Journal of Affective Disorders 84 (2005) 25 – 31

www.elsevier.com/locate/jad

Research report

Personality–life event congruence effects in late-life depression

Jennifer Q. Morsea,*, Clive J. Robinsa,b
a
Department of Psychology, Social and Health Sciences, Duke University, United States
b
Department of Psychiatry and Behavioral Sciences, Duke University, United States
Received 10 February 2004; accepted 14 September 2004

Abstract

Background: This study examined whether specific interactions of personality and life events predicted increases in depressive
symptoms over time in a late-life sample.
Method: Participants (n=55) who were in remission from a recent episode of major depression completed a depression symptom
interview and a questionnaire assessing the personality constructs sociotropy and autonomy. Six months later, they completed
the same personality questionnaire and a checklist of life events experienced during the past 6 months.
Results: As predicted, increases in depressive symptoms were significantly predicted by the congruent interaction of sociotropy
with negative interpersonal events and by the congruent interaction of autonomy with negative autonomy events, but not by
either of the non-congruent interactions.
Limitations: A small sample prevented examinations of important depressive subtypes based on age of depression onset and
vascular status.
Conclusions: These findings strongly support the personality–life event congruence model of depression in a late-life sample.
Clinical implications include attending to stressful events that match an older adult’s personality style, to help the older adult
cope with those events that are more likely to increase his or her depression.
D 2004 Elsevier B.V. All rights reserved.

Keywords: Late-life depression; Personality; Life events

Cognitive and psychoanalytic theories have con-
verged on a similar theoretical framework describing
personality characteristics that create vulnerability to
depression following negative life events that are
* Corresponding author. Now at Personality Studies, Western
Psychiatric Institute and Clinic, 3811 O’Hara Street, Pittsburgh, PA
15213, United States. Tel.: +1 412 246 5838; fax: +1 412 246 5840.
E-mail address: MORSEJQ@upmc.edu (J.Q. Morse).
0165-0327/$ - see front matter D 2004 Elsevier B.V. All rights reserved.
doi:10.1016/j.jad.2004.09.007
congruent with those characteristics. Empirical studies
of adult samples have supported this congruence
hypothesis. While research on late-life depression has
addressed its association with life events and person-
ality, only one study has examined the role of
interactions between personality characteristics and
life events. Depression in late-life can have unique
features, such as involvement of vascular disease, so
the results with adult samples cannot necessarily be
26 J.Q. Morse, C.J. Robins / Journal of Affective Disorders 84 (2005) 25–31
generalized to late-life depression. This paper reports
the results of an empirical test of the personality–life
event congruence effect in a late-life sample.
Theorists have suggested that normal personality
development requires both interpersonal connection
and self-definition (Arieti and Bemporad, 1980; Beck,
1983; Blatt, 1974; Bowlby, 1977) and that over-
emphasis on either theme creates vulnerability to
depression, particularly following matching stressful
life events. Highly sociotropic (Beck, 1983) or depend-
ent (Blatt, 1974) people value close relationships,
which may leave them vulnerable to depression after
negative interpersonal events. Autonomous (Beck,
1983) or self-critical (Blatt, 1974) people value
independence, mastery and control, which may leave
them vulnerable to depression after perceived loss of
control or failure. The interaction between sociotropy
or autonomy and matching events predicts depressive
relapse in adults (Hammen et al., 1989; Segal et al.,
1992). Research on late-life depression has focused on
main effects of life events or personality factors.
There is a positive relation between depressive
symptoms in older adults and negative life events
(Kraaij et al., 1998). Clinically depressed patients
reported both more frequent and more severe life
events than did control groups (Emmerson et al., 1989).
In terms of personality, neuroticism has received the
most attention in late life. Neuroticism is related to
greater depressive symptoms (Abrams et al., 1991) and
predicts increased risk of developing late-life depres-
sion (Oldehinkel et al., 2001). Sociotropy and
autonomy both correlate significantly with depressive
symptoms in older adults (Allen et al., 1997). Thus,
there is evidence linking both life events and person-
ality to late-life depression, but the magnitude of these
effects was modest and it is possible that interactions
between personality and life events account for addi-
tional variance in depression in older adults.
In the lone study investigating the interaction
between personality and life events in late-life depres-
sion, Mazure et al. (2002) compared 42 late-onset
depressed outpatients with 42 non-depressed elderly
matched controls. Depressed group membership was
associated both with the interaction between sociotropy
and negative events and with the interaction between
autonomy and negative events, which was interpreted
as support for the congruence hypothesis. However, the
event measure was nonspecific, rather than differ-
entiated into interpersonal and autonomy events, so it
does not test the congruence hypothesis. And the
study’s cross-sectional case-control design makes it
impossible to infer causal directionality. The current
study, in contrast, is prospective, testing the ability of
the congruence hypothesis to predict the return of
symptoms in a sample of patients who were in
remission from a major depressive episode.
In this study, we assessed sociotropy, autonomy,
and depressive symptoms in a group of older adult
patients who were in remission from a recent episode
of major depressive disorder and reassessed depres-
sive symptoms and recent life events 6 months later.
Our primary hypothesis was that congruent interac-
tions between the two personality variables and types
of events would be associated with increases in
depressive symptoms over the 6-month period.
1. Method
1.1. Participants
Participants were recruited from a longitudinal study
at the NIMH Clinical Research Center (CRC) for the
Study of Depression in Late Life at Duke University.
For inclusion in the CRC study, subjects met criteria for
major depressive episode using the Duke Depression
Evaluation Schedule for the Elderly (George et al.,
1989) and had a Mini-Mental Status Exam (Folstein et
al., 1975) score z25. For inclusion in the current study,
participants had to be in remission, defined as Mont-
gomery 2sberg Depression Rating Scale (Montgomery
and Åsberg, 1979) score V10. Patients with recent
MMSE b25, a diagnosis of Alzheimer’s disease, or
receiving electroconvulsive therapy were excluded.
Seventy-two patients who met these criteria completed
the initial assessment; 15 (21%) did not complete the
second assessment and 2 (3%) had invalid data, based
on visual inspection of the questionnaires following
regression diagnostics. The demographics of the final
sample are described in Table 1.1
1
Participants who completed the second survey (n=55) did not
differ from those who did not (n=15) except for having lower
MMSE error scores than non-completers (completers: M=1.06,
S.D.=1.33, non-completers: M=1.88, S.D.=1.80, t(67)= 2.02,
p=0.05) at CRC entry.
 J.Q. Morse, C.J. Robins / Journal of Affective Disorders 84 (2005) 25–31 27

Table 1
Sample demographics and comparing depressive subgroups
Overall Late onset Early v 2 (df) Non-vascular Vascular v 2 (df)
(n=55) (n=23) onset (n=32) (n=16)a (n=33)
%Women 64 69 57 0.87 (1) 63 64 0.01 (1)
%Married 64 66 61 0.13 (1) 69 58 0.57 (1)
%Minority 7 3 13 1.95 (1) 13 6 0.60 (1)

Mean (S.D.) Mean (S.D.) Mean (S.D.) t (df) Mean (S.D.) Mean (S.D.) t (df)
Age 68.09 (6.82) 67.96 (7.05) 68.19 (6.76) 0.12 (53) 66.50 (5.66) 68.39 (7.43) 0.99 (38.11)
Years of education 14.37 (2.27) 14.23 (2.29) 14.47 (2.29) 0.38 (52) 14.38 (1.86) 14.52 (2.36) 0.21 (47)
Age of onset 46.70 (18.76) 65.77 (7.87) 33.59 (11.15) 11.67 (52)**** 44.81 (19.24) 47.85 (19.74) 0.51 (47)
# previous episodes 4.27 (5.04) 2.00 (1.55) 5.96 (6.03) 4.11b **** 5.13 (7.81) 3.93 (3.50) 0.82b
MMSE errors 1.06 (1.33) 1.18 (1.40) 0.97 (1.30) 0.57 (50) 1.13 (1.64) 1.09 (1.28) 0.09 (45)
Deep white matter 1.53 (1.01) 1.71 (1.19) 1.39 (1.03) 1.01 (47) 0.63 (0.50) 1.97 (1.05) 6.09 (47)****
hyperintensities
Subcortical 1.31 (1.08) 1.62 (1.12) 1.07 (1.02) 1.79 (47) 0.19 (0.40) 1.85 (0.87) 9.13 (46.97)****
hyperintensities
Time 1 MADRS 2.60 (3.20) 2.70 (3.65) 2.53 (2.90) 0.19 (53) 2.25 (2.70) 2.88 (3.34) 0.66 (47)
Time 2 MADRS 5.07 (5.30) 4.26 (5.24) 5.66 (5.35) 0.96 (53) 3.81 (4.25) 5.42 (5.61) 1.01 (47)
Time 1 sociotropy 86.00 (14.09) 85.78 (15.21) 86.15 (13.48) 0.10 (53) 84.67 (14.65) 87.25 (14.42) 0.58 (47)
Time 1 autonomy 77.63 (13.71) 78.19 (13.88) 77.23 (13.79) 0.26 (53) 79.69 (10.29) 77.60 (14.99) 0.50 (47)
Time 2 sociotropy 86.63 (15.98) 84.96 (14.66) 87.84 (16.99) 0.66 (53) 85.22 (18.35) 87.04 (16.18) 0.35 (47)
Time 2 autonomy 78.95 (13.89) 80.13 (12.67) 78.07 (14.87) 0.54 (52) 79.19 (8.56) 79.43 (16.57) 0.05 (46)
Negative interpersonal 1.93 (2.01) 1.96 (2.34) 1.91 (1.77) 0.09 (53) 2.13 (2.03) 2.00 (2.11) 0.20 (47)
events
Negative autonomy 1.78 (1.54) 1.52 (1.47) 1.97 (1.58) 1.07 (53) 1.69 (1.62) 1.97 (1.49) 0.60 (47)
events
a
MRI data were missing for six participants.
b
Mann–Whitney U reported.
**** pb0.0001.

1.2. Procedure ples—sociotropy: a=0.83, autonomy: a=0.79 (Lynch

At each appointment, a psychiatrist assessed
depressive symptoms by interview. Subjects who
were in remission were mailed the Personal Style
Inventory (PSI, Robins et al., 1994) and received $3
for completing it. After a psychiatrist appointment 6
months later, participants completed the PSI and the
Modified Schedule of Life Events (Bieliauskas et al.,
1995) and received $15. Demographic and clinical
information came from baseline CRC assessments.
1.3. Measures
1.3.1. Personal style inventory (Robins et al., 1994)
This 48-item self-report measure assesses the key
concerns of sociotropy and autonomy. Both scales
have good internal consistency in depressed sam-
et al., 2001), but the psychometric properties of the
PSI among older adults are not known.
1.3.2. Schedule of life events—modified
(Bieliauskas et al., 1995)
This inventory of 48 negative and 6 positive life
events was constructed for use with older adults. It has
been modified for the present study. Details regarding
the modification are available from the first author. The
modified measure includes 48 items: 40 stressors, 3
opportunities to identify negative events that were not
asked about, and 5 positive events intended to provide a
slight bupliftQ at the end of the study. Respondents
indicated whether they experienced each event during
the past 6 months.
Three judges rated whether each event was relevant
to sociotropy concerns, autonomy concerns, or nei-
28 J.Q. Morse, C.J. Robins / Journal of Affective Disorders 84 (2005) 25–31
ther. Cohen’s kappa, extended to three judges (Fleiss,
1971), was 0.89. When there was not uniform
agreement, the two agreeing judges categorized the
event. Twenty-one stressors and one positive event
were related to sociotropy, eighteen stressors and two
positive events to autonomy, and one stressor and two
positive events to neither. The 53 responses to open-
ended items were similarly coded. Cohen’s kappa was
0.83. There were no open-ended responses or standard
items where all three judges disagreed. Across all
items Cohen’s kappa was 0.87.
1.3.3. Montgomery Å sberg Depression Rating Scale
(Montgomery and Å sberg, 1979)
This 10-item clinician rating scale assesses depres-
sive symptoms and is sensitive to change. Items are
rated from 0 (none) to 6 (severe). It has good interrater
reliability (ICC=0.89 to 0.97) (Montgomery and
Åsberg, 1979) and good internal consistency
(a=0.86) (Maier and Phillipp, 1985).
2. Results
2.1. Reliability of the personal style inventory
The test–retest correlations for both sociotropy and
autonomy were high (r=0.83 and r=0.80, both
pV0.0001). Cronbach’s alpha was 0.85 at time 1 and
Fig. 1. Changes in depression level as a function of the interaction of sociotropy and negative interpersonal events.
0.90 at time 2 for sociotropy, and 0.85 at both times
for autonomy. Correlations between MADRS changes
and PSI changes examined the effects of depression
on PSI reporting. These correlations were quite low
and not significant.
2.2. Comparison of depression subtypes
Vascular depression was considered present if
either deep white matter hyperintensities or subcort-
ical grey matter hyperintensities were measured at 2 or
greater on the Coffey scale (Krishnan et al., 1998).
The vascular depression group (n=33) did not differ
from the non-vascular group (n=16) (see Table 1).
Depression was considered early onset if the first
episode of depression occurred at or before the age of
50. The late-onset group (n=23) did not differ from
the early-onset group (n=32) (see Table 1).
2.3. Examination of clinical control variables
Time 2 MADRS scores were not correlated with
age, years of education, number of depressive
episodes, or age of onset of first episode. Independent
t-tests revealed no differences in Time 2 MADRS
scores as a function of gender, race, retirement status,
or marital status. Therefore, no covariates beyond
Time 1 MADRS score were entered in the regression
analyses.
 J.Q. Morse, C.J. Robins / Journal of Affective Disorders 84 (2005) 25–31
2.4. Regressions predicting change in depression
2.4.1. Sociotropy and negative interpersonal events
Initial MADRS score strongly predicted Time 2
MADRS score (b=0.40, sr2=0.16, t =3.15, pV0.001).
After controlling for initial MADRS, Time 2 MADRS
score was not related to sociotropy or negative inter-
personal events, but was related to their congruent
interaction (b=0.30, sr2=0.07, t =2.12, p=0.05). This
interaction was probed by examining the relation of
events to depression at sociotropy scores one S.D.
above the mean, one S.D. below the mean, and at the
mean. The positive relation between negative inter-
personal events and increase in MADRS scores was
only significant for high sociotropy scores (b=0.37,
t =2.24, pV0.05), not low or average scores (see Fig. 1).
2.4.2. Autonomy and negative autonomy events
Time 2 MADRS score was not related to autonomy
or negative autonomy events, but was related to their
congruent interaction (b=0.28, sr2=0.06, t =2.21,
pV0.05). When this interaction was probed, the
positive relation between negative autonomy events
and increase in MADRS scores was significant for
high autonomy scores (b=0.58, t =3.49, pV0.001) and
average autonomy scores (b=0.30, t =2.55, pV0.05)
(see Fig. 2).
Fig. 2. Changes in depression level as a function of the interaction of autonomy and negative autonomy events.
29
2.4.3. Autonomy and negative interpersonal events
and sociotropy and negative autonomy events
The non-congruent interactions were not related to
change in MADRS score.
3. Discussion
This study sought to predict increase in depressive
symptoms from the interaction between personality
characteristics and classes of life events. Supporting
our hypothesis, older adult patients in remission who
experienced life events that matched their personality
experienced greater increases in depressive symptoms
over 6 months, suggesting that the personality–life
event congruence model has value in understanding
late-life depression.
The current findings also provide preliminary
evidence on the reliability and validity of the
Personal Style Inventory in older adults. PSI scores
were stable over 6 months, had good internal
consistency and were relatively unaffected by
changes in depressive symptoms. These findings are
similar to psychometric statistics reported in adult
clinical samples (Bagby et al., 2001) and suggest that
the PSI is a reliable measure of sociotropy and
autonomy in older adults.
30 J.Q. Morse, C.J. Robins / Journal of Affective Disorders 84 (2005) 25–31
3.1. Limitations
Research on stressful life events is hampered by
the difficulty of classifying events into meaningful
categories (Kwon and Whisman, 1998). Although the
judges demonstrated high interrater reliability, their
ratings were independent of the context in which the
individual experienced that event. For example,
retiring from work, categorized as related to
autonomy, may be viewed by the individual as
impacting relationships with colleagues, thus related
to sociotropy. However, participant ratings of an
event’s impact confound person and environment
variables, which is problematic when testing for
person–environment interaction effects. Gender is
also a factor to consider as the meaning of retirement
is based more on affinitive loss for women than for
men. Unfortunately, the sample size precluded exam-
ining gender differences. There is no solution other
than to recognize that these findings are based on
independent raters’ judgments of life events that are
separate from the meanings they may have for the
participants.
There are several subtypes of late-life depression—
early onset versus late onset and vascular versus non-
vascular. The personality–life event congruence effect
may apply differently in these groups. Despite having
information about age of onset and vascular status, the
power in the current sample was not sufficient to test
three-way interactions made up by personality style,
life event, and depression subtype. Future research
should investigate the usefulness of the interaction
between personality and life events in predicting
depression in these groups.
3.2. Clinical implications
The personality–life event congruence hypothesis
brings a theoretical framework to understanding late-
life depression. In addition, in adult samples,
autonomy scores have predicted positive response to
antidepressants (Peselow et al., 1992; Scott et al.,
1996). Older adults often have increased risk of drug
interactions because of comorbid medical illnesses; it
may be helpful to predict response to antidepressants
by assessing personality. In terms of psychotherapy,
once assessed, it may be possible to help the patient to
decrease sociotropy or autonomy concerns through
cognitive therapy or other approaches. It may also be
useful to increase a patient’s awareness of the types of
events to which he or she is most vulnerable, as a step
toward decreasing their frequency or developing
coping skills for reducing their negative impact.
Acknowledgement
This paper is based on a doctoral dissertation
submitted to Duke University by Jennifer Morse,
supervised by Clive Robins. Jennifer Morse thanks
the other members of her dissertation committee, John
F. Curry, Thomas R. Lynch, and David C. Steffens for
their support of this project. The research was
supported by a GlaxoWellcome Long Term Care
Career Development Award to Jennifer Morse through
the Leadership in Aging Program at Duke University.
The larger study was supported by NIMH grants P50
MH60451, P30 MH40159, and R01 MH 54846.
Manuscript preparation was supported in part by
NIMH grant T32 MH 18269, Clinical Research
Training for Psychologists (PI: Paul A. Pilkonis).
We thank David Steffens for offering the resources of
the Mental Health Clinical Research Center for the
Study of Depression in Late Life at Duke University
Medical Center and Carrie Dombeck, Ronna Holliday,
Bobby Levy, Stephanie Levy, and Elena Lopez for
their help in collecting data.
References
Abrams, R.C., Young, R.C., Alexopoulos, G.S., Holt, J.H., 1991.
Neuroticism may be associated with history of depression in the
elderly. Int. J. Geriatr. Psychiatry 6, 483 – 488.
Allen, N.B., Ames, D., Layton, T., Bennetts, K., Kingston, K.,
1997. The relationship between sociotropy/autonomy and
patterns of symptomology in the depressed elderly. J. Clin.
Psychol. 36, 121 – 132.
Arieti, S., Bemporad, J.R., 1980. The psychological organization of
depression. Am. J. Psychiatry 137, 1360 – 1365.
Bagby, R.M., Gilchrist, E.J., Rector, N.A., Dickens, S.E., Joffe,
R.T., Levitt, A., Levitan, R.D., Kennedy, S.H., 2001. The
stability and validity of the sociotropy and autonomy personality
dimensions as measured by the Revised Personal Style
Inventory. Cogn. Ther. Res. 25, 765 – 779.
Beck, A.T., 1983. Cognitive therapy of depression: new perspec-
tives. In: Clayton, P.J., Barrett, J.E. (Eds.), Treatment of
Depression: Old Controversies and New Approaches. Raven
Press, New York, pp. 265 – 290.
 J.Q. Morse, C.J. Robins / Journal of Affective Disorders 84 (2005) 25–31
Bieliauskas, L.A., Conte, M.A., Glandon, G.L., 1995. Inventorying
stressing life events as related to health change in the elderly.
Stress Med., 11.
Blatt, S.J., 1974. Levels of object representation in anaclitic and
introjective depression. Psychoanal. Study Child 29, 7 – 157.
Bowlby, J., 1977. The making and breaking of affectional bonds: I.
Aetiology and psychopathology in the light of attachment
theory. Br. J. Psychiatry 130, 201 – 210.
Emmerson, J.P., Burvill, P.W., Finlay-Jones, R., Hall, W.D., 1989.
Life events, life difficulties and confiding relationships in the
depressed elderly. Br. J. Psychiatry 155, 787 – 792.
Fleiss, J.L., 1971. Measuring nominal scale agreement among many
raters. Psychol. Bull. 76, 378 – 382.
Folstein, M.F., Folstein, S.W., McHugh, P.R., 1975. bMini-mental
stateQ: a practical method for grading the cognitive state of
patients for the clinician. J. Psychiatr. Res. 12, 189 – 198.
George, L.K., Blazer, D.G., Hughes, D.C., Fowler, N., 1989. Social
support and the outcome of major depression. Br. J. Psychiatry
154, 478 – 485.
Hammen, C., Ellicott, A., Gitlin, L., Jamison, K.R., 1989. Socio-
tropy/autonomy and vulnerability to specific life events in
patients with unipolar depression and bipolar disorders. J.
Abnorm. Psychol. 98, 145 – 160.
Kraaij, V., Kremmers, E., Arensman, E., Kerhof, A.J.F.M., 1998.
Life events over the life cycle and depression in late life. In:
Kosky, R.J., Eshkevari, H.S., Goldney, R.D., Hassan, R. (Eds.),
Suicide Prevention: The Global Context. Plenum Press, New
York, pp. 163 – 166.
Krishnan, K.R.R., Hays, J.C., George, L.K., Blazer, D.G., 1998.
Six-month outcomes for MRI-related vascular depression.
Depress. Anxiety 8, 142 – 146.
Kwon, P., Whisman, M.A., 1998. Sociotropy and autonomy as
vulnerabilities to specific life events: issues in life event
categorization. Cogn. Ther. Res. 22, 353 – 362.
31
Lynch, T.R., Robins, C.J., Morse, J.Q., 2001. Couple functioning in
depression: the roles of sociotropy and autonomy. J. Clin.
Psychol. 57, 93 – 103.
Maier, W., Phillipp, M., 1985. Comparative analysis of observer
depression scales. Acta Psychiatr. Scand. 72, 239 – 254.
Mazure, C.M., Maciejewski, P.K., Jacobs, S.C., Bruce, M.L., 2002.
Stressful life events interacting with cognitive/personality styles
to predict late-onset major depression. Am. J. Geriatr. Psychiatry
10, 297 – 304.
Montgomery, S.A., 2sberg, M., 1979. A new depression scale
designed to be sensitive to change. Br. J. Psychiatry 134,
382 – 389.
Oldehinkel, A.J., Bouhuys, A.L., Brilman, E.I., Ormel, J., 2001.
Functional disability and neuroticism as predictors of late-life
depression. Am. J. Geriatr. Psychiatry 9, 241 – 248.
Peselow, D.E., Robins, C.J., Sanfilipo, M.P., Block, P., Fieve, R.R.,
1992. Sociotropy and autonomy: relationship to antidepressant
drug treatment response to endogenous–nonendogenous dichot-
omy. J. Abnorm. Psychol. 101, 479 – 486.
Robins, C.J., Ladd, J., Welkowitz, J., Blaney, P.H., Diaz, R.,
Kutchner, G., 1994. The personal style inventory: preliminary
validation studies of new measures of sociotropy and autonomy.
J. Psychopathol. Behav. Assess. 16, 277 – 300.
Scott, J., Harrington, J., House, R., Ferrier, I.N., 1996. A
preliminary study of the relationship among personality,
cognitive vulnerability, symptom profile, and outcome in major
depressive disorder. J. Nerv. Ment. Dis. 184, 503 – 505.
Segal, Z.V., Shaw, B.F., Vella, D.D., Katz, R., 1992. Cognitive and
life stress predictors of relapse in remitted unipolar depressed
patients: test of the congruency hypothesis. J. Abnorm. Psychol.
101, 26 – 36.