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PubMed1993

Recent life events, gender, and the control of diabetes mellitus.

Sixty-six outpatients with insulin-dependent diabetes mellitus (IDDM) filled in a life event questionnaire reflecting positive and negative life events perceived to have occurred over the past year. The difference in glycosylated hemoglobin (HbA1C) measures obtained before and after the 1-year period in question (Delta-HbA1C) served as a proxy measure of change in metabolic control. Among males, those reporting predominantly negative life events showed poorer metabolic control than those reporting few negative life events or none. Among females, the greater the number of events reported, especially positive ones, the greater the change for the better in HbA1C over the event year studied. These results suggest that life events may be significant to metabolic control in insulin-dependent diabetes. This only becomes apparent, however, when the two genders are analyzed separately, as various relationships found in one sex may be lacking or even opposite to the other sex. The findings also suggest the importance to the diabetic of learning of life events both the relative lack and preponderance of positive as well as negative events.

Adaptation, Psychological↗
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↗
PubMed2005

Stress and salivary cortisol during pregnancy.

The purpose of this study was to determine whether exposure to stressful life events was associated with changes in levels of circulating cortisol during pregnancy in a population of 603 pregnant women. The participating pregnant women filled out a questionnaire and collected a morning and evening sample of saliva in early pregnancy (median 14th gestational week) and in late pregnancy (median and 30th gestational week). They were asked to report the number of life events experienced during first and second trimester, respectively, and were asked to rate the intensity of the experienced events. Complications related to the pregnancy such as vaginal bleeding and suspected growth retardation were registered and the women were asked about concerns about their pregnancy. The salivary samples were analyzed for cortisol and the levels were higher in late than in early pregnancy. In late pregnancy women exposed to more than one life event or were concerned about pregnancy complications during second trimester had a higher evening cortisol level, whereas morning values were unaffected. After adjustment for smoking women who experienced more than one very stressful life event had 27% higher evening cortisol concentrations (95% confidence intervals: 1-59%). Women with worries about pregnancy complications had 27% (95% confidence intervals: 2-57%) higher levels. In early pregnancy women reporting stressful life events did not have higher evening cortisol levels, but tended to have a blunted morning HPA response. In conclusion, we found differences in the associations between chronic stress in early and late pregnancy and cortisol levels indicating that the response to chronic stress is dependent on the stage of the pregnancy.

Adult↗
PubMed1984

Reactions to the death of a parent. Results from patients and field subjects.

The authors studied two groups of persons who had experienced either the death of a mother or father. One group consisted of patients who had sought treatment because of pathological aspects of bereavement. The other group consisted of volunteers selected from a review of hospital death records, which indicated the recent death of their parent. The study used a nonequivalent groups design, where both groups were followed over time. The field subjects were initially seen much sooner after the death than the patients. The patient group received a time-limited dynamic therapy focused on the stress response syndrome induced by the death. At the pretherapy evaluation point, the patient sample had significantly higher levels of symptomatic distress than did the nonpatient sample. The distress declined over a 13-month period, so that patients had comparable levels of distress to that of the field subjects. After adjusting for initial values, the main difference was that patients reduced their avoidant operations more than did the field subjects. Intervening variables were assessed for the prediction of change in symptoms over time as related to the parental death. The variables that showed significant correlations to symptomatic change were cumulative negative life events from varied sources, occupation, social class, developmental level of the self-concept, identity of the deceased parent, and attribution of blame for the death. Social support did not relate to change in symptoms over time.

Adaptation, Psychological↗
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↗
PubMed1995

A longitudinal study of life events and metabolic control among youths with insulin-dependent diabetes mellitus.

In a study of school-age children with new-onset insulin-dependent diabetes mellitus (IDDM), life stress, metabolic control (glycosylated hemoglobin), and psychiatric and psychosocial variables were assessed repeatedly for up to 6 years. Life stress was defined as the number of undesirable life events and extent of life change necessitated by all life events. In univariate longitudinal analyses, total life change units were related to metabolic control, with a trend for number of undesirable events to be associated with metabolic control. In multivariate analyses, metabolic control was related to life change units, whether the glycosylated hemoglobin was in the 1st year of IDDM, IDDM duration, and the diagnosis of pervasive noncompliance with medical regimen. The relationship of life stress to metabolic control among youths with diabetes in significant but clinically modest and may be partially mediated by serious noncompliance with the medical regimen.

Adaptation, Psychological↗
PubMed1978

Sex differences in perception of life events using self-weights.

This study investigated the relationship between sex differences and the perception of life events as influenced by social desirability. Change events in the lives of 71 subjects being admitted to the adult inpatient unit of a large mental health center were measured by the Recent Life Changes Questionnaire. Social desirability and role perception were measured using the L-Scale of the Mini-Mult, an abbreviated form of the Minnesota Multiphasic Personality Inventory. The findings suggest that sex differences in the appraisal of life events have a social desirability bias rather than an intrinsic difference between males and females.

Female↗
PubMed2006

[Evaluation of major life events among Hungarian mothers rearing small children].

In this study we present LCU (life change unit) and quality rank orders of 92 significant life events as perceived by 184 Hungarian mothers caring for young children. For data collection, a modified Hungarian version of the Social Readjustment Rating Questionnaire (Miller and Rahe, 1997) was used. As with the American results, we could find no significant demographic effects in our sample on the LCU and quality ranking of the events. Although the Hungarian and the American LCU rank orders of 1997 showed high correlation, the LCU mean of the 63 common items was significantly lower for Hungarian mothers than for American ones. In addition, the stressfulness of some specific life events was perceived differently in the two cultures. The rank order of several life events obtained in an earlier Hungarian study (Tringer and Veér, 1977) allowed us to make a chronological comparison. The correlation of the rank orders of the 32 common items used in the two Hungarian data sets almost 30 years apart was somewhat lower than the association of the present Hungarian rank orders and American ones of 1997. In addition, some life events were ranked quite differently in the two Hungarian studies. Thus, perception of significant life events might differ by culture and by time and this observation should be taken into account in the design of research projects and mainly in their evaluation.

Adaptation, Psychological↗
PubMed1996

Effects of positive and negative life events on time to depression onset: an analysis of additivity and timing.

While the relationship of life events to depression onset has occupied researchers for almost a quarter of a century, few studies have attempted to account for either the temporal patterning of events relative to episode onset, or, the effect of multiple events in a study period. In this report, we attempt to address the issues of timing of events, multiple events (both positive and negative) and multiple aspects (both positivity and negativity) of single events on latency time to depression onset, while simultaneously accounting for possible decay in the effects of events over time. We use the proportional hazards approach to model the effects of life events and consider modelling the change in impact of events with the passage of time. After interviewing 142 recurrent unipolar patients using the Life Events and Difficulties Schedule, we rated severity and positivity of life events reported during the 6-month period prior to onset. As we hypothesized, additional life events occurring after an initial provoking agent level event significantly alter the risk of illness onset. Additional severely threatening events decrease the time to onset, but positive events do not appear to delay onset. Interestingly, seemingly neutral events had a highly significant effect in shortening the time to onset. We note the many limitations imposed on the interpretation of these findings related to the selected group of subjects studied and encourage those who have more generalizable data to apply these methods of analysis.

Adult↗
PubMed2000

The effects of depression, stressful life events, social support, and coping on the progression of HIV infection.

This article reviews recent findings concerning the role of psychosocial factors on the progression of HIV. Specifically, we examine the role of depression, stressful life events, social support, and coping on changes in CD4 T-lymphocytes and other indicators of HIV disease progression. Studies have yielded important evidence that depression, stressful life events, low social support, and denial coping may have a detrimental impact on HIV disease course. Delineating the role of psychosocial factors on HIV disease progression may aid in the development of new interventions for this devastating disease.

Adaptation, Psychological↗
PubMed1993

Influence of socially desirable responding in a study of stress and substance abuse.

Socially desirable responding is the reluctance to admit unpopular beliefs or behavior in order to avoid making a negative impression. It poses a problem for researchers who rely on self-report of heavy drinking and drug use. The Marlowe-Crowne Social Desirability Scale (SDS), which measures socially desirable responding, was administered to 1933 respondents in a general population survey. The relationships between SDS and various self-report measures were examined. SDS was not correlated with gender or race, it increased with greater age and decreased with higher socioeconomic status. With age and socioeconomic status controlled, SDS had a moderate negative relationship with alcohol and drug use, and a strong negative relationship with variables reflecting the expression of anger. Correlations between drinking/drug use and such variables as age, marital conflict, and stressful life events were not substantially changed by controlling for SDS. It was concluded that social desirability response bias probably results in underestimates of rates of heavy drinking and drug use, but does not compromise the study of predictors of heavy drinking or drug use.

Adaptation, Psychological↗
PubMed1996

Life events and the risk of breast cancer: a case-control study.

A case-control study was undertaken to investigate the possibility of an association between stressful life events and the development of breast cancer. Ninety-nine breast cancer cases, and 99 controls matched by age and area of residence, completed a life events inventory to measure life change and distress scores over a 2-year and a 10-year period. Study subjects were also interviewed to establish potential breast cancer risk factors; their height and weight were measured; they completed a food frequency questionnaire and provided a fasting blood sample for hormonal assay. After adjusting for potential confounders, women with a 10-year life change score greater than 210 (i.e. the highest quartile) had 4.67 times the risk of developing breast cancer, compared with those in the lowest quartile (P < 0.05).

Breast Neoplasms↗
PubMed2002

Emotional reactions and life changes of caregivers of demented patients when home caregiving ends.

Many studies indicate that the cessation of caregiving of demented patients has positive effects on caregivers' lives but contradictory findings have also been reported. The aim of this study was to investigate how the caregivers of demented patients experienced the cessation of caregiving, how caregivers' lives changed after this event, and which factors predicted emotional reactions and life changes. Data were collected from 64 caregivers of demented patients, recruited from a previous controlled intervention study. The semi-structured telephone interviews sought (1) sociodemographic data, (2) emotional reactions the caregivers recalled from the point of cessation of caregiving, and (3) life changes experienced after that time point. At the point of cessation of caregiving, spouse caregivers had higher risk for loneliness, depressive feelings and sorrow than non-spouse caregivers. Feelings of relief were associated with non-spouses. Community care support obtained during the previous intervention study had protected the caregivers from loneliness, depressive feelings and sorrow. After the end of caregiving, spouse caregivers tended to experience more negative life changes. The increased number of leisure activities was associated with the support during community care.

Aged↗
PubMed1991

The motivation for change from problem alcohol and heroin use.

This paper provides an overview of the first study in Switzerland on spontaneous remission from substance abuse, conducted 1988. After a rigourous screening process, 60 practically treatment-free remitters could be identified. While 14 of the 30 alcohol cases reduced their consumption almost to abstinence, all but two heroin remitters stopped their consumption altogether. No selection bias could be detected when comparing the groups studied with clinic populations, survey data and police records. The qualitative analysis of the collected extensive life histories led to a typology of the autoremission process. The motivation to change, the implementation of the decision, the maintenance and the negotiation of a new identity or meaning in life represent the three major stages. This paper focuses on the first stage and the role of negative vs positive experiences in setting off subsequent changes in alcohol or heroin consumption. The variation in the motivational background is illustrated by a close look at the rich life history accounts as well as by quantitative data on life events and cognitive prerequisites of change. Methodological drawbacks of this first exploratory study, such as recall problems and a narrow definition of addiction excluding psychological problems, are discussed and the necessity of future prospective studies is underlined.

Alcoholism↗