Stressful life events and changes in substance use among a multiracial/ethnic sample of adolescent boys

This paper presents a comparative analysis of the prevalence of stressful life events and of the relationships between stressful life events and alcohol, illicit drug, and cigarette use among a multi-ethnic community sample (N = 2,446) of early adolescent boys. The data were derived from a longitudinal study of substance use behaviors and their psychosocial correlates among Hispanic, African-American, and White non-Hispanic adolescent boys residing in Dade County, Florida. Similar levels of event exposure were found among the subgroups, with one exception. African Americans were significantly more likely to experience a death-related event in the past year. Stressful life events were not significantly related with substance use among African-American students. Among Hispanics and White non-Hispanics, however, a number of significant positive relationships were found. A number of bidirectional events (i.e., those events that could be either an antecedent to and/or the result of substance use) were significantly related with stressful events, highlighting the importance of longitudinal research in delineating the temporal ordering of events and outcomes. The authors conclude that future stress research with adolescents should pay particular attention to the important moderating influences of culture and ethnicity as well as to the bidirectional nature of life events and substance use.     

Fatigue in a community sample of twins

BACKGROUND: Fatigue is a complex symptom associated with many physiological, psychological and pathological processes. Its correlates and typology remain inadequately understood. METHOD: These data were from two large, longitudinal twin studies. Trained interviewers enquired as to the presence of a > or = 5 day period in the previous year of fatigue or tiredness that interfered with daily activities. A range of potential correlates was assessed in a structured interview: demography; health beliefs; the presence of nine physical disorders; mood, anxiety and addictive disorders; neuroticism and extraversion; recollections of parental rearing; and nine stressful life events. Statistical analyses included logistic regression, CART, MARS, latent class analysis and univariate twin modelling. RESULTS: Data were available for interfering fatigue (IF) on 7740 individual twins (prevalence 9.9% in the previous year). IF was significantly associated with 42 of 52 correlates (most strongly with major depression, generalized anxiety disorder, reported major health problems and neuroticism). Multivariate analyses demonstrated that IF is a highly complex construct with different sets of correlates in its subtypes. There were two broad clusters of correlates of IF: (a) major depression, generalized anxiety disorder and neuroticism; and (b) beliefs of ill health coexisting with alcoholism and stressful life events. Twin analyses were consistent with aetiological heterogeneity--genetic effects may be particularly important in women and shared environmental effects in men. CONCLUSIONS: IF is a complex and common human symptom that is highly heterogeneous. More precise understanding of the determinants of IF may lead to a fuller understanding of more extreme conditions like chronic fatigue syndrome.     

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.     

Impact of Parental Substance Use on Adolescents: A Test of a Mediational Model

Tested a mediational model of the relationship between parentalsubstance use and adolescents' substance (tobacco, alcohol,marijuana) use with data from a sample of 1,775 adolescents,mean age 13.3 years, who completed a questionnaire includingconstructs from three theories of substance use. Mediationalanalyses identified five constructs involved in the relationshipof parental and adolescent use. A structural model with latentconstructs for substance use showed indirect effects of parentalsubstance use through greater tolerance for deviance, lowerbehavioral control, greater perceived coping function of substanceuse, more negative life events, and more affiliation with peerusers, plus a direct effect. Implications for the theory oftransmission of risk are considered.     

The relationship between stressful life events, the serotonin transporter (5-HTTLPR) genotype and major depression

BACKGROUND: Serotonin is a good candidate for major depression. We attempted to replicate the study by Caspi and colleagues [Science (2003) 301, 386-389] which reported a significant interaction between serotonin transporter (5-HTTLPR) genotype and stressful life events when predicting major depression. METHOD: We typed the serotonin promoter 5-HTTLPR gene in 1206 male and female twins aged 19-78 years (mean = 39, S.D. = 11). A DSM-IV diagnosis of major depression was available for 1199 twins. Most of these twins had participated in a 1988-1990 study which included a stressful life events inventory and self-report measure of depression based on the SCL-90 and DSSI/sAD. Complete 5-HTT genotype and life events data, self-report symptoms and major depression diagnoses were available for 1091 subjects. We regressed categorical and ordinal measures of depression onto stressful life events and genotype. RESULTS: There were significant main effects for stressful life events but there was no evidence for any effect of 5-HTT genotype, nor a genotype x stressful life event interaction. CONCLUSIONS: Regardless of whether our results were based on binary logistic or ordinal regression analyses we found no evidence to support a main effect of 5-HTTLPR, or an interaction between the 5-HTTLPR genotype and stressful life events on major depression, Only 20 % of our subjects were aged below 30 years. It is possible that the effect reported by Caspi and colleagues is specific to young people, in which case our study has much less power in this age group.     

Associations among migration risk factors,cultural identity conflict,and psychological symptoms among Syrian emerging adults with refugee backgrounds in the Netherlands

Objectives

In the present study, we examined relations between premigration, perimigration, and postmigration risk factors (i.e., potentially traumatic events [PTEs], postmigration living problems [PMLPs], stressful life events) and psychological symptoms (i.e., anxiety/depression, posttraumatic stress) in Syrian emerging adults with refugee backgrounds; we also tested cultural identity conflict as a possible mediator of these relations. We expected that greater exposure to migration risk factors was associated with more psychological symptoms and that higher cultural identity conflict would contribute to these associations.

Methods

We used data from the first wave of Karakter, a longitudinal study of 158 Syrians with refugee backgrounds (69.0% men, age range 18–35). Participants completed a questionnaire assessing PTEs, PMLPs, stressful life events, cultural identity conflict, and symptoms of anxiety/depression and posttraumatic stress.

Results

Correlational analyses indicated that more PTEs and stressful life events were related to higher levels of cultural identity conflict and more psychological symptoms. Furthermore, greater cultural identity conflict was associated with more psychological symptoms. We did not observe indirect effects of cultural identity conflict in the mediation analyses.

Conclusions

Results suggest that postmigration stressors and cultural identity conflict are associated with psychological symptoms among Syrian emerging adults who have resettled in the Netherlands.     

Stressful life events and depressive problems in early adolescent boys and girls: the influence of parental depression, temperament and family environment

BACKGROUND: Stressful life events increase the probability of depressive problems in early adolescence. Several genetic and environmental risk factors may change individual sensitivity to the depressogenic effect of these events. We examined modification by parental depression and gender, and mediation of the former by temperament and family environment. METHODS: Data were collected as part of a longitudinal cohort study of (pre)adolescents (n = 2127). During the first assessment wave at approximately age 11, we assessed parental depression, family functioning, perceived parenting behaviours, and temperamental frustration and fearfulness. At the second wave, about two and a half years later, stressful life events between the first and second assessment were assessed. Depressive problems were measured at both waves. RESULTS: Adolescents with parents who had a (lifetime) depressive episode were more sensitive to the depressogenic effect of stressful events than adolescents without depressed parents. Furthermore, girls are more sensitive to these effects than boys. The modifying effect of parental depression was not mediated by temperament, family functioning and perceived parenting. LIMITATIONS: Life events were assessed without consideration of contextual information. Depressive problems were measured by questionnaires that did not directly represent DSM-IV criteria. The measure of parental depression was unspecific regarding severity and timing of depressive episodes. CONCLUSION: The results suggest that gender and parental depression are associated with increased sensitivity to depression after experiencing stressful life events during adolescence.     

Stressful events,mastery, and depression: An evaluation of crisis theory

The effect of prior stressful events and mastery on psychological distress during and following a threat to life was examined, and three competing models concerning the effect of prior stressful events on reactions to severe life crisis were compared. The stressful events model suggests that prior stressful events increase vulnerability to new threatening events. The traditional crisis model suggests no such effect of prior stressful events on crisis reaction due to the overwhelming effect of the crisis at hand. A facilitator model predicts that prior events decrease vulnerability to crisis due to a “practice effect.” Fifty-five Israeli women (not found to have cancer) were studied just prior to and 3 months following biopsy for suspected cancer. Those with greater prior stressful events were significantly more state depressed at both times than those experiencing fewer events, supporting the stressful events model. It was also found that mastery moderated the extent to which women were depressed and the period of time they remained depressed. However, mastery did not limit the stressful life event — depression relationship. Implications for research and intervention are discussed.     

Stressful life events promote the manifestation of asthma and atopic diseases

BACKGROUND: Psychosocial stress is known to aggravate asthma. Less is known about the impact of stressful life events on the expression of asthma and atopic disorders. OBJECTIVE: To determine whether the onset of asthma, allergic rhinitis or conjunctivitis, and atopic dermatitis, are associated with stressful life events. METHODS: A postal survey on risk factors for asthma and atopic diseases was carried out among 10 667 Finnish first-year university students aged 18-25 years. Stressful life events, (i) severe disease or death of a family member, and (ii) parental or personal conflicts, were retrospectively recorded during the preceding year, 1-5 years, 6-10 years, and more than 10 years prior to the survey response. In a case-control setting, conditional multiple logistic regression analysis was used to assess the temporal association between major stressful life events occurring during a period either preceding, concomitant or subsequent with subject's diagnoses. RESULTS: Concomitant parental and personal conflicts increased the risk of asthma (OR 1.72, 95% CI 1.10-2.69) when adjusted by parental asthma, education and passive smoking at early age. Concomitant severe disease or death of mother, father or spouse (OR 1.52, 95% CI 1.09-2.16) and precedent parental and personal conflicts (OR 1.75, 95% CI 1.15-2.77) increased the risk of manifestation of allergic rhinoconjunctivitis when adjusted for parental atopic disease, education and passive smoking. Subjects' asthma and atopic dermatitis, but not allergic rhinoconjunctivitis, were related to excess of subsequent stressful life events. CONCLUSION: An association between stressful life events and subjects' asthma, allergic rhinoconjunctivitis and atopic dermatitis is suggested.     

Exogenous corticosteroid exposures are associated with increased recollection of traumatic life events.

BACKGROUND: Exogenous corticosteroid exposures are associated with depression in clinical samples, however, the mechanisms underlying this association are unknown. Recent animal studies have shown that corticosteroids enhance conditioning in stressful learning paradigms. It has been hypothesized that corticosteroids may enhance the recollection of stressful experiences in humans, potentially contributing to the etiology of corticosteroid induced depression. This hypothesis has not been evaluated in human subjects. METHODS: The first phase of the Canadian National Population Health Survey collected data from a probability sample of 17626 members of the general Canadian population over the age of 12. The data set included measures of drug exposure (including corticosteroid exposures) and childhood and adult psychosocial stressors, including traumatic life events. In this study, self-reported traumatic life events were cross-tabulated against corticosteroid exposures in order to evaluate whether these variables were associated. RESULTS: 52% of subjects treated with corticosteroids in the month prior to the interview, as compared to 41% of non-exposed subjects reported one or more of the following stressors: parental divorce, long term parental unemployment, a "frightening" event that was "thought about for years after", being sent away from home for doing something wrong, parental drug or alcohol abuse, or physical abuse. This difference was statistically significant at the 5% level of confidence. LIMITATIONS: The use of cross-sectional survey data in this study precluded confirmation that changes in the pattern of trauma recollection followed exposure to corticosteroids. Also, the study relied on unconfirmed self reported medication exposure data, and ratings from brief survey instruments concerned with life events, stress levels and traumatic experiences. CONCLUSIONS: What we report is consistent with, but not confirmatory of, the hypothesis that increased recollection of stressful events may be a mechanism underlying associations between corticosteroids and depression. Additional research is needed in order to determine whether the basis for this association is an altered recollection of life events, or in a differing pattern of life experiences.     

Trajectories of depressive symptoms and stressful life events among male and female adolescents in divorced and nondivorced families

This 11-year longitudinal study models the trajectories of depressive symptoms among approximately 550 females and males raised in divorced and nondivorced families in the rural Midwest. Using multilevel analyses, we demonstrate that, first, depressive symptoms changed according to a curvilinear pattern, especially for females; they increased during early to midadolescence and then declined in late adolescence to young adulthood. Second, compared with males, females experienced a greater number of depressive symptoms in adolescence and early adulthood. Third, children who experienced parental divorce by age 15 manifested a sharper increase in depressive symptoms compared to those from nondivorced families. Fourth, stressful life events children experienced shortly after parental divorce mediated the effect of parental divorce on depressive symptoms. Fifth and finally, time-varying stressful life events, particularly those related to relationship and personal loss, were significantly associated with the trajectories of depressive symptoms.     

A meta-analysis of work-family conflict and various outcomes with a special emphasis on cross-domain versus matching-domain relations

A literature review of studies analyzing work-family conflict and its consequences was conducted, and 427 effect sizes were analyzed meta-analytically. Work-family conflict was analyzed bidirectionally in terms of work interference with family (WIF) and family interference with work (FIW). We assessed 3 categories of potential outcomes: work-related outcomes, family-related outcomes, and domain-unspecific outcomes. Results show that WIF and FIW are consistently related to all 3 types of outcomes. Both types of interrole conflict showed stronger relationships to same-domain outcomes than to cross-domain outcomes. Thus, WIF was more strongly associated with work-related than with family-related outcomes, and FIW was more strongly associated with family-related than with work-related outcomes. In moderator analyses, parenthood could not explain variability in effect sizes. However, time spent at work did moderate the relationships between WIF and family-related outcomes, as well as FIW and domain-unspecific outcomes.     

Psychosocial and vascular risk factors of depression in later life

BACKGROUND: Research on the aetiology of late-life depression has typically focused on either risk factors from the psychosocial stress-vulnerability domain or degenerative biological changes (for instance, vascular disease). We examined whether vascular risk factors could be interpreted within the stress-vulnerability model of depression. METHODS: The data came from a case-control design, nested in a community survey of elderly people. We compared 83 persons with a recently started episode of major or minor depression with 83 controls, with respect to the occurrence of stressful life events, long-term difficulties, neuroticism, and vascular risk factors (hypertension, heart disease, stroke). RESULTS: The (non-significant) association of vascular risk factors and onset of depressive episodes was not modified by neuroticism or the presence of long-term difficulties. Quite unexpectedly, vascular risk factors seemed to neutralize the depressogenic effect of stressful life events. The effect of vascular risk was significantly stronger in depressive episodes not preceded by a life event than in onsets following an event. CONCLUSIONS: Vascular risk factors cannot be interpreted within the stress-vulnerability model, but represent another pathway to depression. Why vascular risk factors reduce the depressogenic effect of stressful life events is not clear. Replication is critical to exclude the possibility of a chance finding.     

Family, peer, and individual correlates of depressive symptomatology among U.S. and Chinese adolescents

This study examined the correlates of symptoms of depressed mood among adolescents in 2 dramatically different cultures (n = 502 in Tianjin, People's Republic of China; n = 201 in greater Los Angeles). Gender, stressful life events, perceived parental warmth, and conflict with parents were associated in the expected direction with depressive symptoms in each cultural setting. As predicted, regression analyses showed that the quality of family relationships and grades in school had significantly stronger associations with depressive symptoms among Chinese youths than among U.S. youths, whereas gender differences in depressive symptoms were greater among the U.S. youths. Peer warmth moderated the effects of particular risk factors for depressive symptoms in each cultural setting.     

Early parental loss and salivary cortisol in young adulthood: the moderating role of family environment

Early family life adversity has been linked with negative physical and psychological health consequences in adulthood, possibly due to alterations in neuroendocrine activity. Young adults from families characterized by parental loss (N = 45) and control participants (N = 43) completed self-report measures of prior abuse and family conflict, and performed a stressful speech task designed to elicit neuroendocrine responses. Higher reported abuse and conflict were associated with increased cortisol for the loss group, but were unrelated to cortisol in the control group. Results indicate alterations in neuroendocrine functioning associated with early parental loss, which are moderated by the quality of the family environment.     

Death or illness of a family member,violence, interpersonal conflict,and financial difficulties as predictors of sickness absence: longitudinal cohort study on psychological and behavioral links

OBJECTIVE: Although an association between stressful life events and health problems has been demonstrated, the underlying mechanisms have remained unclear. We examined whether psychological problems and health-risk behaviors underpin the health effects of different event categories. METHOD: The initially healthy participants were 2991 (796 men, 2195 women) municipal employees who had taken no sick leave in 1995. In 1997, they completed a questionnaire requesting information on recent life events and psychological and behavioral factors. The outcome was recorded sickness absences in 1998. RESULTS: In men, the death or serious illness of a family member, violence, and financial difficulties increased the risk of later sickness absence. According to structural equation modeling, violence and financial difficulties also induced psychological problems such as anxiety, mental distress, and lowered sense of coherence. Psychological problems were associated with heightened cigarette and alcohol consumption, which in turn increased sickness absence. A corresponding structural model did not fit the data in relation to death or serious illness of a family member. In women, life events were associated with psychological problems and smoking but not sickness absence. CONCLUSIONS: Longitudinal evidence suggests that increased psychological problems and behaviors involving risk to health partially mediate the effect of stressful life events on health, as indicated by sickness absence. This model received support among men and for the event categories of violence and financial difficulties. Women were less affected by stressful life events than men.     

Effects of a preventive parent-training intervention on observed family interactions: proximal outcomes from preparing for the drug free years

Children are especially vulnerable to the initiation of substance use and other problem behaviors as they move from childhood into early adolescence. This is true for children living in urban and rural areas alike. A number of family-related factors have been identified that contribute to the risk for or protection against such problems. This article reports the results of an experimental test of the effects of Preparing for the Drug Free Years (PDFY) on targeted parental behaviors. PDFY is a parenting curriculum based theoretically on the social development model; it seeks to reduce risks and enhance protection against early substance use initiation by improving patterns of parental behavior and family interaction predictive of childhood substance use. The study examined parental behavior targeted by specific intervention sessions, based on systematic observations of videotaped family interactions. The sample consisted of economically stressed, rural Midwestern families. Consistent with hypotheses, the PDFY intervention was found to be effective in promoting proactive communication from parent to child and in improving the quality of parent-child relationships. PDFY also reduced mothers' negative interactions with their children in the study. © 1997 John Wiley & Sons, Inc.     

Perceived family climate,psychological adjustment,and peer relationship of black adolescents: A function of parental marital status or perceived family conflict?

This study examined two contrasting views of divorce and its effect on the adjustment of children. The physical wholeness position maintains that divorce itself is the salient variable that adversely affects children via the physical dissolution of the family; while the psychological wholeness position maintains that conflict is the critical variable which influences adjustment and does so regardless of parental marital status. Results of analyses on a sample of black working lower class adolescents failed to support the physical wholeness position; adolescents' age at the time of parental divorce, gender, and parental marital status were not significantly related to perception of family climate, psychological adjustment, grade point average, or peer relationships. However, results did provide strong support for the psychological wholeness position since adolescents' perception of family climate, psychological adjustment, and peer relationships were all significantly related to level of perceived conflict in the family. Conceptualizing divorce as a crisis situation rather than as a uniformly and universally negative event appears more reasonable since adolescents in our sample adapted to, and coped with, divorce. Use of conflict identification and resolution interventions to reduce family conflict may prevent future problems in child development.     

Evaluating the mediating effects of social support upon life events and depressive symptoms

Previous research has yielded inconsistent results regarding the mediating effects of social support upon psychiatric illness. Using data (N = 2029) gathered as part of a major epidemiologic study in the southeastern United States, the authors examine the relationships among depressive symptoms, social support, stressful life events, and socioeconomic status. As anticipated, direct effects were found for social support, stressful life events, and socioeconomic status upon depressive symptoms. However, when the data were analyzed via three-way analysis of variance and multiple regression (including all possible interaction terms) analysis, no statistically significant interactive effects were found. The authors conclude that these findings clearly demonstrate direct effects of social support and stressful life events upon depressive symptoms. Respondents in the lower social support groups experience the greatest impact of stressful life events; in contrast, persons in high social support groups, although evidencing increased symptom scores with increasing numbers of life events, experience the buffering effect of social support by showing less severe distress.     

The interaction of social network size and stressful life events predict delayed-type hypersensitivity among women with metastatic breast cancer.

This study examined relationships between social support, stressful life events and antigen-specific cell-mediated immunity. Participants were 72 women with documented metastatic breast carcinoma, who completed self-report measures of social support and life stress. Immune response was assessed using the delayed type hypersensitivity (DTH) skin test. Number of positive antigens was significantly related to the interaction of social network size and stressful life events (p<0.05). Number of positive antigens was greater for women who had experienced a high frequency of stressful life events but who reported a larger network of support. However, social network size was inversely related to DTH response among women who had experienced fewer stressful life events. Average induration size was not significantly related to the quality of social support, life stress per se, or their interactions. The relationship between social network size and immune response in women with metastatic breast cancer depends on prior stressful life experience.