Personality dimensions and depression: Review and commentary

Objectives: The relationship between dimensionally assessed personality and the onset, features, and course of depressive illness will be critically examined and considered in relation to 4 hypothesized models: predisposition or vulnerability: pathoplasty; complication or scar: and spectrum or continuity. Method: Studies that have used clinically depressed adult patients to explore the relationship between personality dimensions and depression will be reviewed. Results: Higher-order personality factors that have shown a significant and consistent association with major depressive illness include neuroticism, extraversion (negative relationship), and the factors of Cloninger's Tridimensional Personality Model. Neuroticism appears to be the most powerful predictor of depression. Lower-order factors showing a significant and consistent relationship with depressive illness include dependency, self-criticism, obsessionality, and perfectionism. The links between depression and dependency and self-criticism have the strongest empirical support. Conclusions: Several personality dimensions are significantly associated with depressive illness, but the evidence that unequivocally demonstrates a true personality predisposition for depression is modest. Measures of personality may prove to be clinically useful for treatment selection.