Research report
The absence of positive psychological (eudemonic) well-being as a risk factor for depression: A ten year cohort study

https://doi.org/10.1016/j.jad.2009.06.032Get rights and content

Abstract

Background

Previous research in psychiatry has focused on how negative personality traits and impaired well-being form risk factors for depression. This study presents the first longitudinal test of whether the absence of positive well-being forms an additional unique risk factor for depression.

Methods

A large cohort of 5566 people completed a survey at two time points, aged 51–56 at Time 1 and 63–67 at Time 2. Positive psychological well-being included measures self-acceptance, autonomy, purpose in life, positive relationships with others, environmental mastery, and personal growth. Personality was measured as extraversion, neuroticism, agreeableness, conscientiousness, and openness to experience. Depression was measured with the CES-D scale.

Results

People with low positive well-being were 7.16 times more likely to be depressed 10-years later. After controlling for personality, negative functioning, prior depression, demographic, economic, and physical heath variables, people with low positive well-being were still over twice as likely to be depressed.

Limitations

All measures were self-report, rather than based on peer-report or physician diagnosis. An aging population was studied; replication is needed in younger populations.

Conclusions

The absence of positive well-being forms a substantial risk factor for depression, independent of the presence of negative functioning and impaired physical health. Older people with low PWB are very likely to become depressed over 10 years, and preventative intervention and monitoring of these individuals are indicated.

Section snippets

Method

We used data from the Wisconsin Longitudinal Survey, a cohort survey which began in 1957 with a random sample of men and women graduating from Wisconsin high schools (Wisonsin Longitudinal Study, 2006). In 1992–1993 surviving participants were recontacted, and 6875 people completed an extensive mail questionnaire (Time 1). Ten years later, attempts were made to recontact participants. It was not possible to contact 469 participants (6.8%) primarily due to mortality (N = 406; 86.56%).

Results

Overall, 12.98% of the sample was depressed at T2. The first logistic regression predicted T2 depression from T1 overall PWB. Of people in the normal PWB tertile, 85 were depressed at T2, compared to 177 in the impaired tertile, and 466 in the low tertile. People with low PWB were 7.16 (95% CI 5.63–9.12) times more likely to be depressed (p < .001). Consistently, people with slightly impaired PWB were 2.30 (95% CI 1.75–2.99) times more likely to be depressed (p < .001). This analysis suggests that

Discussion

The results suggest that people with low levels of positive well-being are at a substantially higher risk from being depressed 10 years later. Previous work in psychiatry has focused almost exclusively on how the presence of negative well-being forms a risk factor for depression (Barnett and Gotlib, 1988, Duckworth et al., 2005). Whilst replicating these results, the current study shows that the absence of positive well-being also strongly predicts depression, even after controlling for the

Role of funding source

Nothing declared.

Conflict of interest

The authors do not have any conflicts of interest.

Acknowledgements

This research uses data from the Wisconsin Longitudinal Study (WLS) of the University of Wisconsin-Madison. A public use file of data from the Wisconsin Longitudinal Study is available from the Wisconsin Longitudinal Study, University of Wisconsin-Madison, 1180 Observatory Drive, Madison, Wisconsin 53706 and at http://www.ssc.wisc.edu/wlsresearch/data/. The opinions expressed herein are those of the authors. We would like to thank all of the investigators, and Chris Boyce (Univ. Warwick) for

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