Chunk #54 — PERSONALITY TRAIT DIMENSIONS — The Five-Factor Model — Evidence bearing on causal models — Personality and the subsequent course of depression
Finally, there is evidence that both N/NE and E/PE have pathoplastic influences on the course of depression after the onset of the disorder. For example, many studies have reported that higher N/NE and lower E/PE predict a poorer course and response to treatment, although the findings regarding E/PE are slightly less consistent (de Fruyt et al. 2006, Duggan et al. 1990, Morris et al. 2009, Quilty et al. 2008a, Tang et al. 2009). As noted above, however, these findings are also consistent with diagnostic heterogeneity, such that personality dysfunction is a marker for a more severe or etiologically distinct group. Indeed, there is evidence that the nonmelancholic subtype is characterized by more vulnerable personality styles than is melancholia and that chronic depressions are associated with higher N/NE and lower E/PE than is nonchronic MDD (Klein 2008, Kotov et al. 2010).
