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

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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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“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 65
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 68
“, 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
Bour, A. M. J. J., Rasquin, S. M. C., Aben, I., Boreas, A., Limburg, M., & Verhey, F. R. J. (2010) · The journal of nutrition health & aging · doi:10.1007/s12603-010-0033-x · Cited by 58
“Neuroticism is defined as the tendency to experience negative emotions and to have poor coping skills and it is highly associated with psychopathology, including depression (28).”
Perfectionism in Anxiety and Depression: Comparisons across Disorders, Relations with Symptom Severity, and Role of Comorbidity
Wheeler, H. A., Blankstein, K. R., Antony, M. M., McCabe, R. E., & Bieling, P. (2011) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2011.4.1.66 · Cited by 69
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Incremental validity of sense of coherence, neuroticism, extraversion, and general self-efficacy: longitudinal prediction of substance use frequency and mental health
Grevenstein, D., Bluemke, M., & Jungaberle, H. (2016) · Health and Quality of Life Outcomes · doi:10.1186/s12955-016-0412-z · Cited by 56
“Coming from the same theoretical background, extraversion (E) is conceived as a basic personality trait and characterized by energy, dominance, positive emotionality, and sociability [1, 52].”
Background
Correlates of analogue and clinical depression: a further test of the phenomenological continuity hypothesis
Enns, M. W., Cox, B. J., & Borger, S. C. (2001) · Journal of Affective Disorders · doi:10.1016/s0165-0327(00)00305-0 · Cited by 62
Self-citation
Relationships of neuroticism and extraversion with axis I and II comorbidity among patients with DSM-IV major depressive disorder
Jylhä, P. J., Melartin, T. K., & Isometsä, E. T. (2008) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.06.011 · Cited by 57
“Neuroticism is characterized by proneness to anxiety, emotional instability and self-consciousness, and extraversion by energy, dominance and positive emotionality (Enns and Cox, 1997).”
Background
Long-term personality changes and predictive adaptive responses after depressive episodes
Rosenström, T. H., Jylhä, P. J., Pulkki-Råbäck, L., Holma, M., Raitakari, O. T., Isometsä, E. T., & Keltikangas‐Järvinen, L. (2015) · Evolution and Human Behavior · doi:10.1016/j.evolhumbehav.2015.01.005 · Cited by 54
Research letter: Is neuroticism a risk factor for postpartum depression?
MARTÍN-SANTOS, R., GELABERT, E., SUBIRÀ, S., GUTIERREZ-ZOTES, A., LANGORH, K., JOVER, M., TORRENS, M., GUILLAMAT, R., MAYORAL, F., CANELLAS, F., et al. (2012) · Psychological Medicine · doi:10.1017/s0033291712000712 · Cited by 50
The five-factor model of personality and depressive symptoms: One-year follow-up
Chien, L.-L., Ko, H., & Wu, J. Y. (2007) · Personality and Individual Differences · doi:10.1016/j.paid.2007.02.022 · Cited by 50
Neuroticism, social network, stressful life events: Association with mood disorders, depressive symptoms and suicidal ideation in a community sample of women
Mandelli, L., Nearchou, F., Vaiopoulos, C., Stefanis, C. N., Vitoratou, S., Serretti, A., & Stefanis, N. C. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2014.11.001 · Cited by 53
“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).”
Background
Co-morbidity of bipolar disorder and borderline personality disorder: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions
McDermid, J., Sareen, J., El-Gabalawy, R. M., Pagura, J., Spiwak, R. P., & Enns, M. W. (2015) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2015.01.004 · Cited by 56
“These associations may be explained by shared vulnerabilities or through the effect of pathoplasty [4,64,68–70].”
BackgroundSelf-citation
Self-diagnosed depression in the Norwegian general population – associations with neuroticism, extraversion, optimism, and general self-efficacy
Bonsaksen, T., Grimholt, T. K., Skogstad, L., Lerdal, A., Ekeberg, Ø., Heir, T., & Schou‐Bredal, I. (2018) · BMC Public Health · doi:10.1186/s12889-018-5990-8 · Cited by 50
Personality traits associated with depressive and anxiety disorders in infertile women and men undergoing in vitro fertilization treatment
Volgsten, H., Ekselius, L., Poromaa, I. S., & Svanberg, A. S. (2009) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.3109/00016340903447396 · Cited by 47
“It is considered important to evaluate the social context in which personality traits are assessed (28).”
Background
Adult Adjustment Disorder: A Review of Its Current Diagnostic Status
Casey, P. (2001) · Journal of Psychiatric Practice · doi:10.1097/00131746-200101000-00004 · Cited by 47
The Spectrum of Adjustment Disorders: Too Broad to be Clinically Helpful
Semprini, F., Fava, G. A., & Sonino, N. (2010) · CNS Spectrums · doi:10.1017/s1092852900029254 · Cited by 43
Personality diatheses and Hurricane Sandy: effects on post-disaster depression
Kopala‐Sibley, D. C., Kotov, R., Bromet, E. J., Carlson, G. A., Danzig, A. P., Black, S. R., & Klein, D. N. (2015) · Psychological Medicine · doi:10.1017/s0033291715002378 · Cited by 44
“…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…”
Background
The Five Factor Model of personality applied to adults who stutter
Iverach, L., O’Brian, S., Jones, M., Block, S., Lincoln, M., Harrison, E., Hewat, S., Menzies, R. G., Packman, A., & Onslow, M. (2009) · Journal of Communication Disorders · doi:10.1016/j.jcomdis.2009.12.001 · Cited by 42
Identifying and targeting predictors of drop-out from group cognitive behaviour therapy
Davis, S., Hooke, G. R., & Page, A. C. (2006) · Australian Journal of Psychology · doi:10.1080/00049530500504096 · Cited by 42
Mood and substance use disorders among adults seeking speech treatment for stuttering.
Iverach, L., Jones, M., O'Brian, S., Block, S., Lincoln, M., Harrison, E., Hewat, S., Menzies, R., Packman, A., & Onslow, M. (2010) · Journal of Speech, Language and Hearing Research · doi:10.1044/1092-4388(2010/09-0166 · Cited by 42
Predictors of Depressive Symptoms in Persons With Alzheimer's Disease
Gilley, D. W., Wilson, R. S., Bienias, J. L., Bennett, D. A., & Evans, D. A. (2004) · The Journals of Gerontology Series B · doi:10.1093/geronb/59.2.p75 · Cited by 42
Hierarchical models of personality and psychopathology: the case of self-criticism, neuroticism, and depression
Clara, I. P., Cox, B. J., & Enns, M. W. (2003) · Personality and Individual Differences · doi:10.1016/s0191-8869(02)00143-5 · Cited by 40
Self-citation
Assessing Self-Critical Perfectionism in Clinical Depression
Clara, I. P., Cox, B. J., & Enns, M. W. (2007) · Journal of Personality Assessment · doi:10.1080/00223890701317046 · Cited by 42
“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).”
BackgroundMethodSelf-citation
Self-criticism, dependency and the five factor model of personality in depression: assessing construct overlap
Bagby, R. M., & Rector, N. A. (1998) · Personality and Individual Differences · doi:10.1016/s0191-8869(97)00238-9 · Cited by 39
Differences in temperament and character dimensions in patients with bipolar I or II or major depressive disorder and general population subjects
Jylhä, P. J., Mantere, O., Melartin, T. K., Suominen, K. H., Vuorilehto, M. S., Arvilommi, P., Holma, I. A. K., Holma, M., Leppämäki, S., Valtonen, H., et al. (2011) · Psychological Medicine · doi:10.1017/s0033291710002606 · Cited by 38
“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).”
Background
Passive‐Submissive and Active‐Emotional Trait Dependency: Evidence for a Two‐Factor Model
Morgan, T. A., & Clark, L. A. (2010) · Journal of Personality · doi:10.1111/j.1467-6494.2010.00652.x · Cited by 37
“Also of note is the considerable body of literature linking dependency and Axis I, particularly depression (see Enns & Cox, 1997).”
Background
Neural correlates of personality dimensions and affective measures during the anticipation of emotional stimuli
Brühl, A. B., Viebke, M.-C., Baumgärtner, T., Kaffenberger, T., & Herwig, U. (2011) · Brain Imaging and Behavior · doi:10.1007/s11682-011-9114-7 · Cited by 39
“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).”
BackgroundResultInfluential
Resistance to antidepressant drugs
Willner, P., Scheel‐Krüger, J., & Belzung, C. (2014) · Behavioural Pharmacology · doi:10.1097/fbp.0000000000000066 · Cited by 36
“…genetics and early traumatic events on chronic 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
Personality, neuroticism, and coping towards the end of life.
Chochinov, H., Kristjanson, L., Hack, T., Hassard, T., Mcclement, S., & Harlos, M. (2006) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2006.05.011 · Cited by 29
What predicts depression in cardiac patients: Sociodemographic factors, disease severity or theoretical vulnerabilities?
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Personality Traits, Music Preferences and Depression in Adolescence
Miranda, D., & Claes, M. (2008) · International Journal of Adolescence and Youth · doi:10.1080/02673843.2008.9748008 · Cited by 35
“If they are protective factors, then either Pop or Soul music listening should moderate (buffer) the predictive effect of a possible risk factor of depression, such as Neuroticism (Enns and Cox, 1997; Klein, Durbin, Shankman and Santiago, 2002).”
Background
COMMENTARIES
(2002) · Psychological Inquiry · doi:10.1207/s15327965pli1303_05 · Cited by 37
“Perfectionism and perfectionist strivings within the secular realm have been related to lower self-esteem (Stumpf & Parker, 2000), lower psychological well-being (Mitchelson & Burns, 1998), and higher depression (Enns & Cox, 1997; Rice, Ashby, & Slaney, 1998).”
Background
How subjective are subjective language complaints
Martins, I. P., Mares, I., & Stilwell, P. A. (2012) · European Journal of Neurology · doi:10.1111/j.1468-1331.2011.03635.x · Cited by 43
“negative aspects of one s life or abilities [36] because of”
Background
Interpersonal Sensitivity, Romantic Stress, and the Prediction of Depression: A Study of Inner-City, Minority Adolescent Girls
Rizzo, C. J., Daley, S. E., & Gunderson, B. H. (2006) · Journal of Youth and Adolescence · doi:10.1007/s10964-006-9047-4 · Cited by 35

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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