A growth curve analysis of the course of dysthymic disorder: the effects of chronic stress and moderation by adverse parent-child relationships and family history

J Consult Clin Psychol. 2004 Dec;72(6):1012-21. doi: 10.1037/0022-006X.72.6.1012.


Using mixed effects models, the authors examined the effects of chronic stress, adverse parent-child relationships, and family history on the 7.5-year course of dysthymic disorder. Participants included 97 outpatients with early-onset dysthymia who were assessed with semistructured interviews at baseline and 3 additional times at 30-month intervals for 7.5 years. Results indicated that higher levels of chronic stress 6 months prior to each follow-up predicted greater depression severity at follow-up, controlling for depression severity at the start of the chronic stress assessment. In addition, adverse parent-child relationships and family history of dysthymic disorder moderated this association. For patients with poorer parent-child relationships, chronic stress was associated with increased depression severity at follow-up, whereas patients with a higher familial loading for dysthymic disorder were less responsive to chronic stress over time.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Chronic Disease
  • Depression / diagnosis
  • Depression / epidemiology*
  • Depression / genetics*
  • Diagnostic and Statistical Manual of Mental Disorders
  • Dysthymic Disorder / diagnosis
  • Dysthymic Disorder / epidemiology*
  • Dysthymic Disorder / genetics*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Models, Psychological
  • Parent-Child Relations*
  • Psychology / methods*
  • Psychology / statistics & numerical data*
  • Severity of Illness Index
  • Stress, Psychological / epidemiology*