Development of a Structural Model of Persistent Depressive Disorder Syndrome Based on Childhood Trauma with the Mediating Role of Cognitive, Emotional, and Interpersonal Functions

Abstract

Abstract Background The relationship between childhood traumas and depression is documented, but few studies have analyzed this relationship about the severity of depression. Although several studies have illuminated the role of mediating components in this regard, these components have not been considered in a comprehensive model in the literature. Therefore, the present study aimed to develop a structural model of the severity of persistent depressive disorder symptoms according to childhood trauma and investigate the mediating role of a set of cognitive, emotional, and interpersonal functions. Methods This cross-sectional study utilized a structural equation structure. A total of 180 individuals consisting of patients with persistent depressive disorder, patients with episodic depressive (ED) disorder, and healthy people were selected by convenience sampling based on the eligibility criteria. Subsequently, they were assessed with the Childhood Trauma Questionnaire, BDI-II, 5 DSM- (SCID-5-RV), PHQ, DAQ, DERS-16, PII-32, and LQPT. The data were analyzed using SPSS26 and Pls3 software with structural equation modeling. Results The proposed model fitted the data satisfactorily. Patients with persistent depressive disorder, a more severe type of depression, had a worse condition than patients with ED and normal subjects on the components of childhood trauma, DAQ, emotional functioning, interpersonal functioning, and LQPT. Childhood trauma harmed LQPT and a positive effect on the severity of depression symptoms, depressive attributional style, and interpersonal issues. Also, childhood trauma led to more severe depression, pathological attributional styles, and interpersonal problems, and the sufferers more often engaged in preoperational thinking. Besides, the mediating role and indirect effect of emotional regulation components, interpersonal problems, and preoperational thinking were influential in the relationship between childhood trauma and the severity of depressive symptoms. Conclusion Childhood traumas are associated with more severe depression symptoms and more severe degradation in cognitive, interpersonal, and emotional functioning. They exert their negative effects through increasing emotional dysregulation, enhancing interpersonal problems, and engaging in preoperational thinking.