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Arch Gen Psychiatry -- Life Event Dimensions of Loss, Humiliation, Entrapment, and Danger in the Prediction of Onsets of Major Depression and Generalized Anxiety, A…

1/27/07 10:12 AM

death events and nearly all respondent-initiated separations were rated as having no humiliation. Furthermore, other's delinquency and other-initiated separation were rarely seen with lesser loss. The highest risk of onset (21.6%) occurred when an event was rated as other-initiated separation and other

key loss. By contrast, if other-initiated separation was linked with lesser loss, the event carried a much lower risk for onset (2.6%).

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Table 4. Raw Risk for a Depressive Onset in the Month of Event Occurrence as a Combination of the Categories of Humiliation and Loss*

Four other combinations carried risks for depressive onsets of approximately 10%. Two of these were pure loss events with zero ratings for humiliation: death and respondent-initiated separation. The other 2 each had other key loss ratings accompanied by humiliation categories of either other's delinquency or put down.

IMPACT OF EVENT DIMENSIONS AND CATEGORIES IN MEN VS WOMEN

In the month of event occurrence, we examined the interaction between sex and event ratings in the

prediction of episode onsets. None of these 12 tests (4 event dimensions times 3 syndromes) were significant.

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SLEs AND RISK FOR PURE MD, MIXED MD-GAS, AND PURE GAS Top Introduction Methods Results Comment Author information References SLE Dimensions Among high-threat events that were strongly associated with pure depressive onsets (HR, 10.1), we determined whether dimensions of these SLEs particularly reflected risk for MD. We found that both loss and humiliation assess core aspects of depressogenic SLEs. By contrast, levels of entrapment and danger were unassociated with risk of pure

MD. When examined together, levels of both loss and humiliation substantially predicted onset of MD,

with the impact of loss being more potent. In accord with several previous studies

5, 7, 43

of the SLE-MD

relationship, the impact of these events on risk of depression was short-lived, as no significant associations were seen outside the month of event occurrence.

High-threat events, as a class, were also strongly associated with the onset of mixed depression/anxiety syndromes (HR, 6.6). In the month of event occurrence, the risk for such mixed syndromes was also further predicted by high levels of loss and humiliation but not entrapment or danger. However, 1 month

after a high-threat event, mixed depression/anxiety episodes were significantly predicted by high levels of entrapment and danger.

The onset of pure GAS episodes was also significantly predicted by high-threat events, although the magnitude of the association (HR, 4.5) was less than that seen with the depressive syndromes. In the month of occurrence of high-threat events, pure GAS episodes were modestly and significantly predicted by loss. Of note, the strength of the association with loss was strongest for pure MD episodes (HR, 1.70), weakest for pure GAS episodes (HR, 1.35), and intermediate for mixed depression/anxiety episodes (HR, 1.51). High ratings of danger also significantly increased risk for a pure anxiety episode in the month of

http://archpsyc.ama-assn.org/cgi/content/full/60/8/789?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Humiliation&searchid=1098816550

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