Skip to main content
    • Aa
    • Aa

Accumulation of trauma over time and risk for depression in a twin sample

  • V. V. McCutcheon (a1), A. C. Heath (a1), E. C. Nelson (a1), K. K. Bucholz (a1), P. A. F. Madden (a1) and N. G. Martin (a2)...

Few genetically informative studies have examined the effects of different types of trauma on risk for depression over time. The aim of the present study was to examine the relative contributions over time of assaultive trauma, non-assaultive trauma, and familial effects to risk for depression.


Histories of depression and trauma were obtained during structured diagnostic interviews with 5266 (mean age 29.9 years, s.d.=2.4) members of a volunteer Australian twin panel from the general population. Age at first onset of a DSM-IV major depressive episode was the dependent variable. Associations of depression with traumatic events were examined while accounting for the temporal sequence of trauma and depression and familial effects.


Assaultive traumatic events that occurred during childhood had the strongest association with immediate and long-term risk for depression, and outweighed familial effects on childhood-onset depression for most twins. Although men and women endorsed equal rates of assaultive trauma, women reported a greater accumulation of assaultive events at earlier ages than men, whereas men reported a greater accumulation of non-assaultive events at all ages.


Early exposure to assaultive trauma can influence risk for depression into adulthood. Concordance for early trauma is a significant contributor to the familiality of early-onset depression.

Corresponding author
*Address for correspondence: V. V. McCutcheon, Ph.D., Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Ave., Campus Box 8134, St Louis, MO 63110, USA. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

MA Aziz , S Kenford (2004). Comparability of telephone and face-to-face interviews in assessing patients with posttraumatic stress disorder. Journal of Psychiatric Practice 10, 307313.

N Breslau , GC Davis , P Andreski , E Peterson (1991). Traumatic events and posttraumatic stress disorder in an urban population of young adults. Archives of General Psychiatry 48, 216222.

N Breslau , RC Kessler , HD Chilcoat , LR Schultz , GC Davis , P Andreski (1998). Trauma and posttraumatic stress disorder in the community: the 1996 Detroit Area Survey of Trauma. Archives of General Psychiatry 55, 626632.

N Breslau , EL Peterson , LR Schultz (2008). A second look at prior trauma and the posttraumatic stress disorder effects of subsequent trauma: a prospective epidemiological study. Archives of General Psychiatry 65, 431437.

N Breslau , HC Wilcox , CL Storr , VC Lucia , JC Anthony (2004). Trauma exposure and posttraumatic stress disorder: a study of youths in urban America. Journal of Urban Health 81, 530544.

KK Bucholz , R Cadoret , CR Cloninger , SH Dinwiddie , VM Hesselbrock , JI Nurnberger Jr., T Reich , I Schmidt , MA Schuckit (1994). A new, semi-structured psychiatric interview for use in genetic linkage studies: a report on the reliability of the SSAGA. Journal of Studies on Alcohol 55, 149158.

A Caspi , K Sugden , TE Moffitt , A Taylor , IW Craig , H Harrington , J McClay , J Mill , J Martin , A Braithwaite , R Poulton (2003). Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Science 301, 386389.

WE Copeland , G Keeler , A Angold , EJ Costello (2007). Traumatic events and posttraumatic stress in childhood. Archives of General Psychiatry 64, 577584.

MD De Bellis , MS Keshavan , H Shifflett , S Iyengar , SR Beers , J Hall , G Moritz (2002). Brain structures in pediatric maltreatment-related posttraumatic stress disorder: a sociodemographically matched study. Biological Psychiatry 52, 10661078.

MD De Bellis , M Kuchibhatla (2006). Cerebellar volumes in pediatric maltreatment-related posttraumatic stress disorder. Biological Psychiatry 60, 697703.

S Dinwiddie , AC Heath , MP Dunne , KK Bucholz , PA Madden , WS Slutske , LJ Bierut , DB Statham , NG Martin (2000). Early sexual abuse and lifetime psychopathology: a co-twin-control study. Psychological Medicine 30, 4152.

M Dong , RF Anda , VJ Felitti , SR Dube , DF Williamson , TJ Thompson , CM Loo , WH Giles (2004). The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction. Child Abuse and Neglect 28, 771784.

SR Dube , VJ Felitti , M Dong , WH Giles , RF Anda (2003). The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900. Preventive Medicine 37, 268277.

VJ Felitti , RF Anda , D Nordenberg , DF Williamson , AM Spitz , V Edwards , MP Koss , JS Marks (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine 14, 245258.

DM Fergusson , LJ Horwood , MT Lynskey (1996). Childhood sexual abuse and psychiatric disorder in young adulthood. II. Psychiatric outcomes of childhood sexual abuse. Journal of the American Academy of Child and Adolescent Psychiatry 35, 13651374.

PM Grambsch , TM Therneau (1994). Proportional hazards tests in diagnostics based on weighted residuals. Biometrika 81, 515526.

AC Heath , KK Bucholz , PA Madden , SH Dinwiddie , WS Slutske , LJ Bierut , DJ Statham , MP Dunne , JB Whitfield , NG Martin (1997). Genetic and environmental contributions to alcohol dependence risk in a national twin sample: consistency of findings in women and men. Psychological Medicine 27, 13811396.

C Heim , DJ Newport , R Bonsall , AH Miller , CB Nemeroff (2001). Altered pituitary–adrenal axis responses to provocative challenge tests in adult survivors of childhood abuse. American Journal of Psychiatry 158, 575581.

C Heim , DJ Newport , S Heit , YP Graham , M Wilcox , R Bonsall , AH Miller , CB Nemeroff (2000). Pituitary–adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood. Journal of the American Medical Association 284, 592597.

M Hesselbrock , C Easton , KK Bucholz , M Schuckit , V Hesselbrock (1999). A validity study of the SSAGA – a comparison with the SCAN. Addiction 94, 13611370.

SJ Holmes , LN Robins (1987). The influence of childhood disciplinary experience on the development of alcoholism and depression. Journal of Child Psychology and Psychiatry and Allied Disciplines 28, 399415.

SJ Holmes , LN Robins (1988). The role of parental disciplinary practices in the development of depression and alcoholism. Psychiatry 51, 2436.

SR Jaffee , TE Moffitt , A Caspi , E Fombonne , R Poulton , J Martin (2002). Differences in early childhood risk factors for juvenile-onset and adult-onset depression. Archives of General Psychiatry 59, 215222.

J Kaufman , BZ Yang , H Douglas-Palumberi , S Houshyar , D Lipschitz , JH Krystal , J Gelernter (2004). Social supports and serotonin transporter gene moderate depression in maltreated children. Proceedings of the National Academy of Sciences USA 101, 1731617321.

KS Kendler , CM Bulik , J Silberg , JM Hettema , J Myers , CA Prescott (2000). Childhood sexual abuse and adult psychiatric and substance use disorders in women: an epidemiological and cotwin control analysis. Archives of General Psychiatry 57, 953959.

KS Kendler , CO Gardner , CA Prescott (2002). Toward a comprehensive developmental model for major depression in women. American Journal of Psychiatry 159, 11331145.

KS Kendler , CO Gardner , CA Prescott (2006). Toward a comprehensive developmental model for major depression in men. American Journal of Psychiatry 163, 115124.

KS Kendler , LM Karkowski , CA Prescott (1999). Causal relationship between stressful life events and the onset of major depression. American Journal of Psychiatry 156, 837841.

KS Kendler , L Karkowski-Shuman (1997). Stressful life events and genetic liability to major depression: genetic control of exposure to the environment? Psychological Medicine 27, 539547.

RC Kessler , CG Davis , KS Kendler (1997). Childhood adversity and adult psychiatric disorder in the US National Comorbidity Survey. Psychological Medicine 27, 11011119.

RC Kessler , A Sonnega , E Bromet , M Hughes , CB Nelson (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry 52, 10481060.

MT Lynskey , AL Glowinski , AA Todorov , KK Bucholz , PA Madden , EC Nelson , DJ Statham , NG Martin , AC Heath (2004). Major depressive disorder, suicidal ideation, and suicide attempt in twins discordant for cannabis dependence and early-onset cannabis use. Archives of General Psychiatry 61, 10261032.

PE Meehl (1989). Schizotaxia revisited. Archives of General Psychiatry 46, 935944.

SM Monroe , AD Simons (1991). Diathesis-stress theories in the context of life stress research: implications for the depressive disorders. Psychological Bulletin 110, 406425.

CS North , SJ Nixon , S Shariat , S Mallonee , JC McMillen , EL Spitznagel , EM Smith (1999). Psychiatric disorders among survivors of the Oklahoma City bombing. Journal of the American Medical Association 282, 755762.

CS North , EM Smith , EL Spitznagel (1997). One-year follow-up of survivors of a mass shooting. American Journal of Psychiatry 154, 16961702.

ML O'Donnell , M Creamer , P Pattison (2004). Posttraumatic stress disorder and depression following trauma: understanding comorbidity. American Journal of Psychiatry 161, 13901396.

KM Penza , C Heim , CB Nemeroff (2003). Neurobiological effects of childhood abuse: implications for the pathophysiology of depression and anxiety. Archives of Women's Mental Health 6, 1522.

P Rohde , PM Lewinsohn , JR Seeley (1997). Comparability of telephone and face-to-face interviews in assessing axis I and II disorders. American Journal of Psychiatry 154, 15931598.

C Spatz-Widom , K DuMont , SJ Czaja (2007). A prospective investigation of major depressive disorder and comorbidity in abused and neglected children grown up. Archives of General Psychiatry 64, 4956.

RL Spitzer , JB Williams , M Gibbon , MB First (1992). The Structured Clinical Interview for DSM-III-R (SCID). I: History, rationale, and description. Archives of General Psychiatry 49, 624629.

PF Sullivan , CA Prescott , KS Kendler (2002). The subtypes of major depression in a twin registry. Journal of Affective Disorders 68, 273284.

MH Teicher , NL Dumont , Y Ito , C Vaituzis , JN Giedd , SL Andersen (2004). Childhood neglect is associated with reduced corpus callosum area. Biological Psychiatry 56, 8085.

RD Todd , R Neuman , B Geller , LW Fox , J Hickok (1993). Genetic studies of affective disorders: should we be starting with childhood onset probands? Journal of the American Academy of Child and Adolescent Psychiatry 32, 11641171.

PJ Wickramaratne , S Greenwald , MM Weissman (2000). Psychiatric disorders in the relatives of probands with prepubertal-onset or adolescent-onset major depression. Journal of the American Academy of Child and Adolescent Psychiatry 39, 13961405.

K Wilhelm , PB Mitchell , H Niven , A Finch , L Wedgwood , A Scimone , IP Blair , G Parker , PR Schofield (2006). Life events, first depression onset and the serotonin transporter gene. British Journal of Psychiatry 188, 210215.

JB Williams , M Gibbon , MB First , RL Spitzer , M Davies , J Borus , MJ Howes , J Kane , HG Pope , B Rounsaville , H Wittchen (1992). The Structured Clinical Interview for DSM-III-R (SCID). II. Multisite test–retest reliability. Archives of General Psychiatry 49, 630636.

DE Williamson , ND Ryan , B Birmaher , RE Dahl , J Kaufman , U Rao , J Puig-Antich (1995). A case-control family history study of depression in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 34, 15961607.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 4
Total number of PDF views: 27 *
Loading metrics...

Abstract views

Total abstract views: 156 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 24th June 2017. This data will be updated every 24 hours.