Childhood maltreatment and major depressive disorder in well-being: a network analysis of a longitudinal community-based cohort

Abstract

Background: Little has been done to comprehensively study the relationships between multiple well-being constructs at a time. Even less is known about whether child maltreatment and major depressive disorder (MDD) impact different well-being constructs. This study aims to examine whether maltreated or depressed individuals have specific impacts on well-being structures.

Methods: Data analyzed were from the Montreal South-West Longitudinal Catchment Area Study (N = 1380). The potential confounding of age and sex was controlled by propensity score matching. We used network analysis to assess the impact of maltreatment and MDD on well-being. The centrality of nodes was estimated with the 'strength' index and a case-dropping bootstrap procedure was used to test network stability. Differences in the structure and connectivity of networks between different studied groups were also examined.

Results: Autonomy and daily life and social relations were the most central nodes for the MDD and maltreated groups [MDD group: strength coefficient (SC) _autonomy = 1.50; SC_{daily life and social relations} = 1.34; maltreated group: SC_autonomy = 1.69; SC_{daily life and social relations} = 1.55]. Both maltreatment and MDD groups had statistical differences in terms of the global strength of interconnectivity in their networks. Network invariance differed between with and without MDD groups indicating different structures of their networks. The non-maltreatment and MDD group had the highest level of overall connectivity.

Conclusions: We discovered distinct connectivity patterns of well-being outcomes in maltreatment and MDD groups. The identified core constructs could serve as potential targets to maximize the effectiveness of clinical management of MDD and also advance prevention to minimize the sequelae of maltreatment.

Keywords: Childhood maltreatment; Life satisfaction; Major depressive disorder; Network analysis; Psychological well-being; Quality of life.

Fig. 1.

The network structures of well-being among individuals with and without exposure to childhood maltreatment. Notes: PWB, psychological well-being; QOL, quality of life; LS, life satisfaction; prn, liked personality; rsp, responsibilities management; rlt, warm and trusting relationships; chl, challenge for becoming better; exp, express opinions; men, life meaning; mlv, housing-neighborhood; viq, daily life and social relations; rln, personal relationships; atn, autonomy; lsr, spare time activities; lif, satisfaction with life; stn, satisfaction with living standard; hlt, satisfaction with health; ach, satisfaction with achievement; prs, satisfaction with personal relationship; saf, satisfaction with safety; cmm, satisfaction with community; scr, satisfaction with security; spr, satisfaction with spirituality.

Fig 2.

The network structures of well-being among individuals with and without MDD. Notes: MDD, major depressive disorder; PWB, psychological wellbeing; QOL, quality of life; LS, life satisfaction; prn, liked personality; rsp, responsibilities management; rlt, warm and trusting relationships; chl, challenge for becoming better; exp, express opinions; men, life meaning; mlv, housing-neighborhood; viq, daily life and social relations; rln, personal relationships; atn, autonomy; lsr, spare time activities; lif, satisfaction with life; stn, satisfaction with living standard; hlt, satisfaction with health; ach, satisfaction with achievement; prs, satisfaction with personal relationship; saf, satisfaction with safety; cmm, satisfaction with community; scr, satisfaction with security; spr, satisfaction with spirituality.

Fig. 3.

The network structures of well-being among individuals in the maltreatment only group, non-maltreatment/MDD group, and both maltreatment and MDD group Notes: MDD, major depressive disorder; PWB, psychological wellbeing; QOL, quality of life; LS, life satisfaction; prn, liked personality; rsp, responsibilities management; rlt, warm and trusting relationships; chl, challenge for becoming better; exp, express opinions; men, life meaning; mlv, housing-neighborhood; viq, daily life and social relations; rln, personal relationships; atn, autonomy; lsr, spare time activities; lif, satisfaction with life; stn, satisfaction with living standard; hlt, satisfaction with health; ach, satisfaction with achievement; prs, satisfaction with personal relationship; saf, satisfaction with safety; cmm, satisfaction with community; scr, satisfaction with security; spr, satisfaction with spirituality.