Family Problems Predict Onset Delayed Recovery and Relapse of Major Depression

Using a nationally representative sample, Whisman and Bruce (1999) found that people with marital distress were nearly three times more likely to develop a new major depressive episode in the next year than those who did not report marital distress. Humiliating events, such as infidelity or threats of divorce, may leave people particularly vulnerable to major depression (Cano & O'Leary, 2000). These data are supported by retrospective studies in which large portions of depressed individuals reported that marital problems occurred before the onset of their depression (e.g., Kendler, Karkowski, & Prescott, 1999), and that they believed marital problems had a causal role in the onset of the depression (O'Leary, Riso, & Beach, 1990).

Family problems are also associated with a decreased likelihood of recovery from depression (Keitner, Ryan, Miller, & Zlotnick, 1997). "Expressed emotion," which refers to the tendency of family members to be critical, hostile, and overinvolved with a family member with a psychological disorder, also predicts relapse of major depression (Hooley & Teasdale, 1989).

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