Monday, Aug. 11, 2003
Va. – In addition to serious loss, humiliating events in a person’s life –
particularly involving romantic breakups – appear to be strongly linked to
risk for major depression, according to a study of more than 7,300 twins by
researchers at Virginia Commonwealth University.
The study, published today
(Aug. 11) in the Archives of General Psychiatry, is the largest study to date to
use a rating system to assess the role that highly specific groups of
life events play in sparking depression, anxiety and a combination of the two
psychiatric disorders in both men and women. Previous studies involved much
smaller samples and examined only women and depression.
can make our life wonderful, but it also can make us miserable,” says
psychiatric geneticist Kenneth S. Kendler, M.D., professor of psychiatry and
director of the Virginia Institute for Psychiatric and Behavioral Genetics at
VCU. Kendler was the lead author on the study.
we looked at stressful life events that predisposed men and women to the onset
of episodes of depression, the most toxic combination was loss and humiliation
that in some way directly devalued the individual in a core role,” Kendler
said. “For both men and women, that combination was twice as potent for
predisposing to depression as pure loss alone, such as death of a loved one.
Most cases of combined loss and humiliation involved romantic breakups.
example, if your marriage breaks up, that’s a loss, and it’s reasonable to
expect that you will experience aspects of grief, including sadness and loss of
appetite. If your marriage breaks up, and your husband moves into a house a few
doors away with a woman half his age, and he shows off his new girlfriend to
your friends and family – that’s grief combined with humiliation. That
combination is especially strongly linked to risk for a depressive episode.”
researchers interviewed 7,322 male and female twins registered with VCU’s
Mid-Atlantic Twin Registry (MATR) over several years in the early to mid 1990s
to assess which stressful life events in the year preceding the interview
appeared to have been linked to episodes of depression and anxiety. The twins at
the time ranged in age from about 20 to 60. Of the 98,592 “person-months”
considered, 4,251 person-months, or 4.3 percent of the total, contained a
stressful life event.
a five-point scale, the researchers rated stressful life events that were
grouped into four broad dimensions of humiliation, entrapment, loss and danger
and 15 categories that included 11 “personal” events (such as assault,
divorce, separation, injury and job loss) and four “network” events (such as
the death of someone close). On the scale, “0” meant the event had not
occurred in the preceding year, and “4” meant that a severe level of the
event had occurred. They matched those event ratings against three types of
psychiatric episodes reported by the twins in the year preceding the interview:
major depression, anxiety lasting at least two weeks and mixed
risk for an episode of depression or a mixed episode of depression and
anxiety was significantly increased in a month with high ratings for loss
and humiliation. This was particularly true if the humiliation involved the
split up of a relationship initiated by the other person or prompted by an
infidelity or violence. The risk of depression that month was between 21
percent and 22 percent compared with a 10 percent risk for a depressive
episode in a month where a loved one died but no humiliating event occurred.
The impact of the events was short-lived and appeared to affect the risk for
depression only in the month that the event occurred.
risk for an episode of anxiety was significantly increased in the month
following a month with high ratings for loss and danger.
ratings of entrapment predicted only onsets of mixed episodes of depression
and anxiety and only within the month that the event occurred.
sex differences were seen in the prediction of episodes of illness by event
study was funded by grants from the National Institutes of Health and the
National Alliance for Research on Schizophrenia and Depression.
About the Virginia Institute for Psychiatric and Behavioral Genetics
Virginia Institute for Psychiatric and Behavioral Genetics
is a multi-disciplined, integrated research program of VCU’s Departments of
Psychiatry and Human Genetics, focused on identifying genes and environments
that cause psychiatric diseases and behavioral differences. For more, see www.vipbg.vcu.edu.
About VCU and VCU Medical Center
Virginia Commonwealth University is a major, urban public research university with national and international rankings in sponsored research. Located in downtown Richmond, VCU enrolls more than 31,000 students in 226 degree and certificate programs in the arts, sciences and humanities. Sixty-seven of the programs are unique in Virginia, many of them crossing the disciplines of VCU’s 13 schools and one college. MCV Hospitals and the health sciences schools of Virginia Commonwealth University comprise VCU Medical Center, one of the nation’s leading academic medical centers. For more, see www.vcu.edu.