The Montgomery-Aasberg Depression Rating Scale (MADRS) is a widely used clinician-rated measure of depressive severity. Empirical support for the factor structure of the MADRS is mixed; further, the ...comparison of MADRS scores within and between patients requires the demonstration of consistent instrument properties. The objective of the current investigation was to evaluate MADRS factor structure as well as MADRS factorial invariance across time and gender. The MADRS was administered to 821 depressed outpatients participating in a large-scale effectiveness study of combined pharmacotherapy and psychotherapy for depression. Treatment outcome did not differ across treatment groups. Factor structure and invariance was evaluated via confirmatory factor analysis. A four-factor model consisting of Sadness, Negative Thoughts, Detachment and Neurovegetative symptoms demonstrated a good fit to the data. This four-factor structure was invariant across time and gender. A hierarchical model, in which these four factors served as indicators of a general depression factor, was also supported. A limitation of the current study is the lack of comprehensive characterization of patient clinical features; results need to be replicated in more severely depressed or treatment refractory patients. Overall, evidence supported the use of the MADRS total score as well as subscales focused on affective, cognitive, social and somatic aspects of depression in male and female outpatients. Copyright copyright 2013 John Wiley & Sons, Ltd.
Background Serotonin function has been implicated in both major depressive disorder and neuroticism. In the current investigation, we examined the hypothesis that any change in depression severity is ...mediated through the reduction of neuroticism, but only for those compounds which target serotonin receptors. Methods Ninety-three outpatients in the midst of a major depressive episode received one of three antidepressant medications, classified into two broad types: selective serotonin reuptake inhibitors (SSRIs) and non-SSRIs (i.e. reversible monoamine oxidase inhibitors RIMAs and noradrenergic and dopaminergic reuptake blockers NDMs). Patients completed the Hamilton Rating Scale for Depression, Beck Depression Inventory II and Revised NEO Personality Inventory prior to and following approximately 16 weeks of treatment. Structural equation modeling was used to test two models: a mediation model, in which neuroticism change is the mechanism by which SSRIs exert a therapeutic effect upon depressive symptoms, and a complication model, in which neuroticism change is a mere epiphenomenon of depression reduction in response to SSRIs. Results The mediation model provided a good fit to the data; the complication model did not. Patients treated with SSRIs demonstrated greater neuroticism change than those treated with non-SSRIs, and greater neuroticism change was associated with greater depressive symptom change. These effects held for both self-reported and clinician-rated depressive symptom severity. Limitations Replication within a randomized control trial with multiple assessment periods is required. Conclusion Neuroticism mediates changes in depression in response to treatment with SSRIs, such that any treatment effect of SSRIs occurs through neuroticism reduction. Copyright Elsevier B.V.
Despite evidence of significant symptom heterogeneity and excessive diagnostic comorbidity, many contend that borderline personality disorder (BPD) is unidimensional, an assumption that rests ...primarily on results from factor analytic investigations of BPD symptom criteria. We note several limitations in the literature and argue that the symptom structure of BPD can be best clarified by using both factor analytic techniques and examining the BPD symptom dimensions in relation to external criteria (that is, personality traits). Our goals were to: examine if the symptoms of BPD are best conceptualized as unidimensional or multidimensional, and determine the extent to which personality traits account for any symptom dimensions that underlie BPD. All published structural models of the BPD symptom criteria were identified and tested for statistical fit using confirmatory factor analysis in a sample of 373 patients who had completed the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-Axis II Personality Questionnaire BPD scale. Dimensions from the best fitting model were examined in relation to traits from the Five-Factor Model (FFM) and the Personality Psychopathology Five (PSY-5) using correlational and regression analyses. Sanislow's 3-factor model, containing affect dysregulation, behavioural dysregulation, and disturbed relations symptom dimensions, provided the best fit; the unidimensional model produced the worst. The symptom dimensions of the 3-factor model were differentiable from one another and had unique associations with the FFM and PSY-5 personality traits. BPD is a multidimensional construct.
Much personality research suggests that the variance in personality can be accounted for by a few dimensions, often hypothesized to be connected to neurological circuits. Gray's (1982) behavioural ...activation system (BAS) and behavioural inhibition system (BIS) in particular propose to explain for a variety of behaviour. This investigation sought to determine whether Positive Emotionality is an appropriate measure of the BAS, and how Tellegen's (1985) constructs are related to BAS activity. Measures of BAS and Positive Emotionality were administered to undergraduates. Confirmatory factor analyses revealed that, while Positive Emotionality can be used as an indicator of BAS activity, it is better conceived of as a distinct, correlated construct. In addition, not all components of Positive Emotionality were related to BAS activity, and BAS was further related to components of Negative Emotionality and Constraint.
Research on the relation between personality and depression seems to have generated at least as much heat as light as these reviews neatly summarize. Authors of the first article, Dr Jane Foster and ...Dr Glenda MacQueen,1 point out that it is unclear whether neuroscience has advanced to the point where useful comments on the biological underpinnings of complex traits such as personality can be made, let alone the relation of these traits to depression.
Background This study investigated the association between dimensional personality traits from the Five-Factor Model (FFM) and treatment outcome in patients with Major Depressive Disorder (MDD). ...Methods Six hundred forty-nine outpatients with MDD participated in a randomised double-blind longitudinal study for 6 months. Patients received a combination of medication and psychotherapy; they were randomised to medication condition (tianeptine or fluoxetine), and non-randomly assigned to psychotherapy condition (supportive, cognitive-behavioural, or psychodynamic). The Montgomery Asberg Depression Rating Scale was used to assess depression severity. The Systeme de Description en Cinq Dimensions was used to assess the personality domains of the FFM. Results Group comparisons revealed that patients who responded to both medication and psychotherapy had lower Neuroticism (t = 4.22, p < .01), and higher Extraversion (t = 4.01, p < .01) and Openness to Experience scores (t = 3.57, p < .01) compared to non-responders. Regression analyses, which controlled for shared variance among the five personality domains, indicated that Neuroticism (^D*y2 = 4.06, p = .04) and Conscientiousness (^D*y2 = 8.98, p < .01) were significantly and uniquely associated with response. The two-way interactions between Neuroticism X Extraversion (^D*y2 = 4.49, p = .03) and Extraversion X Conscientiousness (^D*y2 = 5.91, p = .01) were also associated with response. These results were mostly replicated across the treatment-completer and intent-to-treat samples. Conclusions Dimensional personality traits predict response for individuals with MDD. Limitations This study did not examine facet-level traits, patient pre-morbid personality and functioning, and additional patient characteristics. Results may not be generalizable to severely depressed or treatment refractory patients. Copyright Elsevier B.V.
Gignac, Palmer, and Stough (2007/this issue) test a number of different latent factor models for the TAS-20 using a community sample of 355 participants and conclude that this scale is best ...represented by a "nested factors model," with five substantive factors and a method factor. Gignac et al. also report that the correlated three-factor model and a comparable higher order model supported by most studies produced poor levels of incremental close fit. In this article, we challenge Gignac et al's unheralded and largely unsupported use of nested model fitting and the uncritical acceptance of exceptionally high cutoff levels to assess goodness of fit (GOF). Using more traditional and empirically supported model testing procedures and a more flexible approach to the interpretation of multiple tests of GOF, we interpret Gignac et al.'s results as actually supportive of the traditional three-factor model and one that has been recovered in 17 of the 24 factor analytic studies of the TAS-20. PUBLICATION ABSTRACT
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