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PubMed2005

Stress, life events, and socioeconomic disparities in health: results from the Americans' Changing Lives Study.

It has been hypothesized that exposure to stress and negative life events is related to poor health outcomes, and that differential exposure to stress plays a role in socioeconomic disparities in health. Data from three waves of the Americans' Changing Lives study (n = 3,617) were analyzed to investigate prospectively the relationship among socioeconomic indicators, five measures of stress/negative life events, and the health outcomes of mortality, functional limitations, and self-rated health. The results revealed that (1) life events and other types of stressors are clearly related to socioeconomic position; (2) a count of negative lifetime events was positively associated with mortality; (3) a higher score on a financial stress scale was predictive of severe/moderate functional limitations and fair/poor self-rated health at wave 3; and (4) a higher score on a parental stress scale was predictive of fair/poor self-rated health at wave 3. The negative effects of low income on functional limitations attenuated to insignificance when waves 1 and 2 stress/life event measures were controlled for, but other socioeconomic disparities in health change remained sizable and significant when adjusted for exposure to stressors. The results support the hypothesis that differential exposure to stress and negative life events is one of many ways in which socioeconomic inequalities in health are produced in society.

Adult↗
PubMed2005

Road mobility and the risk of road traffic accident as a driver. The impact of medical conditions and life events.

STUDY OBJECTIVE: We conducted a longitudinal investigation of the impact of self-reported life events and medical conditions on changes in road mobility on the wheel between 2000 and 2002 in order to assess whether these changes would affect the risk of road traffic accident (RTA). METHODS: Data are from a cohort of workers and retirees from the French national gas and electricity companies (the Gazel cohort). In the present study, 10,483 participants were included (7843 men aged 51-61 years and 2640 women aged 46-61 years, in 2000). The link between mobility and the risk of RTA was approximated using data on RTA number during lifetime and reported mobility in 2000. We then compared changes in road mobility between 2000 and 2002 resulting from life events and medical conditions reported to have occurred in the year 2001 or changed when compared to year 2000. We also compared road mobilities in 2000 in order to assess any pre-existing differences before life events and medical conditions. This led to estimation of the effect of road mobility changes on the risk of RTA. RESULTS: Changes in road mobility associated with life events and medical conditions were only found among men. These changes in road mobility were minimal. Ensuing changes in the risk of RTA were estimated to be small (odds-ratios ranged from 0.94 to 1.01). The only life events found to be associated with increased road mobility was an important purchase. Hospitalization, serious RTA, and retiring were associated with reduced road mobility. Concerning medical conditions, men who reported cataract, angina pectoris, diabetes, anxiety and stress, sleep disorder, and depression decreased their road mobility. CONCLUSION: We found no or moderate changes in road mobility resulting from life events and medical conditions, suggesting that results from previous published studies that assessed the impact of life events or medical conditions on RTA were not jeopardized by improper adjustment for road mobility.

Accidents, Traffic↗
PubMed1995

Life events and senile dementia. Affective symptoms.

BACKGROUND: Previous research in the elderly has linked threatening life events with depression. Dementia sufferers are known to be sensitive to stressful changes in their daily life such as relocation. This study investigates whether threatening life events are associated with depressive symptoms in dementia sufferers. METHOD: Using the Life Events and Difficulties Schedule, this study examined life events before admission in a group of 70 dementia patients compared with two control groups: dementia sufferers in the community and mentally fit elderly people matched for age and sex. RESULTS: Life events with severe threat were not significantly more frequent in the dementia patients than in two control groups. However, depressive symptoms in the dementia sufferers were significantly associated with independent severe life events. This strong association was maintained when a multivariate analysis was used to control for the effects of other social factors and severity of cognitive impairment. This association appears to be specific to the threat aspect of life events since there was no association between depressive symptoms and events relating to change in the social environment. CONCLUSION: In dementia sufferers, threatening life events are associated with depressive symptoms. This means that dementia sufferers are responsive to stress in the same way as cognitively intact individuals, and clinicians need to be more aware of the social influences on them.

Adaptation, Psychological↗
PubMed2001

Life events and alcohol consumption among mature adults: a longitudinal analysis.

OBJECTIVE: Four waves of the Health and Retirement Study were used to examine changes in alcohol consumption co-occurring and following stress associated with major health, family and employment events. METHOD: The final sample consisted of 7,731 (3,907 male) individuals between the ages of 51 and 61 at baseline. We used multinomial logit analysis to study associations between important life events and changes in alcohol consumption over a 6-year study period. Interactions between stressful life events, gender and problem drinking were also evaluated. RESULTS: Most persons (68%) did not change their use of alcohol over the entire 6 years. Hospitalization and onset of a chronic condition were associated with decreased drinking levels. Retirement was associated with increased drinking. Widowhood was associated with increased drinking but only for a short time. Getting married or divorced was associated with both increases and decreases in drinking, with a complex lag structure. A history of problem drinking influenced the association between certain life events (e.g., divorce and retirement) and changes in drinking. Gender modified the association between losing a spouse and changes in drinking. CONCLUSIONS: Even after controlling for problem drinking history, social support and coping skills, changes in drinking behavior were related to several life events occurring over a 6-year period for a national cohort of individuals in late middle-age. The magnitude of these relationships, however, varied by gender and problem drinking history.

Adaptation, Psychological↗
PubMed2004

The 15-item Geriatric Depression Scale (GDS-15) detects changes in depressive symptoms after a major negative life event. The Leiden 85-plus Study.

BACKGROUND: The 15-item Geriatric Depression Scale (GDS-15) is a widely used screening instrument for depressive symptoms in the elderly, but its ability to detect alterations in depressive symptoms over time has not been established. OBJECTIVE: To assess the change of the GDS-15 score after a major negative life event. METHODS: Within the Leiden 85-plus Study, we prospectively followed a population-based cohort of 599 subjects from 85 years onwards. The GDS-15 was applied annually to participants with a Mini-Mental State Examination (MMSE) score above 18 points. The change in GDS-15 score of 32 subjects who had lost their partner during follow-up was compared with a control group of 32 subjects who had not lost their partner, matched for age, sex, and initial GDS-15 score. RESULTS: At baseline, 241 subjects lived together with a partner. During a mean follow-up of 3.2 years, 55 participants (23%) lost their partner. Of those, 32 subjects completed the GDS-15 before and after the loss of their partner. All subjects reported the bereavement to be a major negative life event. The mean increase of the GDS-15 score after the death of a partner was 1.2 points (paired t-test, p = 0.013). This was significantly higher than the mean change of -0.06 points in the matched control group (independent t-test, p = 0.032), and independent of sex, level of education, pre-bereavement GDS-15 score, and time period since the loss of a partner. CONCLUSION: This study shows that the GDS-15 detects change in depressive symptoms after loss of a partner, a negative life event that is the most important risk factor for depression in the elderly. Therefore, it may be concluded that the GDS-15 has the ability to measure longitudinal alterations in depressive symptomatology.

Aged↗
PubMed2000

Stressful life events, bipolar disorder, and the "kindling model".

A common misconception is that bipolar disorder is an endogenous process. However, previous research suggests a role for life events in the onset of and recovery from bipolar episodes. Yet, there remains some question as to whether the relationship between life events and onset changes over the course of the disorder as a result of the number of episodes an individual has experienced. Using a rigorous interview measure of stressful life events, the current study tested the kindling model (R. M. Post, 1992), which theorizes that major life events play a diminishing role over the course of illness in bipolar patients. Analyses revealed that the number of episodes experienced does not appear to have a significant effect on bipolar 1 patients' reactivity to external stressors. In addition, the results suggest that a more complex relationship exists among age, stress, and onset of new episodes than can be adequately explained by the kindling model.

Adult↗
PubMed1987

The impact of daily stressors on women's adjustment to marital separation.

The relationship between stressful life events and the onset of various forms of illness has been well documented. One aspect of the relationship that has been overlooked, however, is that a major stressful life event frequently creates lifestyle changes that may increase susceptibility to illness. The purpose of the present study was to examine the hypothesis that daily stressors mediate the relationship between the stressful life event of marital separation and psychological distress. Seventy-nine women separated or divorced for less than three years completed measures of daily stressors and psychological distress on two occasions approximately ten weeks apart. The results confirmed the hypothesis that frequency of daily stressors is a better predictor of psychological distress than time since the life event of marital separation. The results also indicated that frequency of daily stressors maintains distress over time. These findings suggest that physicians should focus attention on evaluating the frequency and impact of ordinary stressors in daily life following a major life event.

Adult↗
PubMed1990

Are stressful life events risk factors for herpes zoster?

To determine if psychologically stressful life events are risk factors for herpes zoster, we conducted a case-control study of zoster and self-reported recent negative life events and major changes in spousal relationships. The subjects were 101 healthy community-dwelling cases of zoster and 101 healthy controls matched for age, sex, and race and generated by random digit dialing. The Geriatric Scale of Recent Life Events was administered to case and control subjects, and additional questions were asked regarding the perception of the life event. The results showed that case subjects experienced negative life events significantly more often than subjects in the control groups in the 2 months before zoster onset by analysis of discordant pairs (26 versus 10, odds ratio 2.60, 95% confidence interval [CI] 1.13, 6.27, P = .012), 3 months before (29 versus 11, odds ratio 2.64, 95% CI 1.20, 6.04, P = .007), or 6 months before (35 versus 16, odds ratio 2.00, 95% CI 1.04, 3.93, P = .012). The mean number of total life events was significantly higher in cases at 6 months before zoster (case means = 2.64, control means = 1.82, P = .008), but there were no significant differences at 2, 3, or 12 months before. There were no significant differences between case subjects and control subjects for spousal events, or any given single life event. In conclusion, we found that whereas patients with herpes zoster experienced the same kinds of life events in the year preceding the illness as did control subjects, recent events perceived as stressful were significantly more common among patients with zoster.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1978

Life events: perceptions and frequencies.

Life changes have been associated with illness onset. The Social Readjustment Rating Scale (SRRS) records numerical perceptions of the meaning of life events while the Schedule of Recent Experience (SRE) records the frequency of occurrence of life events. Data on these two instruments from 19 studies done in this laboratory have been surveyed and analyzed. They reveal significant variability among groups in their perceptions of life events as well as in their reports of the frequency of occurrence. Variables indicated to be of significance in either or both of these parameters were age, marital status, sex, socioeconomic status, ethnicity, level of education, culture, and experiencing of an event. These variables impose caution on investigations that relate life changes to illness.

Age Factors↗
PubMed1984

Life events or life processes as determinants of mental strain? A 5-year follow-up study.

In a study among Finnish metal industry employees (n = 748) mental strain was measured at the beginning and at the end of a 5-year follow-up. Life event data for the follow-up period were gathered retrospectively through a questionnaire and a later interview. Mental strain was substantially higher among blue-collar than white-collar workers. In contrast, no differences in the occurrence or in the rating of life events was observed between these groups. Self-rated undesirable events were associated with high levels and desirable events with low levels of mental strain. Similar associations were observed in three objectively defined live events, viz. divorce, promotion in the job and change in housing conditions. Life events were, however, also related with the mental strain measured prior to the life events. Both the self-rated and objectively defined desirable events had usually a favourable impact on mental well-being, whereas undesirable events in most cases slightly increased mental strain. The differences in mental strain between occupational status groups seem to be caused by differences in the life processes rather than life events. Furthermore, many life events, e.g. divorce, are actually only discrete moments in long-lasting processes, which have an impact on mental well-being. And last, desirable life events can be seen rather as a preventive than a risk factor of mental strain.

Adult↗
PubMed1984

Life stress measures and reported frequency of sleep disorders.

Scales to assess nightmare recall frequency and recalled frequency of insomnia-related disorders (sleep onset, sleep-maintenance problems, unrefreshing sleep, and restless sleep) were administered, together with the Social Readjustment Rating Scale of Holmes and Rahe to 170 part-time undergraduate students (mean age 27.4 yr., 97 men, 73 women), and together with the Life Events Inventory of Tennant and Andrews to another sample of 91 part-time undergraduates (mean age 26 yr., 53 men, 37 women). The time span for which life events and sleep disorders were to be assessed was the previous 6 mo. Pearson rs suggested that the relationships of different types of scores for life events (scores for change, for distress, for amount of control over events, weighted and unweighted scores for negative and positive events) to reports of sleep disorders were mostly weak (the largest coefficient was .29) and nonsignificant. Of all life events measures, negative life events listed on the Readjustment Scale were the most closely associated with reports of sleep disorders; all 14 coefficients involving negative events were significant and in the clinically expected direction. Further research is needed to examine whether the size of correlations between events and sleep disorders is related to factors such as readiness to recall and report negative personal experiences.

Adaptation, Psychological↗
PubMed1988

The impact of social support on mental and physical health.

Early research on life-stress grappled with the question of whether significant life-events bring about changes in health status. The emphasis has now shifted to the identification of factors that explain why some people seem to be so severely affected by life's adversities and others are not. From a class of what might be called 'vulnerability variables' (Kessler, 1979), support from one's social network has emerged as a significant factor that can account for at least some of the vulnerability differences between groups of stressed individuals. Since Cassel's (1974) review of the evidence linking social upheavals to adverse health consequences for both humans and animals, hundreds of empirical studies have been completed that assess the direct and indirect effects of social support on mental and physical health. This literature is so voluminous as to require several books devoted to reviews of various aspects of it (e.g. Cohen & Syme, 1985; Gottlieb, 1981; and Gottlieb, 1983). In this paper we will distil these as well as highlight some of the recent empirical developments, particularly in those areas that have received less attention in prior reviews. Social support has been defined as the presence of others, or the resources provided by them, prior to, during, and following a stressful event. While there is no general agreement on a single definition, the variety has spawned a number of typologies attempting to organize the literature (e.g. Cohen & Syme, 1985; Cohen & Wills, 1985; Gottlieb, 1983; House & Kahn, 1985). Most of these typologies initially distinguish between functional and structural operationalizations of social support.

Disease Susceptibility↗
PubMed2003

Going home: the complex effects of reunification on internalizing problems among children in foster care.

When children in fostercare are reunified with their families of origin they encounter changes that may influence their well-being in both positive and negative ways. We examined the effects of reunification among 218 children in foster care to test an integrative model of the effects of reunification using structural equation modeling. We hypothesized that reunification would exert indirect effects on subsequent child adjustment via changes in adverse life events, perceived social isolation, and mental health service utilization. Results indicated no direct effect of reunification on subsequent internalizing problems, but reunification was related to increased adverse life events that, in turn, were related to elevated symptoms. Second, reunification was negatively associated with mental health service use. Finally, reunification was associated with decreased child perceptions of social isolation. In summary, reunification with biological parents is associated with multiple environmental changes, with most but not all effects indicating negative consequences.

Adolescent↗
PubMed2005

Motivation and life events: a prospective natural history pilot study of problem drinkers in the community.

A prospective natural history study was conducted of problem drinkers who were thinking about quitting or reducing their alcohol consumption. Two primary constructs, cognitive appraisals and life events, were measured in a mailed-out baseline survey. A one-year follow-up survey identified those who had made reductions in drinking. Partial correlations controlling for baseline drinking severity revealed some support for both cognitive appraisal and life events explanations of change.

Adaptation, Psychological↗
PubMedDate not supplied

Stressful life events precede exacerbations of multiple sclerosis.

OBJECTIVE: We longitudinally monitored life events and health changes in patients with multiple sclerosis (MS) to determine whether stressful events may trigger exacerbation of MS. METHODS: Twenty-three women with MS were followed for 1 year. Each subject completed the Psychiatric Epidemiologic Research Interview on a weekly basis. Further information on potentially stressful events was acquired using the Life Events and Difficulties Schedule. Neurologic symptoms were also monitored on a weekly basis throughout the year. Potential MS exacerbations were confirmed by a neurologist who was blind to the presence and timing of stressors. RESULTS: Eighty-five percent of MS exacerbations were associated with stressful life events in the preceding 6 weeks. Stressful life events occurred an average of 14 days before MS exacerbations, compared with 33 days before a randomly selected control date (p < .0001). Survival analysis confirmed that an increase in frequency of life events was associated with greater likelihood of MS exacerbations (hazard ratio = 13.18, p < .05). CONCLUSIONS: These results are consistent with the hypothesis that stress is a potential trigger of disease activity in patients with relapsing-remitting MS.

Adult↗
PubMed1978

Chronic gastric ulcer and stress. A comparison of an ulcer population with a control population regarding stressful events over a lifetime.

Stress was measured by the frequency of 31 major life events with consequent change and distress scores in 50 patients with chronic gastric ulcer and 50 control subjects, matched for age, sex and place of residence. The gastric ulcer population did not differ from the control population regarding the number of events experienced and the associated change and distress scores. However, when analysed according to social grade, the ulcer patients in the lower status suburbs experienced more events and more change than their controls, but the stress scores were similar. In the higher status suburbs, no difference was present between the patients and controls. Change and distress scores rose progressively with age, but there was no significant difference in the number of events experienced between the three age groups. Both men patients and their controls experienced significantly more events and higher change scores than women patients and their controls.

Adult↗
PubMed1988

Self-cognitions, stressful events, and the prediction of depression in children of depressed mothers.

In a preliminary effort to integrate cognitive, life stress, and interpersonal approaches to vulnerability to depression, children's cognitions about themselves, their stressful life events, and the interaction of self-cognitions and life events were tested as predictors of depression. Children of normal, medically ill, and bipolar and unipolar depressed mothers were assessed initially and 6 months later for diagnostic status using the Kiddie-SADS interview. As predicted, Piers-Harris self-concept scores and interview-assessed children's stressful life events significantly predicted changes in depression status over the 6-month follow-up. Stressors and the interaction of stressors and self-concept also predicted changes in diagnosis of nonaffective disorders. A self-schema measure of accessibility of negative self-cognitions, known to be mood-dependent, failed to add to the prediction of depression severity. The results are consistent with a model of depression vulnerability that emphasizes cognition about self-worth and self-efficacy as mediators of the impact of stressful events, and we speculate that such self-schemas are acquired in part in the context of parent-child relationships. Recommendations are given for further studies of the acquisition and the mechanisms of self-schemas.

Adolescent↗
PubMed1987

The meaning of stress, anxiety and collective panic in clinical settings.

The physician is often confronted with questions about the meaning of symptoms or diseases. One of the tasks of those practicing psychosomatic medicine is to delve into the answers to these questions. Anxiety is a common phenomenon in everyday practice, and it is evoked in the most different situations. The relationships of this kind of anxiety (i.e. when having to consider painful or life-threatening diseases or medical or surgical procedures) to both neurotic anxiety and normal anxiety (i.e. the one expressed in poetry or artistic creativity or present in the biographies of outstanding men and women who by no means could be considered as psychiatric cases) leads to define anxiety as the psychological equivalent of stress. Anxiety is the unspecific response to a threat induced by too sudden or too extreme variations in the environment (life changes, stressful situations, life events). Such mechanisms, so important for survival, can become self-destructive, paving the way for the appearance of diseases represented by unsuccessful coping mechanisms. The analogy with the diseases of the general adaptation syndrome of Selye (i.e. autoimmune diseases) and with reactions in collective panics in disasters becomes evident under this perspective. The physician has to face anxiety with the same attitude that he faces pain, that is to say, going beyond a consideration of its 'normality' (it is quite normal to feel chest pain in acute heart infarct), keeping in mind its role in survival.(ABSTRACT TRUNCATED AT 250 WORDS)

Anxiety Disorders↗