Interactions between neuroticism and stressful life events predict response to pharmacotherapy for major depression: A CAN-BIND 1 report

Timothy A Allen, Kate L Harkness, Raymond W Lam, Roumen Milev, Benicio N Frey, Daniel J Mueller, Rudolf Uher, Sidney H Kennedy, Lena C Quilty, Timothy A Allen, Kate L Harkness, Raymond W Lam, Roumen Milev, Benicio N Frey, Daniel J Mueller, Rudolf Uher, Sidney H Kennedy, Lena C Quilty

Abstract

Exposure to stressful life events and individual differences in the personality trait neuroticism are important risk factors that interact to predict major depressive disorder (MDD). Less is known about their effect on treatment response in depression. Here, we examine whether stressful life events experienced prior to and during treatment interact with neuroticism to predict response to 16-week pharmacotherapy for MDD. Participants included 159 outpatients with MDD who were initially treated with 8 weeks of escitalopram. Those who responded to the initial treatment continued on escitalopram monotherapy, whereas non-responders received 8 weeks of adjunctive aripiprazole. Personality was assessed using the NEO-Five Factor Inventory, and stressful life events were assessed using the Life Events and Difficulties Schedule, a rigorous contextual interview that includes independent ratings of threatening life events. High baseline neuroticism was associated with a lower likelihood of response when patients experienced one or more negative life events before treatment. Secondary analyses indicated that this effect was specific to neuroticism, and not better accounted for by its self-criticism or negative affect facets. Our results suggest that assessing personality and stressful life events at baseline can help clinicians assess which patients will respond to antidepressant therapy and which may need treatment augmentation.

Trial registration: ClinicalTrials.gov NCT01655706.

© 2021 John Wiley & Sons, Ltd.

Figures

Figure 1.
Figure 1.
Interaction between neuroticism and pretreatment total negative life events (NE) predicting the probability of response on the MADRS at Week 16. A) Effect of neuroticism on treatment response moderated by pretreatment total negative events. B) Effect of pretreatment total negative events on treatment response moderated by neuroticism.
Figure 2.
Figure 2.
Interaction between neuroticism and pretreatment independent negative life (INE) events predicting the probability of response on the MADRS at Week 16. Note, this effect was reduced to non-significance after controlling for conscientiousness and its interaction with pretreatment independent negative events (see Table S5 and Figure S2). A) Pretreatment negative independent events as moderator. B) Neuroticism as moderator.

References

    1. Zuckerman M Diathesis-stress models. In: Zuckerman M, ed. Vulnerability to Psychopathology: A Biosocial Model. American Psychological Association; 1999:3–23.
    1. Costa PT, McCrae RR. NEO Personality Inventory – Revised (Neo-Pi-r) and NEO Five-Factor Inventory (Neo-Ffi) Professional Manual. Odessa, FL: Psychological Assessment Resources; 1992.
    1. Hisler GC, Krizan Z, DeHart T, Wright AGC. Neuroticism as the intensity, reactivity, and variability in day-to-day affect. J Res Pers. 2020;87:103964. doi:10.1016/j.jrp.2020.103964
    1. Bolger N, Schilling EA, Bem D, et al. Personality and the problems of everyday life: The role of neuroticism in exposure and reactivity to daily stressors. J Pers. 1991;59(3):355–386.
    1. Suls J, Martin R, David JP. Person-environment fit and its limits: Agreeableness, Neuroticism, and emotional reactivity to interpersonal conflict. Personal Soc Psychol Bull. 1998;24(1):88–98. doi:10.1177/0146167298241007
    1. Shackman AJ, Tromp DPMM, Stockbridge MD, Kaplan CM, Tillman RM, Fox AS. Dispositional negativity: An integrative psychological and neurobiological perspective. Psychol Bull. 2016;142(12):1275–1314. doi:10.1037/bul0000073
    1. Brown TA, Rosellini AJ. The direct and interactive effects of neuroticism and life stress on the severity and longitudinal course of depressive symptoms. J Abnorm Psychol. 2011;120(4):844–856. doi:10.1037/a0023035
    1. Kendler KS, Kuhn J, Prescott CA. The interrelationship of Neuroticism, sex, and stressful life events in the prediction of episodes of major depression. Am J Psychiatry. 2004;161(4):631–636. doi:10.1176/appi.ajp.161.4.631
    1. Bondy E, Baranger DAA, Balbona J, et al. Neuroticism and reward-related ventral striatum activity: Probing vulnerability to stress-related depression. J Abnorm Psychol. February 2021. doi:10.1037/abn0000618
    1. Steffens DC, Wu R, Grady JJ, Manning KJ. Presence of neuroticism and antidepressant remission rates in late-life depression: Results from the Neurobiology of Late-Life Depression (NBOLD) study. Int Psychogeriatrics. 2018;30(7):1069–1074. doi:10.1017/S1041610217002551
    1. Bock C, Bukh JD, Vinberg M, Gether U, Kessing LV. The influence of comorbid personality disorder and neuroticism on treatment outcome in first episode depression. Psychopathology. 2010;43(3):197–204. doi:10.1159/000304176
    1. Fiedorowicz JG, Hale N, Spector AA, Coryell WH. Neuroticism but not omega-3 fatty acid levels correlate with early responsiveness to escitalopram. Ann Clin Psychiatry. 2010;22(3):157–163. /pmc/articles/PMC3035677/. Accessed February 24, 2021.
    1. Quilty LC, Meusel LAC, Bagby RM. Neuroticism as a mediator of treatment response to SSRIs in major depressive disorder. J Affect Disord. 2008;111(1):67–73. doi:10.1016/j.jad.2008.02.006
    1. Tang TZ, DeRubeis RJ, Hollon SD, Amsterdam JD, Shelton R, Schalet B. Personality change during depression treatment. Arch Gen Psychiatry. 2009;66(12):1322. doi:10.1001/archgenpsychiatry.2009.166
    1. Monroe SM, Kupfer DJ, Frank EF. Life stress and treatment course of recurrent depression: I. Response during index episode. J Consult Clin Psychol. 1992;60(5):718–724. doi:10.1037/0022-006X.60.5.718
    1. Fournier JC, DeRubeis RJ, Shelton RC, Hollon SD, Amsterdam JD, Gallop R. Prediction of response to medication and cognitive therapy in the treatment of moderate to severe depression. J Consult Clin Psychol. 2009;77(4):775–787. doi:10.1037/a0015401
    1. Keers R, Uher R, Huezo-Diaz P, et al. Interaction between serotonin transporter gene variants and life events predicts response to antidepressants in the GENDEP project. Pharmacogenomics J. 2011;11(2):138–145. doi:10.1038/tpj.2010.14
    1. Bulmash E, Harkness KL, Stewart JG, Bagby RM. Personality, stressful life events, and treatment response in major depression. J Consult Clin Psychol. 2009;77(6):1067–1077. doi:10.1037/a0017149
    1. Clara IP, Cox BJ, Enns MW. Hierarchical models of personality and psychopathology: the case of self-criticism, neuroticism, and depression. Pers Individ Dif. 2003;35(1):91–99. doi:10.1016/S0191-8869(02)00143-5
    1. Vrshek-Schallhorn S, Ditcheva M, Corneau G, Vrshek-Schallhorn S, Ditcheva M, Corneau G. Stress in Depression; 2020. doi:10.1093/oxfordhb/9780190681777.013.5
    1. Mazure CM, Bruce ML, Maciejewski PK, Jacobs SC. Adverse life events and cognitive-personality characteristics in the prediction of major depression and antidepressant response. Am J Psychiatry. 2000;157(6):896–903. doi:10.1176/appi.ajp.157.6.896
    1. Harkness KL, Monroe SM. The assessment and measurement of adult life stress: Basic premises, operational principles, and design requirements. J Abnorm Psychol. 2016;125(5):727–745. doi:10.1037/abn0000178
    1. Saucier G Replicable item-cluster subcomponents in the NEO Five-Factor Inventory. J Pers Assess. 1998;70(2):263–276. doi:10.1207/s15327752jpa7002_6
    1. Kennedy S, Lam R, … SR-TJ of clinical, 2019 undefined. Symptomatic and functional outcomes and early prediction of response to escitalopram monotherapy and sequential adjunctive aripiprazole therapy in patients with. . . Accessed February 25, 2021.
    1. Lam RW, Milev R, Rotzinger S, et al. Discovering biomarkers for antidepressant response: protocol from the Canadian biomarker integration network in depression (CAN-BIND) and clinical characteristics of the first patient cohort. BMC Psychiatry. 2016;16(1):105. doi:10.1186/s12888-016-0785-x
    1. Montgomery SA, Asberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry. 1979;134(4):382–389. doi:10.1192/bjp.134.4.382
    1. Sheehan D V, Lecrubier Y, Sheehan KH, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59(Suppl 20):22–33.
    1. Bifulco A, Brown G, Edwards A, et al. Ife Events and Difficulties Schedule (LEDS-2) Vol. 1: Life Events Manual. London, England: Royal Holloway and Bedford New College, University of London; 1989.
    1. Muthén LK, Muthén BO. Mplus User’s Guide. Eighth Edition. Los Angeles, CA: Muthén & Muthén
    1. Hallquist MN, Wiley JF. MplusAutomation : An R Package for Facilitating Large-Scale Latent Variable Analyses in Mplus. Struct Equ Model A Multidiscip J. 2018;25(4):621–638. doi:10.1080/10705511.2017.1402334
    1. Muthen BO, Satorra A. Complex Sample Data in Structural Equation Modeling. Sociol Methodol. 1995;25:267. doi:10.2307/271070
    1. Allen TA, Schreiber AM, Hall NT, Hallquist MN. From description to explanation: Integrating across multiple levels of analysis to inform neuroscientific accounts of dimensional personality pathology. J Pers Disord. 2020;34(5). doi:10.1521/pedi.2020.34.5.650
    1. Allen TA, DeYoung CG. Personality Neuroscience and the Five Factor Model. Vol 1.; 2016. doi:10.1093/oxfordhb/9780199352487.013.26
    1. Allen TA, Lam RW, Milev R, et al. Early change in reward and punishment sensitivity as a predictor of response to antidepressant treatment for major depressive disorder: A CAN-BIND-1 report. Psychol Med. 2018. doi:10.1017/S0033291718002441
    1. Serretti A, Kato M, De Ronchi D, Kinoshita T. Meta-analysis of serotonin transporter gene promoter polymorphism (5-HTTLPR) association with selective serotonin reuptake inhibitor efficacy in depressed patients. Mol Psychiatry. 2007;12(3):247–257. doi:10.1038/sj.mp.4001926
    1. Edes AE, McKie S, Szabo E, et al. Spatiotemporal brain activation pattern following acute citalopram challenge is dose dependent and associated with neuroticism: A human phMRI study. Neuropharmacology. 2020;170:107807. doi:10.1016/j.neuropharm.2019.107807
    1. Wright AGC, Creswell KG, Flory JD, Muldoon MF, Manuck SB. Neurobiological functioning and the personality-trait hierarchy: Central serotonergic responsivity and the stability metatrait. Psychol Sci. 2019;30(10):1413–1423. doi:10.1177/0956797619864530
    1. McGuffin P, Alsabban S, Uher R. The truth about genetic variation in the serotonin transporter gene and response to stress and medication. Br J Psychiatry. 2011;198(6):424–427. doi:10.1192/bjp.bp.110.085225
    1. Hampson SE, Andrews JA, Barckley M, Lichtenstein E, Lee ME. Personality traits, perceived risk, and risk-reduction behaviors: A further study of smoking and radon. Heal Psychol. 2006;25(4):530–536. doi:10.1037/0278-6133.25.4.530
    1. Korotkov D Does personality moderate the relationship between stress and health behavior? Expanding the nomological network of the five-factor model. J Res Pers. 2008;42(6):1418–1426. doi:10.1016/J.JRP.2008.06.003
    1. DeYoung CG. Higher-order factors of the big five in a multi-informant sample. J Pers Soc Psychol. 2006;91(6):1138–1151. doi:10.1037/0022-3514.91.6.1138
    1. Stockdale SE, Lagomasino IT, Siddique J, McGuire T, Miranda J. Racial and ethnic disparities in detection and treatment of depression and anxiety among psychiatric and primary care visits, 1995–2005. 2008;46(7):668–677. doi:10.1097/MLR.0b013e3181789496
    1. Hatch SL, Dohrenwend BP. Distribution of traumatic and other stressful life events by race/ethnicity, gender, SES and age: A review of the research. Am J Community Psychol. 2007;40(3–4):313–332. doi:10.1007/s10464-007-9134-z
    1. Slavich GM, Shields GS. Assessing lifetime stress exposure using the stress and adversity inventory for adults (Adult STRAIN): An overview and initial validation. In: Psychosomatic Medicine. Vol 80. 2018:17–27. doi:10.1097/PSY.0000000000000534

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