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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↗
PubMed2005

Optimism and pessimism as predictors of change in health after death or onset of severe illness in family.

The authors prospectively examined changes in health after a major life event (death or onset of severe illness in family) among 5,007 employees (mean age=44.8 years) whose optimism and pessimism levels were assessed in 1997 and major life events in 2000. Health was indicated by sickness absence days during a period covering 36 months prior to the event and 18 months after the event. Increase in sick days after the event was smaller and returned to the prevent level more quickly among highly optimistic individuals than among their counterparts with low optimism. Parallel changes were not observed in relation to pessimism. These findings suggest that optimism may reduce the risk of health problems and may be related to a faster recovery after a major life event.

Acute Disease↗
PubMed1991

The context of childhood depression. The Newcastle Childhood Depression Project.

This paper examines the family background, premorbid personality traits and adverse life events preceding childhood depression. The non-depressed group proved more likely to have experienced pre-school bereavement and familial disturbance, and to come from the more deprived background; there was also an excess of premorbid anxiety and hysterical personality traits in this group. School phobia and premorbid obsessional traits were associated with the depressed group. Although there was an association between depression and the total number of adverse life events, this was more substantial when the perceived impact of the events was taken into account. Of the individual classes of life event, only illness and a change in social relationships were associated specifically with depression.

Adaptation, Psychological↗
PubMed2003

Positive life change and remission of non-psychotic mental illness. A competing outcomes approach.

BACKGROUND: Episode duration in non-psychotic mental illness is associated with personal characteristics of patients, like age or personality. Part of these links may be mediated by life change, a predictor of episode duration in its own right. METHODS: In 170 primary care patients who suffered 4171 person-months of non-psychotic mental illness diagnosed according to Bedford College Criteria, we examined to what extent associations with episode duration of nine person-linked variables including personal vulnerability, coping styles and social support, are mediated by their effects on the occurrence, during episodes, of positive life changes (PLC) assessed using the Life Events and Difficulties Schedule. Cox regression for competing endpoints was used to analyse the simultaneous effects of baseline variables on PLC and on remission, whether spontaneous or not. RESULTS: Irrespective of diagnosis and symptom intensity, PLC during episodes increases remission rates 2.9-fold (P<0.001). Remission rates are higher in patients with larger social networks and who seek more help but this is partly because such persons experience more PLC earlier during episodes. Lower neuroticism is also linked with shorter episode duration but this effect is unmediated by PLC. LIMITATIONS: Mental state may bias dating and reporting of life change. Treatment aspects were not recorded. Elderly subjects were not included. CONCLUSION: PLC occurrence during common mental illness is associated with psychosocial variables which are also overall predictors of episode remission. Thus, PLC mediates between patients' psychosocial make-up and their chances of speedy recovery. This has implications for the management of non-psychotic mental illness.

Adult↗
PubMed1990

Letters from V: adolescent personality development in sociohistorical context.

Systematic content analysis of personal documents is used to assess the course of personality development in one adolescent female exposed to traumatic historical and personal events, as well as more normative life changes. Seventy-one letters written by a young girl to her former teacher over a 9-year period comprise the data for this study. Our analyses assess the normal developmental processes of preoccupation with identity formation and the establishment of intimate relationships, as well as responses to life changes (emigration, marriage, pregnancy). Overall, results suggest that despite serious challenges and losses, this individual experienced normal personality development throughout her trying adolescence. In addition, particular life events affected the course of that development. Factors which may have facilitated her resilience are discussed.

Adaptation, Psychological↗
PubMed2003

Alleged sexual abuse at a day care center: impact on parents.

OBJECTIVE: This report describes the cascade of stressful events and secondary life changes experienced by parents in a case of alleged sexual abuse at a day care program. The study evaluated parents' Posttraumatic Stress Disorder (PTSD) symptoms and general psychological responses to the stressful events 4 years after the alleged abuse, and explored predictive factors of parental distress. METHODS: A total of 39 parents were interviewed about stressful events, life changes, and social support. Current distress reactions, psychological wellbeing, and locus of control were assessed with a battery of standardized measures. RESULTS: Hearing about the sexual abuse, testifying in court, hearing the verdict, and being exposed in media reports were all rated by the parents as distressing events. The majority of the parents experienced secondary life changes after the alleged sexual abuse. Four years after the alleged sexual abuse, one-third of the parents reported a high level of PTSD Intrusive symptoms and one-fourth reported a high level of PTSD Avoidance symptoms. There was a significant positive correlation between a measure of psychological wellbeing and PTSD. Secondary life changes and locus of control significantly predicted PTSD. CONCLUSION: This study demonstrates that the alleged sexual abuse of children in day care and the resulting events in the legal system and the media constitute significant and chronic stressors in the lives of the children's parents. These findings underscore the need to expand the focus of trauma-related sequelae from the child victim to their parents and family.

Adult↗
PubMed1991

A biopsychosocial treatment approach to the management of diabetes mellitus.

The relationship among recent life stress, social support, a patient's locus of control, and the control of blood glucose is evaluated in persons with diabetes mellitus, using objective measures of these psychosocial variables. Short-term [fasting blood sugar (FBS)] and long-term [glycosylated hemoglobin (Hgb A-1C)] control measures are taken at two points in time in order to evaluate the effects of the psychosocial variables on change in diabetes control. For life events, a significant positive association was found between the number of recent life events and blood glucose control. Decrease in social support predicted a worsening of longer-term (Hgb A-1C) control over time. An external locus of control within the patient was associated both with poor short-term control at time one and prediction of poorer long-term control over time. The implications of these findings are discussed in support of a biopsychosocial approach to the management of diabetes mellitus.

Blood Glucose↗
PubMed1994

Stressful life events, social rhythms, and depressive symptoms among the elderly: an examination of hypothesized causal linkages.

This study sought to determine possible causal linkages among stressful life events, social rhythms, and levels of depressive symptomatology for 81 elderly subjects (51 recently widowed, 30 healthy controls). We examined the associations among stressful life events (i.e., bereavement status at baseline or a severely threatening event occurring between baseline and followup), social rhythm stability, and the level of depressive symptoms. Results indicated that while stressful life events were not associated with significant changes in social rhythm stability, social rhythm stability was a significant negative correlate of both baseline and followup levels of depressive symptomatology; that is, lower levels of social rhythm stability at baseline were associated with high levels of depressive symptoms at baseline (rho = -0.33, n = 81, p < 0.001) and at followup (rho = -0.23, n = 81, p < 0.05). Bereavement was also a significant positive correlate of depressive symptomatology both at baseline (rho = 0.79, n = 81), p < 0.0001) and at followup (rho = 0.55, n = 81, p < 0.0001). It is likely that future research will benefit from social rhythm assessment obtained temporally closer to major life events and from the use of structured interviews to ascertain the presence of syndromal major depression at followup as well as the inclusion of subjects with a wider range of functional impairments. Nevertheless, these results represent a first step in disentangling possible causal connections among stressful life events, social rhythms, and depressive symptomatology.

Aged↗
PubMed1994

Urbanization and mental health in developing countries: a research role for social scientists, public health professionals and social psychiatrists.

Urbanization in developing countries involves changes in social support and life events which have been shown to affect mental health; mainly depression and anxiety, particularly among low income women. Although depressive and anxiety disorders have a high prevalence and account for a large proportion of visits to primary health services there is little international health research in this field. The determinants, extent and outcome of the association between urbanization and mental health requires multi-disciplinary research by social scientists, social psychiatrists and public health professionals. An appreciation of different conceptual models and associated methods is required before effective research can begin. Other issues such as the avoidance of environmental determinism; the separation of macro-social and micro-social variables; the weakness of urban/rural comparisons of mental health; the role of rural to urban migration; the debates about cross-cultural psychiatry; and the policy-relevance of research, all need consideration in the development of research into this rapidly emerging, but relatively neglected problem.

Community Psychiatry↗
PubMed2006

A prospective analysis of life events, problem behaviours and depression in adults with intellectual disability.

BACKGROUND: Life events have consistently been found to be associated with behaviour problems and depression among individuals with intellectual disability (ID). However, prior findings have typically been based on correlational or retrospective analyses of case files. The current study attempted to replicate prior findings from life events with concurrent data and extend them to the prospective prediction of behaviour problems and depression. The influence of impact ratings of life events was also explored. METHODS: Seventy-four informants rated 104 adults with ID on measures of life events, behaviour problems and depressive symptoms. Life events were rated as having either a positive, negative or no impact on the life of the individual with ID. Measures were completed twice, at a 4-month interval. RESULTS: Behaviour problems were both correlated with and predicted by frequency counts of life events and life events perceived as negative. However, the predictive ability depended on which measure of problem behaviour was selected. Positive life events were not associated with concurrent behaviour problems. Depressive symptoms were correlated with all life changes, but only predicted by frequency counts of life events and life events perceived as negative. Again, the predictive ability depended on which measure of depression was selected. Findings were corroborated with a group of individuals with clinical diagnoses of major depression. CONCLUSIONS: Frequency counts of all life events and life events perceived as negative play a role in the development of behaviour problems and depressive symptoms among adults with ID. The results have implications for interventions for behaviour problems following a life event, and for reducing depressive symptoms for adults with mild ID.

Adult↗
PubMedDate not supplied

[Home life of the aged--psychological aspects].

With increasing age the social and physical environment of elderly persons becomes increasingly focussed upon the home and its immediate surroundings, whilst life within the home ("Wohnen") expands to take in a wider variety of activities. Critical life events and transitions in old age often induce changes both in the way of life within the home and also in housing. The way of life of elderly people in the home ("Alterswohnen") can be defined as the totality of goal-directed activities within the social-physical context of their home and its immediate surroundings. This includes as central elements physical and psychological regeneration, communication, recreation, and the emergence of an emotional relationship to the home. From a stress and coping paradigm, difficulties in home life can be interpreted as the result of transactions between individual and environment. These transactions are influenced by the cognitive appraisal of the living situation and by the efforts of the individual to cope with the stressful aspects of home life.

Aged↗
PubMed2005

Life satisfaction set point: stability and change.

Using data from 17 years of a large and nationally representative panel study from Germany, the authors examined whether there is a set point for life satisfaction (LS)--stability across time, even though it can be perturbed for short periods by life events. The authors found that 24% of respondents changed significantly in LS from the first 5 years to the last 5 years and that stability declined as the period between measurements increased. Average LS in the first 5 years correlated .51 with the 5-year average of LS during the last 5 years. Height, weight, body mass index, systolic and diastolic blood pressure, and personality traits were all more stable than LS, whereas income was about as stable as LS. Almost 9% of the sample changed an average of 3 or more points on a 10-point scale from the first 5 to last 5 years of the study.

Adult↗
PubMed2003

Correlates of experiencing life events just before or during pregnancy.

This study evaluates the prevalence of selected life events around the time of pregnancy, examining changes in the prevalence of these events, and identifying maternal characteristics associated with these events. We used data from the Pregnancy Risk Assessment Monitoring System (PRAMS) to examine 18 stressful life events among women who recently gave birth and to identify maternal characteristics associated with these events. PRAMS is a mail sample survey with telephone follow-up for non-respondents. Sixty-four percent of women experienced at least one event. The prevalence of specific events ranged from 0.4 to 30%. Women who experienced events differed from those who did not. Most notably, women of low socioeconomic status (SES) were much more likely to experience stressful life events. These events were also associated with other demographic and behavioral characteristics after controlling for SES. These results have implications for interpreting studies of stressful life events. The strong associations with SES highlight the importance of controlling for SES in studies of life events and health, and of considering differences in SES when interpreting these studies.

Adolescent↗