Influence of trait anxiety, child maltreatment, and adulthood life events on depressive symptoms

Abstract

Background

Various personality traits mediate the association between childhood stress and depressive symptoms in adulthood. The aim of this study was to clarify the indirect effects of the experience of child maltreatment on depressive symptoms and appraisal of life events in adulthood through trait anxiety.

Subjects and methods

A total of 404 participants who were volunteer subjects from the community were studied using the following self-administered questionnaire surveys: Patient Health Questionnaire-9, which measures depressive symptoms; State-Trait Anxiety Inventory Form Y, which measures trait anxiety; the Child Abuse and Trauma Scale, which measures child maltreatment; and Life Experiences Survey, which measures negative and positive appraisal of adulthood life events.

Results

Structural equation modeling demonstrated that the experience of child maltreatment increased depressive symptoms in adulthood as well as the negative appraisal of life events in adulthood through an increase in trait anxiety. Furthermore, trait anxiety affected depressive symptoms in adulthood through its influence on the negative appraisal of adulthood life events. The following indirect effect was also significant: the experience of child maltreatment increased the negative appraisal of adulthood life events via trait anxiety and subsequently influenced adult depressive symptoms.

Limitations

The subjects of this study are volunteer subjects from the community including healthy people, and hence the results may not be generalizable to major depressive patients. Recall bias should be considered when interpreting the results. Because this study is a cross-sectional study, the causality between the experience of child maltreatment and depression is not clear.

Conclusion

This study suggests that trait anxiety may play a mediating role in the influence of the experience of child maltreatment on depressive symptoms in adulthood and negative appraisal of adulthood life events.

Keywords:

• child maltreatment
• covariance structure analysis
• depression
• STAI-Y
• trait anxiety
• life events

Acknowledgments

This work was partly supported by a Grant-in-Aid for Scientific Research (no 16K10194, to T. Inoue) from the Japanese Ministry of Education, Culture, Sports, Science and Technology, the Research and Development Grants for Comprehensive Research for Persons with Disabilities from the Japan Agency for Medical Research and Development under grant no JP18dk0307060 (to T Inoue), and SENSHIN Medical Research Foundation (to T Inoue).

Author contributions

TI designed the study and wrote the protocol. YU and TI collected and analyzed the data. All authors contributed to data analysis and drafting and critically revising the manuscript. In addition, all authors gave final approval for the present version of the manuscript to be published and agreed to be accountable for all aspects of the work.

Disclosure

JM has received personal compensation from Otsuka Pharmaceutical, Eli Lilly, Astellas, and Meiji Yasuda Mental Health Foundation and grants from Pfizer. MI has received personal compensation from Otsuka Pharmaceutical, Pfizer, Eli Lilly, Mitsubishi Tanabe Pharma, Mochida Pharmaceutical, Meiji Seika Pharma, Janssen Pharmaceutical, Takeda Pharmaceutical Company, MSD, Dainippon Sumitomo Pharma, and Eisai; grants from Otsuka Pharmaceutical, Eli Lilly, Eisai, Shionogi, Takeda Pharmaceutical, MSD, and Pfizer; and is a member of the advisory board of Meiji Seika Pharma. IK has received personal compensation from Astellas, Chugai Pharmaceutical, Daiichi Sankyo, Dainippon Sumitomo Pharma, Eisai, Eli Lilly, Janssen Pharmaceutical, Kyowa Hakko Kirin, Meiji Seika Pharma, MSD, Nippon Chemiphar, Novartis Pharma, Ono Pharmaceutical, Otsuka Pharmaceutical, Pfizer, Tanabe Mitsubishi Pharma, Shionogi, and Yoshitomiyakuhin; and has received research grants from AbbVie GK, Asahi Kasei Pharma, Astellas, Boehringer Ingelheim, Chugai Pharmaceutical, Daiichi Sankyo, Dainippon Sumitomo Pharma, Eisai, Eli Lilly, GlaxoSmithKline, Kyowa Hakko Kirin, Meiji Seika Pharma, MSD, Novartis Pharma, Ono Pharmaceutical, Otsuka Pharmaceutical, Pfizer, Takeda Pharmaceutical, Tanabe Mitsubishi Pharma, Shionogi, and Yoshitomiyakuhin; and is a member of the advisory board of Dainippon Sumitomo Pharma and Tanabe Mitsubishi Pharma. TI has received personal compensation from GlaxoSmithKline, Mochida Pharmaceutical, Asahi Kasei Pharma, and Shionogi; grants from Astellas; and grants and personal compensation from Otsuka Pharmaceutical, Dainippon Sumitomo Pharma, Eli Lilly, Eisai, Mitsubishi Tanabe Pharma, Pfizer, AbbVie GK, MSD, Yoshitomiyakuhin, Takeda Pharmaceutical, and Meiji Seika Pharma; and is a member of the advisory boards of GlaxoSmithKline, Pfizer, Eli Lilly, Mochida Pharmaceutical, and Mitsubishi Tanabe Pharma. The authors report no other conflicts of interest in this work.