Biopsychological assessment of resilience in depression from the perspective of Positive Psychiatry

Alqahtani, Bandar (2025): Biopsychological assessment of resilience in depression from the perspective of Positive Psychiatry. Dissertation, LMU München: Medizinische Fakultät

Abstract

Background: Positive psychiatry is the science and practice of psychiatry that seeks to understand and promote well-being through assessments and interventions aimed at enhancing positive psychosocial factors such as resilience. Aim: The aim of this study was to better understand the associations between biological and psychological aspects of resilience in patients with depression from the perspective of positivepsychiatry. Hypothesis 1a: Patients with higher scores in positive coping strategies tend to have lower depression symptomatology. Hypothesis 1b: Patients with higher scores in negative coping strategies tend to have higher depression symptomatology. Hypothesis 2: Patients with higher levels of general resilience have lower depression scores. Hypothesis 3a: Morning plasma cortisol shows a negative association with positive coping strategies. Hypothesis 3b: ACTH/cortisol response to the Dex/CRH-test is inversely associated with positive coping strategies. Hypothesis 4: Childhood trauma and cumulated life events have a negative impact on coping strategies and resilience, and increase the severity of depression. Methods: The analyses were performed within a sample of 397 depressed in-patients of the Munich Antidepressant Response Signature (MARS) study and assessments used in this analysis include depression severity (Hamilton Depression Rating Scale. HAM-D), resilience- related coping and general resilience (Stress Coping Style Questionnaire, SVF-78, and the Resilience Scale (RS-11), life events and childhood trauma (Event List and Childhood Trauma Questionnaire, CTQ), and the regulatory function of the HPA axis (Dex-CRH test). Results: The severity of depression shows a significant negative correlation with positive coping strategies and the level of general resilience, and a significant positive correlation with negative coping strategies. The cortisol response in terms of the total and net AUC showed a negative association with subscales minimization and situation control. The subscales distraction and situation control have a significant positive correlation with basal morning cortisol. The net AUC of the cortisol response was linked to the subscale rumination, in addition to factors devaluation and control. A significant association was found between the subscale situation control and factor control and ACTH. ACTH baseline was linked to the subscale response control and resignation. The uncategorized subscales need for social support was positively associated with ACTH AUC and ACTH AUCnet. Of note, the ACTH and cortisol response to the Dex/CRH test at admission was positively associated with depression severity. A significant negative association was found between the childhood trauma and level of psychological resilience and positive coping strategies, whereas a significant positive association was observed with negative coping strategies, stressful life events and severity of depression. These results are largely consistent with our hypotheses. Conclusion: This study shows that a low level of resilience seems to be a risk factor for residual depression symptoms after inpatient treatment and that some parameters of HPA axis regulation might be potential biomarkers for resilience. Improving the understanding of the biological basis of resilience may help to find new biomarkers for depression, as one of the goals of positive psychiatry, which seeks to find biomarkers for positive psychological factors.

• Dokumententyp: Dissertationen (Dissertation, LMU München)
• Keywords: positive psychological factors, biomarkers, resilience, Positive psychiatry, Positive psychology, well-being
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften ; 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Fakultäten: Medizinische Fakultät
• Sprache der Hochschulschrift: Englisch
• Datum der mündlichen Prüfung: 27. Mai 2025
• 1. Bericht­erstatter:in: Falkai, Peter