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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↗
PubMed2001

Stressful life events and depressive symptoms: social support and sense of control as mediators or moderators?

Depression is quite common among the elderly members of the Hong Kong Chinese society. This study examined the impact of a series of common stressful life events (SLEs) on change in depressive symptoms among the older people. The respondents were 411 people aged sixty years or older from a survey of a representative community sample of the elderly population in Hong Kong. Using multiple regression models, the authors found that sense of control acted as a mediator in the linkage between the number of SLEs and depressive symptoms, even after controlling sociodemographic, and physical health status were applied. In addition, the social support measured by Lubben Social Network Scale moderated the influence of the exposure to SLEs on depression. Findings suggest that sense of control and social support play distinguished and important roles in the stress-outcome relationship. Service implications were discussed based on these findings.

Aged↗
PubMed2000

Predictors of time to remission from depression in primary care patients: do some people benefit more from positive life change than others?

The authors examined the role of personality, social support, and coping strategies and their interaction with positive life change (PLC) in influencing time to remission from depression in 86 depressed primary care patients (69% women, mean age = 36.6 years), who were followed for 3.5 years. Diagnostic information was obtained by the Present State Examination (J. K. Wing, J. Cooper, & N. Sartorius, 1974), and life change by the Life Events and Difficulties Schedule (G. W. Brown & T. O. Harris, 1978). The association of PLC and other predictors with the time to remission was studied by means of Cox regression. PLC reduced time to remission in women, but not in men. Other predictors that expedited remission were low severity of premorbid difficulties, high self-esteem, and a tension-reducing coping style. Neuroticism modified the effect of PLC in that the remission forward bringing effect of PLC was stronger for highly neurotic people. The results suggests that women and psychologically vulnerable persons benefit most from PLC.

Adult↗
PubMed2000

Stressful events and depressive symptoms among old women and men: a longitudinal study.

Depression is quite common among the elderly members of Hong Kong Chinese society. This study examined the impact of a series of common stressful life events (SLEs) on changes in depressive symptoms among the older people. The respondents were 260 people aged seventy years or older from a longitudinal study of a representative community sample of the elderly population in Hong Kong. Using multiple regression models, the authors found that, of eight SLEs examined, only widowhood was associated with depressive symptoms three years later, even after controlling sociodemographic, physical health status, and social support variables were applied. In addition, the SLE influenced the depression differently for men and women, as we found that the death of a spouse was associated with increased in depressive symptoms among elder women, and the moving out of children was associated with a decrease in depressive symptoms among old men. Finally, we also found a close relationship between number of SLEs and depression.

Aged↗
PubMed2004

[Analysis of negative life events among 304 elderly suicide victims].

OBJECTIVE: To identify the most common life events that occurred prior to suicide in elderly individuals and the relationship of these life events to depressive symptoms. METHODS: A detailed study considering life events in the year prior to death, the presence of mental illness at the time of death and the level of depressive symptoms in the 2 weeks prior to death was undertaken with the family members and other associates of 304 persons at 55 years of age and older who died of suicide. RESULTS: The three most common negative life events were acute or chronic physical illness or injury (59.2%), major changes in diet, sleeping or other daily routines (37.8%) and financial difficulties (34.5%). The severity of depressive symptoms was significantly greater among persons who had experienced these life events both for persons with or without definite mental illness. CONCLUSION: Most elderly persons who died of suicide events had experienced multiple negative life events in the year prior to death and these life events were closely related to the severity of depressive symptoms at the time of death.

Aged↗
PubMed1993

Life stress and dysphoria: the role of self-esteem and hopelessness.

This study evaluated the hypotheses that the relation between life stress (life events and daily hassles) and longitudinal change in dysphoria would be (a) moderated by self-esteem and (b) mediated by longitudinal change in hopelessness. Eighty undergraduates were first assessed on self-esteem, hopelessness, and dysphoria and then reassessed 3 months later on life events, daily hassles, hopelessness, and dysphoria. Residual change in dysphoria was significantly associated with self-esteem, life stress, and a Self-Esteem X Life Stress interaction. However, inconsonant with predictions, the moderating impact of self-esteem was greatest under conditions of low (vs. high) life stress. Moreover, residual change in hopelessness mediated the relations between residual change in dysphoria and both self-esteem and life stress.

Adolescent↗
PubMed2002

Emotionally charged autobiographical memories across the life span: the recall of happy, sad, traumatic, and involuntary memories.

A sample of 1,241 respondents between 20 and 93 years old were asked their age in their happiest, saddest, most traumatic, most important memory, and most recent involuntary memory. For older respondents, there was a clear bump in the 20s for the most important and happiest memories. In contrast, saddest and most traumatic memories showed a monotonically decreasing retention function. Happy involuntary memories were over twice as common as unhappy ones, and only happy involuntary memories showed a bump in the 20s. Life scripts favoring positive events in young adulthood can account for the findings. Standard accounts of the bump need to be modified, for example, by repression or reduced rehearsal of negative events due to life change or social censure.

Adult↗
PubMed1976

Changes in environmental life events and their relationship to psychiatric hospital admissions.

This study was designed to determine if differences exist in the number of stressful life events experienced by individuals precipitating a first admission vs. readmission to an inpatient psychiatric facility based on diagnostic classification and sex. The subjects consisted of adult patients diagnosed as schizophrenic, depressive neurotic, or chemically addicted, who had not been hospitalized for psychiatric problems for at least 12 months prior to the current hospitalization. The Holmes and Rahe Social Readjustment Rating Scale was used to quantify the life stresses experienced. A 3 X 2 X 2 analysis of variance showed no significant differences between groups.

Adjustment Disorders↗
PubMed1983

A study of a stress questionnaire: the later years.

A twenty-seven item life stress questionnaire was derived from the Holmes-Rahe Social Readjustment Rating Scale, modified for older respondents, and administered to sixty-two patients hospitalized for neuro-behavioral diagnosis and treatment. The aims were to focus on significant life stresses and the patients' responses to these, and to identify those life events that were subjectively evaluated by the patients as significantly affecting their life adjustment. The study suggests that fewer than twenty items--seventeen in this investigation--may be an efficient range of events to estimate life change effects and that the degree of impact of these stresses must be sought out systematically if these phenomena are to be better understood.

Adaptation, Psychological↗
PubMed1979

Life event classifications and the event-illness relationship.

Several theoretically important and distinct categories of life change are found in most life event scales. These categories can be organized in terms of at least three dimensions: the person's control over the event, the desirability of the event, and whether or not the independent variable of the event is confounded with the dependent variable of illness. It is important to separate conceptually and, to the extent possible, to distinguish empirically among events according to these dimensions, because several different models of the event-illness relationship are implied when events from several categories are combined. A secondary analysis of recently published data shows that the kinds of events associated with illness are undesirable events within the subject's control. It may not be necessary to consider these dimensions in predicting illness, but the prevention and understanding of illness are furthered by their consideration.

Disease↗
PubMed1997

Temporal variability in global self-esteem and specific self-evaluation as prospective predictors of emotional distress: specificity in predictors and outcome.

Recent studies have found that temporal variability and reactivity in self-esteem (SE) are associated with risk for depressive symptoms subsequent to life stress. It is unclear, however, whether it is variability uniquely in SE that is critical, or whether variability in other domains, such as specific self-evaluation (SSE) and affect, would show similar effects. Further, the specificity of these effects to depression is unknown. In the present study, initially nondepressed women completed 7 daily ratings of SE, SSE, and affect. Over a 6-week prospective interval, the interactions of stressful life events and variability in both SE and SSE predicted changes in depression, particularly in individuals with more severe worst lifetime episodes of depressive symptoms. These effects were independent of average level of SE and SSE, as well as neuroticism and self-concept uncertainty. In contrast, variability in affect failed to predict changes in depression in interaction with life stress. Finally, none of the predictor variables interacted with stressful life events in predicting changes in anxiety.

Adult↗
PubMed2001

Sex differences in event-related risk for major depression.

BACKGROUND: This study sought to determine if women are more likely than men to experience an episode of major depression in response to stressful life events. METHOD: Sex differences in event-related risk for depression were examined by means of secondary analyses employing data from the Americans' Changing Lives study. The occurrence and time of occurrence of depression onset and instances of stressful life events within a 12-month period preceding a structured interview were documented in a community-based sample of 1024 men and 1800 women. Survival analytical techniques were used to examine sex differences in risk for depression associated with generic and specific stressful life events. RESULTS: Women were approximately three times more likely than men to experience major depression in response to any stressful life event. Women and men did not differ in risk for depression associated with the death of a spouse or child, events affecting their relationship to a spouse/partner (divorce and marital/love problems) or events corresponding to acute financial or legal difficulties. Women were at elevated risk for depression associated with more distant interpersonal losses (death of a close friend or relative) and other types of events (change of residence, physical attack, or life-threatening illness/injury). CONCLUSION: Stressful life events overall, with some exceptions among specific event types, pose a greater risk for depression among women compared to men.

Adult↗
PubMed1989

Life-style changes in a cardiac rehabilitation program: the client perspective.

Major life-style changes are required after an acute coronary event, although the vast majority of patients are unsuccessful in maintaining these changes. This study examines factors clients view as enabling or disabling their life-style changes for health promotion. Ten patients in a cardiac rehabilitation program were interviewed using grounded theory methodology. Both health protection and health promotion stimulated life-style change, as did instructions from the physician and life enjoyment. Enabling and disabling factors affecting the process of repatterning were individually defined, but changes in beliefs, attitudes, and plans facilitated repatterning. Specific precipitants to change, forces influencing change, and methods of repatterning life style are discussed, as are nursing implications.

Adult↗
PubMed2001

[Significance of subjective evaluation of life events as risk factors for predicting future suicide attempts].

Among the total population of 180 patients undergoing medical examination between March and December 2000, hospitalized for suicide attempts (drug intoxication) in the Department of Clinical Toxicology CM UJ in Kraków, 159 persons were examined by means of modified questionnaire of life events based on a scale elaborated by Thomas Holmes and Richard Rache. The patients were divided into 2 groups--first group comprised patients after first suicide attempt and second group consisted of those who had reattempted suicide. In regard to sex and age there were no significant differences between these two groups and the total population of 180 patients. In order to obtain the patients' subjective evaluation of the influence of their course of life on their attempting suicide, we asked the patients to select from the list of life events those that had affected their mental and physical state during of whole their life. Objectivization of life events was based on the 'units of life change' by T. Holmes and R. Rache. The sum of units of life events was 373 scores (SD +/- 200, in the range of 39-1042 units). From the total list of life events (max. score--1513) we selected the events estimated at 40 and more units of life change. Those were; marriage, divorce, separation, marital reconciliation, patient's illness, change of behavior and illness of a close relative, death of a husband/wife, child, close relative, imprisonment, pregnancy, unemployment, retirement. In the patients' subjective evaluation part, the events most frequently selected by the patients as those that had affected their mental state were: death of a close relative (56.6%), illness of a relative (40.8%), patient's illness (37.7%). A high number of patients stated events testifying to a conflict in marriage--45.7% of patients stated marital separation, and reconciliation, and 27% of patients stated unemployment as a fact that had influenced their mental state. 30.6% of these patients belonged to the first group (after first suicide attempt) and only 18.7% belonged to the second group (after repeated attempt). The authors of the study have presented a discussion over the results of the analysis and demonstrated the need for cultural adaptation of so that it can be effectively used in General Practitioners' training.

Adaptation, Psychological↗
PubMed1997

Are dependency and self-criticism risk factors for major depressive disorder?

OBJECTIVE: To determine whether dependent and self-critical personality traits are associated with specific types of life events and whether these traits change with pharmacotherapy. METHOD: Overall, 142 depressed outpatients completing 8 weeks of fluoxetine treatment were administered the Life Experiences Survey (LES) at baseline and the Dysfunctional Attitude Scale (DAS) and Hamilton Depression Rating Scale (HDRS) at baseline and endpoint. RESULTS: The DAS dependency subscale, but not the self-criticism subscale, showed significant correlations with life events regardless of congruency. Baseline HDRS scores were positively correlated with both DAS subscales and total score. The DAS subscales, the total DAS score, and the HDRS all improved significantly with treatment. CONCLUSIONS: These results confirm a growing body of research that has found an association between sociotropic or dependent personality traits and life events.

Adult↗
PubMed1985

Stressful events, stressful conditions and alcohol problems in the United States: a partial test of Bales's theory.

Bales's theory that sociostructural factors that produce stress for members of a society increase the rate of alcoholism is examined to explain variations in the levels of alcoholism in the 50 states. Two types of social stress are conceptualized and measured at the state level: The first, the "life events" model, is based on life changes that require adaptation. An index is described in which (negative) personal life events in 15 categories (e.g., divorce and plant closings) are aggregated for each state using macro measures. The second model is based on the idea of chronic stressful conditions, and is measured through the Measure of Status Integration and the Index of Relative Opportunities. Alcohol-related problems are measured by death rates for cirrhosis, alcoholism and alcoholic psychosis, and by per capita alcohol consumption. Both stressful events and stressful conditions are correlated with all indicators of alcoholism at the state level, 19 of 20 correlations being in the theoretically expected direction. Correlations are enhanced when age, urbanicity, the percentage of Blacks, low income and education are controlled for. The three macro measures of stress taken together explain 27% of the variation in cirrhosis death rates, 14% of the variation in alcoholism and alcoholic psychosis death rates and 47% of the variation in alcohol consumption rates.

Adaptation, Psychological↗