程度较低具有独特的预测作用。然而，与应激产生框架一致的是，初始抑郁症状严重程度与随访期间的慢性应激呈正相关。这些结果在情绪障碍的素质-应激概念模型以及生活压力事件在抑郁发病、严重程度和维持中的各种作用方面进行了讨论。
