The impact of resilience and subsequent stressful life events on MDD and GAD

Abstract

Background: There remains a dearth of research examining the "buffering" effect of resilience, wherein resilience at one point in time would be expected to protect an individual against development of psychopathology following future adverse life events.

Methods: Using longitudinal data from an epidemiological twin sample (N = 7463), this study tested whether resilience would act as a buffer for stressful life events (SLEs) against risk for major depressive disorder (MDD) and generalized anxiety disorder (GAD). Resilience, demographics, and psychopathology were measured at Time 1 and recent SLEs and current MDD and GAD were measured at Time 2.

Results: Final models, controlling for demographic covariates and Time 1 diagnosis, examined the impact of Time 1 resilience, recent SLEs, their interaction, and a three-way interaction adding sex on MDD and GAD.

Conclusions: The pattern of findings was the same for MDD and GAD, wherein main effects and two-way interactions of resilience and SLEs were significant, such that greater resilience was protective even in the context of high numbers of past-year SLEs. The three-way interaction was not significant, suggesting that the relationship between SLEs and resilience on psychopathology was the same for both men and women. Findings support the conceptualization of resilience as a buffer against the impact of future life stressors on common internalizing psychopathology. Longitudinal designs and trajectory-based studies that include recurring measures of SLEs could inform conceptualizations of resilience in the context of ongoing adversity and aid in developing interventions aimed at fostering healthy adaptation in the face of stressors.

Keywords: anxiety; depression; life stress; longitudinal studies; psychological; resilience.

Figure 1

Resilience at Time 1 predicting (a) MDD and (b) GAD status at Time 2, by SLE count. This figure plots regression lines for resilience at Time 1 (x-axis; resilience measured using the continuous variable quantified as the residuals of internalizing symptoms left over after the effect of number of previous stressful life events [SLEs] has been regressed out) predicting psychopathology diagnosis (y-axis; [a] major depressive disorder [MDD]; or [b] generalized anxiety disorder [GAD]) at Time 2, across different past-year SLE counts (ranging from 0 to 6 events; stressor events have been binned in this figure for readability as 0, 1, 2–4, and 5+). Note that for clarity in interpretation, residual scores are reverse-coded, such that positive scores reflect higher resilience and negative scores represent lower resilience. The significant interaction between resilience and SLEs predicting both outcomes can be visualized in the regression lines (i.e., individuals with higher resilience were less likely to endorse MDD or GAD, regardless of SLE count).