Personality Dimensions and Depression: Review and Commentary

Enns, Murray W; Cox, Brian J

doi:10.1177/070674379704200305

Cited by 241Personality Traits and PsychologyPersonality Disorders and PsychopathologyAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Personality Dimensions and Depression: Review and Commentary

Enns, Murray W, Cox, Brian J·1997·The Canadian Journal of Psychiatry

DOI 10.1177/070674379704200305

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Abstract

OBJECTIVES: The relationship between dimensionally assessed personality and the onset, features, and course of depressive illness will be critically examined and considered in relation to 4 hypothesized models: predisposition or vulnerability: pathoplasty: complication or scar: and spectrum or continuity. METHOD: Studies that have used clinically depressed adult patients to explore the relationship between personality dimensions and depression will be reviewed. RESULTS: Higher-order personality factors that have shown a significant and consistent association with major depressive illness include neuroticism, extraversion (negative relationship), and the factors of Cloninger's Tridimensional Personality Model. Neuroticism appears to be the most powerful predictor of depression. Lower-order factors showing a significant and consistent relationship with depressive illness include dependency, self-criticism, obsessionality, and perfectionism. The links between depression and dependency and self-criticism have the strongest empirical support. CONCLUSIONS: Several personality dimensions are significantly associated with depressive illness, but the evidence that unequivocally demonstrates a true personality predisposition for depression is modest. Measures of personality may prove to be clinically useful for treatment selection.

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Parker, G. B., Hadži-Pavlović, D., Brodaty, H., Boyce, P. M., Mitchell, P. B., Wilhelm, K. A., & Hickie, I. B. (1992) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199211000-00003 · Cited by 38 · see citing works
Outcome profiles in the treatment of unipolar depression
Taylor, S. J., & McLean, P. D. (1993) · Behaviour Research and Therapy · doi:10.1016/0005-7967(93)90032-p · Cited by 38 · see citing works
Major depression and the self-criticism and dependency personality dimensions
Bagby, R. M., Schuller, D. R., Parker, J. D., LEVITT, A. J., Joffe, R. T., & Shafir, M. S. (1994) · American Journal of Psychiatry · doi:10.1176/ajp.151.4.597 · Cited by 37 · see citing works
Personality and Psychopathology
Paris, J. (2021) · Routledge eBooks · doi:10.4324/9781003156215-2 · Cited by 33 · see citing works
The relationship of sociotropy and autonomy to symptoms, cognition and personality in depressed patients
Moore, R. G., & Blackburn, I. (1994) · Journal of Affective Disorders · doi:10.1016/0165-0327(94)90087-6 · Cited by 30 · see citing works
The Measurement of Dependence by Questionnaire
Birtchnell, J. (1991) · Journal of Personality Disorders · doi:10.1521/pedi.1991.5.3.281 · Cited by 29 · see citing works
Recurrently situational (reactive) depression: A study of course, phenomenology and familial psychopathology
Coryell, W. H., Winokur, G., Maser, J. D., Akiskal, H. S., Keller, M. B., & Endicott, J. (1994) · Journal of Affective Disorders · doi:10.1016/0165-0327(94)90030-2 · Cited by 25 · see citing works
Treatment, Prediction of Relapse and Prognosis of Chronic Primary Major Depression
ECCLESTON, D., & Scott, J. L. (1991) · International Clinical Psychopharmacology · doi:10.1097/00004850-199112002-00003 · Cited by 22 · see citing works
Clinical Features of Situational and Nonsituational Major Depression
Joffe, R. T., LEVITT, A. J., Bagby, M. R., & Regan, J. J. (2010) · Psychopathology · doi:10.1159/000284813 · Cited by 10 · see citing works
Untitled work
Zettle (1995) · doi:10.1002/1097-4679(199503)51:2

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Linking “big” personality traits to anxiety, depressive, and substance use disorders: A meta-analysis
Kotov, R., Gamez, W., Schmidt, F., & Watson, D. (2010) · Psychological Bulletin · doi:10.1037/a0020327 · Cited by 2,677 · see citing works
Risk for recurrence in depression
Burcusa, S. L., & Iacono, W. G. (2007) · Clinical Psychology Review · doi:10.1016/j.cpr.2007.02.005 · Cited by 1,023 · see citing works
The neurobiology of depression and antidepressant action
Willner, P., Scheel-Krüger, J., & Belzung, C. (2013) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2012.12.007 · Cited by 519 · see citing works
PERSONALITY AND DEPRESSIVE SYMPTOMS: INDIVIDUAL PARTICIPANT META-ANALYSIS OF 10 COHORT STUDIES: Research Article: Personality and Depression
Hakulinen, C., Elovainio, M., Pulkki-Råback, L., Virtanen, M., Kivimäki, M., & Jokela, M. (2015) · Depression and Anxiety · doi:10.1002/da.22376 · Cited by 418 · see citing works
Temperament, stress reactivity, and coping: implications for depression in childhood and adolescence
Compas, B. E., Connor-Smith, J., & Jaser, S. S. (2004) · Journal of Clinical Child & Adolescent Psychology · doi:10.1207/s15374424jccp3301_3 · Cited by 361 · see citing works
“…symptoms and disorders in college students and adults, with reviews showing a consistent positive relation between depression and negative affectivity and a consistent negative relation between depression and positive affectivity (Enns & Cox, 1997; Klein, Durbin, Shankman, & Santiago, 2002).”
The relationship of neuroticism and extraversion to symptoms of anxiety and depression in the general population
Jylhä, P., & Isometsä, E. (2006) · Depression and Anxiety · doi:10.1002/da.20167 · Cited by 355 · see citing works
Personality Pathology and Treatment Outcome in Major Depression: A Review
Mulder, R. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.3.359 · Cited by 355 · see citing works
Neuroticism as a risk factor for schizophrenia
van Os, J., & Jones, P. (2001) · Psychological Medicine · doi:10.1017/s0033291701004044 · Cited by 276 · see citing works
“In line with previous research (Maier et al. 1992; Enns & Cox, 1997), earlier investigations in this cohort established that childhood neuroticism was a strong risk factor for adult non-psychotic affective disorder (Rodgers, 1990), whereas extraversion reduced the risk (Van Os & Jones, 1999).”
BackgroundResult
Personality and psychopathology: working toward the bigger picture.
Krueger, R. F., & Tackett, J. L. (2003) · Journal of Personality Disorders · doi:10.1521/pedi.17.2.109.23986 · Cited by 282 · see citing works
“A thorough examination of this work is also presented in a review by Enns and Cox (1997).”
High anxiety trait: A vulnerable phenotype for stress‐induced depression
Weger, M., & Sandi, C. (2018) · Neuroscience and Biobehavioral Reviews · doi:10.1016/j.neubiorev.2018.01.012 · Cited by 234 · see citing works
“…individuals’ responsiveness to stress and susceptibility to develop stress-induced psychopathologies (DiGangi et al., 2013; Duggan et al., 2003; Tosevski et al., 2010), particularly depression (Bagby R. M., Joffe R. T., Parker J. D. A., Kalemba V., 1995; Enns and Cox, 1997; Kendler et al., 1993).”
Psychological Vulnerability to Completed Suicide: A Review of Empirical Studies
Conner, K. R., Duberstein, P. R., Conwell, Y., Seidlitz, L., & Caine, E. D. (2001) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.31.4.367.22048 · Cited by 251 · see citing works
The genetic and environmental relationship between major depression and the five-factor model of personality
Kendler, K. S., & Myers, J. R. (2009) · Psychological Medicine · doi:10.1017/s0033291709991140 · Cited by 251 · see citing works
“A long tradition of research has examined the interrelationship between personality and major depression (MD) with a leading hypothesis being that certain personality traits reflect an enduring vulnerability to MD (Kendler et al. 1993a ; Klein et al. 1993 ; Bagby et al. 1995; Enns & Cox, 1997).”
Background
Personality traits and the development of depression, hopelessness, and suicide ideation
Chioqueta, A. P., & Stiles, T. C. (2004) · Personality and Individual Differences · doi:10.1016/j.paid.2004.08.010 · Cited by 243 · see citing works
Is low positive emotionality a specific risk factor for depression? A meta-analysis of longitudinal studies.
Khazanov, G. K., & Ruscio, A. M. (2016) · Psychological Bulletin · doi:10.1037/bul0000059 · Cited by 240 · see citing works
“…PE and depression and have come to different conclusions, suggesting that PE probably does predict depression (Clark et al., 1994; Morris, Bylsma, & Rottenberg, 2009; Watson & NaragonGainey, 2010), probably does not (Shankman & Klein, 2003), or that results are inconclusive (Enns & Cox, 1997).”
MethodResult
Associations between adult attachment ratings and health conditions: Evidence from the National Comorbidity Survey Replication.
McWilliams, L. A., & Bailey, S. J. (2010) · Health Psychology · doi:10.1037/a0020061 · Cited by 226 · see citing works
“However, neuroticism overlaps conceptually and empirically with the psychiatric disorders included in this study (see Enns & Cox, 1997), so adjusting for psychiatric disorders in this study could arguably be considered similar to adjusting for neuroticism.”
Background
Personality self-reports are concurrently reliable and valid during acute depressive episodes
Costa, P. T., Bagby, R. M., Herbst, J. H., & McCrae, R. R. (2005) · Journal of Affective Disorders · doi:10.1016/j.jad.2005.06.010 · Cited by 218 · see citing works
“Because personality traits are mistakenly believed to be fixed and immutable, this phenomenon has caused endless confusion in the literature on personality and depression (Akiskal et al., 1983; Barnett and Gotlib, 1988; Enns and Cox, 1997; Klein et al., 1993; Liebowitz et al., 1979).”
Background
A latent profile analysis of the Five Factor Model of personality: Modeling trait interactions
Merz, E. L., & Roesch, S. C. (2011) · Personality and Individual Differences · doi:10.1016/j.paid.2011.07.022 · Cited by 218 · see citing works
“Extraversion has been shown to correlate with a number of psychological constructs (e.g., Brown, Chorpita, & Barlow, 1998; Clark et al., 1994; Enns & Cox, 1997), as has Conscientiousness (e.g., Besser & Shackelford, 2007; Hayes & Joseph, 2003), but less is known about Openness and Agreeableness.”
Background
Are Perfectionism Dimensions Vulnerability Factors for Depressive Symptoms after Controlling for Neuroticism? A Meta–analysis of 10 Longitudinal Studies
Smith, M. M., Sherry, S., Rnic, K., Saklofske, D. H., Enns, M. W., & Gralnick, T. M. (2016) · European Journal of Personality · doi:10.1002/per.2053 · Cited by 198 · see citing works
“…variance with depressive symptoms, researchers have legitimately questioned whether lower-order personality traits such as perfectionism predict depressive symptoms beyond higherorder vulnerability factors such as neuroticism (Coyne & Whiffen, 1995; Enns & Cox, 1997; Enns, Cox, & Clara, 2005).”
BackgroundSelf-citation
Personality and Vulnerability to Depression in Stroke Patients
Aben, I., Denollet, J., Lousberg, R. L., Verhey, F. R. J., Wojciechowski, F. L., & Honig, A. (2002) · Stroke · doi:10.1161/01.str.0000029826.41672.2e · Cited by 180 · see citing works
Perfectionism and depression symptom severity in major depressive disorder
Enns, M. W., & Cox, B. J. (1999) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(98)00188-0 · Cited by 180 · see citing works
Self-citation
The nature and assessment of perfectionism: A critical analysis.
Enns, M. W., & Cox, B. J. (2002) · Perfectionism: Theory, research, and treatment. · doi:10.1037/10458-002 · Cited by 406 · see citing works
Self-citation
Clinical relevance of comorbidity in anxiety disorders: A report from the Netherlands Study of Depression and Anxiety (NESDA)
Klein Hofmeijer-Sevink, M., Batelaan, N. M., van Megen, H. J. G. M., Penninx, B. W., Cath, D. C., van den Hout, M. A., & van Balkom, A. J. L. M. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.12.008 · Cited by 176 · see citing works
“This finding may not be specific for anxiety disorders but may reflect general vulnerability given that more psychiatric disorders are associated with high neuroticism (Cox et al., 2004; Enns and Cox, 1997; van Os and Jones, 2001).”
Background
Cognitive Bias Modification Using Mental Imagery for Depression: Developing A Novel Computerized Intervention to Change Negative Thinking Styles
Lang, T. J., Blackwell, S. E., Harmer, C. J., Davison, P., & Holmes, E. A. (2012) · European Journal of Personality · doi:10.1002/per.855 · Cited by 171 · see citing works
“The personality trait neuroticism refers to ‘ temperamental sensitivity to negative stimuli ’ (p. 247; Enns & Cox, 1997).”
Background
Self-criticism and social phobia in the US national comorbidity survey
Cox, B. J., Fleet, C., & Stein, M. B. (2004) · Journal of Affective Disorders · doi:10.1016/j.jad.2003.12.012 · Cited by 171 · see citing works
“, 2002), our findings suggest that the self-criticism construct may be of value in understanding psychological processes in social phobia, potentially in much the same way it has contributed to our understanding of personality factors in depression (Enns and Cox, 1997; Nietzel and Harris, 1990).”
BackgroundSelf-citation
Personality and Depression
Bagby, R. M., Quilty, L. C., & Ryder, A. G. (2008) · The Canadian Journal of Psychiatry · doi:10.1177/070674370805300104 · Cited by 166 · see citing works
Neuroticism and self-esteem as indices of the vulnerability to major depression in women
Roberts, S. B., & Kendler, K. S. (1999) · Psychological Medicine · doi:10.1017/s0033291799008739 · Cited by 164 · see citing works
“Other studies suggest that the personality construct most closely related to risk for MD is neuroticism (N) (Parker, 1980; Enns & Cox, 1997).”
Background
High harm avoidance and low self-directedness in euthymic young adults with recurrent, early-onset depression
Smıth, D. J., Duffy, L. S., Stewart, M. E., Muir, W. J., & Blackwood, D. (2005) · Journal of Affective Disorders · doi:10.1016/j.jad.2005.03.014 · Cited by 145 · see citing works
Perfectionism and depressive symptoms 3 years later: negative social interactions, avoidant coping, and perceived social support as mediators
Dunkley, D. M., Sanislow, C. A., Grilo, C. M., & McGlashan, T. H. (2006) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2005.06.003 · Cited by 143 · see citing works
Can onset and recovery in depression be predicted by temperament? A systematic review and meta-analysis
Kampman, O., & Poutanen, O. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.12.021 · Cited by 140 · see citing works
Treatment-resistant depression: are animal models of depression fit for purpose?
Willner, P., & Belzung, C. (2015) · Psychopharmacology · doi:10.1007/s00213-015-4034-7 · Cited by 140 · see citing works
“…of both genetics and early traumatic events on depressive symptomatology is mediated through the personality factor of neuroticism (Kendler and Gardner 2011), which is one of the strongest risk factors for depression (Enns and Cox 1997; Christensen and Kessing 2006; Kendler and Myers 2010).”
Background
Clinical Guidelines for the Treatment of Depressive Disorders VII. Comorbidity
Enns, M. W., Swenson, J. R., McIntyre, R. S., Swinson, R. P., Kennedy, S. H., & The CANMAT Depression Work Group (2001) · The Canadian Journal of Psychiatry · doi:10.1177/070674372001460101007 · Cited by 136 · see citing works
Self-citation
Cloninger's temperament and character dimensions of personality in patients with major depressive disorder
Çelıkel, F. Ç., Köse, S., Cumurcu, B. E., Erkorkmaz, Ü., Sayar, K., Borckardt, J. J., & Cloninger, C. R. (2009) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2008.11.012 · Cited by 134 · see citing works
“Personality features may not only predispose an individual to the onset of depression but may also affect the expression of depression or a separate process is responsible for both personality factors and depression [29].”
Trait sensory-processing sensitivity and subjective well-being: Distinctive associations for different aspects of sensitivity
Sobocko, K., & Zelenski, J. M. (2015) · Personality and Individual Differences · doi:10.1016/j.paid.2015.03.045 · Cited by 134 · see citing works
Genomewide Significant Linkage to Recurrent, Early-Onset Major Depressive Disorder on Chromosome 15q
Holmans, P., Zubenko, G. S., Crowe, R., DePaulo, J. R., Scheftner, W. A., Weissman, M. M., Zubenko, W. N., Boutelle, S., Murphy-Eberenz, K. P., MacKinnon, D. F., et al. (2004) · The American Journal of Human Genetics · doi:10.1086/421333 · Cited by 130 · see citing works
“A substantial overlap has been estimated between the genetic factors underlying MDD and neuroticism (Kendler et al. 1993a; Clark et al. 1994; Duggan et al. 1995; Fava et al. 1996; Enns and Cox 1997).”
Background
Interaction between BDNF Val66Met and Dopamine Transporter Gene Variation Influences Anxiety-Related Traits
Hünnerkopf, R., Strobel, A., Gutknecht, L., Brocke, B., & Lesch, K. (2007) · Neuropsychopharmacology · doi:10.1038/sj.npp.1301383 · Cited by 129 · see citing works
“In previous studies, Neuroticism has clearly been found to be associated with both PTSD (Bowman, 1999; Holeva and Tarrier, 2001) and depression (Enns and Cox, 1997).”
Background
Personality and bipolar disorder: dissecting state and trait associations between mood and personality
Barnett, J. H., Huang, J., Perlis, R. H., Young, M. M., Rosenbaum, J. F., Nierenberg, A. A., Sachs, G. S., Nimgaonkar, V. L., Miklowitz, D. J., & Smoller, J. W. (2010) · Psychological Medicine · doi:10.1017/s0033291710002333 · Cited by 125 · see citing works
“Elevated neuroticism scores are common among patients with major depressive disorder (MDD) (Hirschfeld & Klerman, 1979 ; Trull & Sher, 1994 ; Enns & Cox, 1997), including pre-morbidly (Rodgers, 1990 ; Furukawa et al. 1998), and among their healthy relatives (Maier et al. 1992; Modell et al. 2003),…”
Background
Genetics of personality: are we making progress?
Gestel, S. V., & Broeckhoven, C. V. (2003) · Molecular Psychiatry · doi:10.1038/sj.mp.4001367 · Cited by 127 · see citing works
Personality traits predict job stress, depression and anxiety among junior physicians
Gramstad, T. O., Gjestad, R., & Haver, B. (2013) · BMC Medical Education · doi:10.1186/1472-6920-13-150 · Cited by 134 · see citing works
“Also at a general population level, neuroticism is a risk factor for developing symptoms of depression [30,31], as well as suicidal ideation and planning [30,32-35], while high levels of reality weakness predict suicidal ideation [34].”
Background
Influence of Personality Traits and Moral Values on Employee Well‐Being, Resilience and Performance: A Cross‐National Study
Athota, V. S., Budhwar, P. S., & Malik, A. (2019) · Applied Psychology · doi:10.1111/apps.12198 · Cited by 120 · see citing works
Additional evidence for a quantitative hierarchical model of mood and anxiety disorders for DSM-V: The context of personality structure.
Tackett, J. L., Quilty, L. C., Sellbom, M., Rector, N. A., & Bagby, R. M. (2008) · Journal of Abnormal Psychology · doi:10.1037/a0013795 · Cited by 112 · see citing works
Genetics and genomics of depression
Hamet, P., & Tremblay, J. (2005) · Metabolism · doi:10.1016/j.metabol.2005.01.006 · Cited by 110 · see citing works
“Later on, Fullerton et al [31] performed a genome scan in 559 sibling pairs who were concordant or discordant for neuroticism scores, as a substantial overlap was estimated between the genetic factors underlying MDD and neuroticism [32-36].”
Background
On the relation between neuroticism, self-esteem, and depression: results from the National Comorbidity Survey
Schmitz, N., Kügler, J., & Rollnik, J. D. (2003) · Comprehensive Psychiatry · doi:10.1016/s0010-440x(03)00008-7 · Cited by 109 · see citing works
Neuroticism, marital violence, and the moderating role of stress and behavioral skills.
Hellmuth, J. C., & McNulty, J. K. (2008) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.95.1.166 · Cited by 107 · see citing works
Negative problem orientation (Part II): construct validity and specificity to worry
Robichaud, M., & Dugas, M. J. (2004) · Behaviour Research and Therapy · doi:10.1016/j.brat.2004.02.008 · Cited by 104 · see citing works
Personality and depressive symptoms: a multi-dimensional analysis
Grucza, R. A. (2003) · Journal of Affective Disorders · doi:10.1016/s0165-0327(02)00303-8 · Cited by 104 · see citing works
Recent progress in psychiatric genetics--some hope but no hype
Stoltenberg, S. F. (2000) · Human Molecular Genetics · doi:10.1093/hmg/9.6.927 · Cited by 103 · see citing works
Residual symptoms in depression
Fava, G. A., Fabbri, S., & Sonino, N. (2002) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/s0278-5846(02)00226-9 · Cited by 137 · see citing works
Clinical relevance of comorbidity in obsessive compulsive disorder: The Netherlands OCD Association study
Hofmeijer-Sevink, M. K., van Oppen, P., van Megen, H. J. G. M., Batelaan, N. M., Cath, D. C., van der Wee, N. J. A., van den Hout, M., & van Balkom, A. J. L. M. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.03.014 · Cited by 100 · see citing works
“Although instances of traumatic experience occurred in higher proportions in OCD than in the normal population, these findings are not specific to OCD, since both high rates of neuroticism (Enns and Cox, 1997; Van Os and Jones, 2001; Cox et al., 2004) and childhood trauma (Kessler et al.”
Background
Self-criticism versus neuroticism in predicting depression and psychosocial impairment for 4 years in a clinical sample
Dunkley, D. M., Sanislow, C. A., Grilo, C. M., & McGlashan, T. H. (2008) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2008.09.004 · Cited by 101 · see citing works
“Second, as theoretical writings have concentrated on perfectionism as a pervasive neurotic style [30-32], there is a need to demonstrate the unique contribution of SC over and above broader source traits, such as neuroticism, in predicting depression and psychosocial impairment over time [21,33,34].”
Are there gender differences in major depression and its response to antidepressants?
Scheibe, S., Preuschhof, C., Cristi, C., & Bagby, R. M. (2002) · Journal of Affective Disorders · doi:10.1016/s0165-0327(02)00050-2 · Cited by 94 · see citing works
Perceptions of Parental Bonding and Symptom Severity in Adults with Depression: Mediation by Personality Dimensions
Enns, M. W., Cox, B. J., & Larsen, D. K. (2000) · The Canadian Journal of Psychiatry · doi:10.1177/070674370004500305 · Cited by 93 · see citing works
Self-citation
Is self-criticism unique for depression? A comparison with social phobia
Cox, B. J., Rector, N. A., Bagby, R. M., Swinson, R. P., LEVITT, A. J., & Joffe, R. T. (2000) · Journal of Affective Disorders · doi:10.1016/s0165-0327(99)00043-9 · Cited by 93 · see citing works
Self-citation
Temperament and character traits in major depressive disorder: influence of mood state and recurrence of episodes
Nery, F. G., Hatch, J. P., Nicoletti, M., Monkul, E. S., Najt, P., Matsuo, K., Cloninger, C. R., & Soares, J. C. (2009) · Depression and Anxiety · doi:10.1002/da.20478 · Cited by 91 · see citing works
“, fluctuations of harm avoidance, self-directedness, and cooperativeness with the TCI,([10,18,23,24]) and of neuroticism and extraversion with the Maudsley Personality Inventory.([25]) Nonetheless, regarding the TCI, it has been demonstrated that it has a high internal consistency and TABLE 2.”
Method
Self-critical perfectionism, experiential avoidance, and depressive and anxious symptoms over two years: A three-wave longitudinal study
Moroz, M., & Dunkley, D. M. (2019) · Behaviour Research and Therapy · doi:10.1016/j.brat.2018.11.006 · Cited by 89 · see citing works
Personality and risk for postpartum depressive symptoms
Iliadis, S. I., Koulouris, P., Gingnell, M., Sylvén, S. M., Sundström-Poromaa, I., Ekselius, L., Papadopoulos, F. C., & Skalkidou, A. (2015) · Archives of Women's Mental Health · doi:10.1007/s00737-014-0478-8 · Cited by 83 · see citing works
Psychological Dimensions Associated with Suicidal Ideation and Attempts in the National Comorbidity Survey
Cox, B. J., Enns, M. W., & Clara, I. P. (2004) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.34.3.209.42781 · Cited by 82 · see citing works
Self-citation
Neuroticism, daily hassles, and depressive symptoms: An examination of moderating and mediating effects
Hutchinson, J. G., & Williams, P. (2007) · Personality and Individual Differences · doi:10.1016/j.paid.2006.10.014 · Cited by 81 · see citing works
“…of developing psychopathology in response to stress, numerous studies have shown N to be related in a number of ways with the different manifestations of depressive illness, with more supporting evidence of this effect than for any other personality factor (for an overview, see Enns & Cox, 1997).”
Result
Neuroticism, introversion, and major depressive disorder-traits, states, or scars?
Jylhä, P. J., Melartin, T. K., Rytsälä, H. J., & Isometsä, E. T. (2009) · Depression and Anxiety · doi:10.1002/da.20385 · Cited by 76 · see citing works
“Overall, the role of extraversion as a risk factor for depression is more obscure than that of neuroticism.([4]) In this study, we investigated the associations between neuroticism and extraversion and MDD in a relatively large cohort of depressive patients as compared with the general population, examining both perso…”
Background
Neuroticism and extraversion personality traits, health behaviours, and subjective well-being: the Fukuoka Study (Japan)
Otonari, J., Nagano, J., Morita, M., Budhathoki, S., Tashiro, N., Toyomura, K., Kono, S., Imai, K., Ohnaka, K., & Takayanagi, R. (2011) · Quality of Life Research · doi:10.1007/s11136-011-0098-y · Cited by 72 · see citing works
Major depression during interferon-α treatment: vulnerability and prevention
Lotrich, F. E. (2009) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2009.11.4/felotrich · Cited by 71 · see citing works
Poststroke Depression: A Review Emphasizing the Role of Prophylactic Treatment and Synergy with Treatment for Motor Recovery
Flaster, M. S., Sharma, A., & Rao, M. S. (2013) · Topics in Stroke Rehabilitation · doi:10.1310/tsr2002-139 · Cited by 71 · see citing works
Broad and specific personality dimensions associated with major depression in a nationally representative sample
Cox, B. J., McWilliams, L. A., Enns, M. W., & Clara, I. P. (2004) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2004.03.002 · Cited by 68 · see citing works
Self-citation
Neuroticism and Longitudinal Change in Caregiver Depression: Impact of a Spouse-Caregiver Intervention Program
Jang, Y., Clay, O. J., Roth, D. L., Haley, W. E., & Mittelman, M. S. (2004) · The Gerontologist · doi:10.1093/geront/44.3.311 · Cited by 68 · see citing works
Stress‐Induced Depression: Is Social Rank a Predictive Risk Factor?
Larrieu, T., & Sandi, C. (2018) · BioEssays · doi:10.1002/bies.201800012 · Cited by 61 · see citing works
Neuroticism-related personality traits are related to symptom severity in patients with premenstrual dysphoric disorder and to the serotonin transporter gene-linked polymorphism 5-HTTPLPR
Gingnell, M., Comasco, E., Oreland, L., Fredrikson, M., & Poromaa, I. S. (2010) · Archives of Women s Mental Health · doi:10.1007/s00737-010-0164-4 · Cited by 62 · see citing works
“As both these factors, and especially genetic vulnerability factors, are associated with major depression (Enns and Cox 1997; Kendler et al. 2006; Ramklint and Ekselius 2003), our results may also suggest that highly symptomatic PMDD patients (with elevated neuroticismrelated personality trait…”
Testgüte einer deutschsprachigen Version der Mehrdimensionalen Perfektionismus Skala von Frost, Marten, Lahart und Rosenblate (MPS-F)
Altstötter–Gleich, C., & Bergemann, N. (2006) · Diagnostica · doi:10.1026/0012-1924.52.3.105 · Cited by 62 · see citing works
Temperament among offspring at high and low risk for depression
Bruder-Costello, B., Warner, V., Talati, A., Nomura, Y., Bruder, G. E., & Weissman, M. M. (2007) · Psychiatry Research · doi:10.1016/j.psychres.2007.02.013 · Cited by 60 · see citing works
“, 2004, for review) have been shown to correlate positively with depressive symptoms and disorders in adults, whereas those associated with positive emotionality (activity, approach-withdrawal, sociability) are negatively correlated with these symptoms (Enns and Cox, 1997; Klein et al., 2002).”
A one-year follow-up study into the course of depression after stroke
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“This finding is of interest, as it sustains a large body of the literature suggesting neuroticism as a strong risk factor for MD, depression and suicide (Brezo et al., 2006; Enns and Cox, 1997; McKinnon et al., 2013).”
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“…factors against, depression, with high levels of NE/neuroticism and low levels of PE/extraversion being hypothesized as key vulnerabilities (e.g. Enns & Cox, 1997; Gershuny & Sher, 1998; Bienvenu et al. 2004; Watson et al. 2005; Brown, 2007; Verstraeten et al. 2009; Kotov et al. 2010; Klein et…”
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The Five Factor Model of personality applied to adults who stutter
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Assessing Self-Critical Perfectionism in Clinical Depression
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“Evidence regarding the internal consistency, test-retest reliability, factor structure, and convergent validity for the Frost MPS were reviewed extensively in Enns and Cox (2002).”
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“Personality features may result from, predispose an individual to, or modify the clinical picture of an affective illness, or be an attenuated expression of an affective disorder (Enns & Cox, 1997).”
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“Also of note is the considerable body of literature linking dependency and Axis I, particularly depression (see Enns & Cox, 1997).”
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Neural correlates of personality dimensions and affective measures during the anticipation of emotional stimuli
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“In particular the association between neuroticism and affective disorders, particularly major depression and anxiety disorders has been noted early and continuously (reviews: e.g. Clark et al. 1994; Enns and Cox 1997; Jylha and Isometsa 2006, meta-analyses: Kotov et al. 2010; Malouff et al. 2005).”
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Authors: Enns, M. W., & Cox, B. J.
Affiliations: University of Manitoba (CA)
ORCID: Enns, Murray W
Cox, Brian J
Venue: The Canadian Journal of Psychiatry
Publisher: SAGE Publications
Published: 1997-04
Volume: 42
Issue: 3
Pages: 274-284
ISSN: 0706-7437 (ISSN-L)
1497-0015
DOI: 10.1177/070674379704200305
OpenAlex: W1732822633
Cited by: 241
References: 98
Citations by year: 2025: 4 · 2024: 8 · 2023: 2 · 2022: 5 · 2021: 6 · 2020: 3 · 2019: 5 · 2018: 9 · 2017: 9 · 2016: 11 · 2015: 14 · 2014: 11 · 2013: 8 · 2012: 15
FWCI: 1.18
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: The Canadian Journal of Psychiatry (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: personality factors, depression, neuroticism, extraversion, dependency, self-criticism, obsessionality, perfectionism, personality predisposition, vulnerability model, course of depression, treatment selection
MeSH terms: Adult, Depressive Disorder, Humans, Personality Development, Personality Disorders, Personality Inventory, Risk Factors, Comorbidity, Diagnosis, Dual (Psychiatry)

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Personality Dimensions and Depression: Review and Commentary

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