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Longitudinal associations between post-traumatic distress and depressive symptoms following a traumatic event: a test of three models

Published online by Cambridge University Press:  11 January 2010

I. Schindel-Allon ,
I. M. Aderka ,
G. Shahar ,
M. Stein  and
E. Gilboa-Schechtman
I. Schindel-Allon
Affiliation:
Psychology Department and Gonda Brain Research Center, Bar-Ilan University, Israel
I. M. Aderka
Affiliation:
Psychology Department and Gonda Brain Research Center, Bar-Ilan University, Israel
G. Shahar
Affiliation:
Psychology Department, Ben-Gurion University of the Negev, Israel Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
M. Stein
Affiliation:
The Trauma Unit, Department of General Surgery, Rabin Medical Center – Beilinson Hospital, Petach-Tikva, Israel
E. Gilboa-Schechtman*
Affiliation:
Psychology Department and Gonda Brain Research Center, Bar-Ilan University, Israel
*
*Address for correspondence: E. Gilboa-Schechtman, Ph.D., Psychology Department and Gonda Brain Research Center, Ramat Gan, Israel52900. (Email: evagilboa@gmail.com).
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Abstract

Background

Symptoms of post-traumatic stress disorder (PTSD) and depression are highly co-morbid following a traumatic event. Nevertheless, decisive evidence regarding the direction of the relationship between these clinical entities is missing.

Method

The aim of the present study was to examine the nature of this relationship by comparing a synchronous change model (PTSD and depression are time synchronous, possibly stemming from a third common factor) with a demoralization model (i.e. PTSD symptoms causing depression) and a depressogenic model (i.e. depressive symptoms causing PTSD symptoms). Israeli adult victims of single-event traumas (n=156) were assessed on measures of PTSD and depression at 2, 4 and 12 weeks post-event.

Results

A cross-lagged structural equation modeling (SEM) analysis provided results consistent with the synchronous change model and the depressogenic model.

Conclusions

Depressive symptoms may play an important role in the development of post-traumatic symptoms.

Keywords

Depressionlongitudinalpost-traumatic stress disordertrauma
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 10 , October 2010 , pp. 1669 - 1678
Copyright
Copyright © Cambridge University Press 2010

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References

Abramson, LY, Metalsky, GI, Alloy, LB (1989). Hopelessness depression: a theory-based subtype of depression. Psychological Review 96, 358–372.CrossRefGoogle Scholar
Anderson, TW (1957). Maximum likelihood estimates for a multivariate normal distribution when some observations are missing. Journal of the American Statistical Association 52, 200–203.CrossRefGoogle Scholar
Andrew, B, Hawton, K, Fagg, J, Westbrook, D (1993). Do psychosocial factors influence outcome in severely depressed female psychiatric in-patients? British Journal of Psychiatry 163, 747–754.CrossRefGoogle ScholarPubMed
APA (2000). The Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
Barnett, PA, Gotlib, IH (1988). Psychosocial functioning and depression: distinguishing among antecedents, concomitants, and consequences. Psychological Bulletin 104, 97–126.CrossRefGoogle ScholarPubMed
Beck, AT (1964). Thinking and depression: II. Theory and therapy. Archives of General Psychiatry 10, 561–571.CrossRefGoogle ScholarPubMed
Beck, AT, Ward, CH, Mendelson, M, Mock, J, Erbaugh, J (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561–571.CrossRefGoogle ScholarPubMed
Bentler, PM (1990). Comparative fit indices in structural equation models. Psychological Bulletin 107, 238–246.CrossRefGoogle Scholar
Bentler, PM, Bonett, DG (1980). Significance tests and goodness of fit in the analysis of covariance structure. Psychological Bulletin 88, 588–606.CrossRefGoogle Scholar
Bentler, PM, Moojaart, A (1989). Choice of structural equation models via parsimony: a rational based on precision. Psychological Bulletin 106, 315–317.CrossRefGoogle Scholar
Bleiberg, KL, Markowitz, JC (2005). A pilot study of interpersonal psychotherapy for posttraumatic stress disorder. American Journal of Psychiatry 162, 181–183.CrossRefGoogle ScholarPubMed
Bleich, A, Koslowsky, M, Dolev, A, Lerer, B (1997). Post-traumatic stress disorder and depression: an analysis of comorbidity. British Journal of Psychiatry 170, 479–482.CrossRefGoogle ScholarPubMed
Bonanno, GA (2004). Loss, trauma, and human resilience: have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist 59, 20–28.CrossRefGoogle ScholarPubMed
Breslau, N, Davis, GC, Andreski, P, Peterson, EL (1991). Traumatic events and posttraumatic stress disorder in an urban population of young adults. Archives of General Psychiatry 48, 216–222.CrossRefGoogle Scholar
Breslau, N, Davis, GC, Andreski, P, Peterson, EL, Schultz, L (1997). Sex differences in posttraumatic stress disorder. Archives of General Psychiatry 54, 1044–1048.CrossRefGoogle ScholarPubMed
Breslau, N, Davis, GC, Peterson, EL, Schultz, L (2000). A second look at comorbidity in victims of trauma: the posttraumatic stress disorder–major depression connection. Biological Psychiatry 48, 902–909.CrossRefGoogle Scholar
Bromberger, JT, Matthews, KA (1996). A longitudinal study of the effects of pessimism, trait anxiety, and life stress on depressive symptoms in middle-aged women. Psychology and Aging 11, 207–213.CrossRefGoogle ScholarPubMed
Bromet, E, Sonnega, A, Kessler, RC (1998). Risk factors for DSM-III-R posttraumatic stress disorder: findings from the National Comorbidity Survey. American Journal of Epidemiology 147, 353–361.CrossRefGoogle ScholarPubMed
Bryant, RA, Guthrie, RM (2007). Maladaptive self-appraisals before trauma exposure predict posttraumatic stress disorder. Journal of Consulting and Clinical Psychology 75, 812–815.CrossRefGoogle ScholarPubMed
Bryant, RA, Sutherland, K, Guthrie, RM (2007). Impaired specific autobiographical memory as a risk factor for posttraumatic stress after trauma. Journal of Abnormal Psychology 116, 837–841.CrossRefGoogle ScholarPubMed
Clark, DA, Beck, AT, Alford, BA (1999). Scientific Foundations of Cognitive Theory and Therapy of Depression. John Wiley & Sons: Hoboken, NJ.Google Scholar
Clark, LA, Watson, D (1991). Tripartite model of anxiety and depression: psychometric evidence and taxonomic implications. Journal of Abnormal Psychology 100, 316–336.CrossRefGoogle ScholarPubMed
Cole, DA, Peeke, LG, Martin, JM, Truglio, R, Seroczynski, AD (1998). A longitudinal look at the relation between depression and anxiety in children and adolescents. Journal of Consulting and Clinical Psychology 66, 451–460.CrossRefGoogle Scholar
Connor, KM, Davidson, JRT (1997). Familial risk factors in posttraumatic stress disorder. In Psychobiology of Posttraumatic Stress Disorder ( ed. Yehuda, R. and Mcfarlane, A. C.), Annals of the New York Academy of Sciences, vol. 821, pp. 35–51. New York Academy of Sciences: New York, NY.Google Scholar
Creamer, M, Burgess, P, McFarlane, AC (2001). Post-traumatic stress disorder: findings from the Australian National Survey of Mental Health and Well-Being. Psychological Medicine 31, 1237–1247.CrossRefGoogle ScholarPubMed
Davidson, J, Swartz, M, Storck, M, Krishnan, RR, Hammett, E (1985). A diagnostic and family study of posttraumatic stress disorder. American Journal of Psychiatry 142, 90–93.Google ScholarPubMed
Ehring, T, Ehlers, A, Glucksman, E (2006). Contribution of cognitive factors to the prediction of post-traumatic stress disorder, phobia and depression after motor vehicle accidents. Behaviour Research and Therapy 44, 1699–1716.CrossRefGoogle Scholar
Foa, EB, Cashman, L, Jaycox, L, Perry, K (1997). The validation of a self-report measure of posttraumatic stress disorder: the Posttraumatic Diagnostic Scale. Psychological Assessment 9, 445–451.CrossRefGoogle Scholar
Foa, EB, Ehlers, A, Clark, DM, Tolin, DF, Orsillo, SM (1999). The Posttraumatic Cognitions Inventory (PTCI): development and validation. Psychological Assessment 11, 303–314.CrossRefGoogle Scholar
Foa, EB, Hembree, EA, Cahill, SP, Rauch, SAM, Riggs, DS, Feeny, NC, Yadin, E (2005). Randomized trial of prolonged exposure therapy for posttraumatic stress disorder with or without cognitive restructuring: outcomes at academic and community clinics. Journal of Consulting and Clinical Psychology 73, 953–964.CrossRefGoogle ScholarPubMed
Foa, EB, Kozak, MJ (1986). Emotional processing of fear: exposure to corrective information. Psychological Bulletin 99, 20–35.CrossRefGoogle ScholarPubMed
Fredrickson, BL, Tugade, MM, Waugh, CE, Larkin, GR (2003). What good are positive emotions in crisis? A prospective study of resilience and emotions following the terrorist attacks on the United States on September 11th, 2001. Journal of Personality and Social Psychology 84, 365–376.CrossRefGoogle Scholar
Gilboa-Schechtman, E, Foa, EB (2001). Patterns of recovery from trauma: the use of intraindividual analysis. Journal of Abnormal Psychology 110, 392–400.CrossRefGoogle ScholarPubMed
Grant, DM, Beck, JG, Marques, L, Palyo, SA, Clapp, JD (2008). The structure of distress following trauma: posttraumatic stress disorder, major depressive disorder, and generalized anxiety disorder. Journal of Abnormal Psychology 117, 662–672.CrossRefGoogle ScholarPubMed
Guthrie, RM, Bryant, RA (2006). Extinction learning before trauma and subsequent posttraumatic stress. Psychosomatic Medicine 68, 307–311.CrossRefGoogle ScholarPubMed
Hays, RD, Marshall, GN, Wang, EYI, Sherbourne, CD (1994). Four-year cross-lagged associations between physical and mental health in the Medical Outcomes Study. Journal of Consulting and Clinical Psychology 62, 441–449.CrossRefGoogle ScholarPubMed
Helzer, JE, Robins, LN, McEvoy, L (1987). Post-traumatic stress disorder in the general population: findings of the Epidemiologic Catchment Area survey. New England Journal of Medicine 317, 1630–1634.CrossRefGoogle ScholarPubMed
Hoyle, RH (1995). Structural Equation Modeling. Sage Publications, Inc.: Thousand Oaks, CA.Google Scholar
Hoyle, RH, Smith, GT (1994). Formulating clinical research hypotheses as structural equation models: a conceptual overview. Journal of Consulting and Clinical Psychology 62, 429–440.CrossRefGoogle ScholarPubMed
Hu, L, Bentler, PM (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling 6, 1–55.CrossRefGoogle Scholar
Jakupcak, M, Roberts, LJ, Martell, C, Mulick, P, Michael, S, Reed, R, Balsam, KF, Yoshimoto, D, McFall, M (2006). A pilot study of behavioral activation for veterans with posttraumatic stress disorder. Journal of Traumatic Stress 19, 387–391.CrossRefGoogle ScholarPubMed
Kessler, RC, Magee, WJ (1993). Childhood adversities and adult depression: basic patterns of associations in a US national survey. Psychological Medicine 23, 679–690.CrossRefGoogle Scholar
Kessler, RC, Sonnega, A, Bromet, E, Hughes, M, Nelson, CB (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry 52, 1048–1060.CrossRefGoogle ScholarPubMed
Kleim, B, Ehlers, A (2008). Reduced autobiographical memory specificity predicts depression and posttraumatic stress disorder after recent trauma. Journal of Consulting and Clinical Psychology 76, 231–242.CrossRefGoogle ScholarPubMed
Kline, RB (1998). Principles and Practice of Structural Equation Modeling. Guilford Press: New York, NY.Google Scholar
Krueger, RF, Markon, KE (2006). Reinterpreting comorbidity: a model-based approach to understanding and classifying psychopathology. Annual Review of Clinical Psychology 2, 111–133.CrossRefGoogle ScholarPubMed
Lim, SL, Kim, JH (2005). Cognitive processing of emotional information in depression, panic and somatoform disorder. Journal of Abnormal Psychology 114, 50–61.CrossRefGoogle ScholarPubMed
Litz, BT, Orsillo, SM, Kaloupek, D, Weathers, F (2000). Emotional processing in posttraumatic stress disorder. Journal of Abnormal Psychology 109, 26–39.CrossRefGoogle ScholarPubMed
Loas, G (1996). Vulnerability to depression: a model centered on anhedonia. Journal of Affective Disorders 41, 39–53.CrossRefGoogle Scholar
Mangelli, L, Giovanni, AF, Grandi, S, Grassi, L, Ottolini, F, Porcelli, P, Rafanelli, C, Rigatelli, M, Sonino, N (2005). Assessing demoralization and depression in the setting of medical disease. Journal of Clinical Psychiatry 66, 391–394.CrossRefGoogle ScholarPubMed
McFarlane, AC (1989). The aetiology of posttraumatic morbidity: predisposing, precipitating, and perpetuating factors. British Journal of Psychiatry 154, 221–228.CrossRefGoogle ScholarPubMed
Merriman, C, Norman, P, Barton, J (2007). Psychological correlates of PTSD symptoms following stroke. Psychology, Health and Medicine 12, 592–602.CrossRefGoogle ScholarPubMed
Miller, MW, Litz, BT (2004). Emotional processing in posttraumatic stress disorder II: Startle reflex modulation during picture processing. Journal of Abnormal Psychology 113, 451–463.CrossRefGoogle ScholarPubMed
Mineka, S, Watson, D, Clark, LA (1998). Comorbidity of anxiety and unipolar mood disorders. Annual Review of Psychology 49, 377–412.CrossRefGoogle ScholarPubMed
Moffitt, TE, Harrington, H, Caspi, A, Kim-Cohen, J, Goldberg, D, Gregory, AM, Poulton, R (2007). Depression and generalized anxiety disorder: cumulative and sequential comorbidity in a birth cohort followed prospectively to age 32 years. Archives of General Psychiatry 64, 651–660.CrossRefGoogle Scholar
Muthen, B, Kaplan, D, Hollis, M (1987). On structural equation modeling with data that are not missing completely at random. Psychometrika 52, 431–462.CrossRefGoogle Scholar
Pos, AE, Greenberg, LS, Goldman, RN, Korman, LM (2003). Emotional processing during experiential treatment of depression. Journal of Consulting and Clinical Psychology 71, 1007–1016.CrossRefGoogle ScholarPubMed
Resick, PA, Nishith, P, Weaver, TL, Astin, MC, Feuer, CA (2002). A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. Journal of Consulting and Clinical Psychology 70, 867–879.CrossRefGoogle Scholar
Rosenbaum, M, Shichman, S (1979). Learned helplessness and depression among Israeli women. Journal of Clinical Psychology 35, 395–400.3.0.CO;2-Y>CrossRefGoogle ScholarPubMed
Shahar, G (2001). Maternal personality and distress as predictors of child neglect. Journal of Research in Personality 35, 537–545.CrossRefGoogle Scholar
Shahar, G, Bareket, L, Rudd, MD, Joiner, TE (2006). In severely suicidal young adults, hopelessness, depressive symptoms, and suicidal ideation constitute a single syndrome. Psychological Medicine 36, 913–922.CrossRefGoogle ScholarPubMed
Shahar, G, Blatt, SJ, Zuroff, DC, Krupnick, J, Sotsky, SM (2004). Perfectionism impedes social relations and response to brief treatment for depression. Journal of Social and Clinical Psychology 23, 140–154.CrossRefGoogle Scholar
Shahar, G, Davidson, L (2003). Depressive symptoms erode self-esteem in severe mental illness: a three-wave, cross-lagged study. Journal of Consulting and Clinical Psychology 71, 890–900.CrossRefGoogle ScholarPubMed
Shalev, AY, Freedman, S, Peri, T, Brandes, D, Sahar, T, Orr, SP, Pitman, RK (1998). Prospective study of posttraumatic stress disorder and depression following trauma. American Journal of Psychiatry 155, 630–637.CrossRefGoogle ScholarPubMed
Steiger, JH (1980). Test for comparing elements of a correlation matrix. Psychological Bulletin 87, 245–251.CrossRefGoogle Scholar
Stein, D, Apter, A, Ratzoni, G, Har-Even, D, Avidan, G (1998). Association between multiple suicide attempts and negative affects in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 37, 488–494.CrossRefGoogle ScholarPubMed
van Minnen, A, Wessel, I, Verhaak, C, Smeenk, J (2005). The relationship between autobiographical memory specificity and depressed mood following a stressful life event: a prospective study. British Journal of Clinical Psychology 44, 405–415.CrossRefGoogle ScholarPubMed
Wagner, AW, Zatzick, DF, Ghesquiere, A, Jurkovich, GJ (2007). Behavioral activation as an early intervention for posttraumatic stress disorder and depression among physically injured trauma survivors. Cognitive and Behavioral Practice 14, 341–349.CrossRefGoogle Scholar
Wei, M, Russell, DW, Zakalik, RA (2005). Adult attachment, social self-efficacy, self-disclosure, loneliness, and subsequent depression for freshman college students: a longitudinal study. Journal of Counseling Psychology 52, 602–614.CrossRefGoogle Scholar
Weiss, EL, Longhurst, JG, Mazure, CM (1999). Childhood sexual abuse as a risk factor for depression in women: psychosocial and neurobiological correlates. American Journal of Psychiatry 156, 816–828.CrossRefGoogle ScholarPubMed
Wetherell, J, Loebach, GM, Pedersen, NL (2001). A longitudinal analysis of anxiety and depressive symptoms. Psychology and Aging 16, 187–195.CrossRefGoogle ScholarPubMed
Wittchen, HU, Beesdo, K, Bittner, A, Goodwin, RD (2003). Depressive episodes – evidence for a causal role of primary anxiety disorders? European Psychiatry 18, 384–393.CrossRefGoogle ScholarPubMed
Zaidi, LY, Foy, DW (1994). Childhood abuse experiences and combat-related PTSD. Journal of Traumatic Stress 7, 33–42.Google ScholarPubMed
Zlotnick, C, Shea, MT, Pilkonis, PA, Elkin, I, Ryan, C (1996). Gender, type of treatment, dysfunctional attitudes, social support, life events, and depressive symptoms over naturalistic follow-up. American Journal of Psychiatry 153, 1021–1027.Google ScholarPubMed