Multisystem resiliency moderates the major depression-telomere length association: findings from the Heart and Soul Study
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Major depressive disorder (MDD) has been associated with reduced leukocyte telomere length (LTL). It is not known, however, whether psychosocial and behavioral protective factors moderate this association. In the current study, we examine whether multisystem resiliency--defined by healthy emotion regulation, strong social connections, and health behaviors (sleep and exercise)--predicts LTL and mitigates previously demonstrated associations between depression diagnosis and LTL. LTL was measured, using a quantitative PCR assay, in 954 patients with stable cardiovascular disease in the Heart and Soul Study. In a fully adjusted model, high multisystem resiliency predicted longer LTL (b=80.00, SE=27.17, p=.003), whereas each individual factor did not. Multisystem resiliency significantly moderated the MDD-LTL association (p=.02). Specifically, MDD was significantly related to LTL at 1 SD below the mean of multisystem resiliency (b=-142.86, SE=56.46, p=.01), but not at 1 SD above the mean (b=49.07, SE=74.51, p=.51). This study suggests that MDD associations with biological outcomes should be examined within a psychosocial-behavioral context, because this context shapes the nature of the direct relationship. Further research should explore the cognitive, neural, and other physiological pathways through which multisystem resiliency may confer biological benefit.
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Puterman et al. (2013) found that aspects of multi-system resiliency and positive lifestyle (e.g., social support, good emotion regulation, sleep and exercise), collectively but not individually, statistically attenuated the negative relationship between MDD and LTL.
“One study found that aspects of “multi-system resiliency” and positive lifestyle (e.g., social support, good emotion regulation, sleep and exercise), collectively but not individually, statistically attenuated the negative relationship between MDD and LTL (Puterman et al., 2013).”
From Psychiatric disorders and leukocyte telomere length: Underlying mechanisms linking mental illness with cellular aging (2015) · cites this paper as Puterman et al., 2013
In Puterman et al. (2013), analyses were cross-sectional, so causality cannot be inferred, and data on diet were not available.
“Analyses in this study were cross-sectional, thus causality cannot be inferred, and data on diet, another lifestyle factor that can influence LTL, were not available.”
From Psychiatric disorders and leukocyte telomere length: Underlying mechanisms linking mental illness with cellular aging (2015) · cites this paper as Puterman et al., 2013
Healthy lifestyle factors, alone or in combination, might mitigate the impact of chronic psychological stress on telomere length, and this effect has been documented cross-sectionally in chronically stressed adults and in depressed adults.
“We recently proposed that healthy lifestyle factors, alone or in combination, might mitigate the impact of chronic psychological stress on telomere length (48,49), and documented this effect cross-sectionally in chronically stressed adults and in depressed adults (31,50).”
From Determinants of telomere attrition over 1 year in healthy older women: stress and health behaviors matter (2015) · cites this paper as [49]
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- Authors
- Puterman, E., Epel, E. S., Lin, J., Blackburn, E. H., Gross, J. J., Whooley, M. A., & Cohen, B. E.
- Affiliations
- University of California, San Francisco (US)
- Stanford University (US)
- San Francisco VA Medical Center (US)
- Corresponding author
- Puterman, Eli
- ORCID
- Venue
- Brain Behavior and Immunity
- Publisher
- Elsevier BV
- Published
- 2013-10
- Volume
- 33
- Pages
- 65-73
- ISSN
- 0889-1591 (ISSN-L)
- PMC
- PMC3855878
- OpenAlex
- W2135089880
- Cited by
- 61
- References
- 119
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 7 · 2020: 3 · 2019: 9 · 2018: 4 · 2017: 6 · 2016: 6 · 2015: 4 · 2014: 6 · 2013: 3
- FWCI
- 7.05
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Brain Behavior and Immunity (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- U.S. Department of Veterans Affairs
- American Federation for Aging Research
- National Heart, Lung, and Blood Institute (R01 HL079235, K99HL109247)
- Ischemia Research and Education Foundation
- National Institutes of Health
- Robert Wood Johnson Foundation (K23 HL 094765-01)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
- Health Sciences › Medicine › Physiology › Telomeres, Telomerase, and Senescence
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- major depressive disorder, telomere length, emotion regulation, social connectedness, sleep, physical activity, cardiovascular disease, moderating effect, leukocyte telomere length, psychosocial protective factors
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Cardiovascular Diseases, Cross-Sectional Studies, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Motor Activity, Prospective Studies, Psychology, Sex Factors, Sleep, Cohort Studies, Cellular Senescence, Resilience, Psychological, Telomere Homeostasis
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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