Earlier stress exposure and subsequent major depression in aging women.
OBJECTIVE
Despite evidence that stress exposure earlier in the life course may have long-term consequences for psychopathology, most models of vulnerability for late life depression are limited to current stressors or to retrospective reports of stress history. This study estimates the influences of earlier stressors assessed longitudinally on subsequent major depressive disorder (MDD) in women at average age 60 (range 50-75).


METHODS
MDD, negative life events (NLE), and marital stress were assessed multiple times in a community-based sample of 565 women followed for three decades. Adverse events experienced in childhood also were assessed prior to outcome.


RESULTS
Greater childhood adversity, earlier high levels of NLE and marital stress, and a more rapid increase in marital stress over time elevated the odds of MDD at average age 60 independent of all stressors and other salient risk factors. Childhood adversity was mediated in part by intervening risks. Prior depression, earlier poor health status, a more rapid deterioration in health with age, and current disability owing to physical problems also were related independently to later MDD.


CONCLUSIONS
These findings support the enduring effects of earlier stress burden on MDD in women into old age and, in light of the increasing proportion of older women in the population, have important clinical implications for identification and treatment of those at risk for depression. Findings also underscore the need to develop resources to counteract or buffer similar stress exposure in younger generations of women.
Kasen
Stephanie
S
Columbia University and New York State Psychiatric Institute, NY, USA. sk57@columbia.edu
Chen
Henian
H
Sneed
Joel R
JR
Cohen
Patricia
P
D000368:Aged; D000375:Aging / Q000523:psychology*; D003865:Major Depressive Disorder / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008393:Marriage / Q000523:psychology; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D013315:Stress, Psychological