Vulnerability to specific life events and prediction of course of disorder in unipolar depressed patients.

Abstract
Although research reliably finds an association between stressful live events and depression, little progress has been made on understanding which events will lead to depression in which people. A cognitive-life stress integrative model was tested that predicted depressive symptoms following stressful life events when the negative events were personally meaningful the individual, and likely to be interpreted as depletions or failure in the domain of central relevance to self-worth. Using Beck and colleagues'' Sociotropy-Autonomy Scale to classify participants according to the value they placed on interpersonal and autonomy/achievement goals, unipolar depressed outpatients were followed prospectively for periods of up to two years, with periodic assessments of life events and symptoms. As predicted, patients'' periods of worst symptoms followed a 3-month period in which life event stress that matched their personally relevant domain significantly exceeded that of the non-relevant domain. Also, of patients who experienced an onset following a symptom-free period, the severity of symptoms was significant predicted by the predicted by the interaction of their autonomy score and achievement events; however, the same pattern did not occur for sociotropy score and interpersonal events. The results provide some support for the integration of cognition and life event approaches to depression, but limitations in the study, including small sample size, necessitate further research.

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