The studies in the meta-analysis by Nanni et al. (1) cannot clearly distinguish these two possibilities. Alternative research designs can, however, help clarify the direction of causality. In support of the hypothesis that childhood maltreatment causes subsequent depression, two prospective studies (2, 3) demonstrated an association between documented maltreatment and subsequent depression. In addition, two twin studies (4, 5) indicated that childhood maltreatment has a specific effect on the risk of adult depression beyond any genetic or shared familial effects. However, we also have evidence that childhood maltreatment is not often reported (6) and that recall is influenced by mood state (7). This evidence suggests a recursive relationship: childhood maltreatment increases the risk for adult depression, which may then increase the likelihood that childhood maltreatment will be recalled. Expressed in more general terms, negative experiences increase the risk of depression, but depression can also increase the recall of negative experiences.