BRITISH JOURNAL OF )2001), 178, 549^552

Sensation-seeking, life events and depression no current or past history of depression and had a sibling C-sib) who was willing The Depression Study to participate in the study. Wherever possible, the sibling nearest in age to the D-proband or the C-proband was studied. ANNE FARMER, KATE REDMAN, TANYA HARRIS, ARSHAD MAHMOOD, However, if this sibling was unavailable STEPHANIE SADLER and PETER MCCGUFFIN or unwilling, the sibling next in age was asked to participate. Most interviews were conducted face to face but for 18.5% of the D-sibs and 33.3% of the C-sibs telephone interviews were undertaken.

Background The relationship Adverse events are associated with the onset between adversityandgeneticriskadversityandgenetic risk factors of depressive episodes Brown & Harris, Interviews and self-rating 1978; Paykel, 1978) and there is evidence questionnaires in depression could be mediated by familial that both depression and adversity are All subjects were interviewed using the `hazard prone'traits, as reflectedin high familial and genetically influenced Plomin Schedules for Clinical Assessment in levels of sensation-seeking. & Bergman, 1991; Thapar & McGuffin, Neuropsychiatry SCAN; Wing et aletal,, 1996). This familial relationship could be 1990) and the Life Events and Difficulties Aims To eexamine x a min e wwhether h e t h e r highigh h mediated by aspects of personality that also Schedule LEDS; Brown & Harris, 1978). sensation-seeking scores are associated run in families. For example, certain person- The severity and threat of events scored with more adverse life events resultingresultingin in ality characteristics could lead to risk-taking on the LEDS were rated contextually by depression.depression. behaviour, which could generate an excess an expert panel Brown & Harris, 1978; of adverse life events. This has been FarmerFarmer et aletal, 2000). For subjects who were MethodMethod In a sib-pair design,108 dedescribedscribed as `hazard proneness' McGuffin depressed at the time of interview, the date probands with depression and their et aletal, 1988), and the Sensation-Seeking of onset of the current episode was deter- Questionnaire SSQ; Zuckerman et aletal,, mined and life events were recorded for siblings and105 healthyhealthycontrol control subjects 1978) provides one method for measuring the 12 months prior to that date. For all and their siblings were compared for such risk-taking personality traits. In this non-depressed subjects, events and diffi- psychopathology,lifepsychopathology, life events and scores on study, we have used a sib-pair design to culties were recorded for the 12 months the Sensation-Seeking Questionnaire examine whether those who have high prior to interview. scores on the SSQ have more adverse events 'SSQ).'SSQ). All subjects also completed a number of and therefore are more likely to become self-report questionnaires, including the ResultsResults The SSQ scores were depressed.depressed. SSQ Zuckerman et aletal, 1978) and the Beck correlated negatively with depression, Depression Inventory BDI; Beck et aletal,, METHOD 1961).1961). were familial and were correlated Information obtained at the SCAN Proband and sibling recruitment positively with less severe events, but not interview was entered into the CATEGO the severe events typically associated with One hundred and five probands with 5 scoring program to obtain ICD±10 diag- depressive onsets. depression D-probands) aged 18±65 years noses and an eight-point psychopathology who fulfilled the research criteria of the severity rating, the index of definition ID) Conclusions The SSQ measures a International Classification of Diseases,, for each subject. 10th edition ICD±10; World Health Orga- familialpersonality trait and depressionis The Statistical Package for the Social nization, 1992) F32 and F33) and who had Sciences SPSS, version 8, for Windows) associated with lower scores. Although a sibling D-sib) who was willing to be was used to create a database and to under- high sensation-seeking is associated with a studied were recruited via the psychiatric take the statistical analyses. higher rate of life events, these carrylittlecarry little services and general practitioner lists based threat. in Cardiff and South Gwent, Wales. Subjects with a current or prior history of RESULTSRESULTS Declaration of interest Study psychotic or bipolar symptoms were Age and gender and sensation- funded by the WellcomeTrust. excluded.excluded. Age- and gender-matched control seeking scores subjects C-probands) were drawn from Age was significantly negatively correlated patients attending dental and orthopaedic with SSQ scores Pearson correlation co- out-patient clinics and from among the efficientefficient rrˆ770.49,0.49, PP550.001).0.001). employees of the University Hospital of The mean SSQ score for 140 male sub- Wales National Health Service NHS) jects was 17.79 95% CI 16.52±19.06) Trust. The latter were invited to participate and for 286 female subjects it was 13.33 via a request in their wage or salary slips. 95% CI 12.54±14.13) ttˆ6.09, d.f.d.f.6.09, ˆ424,424, The C-probands were included if they had PP550.001).0.001).

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The mean sensation scores for male and Table 1 shows that mean SSQ scores depression was therefore undertaken, female subjects by each subject group are are significantly lower for both male and dividing the subjects into 116 who were shown in Table 1. For D-probands there female D-probands compared with the depressed at the time of interview mean were no significant differences for SSQ other three groups male subjects: analysis SSQ scoreSSQscoreˆ11.93, 95% CI 10.83±13.03), scores by gender ttˆ1.39, d.f.1.39,d.f.ˆ106,106, of variance ANOVA), FFˆ8.61, d.f.8.61,d.f.ˆ33 24 who reported any previous episode of PPˆNS). For the other three groups the male and 136,and136, PP550.001; female subjects: depression mean SSQ scoreˆ14.50, 95% subjects had significantly higher SSQ scores ANOVA,ANOVA, FFˆ3.99, d.f.3.99,d.f.ˆ3 and 281, CI 11.64±17.36) and 286 who had never than female subjects D-sibs: ttˆ4.02,4.02, PPˆ0.008). The ANOVAs also showed been depressed mean SSQ scoreˆ16.00,16.00, d.f.d.f.ˆ106,106, PP550.001; C-probands: ttˆ2.91,2.91, significant effects for gender and depressive 95% CI 15.10±16.89). The results showed d.f.d.f.ˆ103,103, PPˆ0.004; C-sibs: ttˆ4.03,4.03, status independently, but no significant that those who were currently depressed d.f.d.f.ˆ103,103, PP550.001).0.001). interactional effects between these variables had significantly lower SSQ scores than gender:gender: FFˆ11.47, d.f.ˆ1,1, PPˆ0.001;0.001; the other two groups FF ratioratioˆ13.19,13.19, depressive status: FFˆ16.42, d.f.16.42,d.f.ˆ2,2, PP55 d.f.d.f.ˆ3 and 422,422,3and PP550.001). However, there 0.001; gender by depressive status: was no significant difference in scores FFˆ2.54, d.f.2.54,d.f.ˆ2,2, PPˆ0.08).0.08). between those with a past history of Sensation-seeking and depression Eight of the D-sibs were depressed at depression compared with those who had measuresmeasures the time of interview and a further 22 D-sibs never been depressed ttˆ1.03, d.f.1.03,d.f.ˆ28.21,28.21, The SSQ scores were significantly nega- plus two of the C-sibs had experienced an PPˆNS).NS). tively correlated with scores on the BDI episode of depression in the past but were rrˆ770.22,0.22, PP550.001) and significantly not currently depressed. An ANOVA to Familial patterns and SSQ scores negatively correlated with the CATEGO- examine the relationship between SSQ The SSQ scores for D-probands and C- 5-derived ID rrˆ770.21,0.21, PP550.001).0.001). scores for current and past history of probands were correlated significantly with those of their siblings rrˆ0.28,0.28, PP550.001).0.001). TaTable b l e 1 Mean Sensation-Seeking Questionnaire #SSQ) score and 95% CI for males and females by each When the D-sibs were compared with subject group the C-sibs omitting any sibling with a current or past history of depression), the Subject groupNo. of subjectsSSQscore 95% CI C-sibs had significantly higher mean SSQ scores mean SSQ score for 103 C- D-probandsD-probands sibssibsˆ17.31, 95% CI 15.66±18.96; mean Male 38 13.18 10.96^15.41 SSQ score for 87 D-sibsˆ14.20, 95% CI FemaleFemale 70 11.47 10.11^12.83 12.69±15.70, ttˆ2.72, d.f.d.f.2.72, ˆ188,188, PPˆ0.007).0.007). D-sibsD-sibs Male 33 17.94 15.53^20.35 Relationship between life event FemaleFemale 7575 12.54 11.1011.10^13.99 ^13.99 measures, depression and SSQ C-probandsC-probands scoresscores Male 27 19.15 16.80^21.5016.80^21.50 The mean number of independent, and FemaleFemale 78 14.69 13.08^16.30 possibly independent, severe threatening C-sibs LEDS rated 1+2) and less severe LEDS rated 3+4) life events contextually rated, Male 42 20.9820.98 18.46^23.49 with 95% CIs for each subject group over FemaleFemale 63 14.65 12.70^16.60 a 12-month time frame for currently D-probands, probands with depression; D-sibs, siblings of probands with depression; C-probands, control probands; depressed subjects this was the 12 months C-sibs, siblings of control probands. prior to illness onset and for non-depressed subjects it was the 12 months prior to inter- TaTable b l e 2 Mean number of severe threatening events and less severe events over12 months11 for each subject view), are shown in Table 2. Although D- group #with 95% CI) probands had significantly more severe events over 12 months FFˆ10.52, d.f.10.52,d.f.ˆ33 Subject groupMean no. of 95% CIMeanno.ofless Mean no. of less 95% CI and 422,and422, PP550.001), Table 2 also shows severe events severe events that they had fewer less severe events compared with the other groups although D-probandsD-probands 1.0422 0.76^1.31 1.95 1.59^2.311.59^2.31 this is not statistically significant). D-sibsD-sibs 0.52 0.34^0.69 2.20 1.88^2.531.88^2.53 The SSQ scores were not correlated C-probandsC-probands 0.36 0.24^0.48 2.46 2.08^2.83 with the number of independent, and C-sibs 0.41 0.26^0.560.26^0.56 2.262.26 1.86^2.66 possibly independent, severe threatening life events reported or contextually rated 1. Life events recorded for12 months prior to illness onset for current depressed subjects and for12 months prior to interview for non-depressed subjects. over a 12-month time frame number of 2. D-probands have significantly more of the severe threatening events compared with the other three groups. severe threatening life events reported: Analysis of variance #ANOVA): FFˆ10.52, d.f.ˆ3and422,3and422,PP550.001).0.001). D-probands, probands with depression; D-sibs, siblings of probands with depression; C-probands, control probands; rrˆ770.06,0.06, PPˆNS; number of severe C-sibs, siblings of control probands. threatening life events contextually rated:

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rrˆ770.01,0.01, PPˆNS). This was also the case when the correlations were calculated only CLINICAL IMPLICATIONS for the 286 subjects who had never been depressed rrˆ0.01,0.01, PPˆNS). However, for && Sensation-seeking is associated with high rates of life events carrying low threat. all four groups combined the SSQ scores were correlated significantly with the && Sensation-seeking is not associated with a`hazard prone' lifestyle and does not number of less severe events both reported provide an explanation for the familial clustering of both depression and life events. rrˆ0.22,0.22, PP550.001) and contextually rated && Sensation-seeking is a familial trait. rrˆ0.20,0.20, PP550.001).0.001).

LIMITATIONS DISCUSSION && Sib-pair design did not allow for a strictly systematic ascertainment of depression Age, gender and SSQ scores and control probands. The results show that higher scores on the && Controls selected for mental health may have magnified differences #including SSQ are associated significantly with being young and male. This is a consistent scores on the SSQ) between groups.

finding in the literature Zuckerman & && SSQmay not be sensitive enough to measure the more subtle ways in which Neeb, 1979; Ball et aletal, 1984; Zuckerman, individuals may createcreate`hazardous' `hazardous' environments for themselves. 1994). Zuckerman 1994) noted that ``sensation seeking rises between the ages of 9 and 14, peaks in late adolescence or early twenties then declines steadily with age thereafter''. It has been suggested that ANNE FARMER, FRCPsych, MRC Social,Genetic and Developmental Psychiatry Research Centre, Institute of these age and gender differences in SSQ Psychiatry,; KATE REDMAN, PhD,TANYAPhD,TANYAHARRIS, HARRIS, PhD, ARSHAD MAHMOOD, MRCPsych, scores could be due to either cultural STEPHANIE SADLER, MRCPsych, Department of Psychological Medicine,Medicine,University College of differences Zuckerman & Neeb, 1980) or Medicine,Cardiff; PETER McGUFFIN, FRCPsych, MRC Social,Genetic and Developmental Psychiatry Research the psychometric limitations of the Centre, Institute of Psychiatry,London questionnaire Zuckerman, 1994). CorrespCorrespondence:ondence: Professor Anne Farmer,MRC SoSocial,Geneticcial,Genetic and Developmental Psychiatry Research Centre,Centre,Institute Institute of Psychiatry,De Crespigny Park,Park,Denmark Denmark Hill,Hill,London London SE5 8AF,UK SSQ scores and depression ratings 'First received 31August 2000, 2000, final final revision revision 20 20 December December 2000, 2000, accepted accepted 22 22 December December 2000) 2000) The SSQ scores were significantly negatively associated with the BDI score a self-report continuous measure of current depressed mood) as well as with the F32 and F33 ICD±10 operational definitions of this correlation was suppressed. However, Familiality of SSQ scores depression and the ID derived from the the failure to find a significant correlation The SSQ scores were familial, as indicated SCAN interview. Thus, low mood is between SSQ scores and severe events in by a moderately high sib-pair correlation. associated with lower SSQ scores. This is the 286 subjects who had never been When the never-depressed D-sibs and C-sibs not in keeping with our hypothesis that high depressed fails to support this hypothesis. were compared i.e. when those siblings levels of sensation-seeking might be a Our study has shown also that the with a current or past history of depression common familial factor underlying pre- gender difference in SSQ scores failed to were omitted from the analysis), the D-sibs disposition to depression and life events, reach statistical significance in the D- had significantly lower scores compared but it agrees with the findings of Carton etet probands, which suggests that depression with the C-sibs. These findings are supportive alal 1992), who showed a significant in male subjects may have a greater impact of the view that SSQ scores represent a negative association between SSQ score on the suppression of SSQ scores than in somewhat stable and familial personality and low mood. However, the SSQ scores female subjects. To examine this further, trait. However, the reduction in the scores of the 24 subjects who had a past history an ANOVA was carried out that factored of those who were currently depressed of depression but who were well at inter- according to gender and depressed status indicates that the measure may be partly view did not differ from those of individuals defined as whether the individual was mood-state dependent. who had never been depressed. This currently depressed, had a past history of suggests that sensation-seeking returns to depression or had never been depressed). premorbid levels following recovery from This showed independent effects for both SSQ scores and life event measures depression.depression. gender and depressed status but failed to The SSQ scores were not associated sig- It is possible that in those who were demonstrate a significant gender by status nificantly with the type of severe threaten- currently depressed there had been an interaction. Consequently, we have not ing life events that are usually recognised association between high SSQ scores and confirmed any differential effect on the as being associated with depressive onsets severe threatening events before the lowering of SSQ scores in male subjects Brown & Harris, 1978; Paykel, 1978). depression, but because of their depression with depression compared with female However, SSQ scores were correlated signif- and its effect in reducing the SSQ score) subjects with depression. icantly with the number of less severe events

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those rated 3 and 4 on the LEDS scheme). Higher SSQ scores were associated with McGuffin, P., Katz, R. & Bebbington, P. )1988) TheThe Thus, as predicted, high sensation-seeking higher rates of life events, but these were Camberwell Collaborative Depression Study.III.Study. III. Depression and adversity in the relatives of depressed is modestly associated with being more of the lower threat variety rather than the probands. British Journal of Psychiatry,, 152152, 775^582.,775^582. `event prone' but not with being `hazard major hazards usually associated with Paykel, E. S. )1978) Contributions of life-events to prone', if we define hazards as highly depressive onsets. This went against our causation of psychiatric illness. Psychological Medicine,, 88,, threatening events of the type commonly `hazard prone' hypothesis as the mediating 245^253.245^253.

associated with depressive onsets. factor between adversity and familial Plomin, R. & Bergman, C. S. )1991) The nature of Contrary to our original hypothesis, depression, and instead suggests that nurture: genetic influences on`environmental'on `environmental' measures. sensation-seeking was not found to be although sensation-seeking is indeed Behaviour and Brain Sciences,, 1414,373^427., 373^427. associated with a `hazard prone' lifestyle associated with an eventful life the happen- Thapar, A. & McGuffin, P. )1996) Genetic influences and hence did not offer an explanation for ings that occur tend to be benign. on life-events in childhood. Psychological Medicine,, 26,, 813^820. the connection between familial clustering of life events and familial aggregation of REFERENCES Wing, J. K., Babor,T., Brugha,Brugha,T., T., et aletal )1990))19 9 0) SCAN: Schedules for Clinical Assessment in Neuropsychiatry. depression. Indeed, depression was Archives of General Psychiatry,, 47, 589^593.,589^593. associated with low sensation-seeking. Ball, I. L., Farnill, D. & Wangeman, J.)19 )1984) 8 4) Sex andandSex Although this may be partly a consequence age differences in sensation seeking. Some national WorldWorldHealthOrganization)1992) Health Organization )1992) Tenth Revision of comparisons. British Journal of Psychology,, 7575, 257^265. the International Classification of Diseases and Related of mood state, where currently depressed Health Problems 'ICD ^10).^10).Geneva: Geneva: WHO. individuals tend to avoid risk-taking be- Beck, A. T.,Ward, C. H., Mendelson, M., et aletal )19 61) Zuckerman, M. )1994) Behavioural Expressions and haviour, we have evidence that sensation- An inventory for measuring depression 'BDI). ArchivesArchives of General Psychiatry,, 44,561^571. Biosocial Bases of Sensation-Seeking.Cambridge: seeking has the characteristics of a familial Cambridge University Press. Brown, G.W. & Harris, T.O. )1978) Social Origins of trait: the SSQ scores were substantially __ & Neeb, M. )1979) Sensation-seeking and Depression. A Study of Psychiatric Disorder in Women '5th'5th correlated within our sib-pairs as a whole; psychopathology. Psychiatry Research,, 11,255^264., 255^264. edn). London: Routledge.

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