title: Direct and indirect influences of childhood abuse on depression symptoms in patients with major depressive disorder.
abstract: BACKGROUND
  It is known that the onset, progression, and prognosis of major depressive disorder are affected by interactions between a number of factors. This study investigated how childhood abuse, personality, and stress of life events were associated with symptoms of depression in depressed people.
  
  
  METHODS
  Patients with major depressive disorder (N = 113, 58 women and 55 men) completed the Beck Depression Inventory-II (BDI-II), the Neuroticism Extroversion Openness Five Factor Inventory (NEO-FFI), the Child Abuse and Trauma Scale (CATS), and the Life Experiences Survey (LES), which are self-report scales. Results were analyzed with correlation analysis and structural equation modeling (SEM), by using SPSS AMOS 21.0.
  
  
  RESULTS
  Childhood abuse directly predicted the severity of depression and indirectly predicted the severity of depression through the mediation of personality. Negative life change score of the LES was affected by childhood abuse, however it did not predict the severity of depression.
  
  
  CONCLUSIONS
  This study is the first to report a relationship between childhood abuse, personality, adulthood life stresses and the severity of depression in depressed patients. Childhood abuse directly and indirectly predicted the severity of depression. These results suggest the need for clinicians to be receptive to the possibility of childhood abuse in patients suffering from depression. SEM is a procedure used for hypothesis modeling and not for causal modeling. Therefore, the possibility of developing more appropriate models that include other variables cannot be excluded.
authors.affiliation: Graduate School of Biomedical Sciences Programs for Biomedical Research, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan. d095159@hiroshima-u.ac.jp.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Hayashi
authors.affiliation: Department of Psychiatry and Neurosciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan. oy@hiroshima-u.ac.jp.
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Okamoto
authors.affiliation: Department of Psychiatry and Neurosciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan. koki.takagaki@gmail.com.
authors.forename: Koki
authors.initials: K
authors.lastname: Takagaki
authors.affiliation: Department of Psychiatry and Neurosciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan. goookada@hiroshima-u.ac.jp.
authors.forename: Go
authors.initials: G
authors.lastname: Okada
authors.affiliation: Department of Psychiatry and Neurosciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan. gerutoki@hiroshima-u.ac.jp.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Toki
authors.affiliation: Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, Japan. tinoue@med.hokudai.ac.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Inoue
authors.affiliation: Department of Clinical Human Sciences, Graduate School of Humanities and Social Sciences, Shizuoka University, 836 Ohya, Suruga-ku, Shizuoka City, Shizuoka Prefecture, Japan. jhtanab@ipc.shizuoka.ac.jp.
authors.forename: Hajime
authors.initials: H
authors.lastname: Tanabe
authors.affiliation: Department of Psychiatry and Neurosciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan. koba0515@hiroshima-u.ac.jp.
authors.forename: Makoto
authors.initials: M
authors.lastname: Kobayakawa
authors.affiliation: Department of Psychiatry and Neurosciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan. yamawaki@hiroshima-u.ac.jp.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Yamawaki
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D000368:Aged; D003865:Major Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D010551:Personality; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires