The relationship of personality pathology to depression and life stress in late adolescent women

This paper reviewed the literature regarding the association between personality pathology and depression, including the comorbidity of Axis II disorders and depressive disorders and the implications of an Axis II disorder for the presentation and course of depression. Three models to account for the relationship between personality pathology and depression were proposed. First, it was hypothesized that individuals with Axis II symptoms would behave in a manner that increases the likelihood of experiencing stressful life circumstances, which in turn would increase vulnerability to depression. Second, it was proposed that individuals with high personality pathology would be at greater risk for developing depression in the face of equivalent stress than would those with low personality disturbance. Third, it was hypothesized that a common cause variable, namely family psychopathology, could account for the relationship between Axis II symptoms and depression. These three models were tested in a three-year longitudinal study of late adolescent women. Support was found for the first model. Women with higher levels of personality pathology did indeed go on to experience greater levels of depressive symptomatology than did women with lower levels of Axis II symptoms, accounting for initial depression. They furthermore experienced greater levels of stress, including chronic stress and self-generated episodic stress. Self-generated stress was found to mediate the relationship between Axis II symptoms and subsequent depression. In other words, personality pathology led to stress-generation which, in turn, led to depression. Thus, this study confirmed previous literature indicating that a relationship exists between personality pathology and depression and extended this literature by demonstrating this effect in a community sample of adolescents and also by elucidating one causal mechanism involved in the association.