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Cited by 962Child and Adolescent Psychosocial and Emotional DevelopmentAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and Access

Toward a comprehensive developmental model for major depression in women

Kendler, Kenneth S., Gardner, Charles O., Prescott, Carol A.·2002·American Journal of Psychiatry
DOI 10.1176/appi.ajp.159.7.1133
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Abstract

OBJECTIVE: Major depression is a multifactorial disorder with many etiologic variables that are interrelated through developmental pathways. The authors used structural equation modeling to generate a developmental model for the etiology of major depression in women. METHOD: Data from 1,942 adult female twins, interviewed up to four times over a 9-year period, were used to construct a developmental model to predict depressive episodes in the year before the most recent interview. Eighteen risk factors in five developmental tiers were considered: 1) childhood (genetic risk, disturbed family environment, childhood sexual abuse, and childhood parental loss), 2) early adolescence (neuroticism, self-esteem, and early-onset anxiety and conduct disorder), 3) late adolescence (educational attainment, lifetime traumas, social support, and substance misuse), 4) adulthood (history of divorce and past history of major depression), and 5) the last year (marital problems, difficulties, and stressful life events). RESULTS: The best fitting model included six correlations and 64 paths, provided an excellent fit to the data, and explained 52% of the variance in liability to episodes of major depression. The findings suggest that the development of risk for major depression in women results from three broad pathways reflecting internalizing symptoms, externalizing symptoms, and psychosocial adversity. CONCLUSIONS: Major depression is an etiologically complex disorder, the full understanding of which will require consideration of a broad array of risk factors from multiple domains. These results, while plausible, should be treated with caution because of problems with causal inference, retrospective recall bias, and the limitations of a purely additive statistical model.

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Crossref · 10.1176/appi.ajp.159.7.1133

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65 of 65 references verified0 citation errors · 0 not checkable

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  • Major life events emerge as the strongest risk factor for MDD even in multifactorial models that simultaneously evaluate stress with other well-known risk factors for depression.

    “major life events emerge as the strongest risk factor for MDD even when examined in multifactorial models that simultaneously evaluate the effects of stress with other well-known risk factors for depression”

    From From stress to inflammation and major depressive disorder: A social signal transduction theory of depression. (2014) · cites this paper as Kendler, Gardner, & Prescott, 2002

  • Increased rates of major depression follow dependent stressful life events and prior depressive episodes.

    “Increased rates of MD follow dSLEs7–9 and PDEs.10–12”

    From Dependent Stressful Life Events and Prior Depressive Episodes in the Prediction of Major Depression (2010) · cites this paper as [11]

  • Because numerous risk factors for major depression, including genes and childhood adversities, have long-lasting effects, the tendency for major depression to recur could arise without one depressive episode having a causal effect on the next.

    “Because numerous risk factors for MD—including genes and childhood adversities—have long-lasting effects,11,12,22,23 the tendency for MD to recur could arise without one depressive episode having a causal effect on the next.”

    From Dependent Stressful Life Events and Prior Depressive Episodes in the Prediction of Major Depression (2010) · cites this paper as [11]

  • The association of dSLEs with MD is typically stronger than that observed for independent SLEs.

    “We specifically studied dSLEs because their causal relationship with psychiatric illness is inherently unclear and their association with MD is typically stronger than that observed for independent SLEs.11,12”

    From Dependent Stressful Life Events and Prior Depressive Episodes in the Prediction of Major Depression (2010) · cites this paper as [11]

  • Previous analyses in this and other samples found that, in the presence of many covariates, PDEs modestly predict risk for future depressive episodes.

    “This interpretation is consistent with previous analyses in this11,12 and other10 samples in which, in the presence of many covariates, PDEs modestly predict risk for future depressive episodes.”

    From Dependent Stressful Life Events and Prior Depressive Episodes in the Prediction of Major Depression (2010) · cites this paper as [11]

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Authors
Kendler, K. S., Gardner, C. O., & Prescott, C. A.
Affiliations
Virginia Commonwealth University (US)
ORCID
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
2002-07-01
Volume
159
Issue
7
Pages
1133-1145
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/appi.ajp.159.7.1133
OpenAlex
W2128151309
Cited by
962
References
65
Citations by year
2026: 15 · 2025: 15 · 2024: 22 · 2023: 22 · 2022: 21 · 2021: 23 · 2020: 52 · 2019: 41 · 2018: 23 · 2017: 42 · 2016: 45 · 2015: 45 · 2014: 48 · 2013: 61 · 2012: 56
FWCI
42.41
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institute on Alcohol Abuse and Alcoholism (R01AA009095, AA-09095, AA-00236)
  • National Institute of Mental Health (R01MH040828, MH 40828, MH/AA/DA-49492)
  • National Institute on Drug Abuse (DA11287, R01DA011287)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
major depressive disorder, women, developmental model, etiology of depression, risk factors, child sexual abuse, childhood family environment, neuroticism, self-esteem, conduct disorder, anxiety, substance abuse, social support, marital problems, life events, internalizing problems, externalizing problems, psychosocial adversity, twin studies, genetic risk
MeSH terms
Adult, Age Factors, Depressive Disorder, Diseases in Twins, Factor Analysis, Statistical, Female, Humans, Life Change Events, Longitudinal Studies, Probability, Registries, Retrospective Studies, Risk Factors, Sex Factors, Virginia, Models, Statistical, Genetic Predisposition to Disease

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