Negative life events, social support and gender difference in depression

Objective

To explore if differences in negative life events, vulnerability and social support may explain the gender difference in depression.

Methods

Cross-sectional, multinational, community survey from five European countries (n = 8,787). Depression is measured by Beck Depression Inventory, whereas negative life events and social support are measured by various questionnaires.

Results

Women report slightly more negative life events than men do, mainly related to the social network, but more social support in general and in connection with reported life events. This trend is the same in all participating countries except Spain, where there is no gender difference in the reported support. In general, women are not more vulnerable to negative life events than men are. However, women with no social support, who are exposed to life events, are more vulnerable than men without support.

Conclusion

The higher rate of depression in women is not explained by gender differences in negative life events, social support or vulnerability.     

Social support, life events, and depression during pregnancy and the puerperium

A sample of 99 women was studied prospectively from the second trimester of pregnancy until nine weeks post partum. Depressed and nondepressed women identified at the second-trimester assessment and the postpartum assessment were compared on measures of stressful life events and social support provided by their spouses and close confidants. Nine percent of women during pregnancy and 12% of women after delivery were depressed. Women experiencing postpartum depression reported more stressful life events and less support from their spouses after delivery than the women not experiencing postpartum depression. Women experiencing depression during pregnancy reported somewhat less support from their spouses and more support from their confidants than nondepressed women. The results of the study suggest that different causes may be responsible for prepartum and postpartum depression.     

Genetic risk, number of previous depressive episodes, and stressful life events in predicting onset of major depression

OBJECTIVE: The association between stressful life events and the onset of major depression decreases as the number of previous depressive episodes increases. How do genetic risk factors for major depression impact on this "kindling" phenomenon? In particular, do those at high genetic risk exhibit an increase in the speed of kindling, or are they "prekindled"? METHOD: Using discrete-time survival analysis, the authors examined the interaction between genetic risk, number of previous depressive episodes, and life event exposure in the prediction of episodes of major depression in female-female twin pairs from a population-based registry. The twins were interviewed four times over a 9-year period, producing 92,521 person-months of exposure. RESULTS: The decline in the association between stressful life events and risk for major depression as the number of previous depressive episodes increased was strongest in those at low genetic risk and was weak to absent in those at high genetic risk. In the absence of previous depressive episodes, those at high genetic risk frequently experienced depressive episodes without major environmental stressors. CONCLUSIONS: Genetic risk factors for depression produce a "prekindling" effect rather than increase the speed of kindling. The "kindled" state, wherein depressive episodes occur with little provocation, may be reached by two pathways: many previous depressive episodes, perhaps driven by multiple adversities, and high genetic risk.     

Social support and life events as risk factors for depression amongst women in an urban setting in Zimbabwe

  Background: This paper explores the applicability of a psychosocial model of depression in an African setting. Method: Of a random sample of women (n=172) from a Zimbabwean township, 79 had a severe life event in the year before interview. Twenty-nine who had an onset of depression were compared with 50 who did not. Results: Having crisis support following a severe life event reduced the risk of onset of depression. The effect of crisis support was confounded by the number of severe events in the study year, but just persisted following adjustment for number of severe events and for socio-demographic factors. Women received crisis support more often from relatives than from partners or friends. The following variables were independently associated with onset of depression following a severe life event: number of life events in the previous 6 months, age, being in formal employment, having crisis support and separation from mother in childhood. Conclusion: This study supports the ubiquity of the social support construct. For Zimbabwe, the data suggest that crisis support from family members may be of particular importance in protecting against onset of depression. Accepted: 7 December 2000     

Neuroticism,depression and life events: A structural equation model

Summary The relationship between trait neuroticism, life events and depressive symptoms was studied in a sample of New Zealand women over a 4-year period. These results were analysed using a structural equation modelling approach which attempted to estimate the effects of both random and systematic errors of measurement on the correlation between neuroticism and depressive symptoms. The analysis suggested the following major conclusions. — Firstly, simple correlations between neuroticism and depression measures are strongly biassed upward as a result of systematic errors of measurement. The correlation between neuroticism and depression was + 0.50 after correction of systematic measurement error, whereas prior to this correction it was + 0.70. — Secondly, there were consistent correlations between neuroticism measures, corrected for random and systematic measurement error, and life events scores, indicating that subjects who scored high on neuroticism had a greater susceptibility to adversity. — The implications of the approach for understanding the relationships between measures of personality traits and psychopathology are discussed.     

Genetic and population perspectives on life events and depression

Population comparisons of epidemiological surveys using the same investigator-based measures suggest that large differences are possible in the experience of clinically relevant depression and of life events capable of provoking such episodes. It is argued that, given the great majority of onsets in the various populations were provoked by a life event, the differences in the experience of depression are likely to have been largely the result of psychosocial factors. Moreover, this interpretation would still be likely to hold even if heritability (h ²) coefficients for depression within the component populations were substantial. The same argument would hold for the interpretation of the across-population differences in the experience of life events. New material concerning the differing experience across populations of humiliation/entrapment events, known to be particularly depressogenic, is also presented and the implications of the findings for future aetiological research discussed. Accepted: 27 January 1998     

Method and technique of life events research in depression and anxiety

Methodological aspects still have a decisive impact on the putative etiological role of life events in clinical research. Questions of a diagnostic nature also serve to complicate this kind of research still further, in this present review in particular, when it deals with depression and/or anxiety. The relationship between life events and disturbed behavior also depends on additional variables, such as personality factors and social support. It is for this reason that detailed specification of the concepts used in life events research would seem to be necessary. And finally--when more than two variables are present--the simultaneous application of a number of statistical models is worthy of recommendation.     

Major life events and risk of Parkinson's disease

Major life events such as divorce, death of a spouse or a child, or long‐term unemployment are stressful to most people and animal models have suggested a link between stress and onset of parkinsonian symptoms. In a large case‐control study based on nationwide registries, we aim to address whether major life events are risk factors for Parkinson's disease. Between 1986 and 2006, we identified 13,695 patients with a (PD) primary diagnosis of PD in the Danish National Hospital Register. Each case was frequency matched by age and gender to five population controls. Information on major life events before onset of PD was ascertained from national registries. Among men, number of life events was associated with risk of Parkinson's disease in an inverse dose‐response manner (P < 0.0001). Compared to no events, three or more events were associated with a 42% lower risk of PD (OR = 0.58; 95 % CI: 0.34–0.99). Life events were not associated with PD in women. In contrast, a higher risk of PD was observed among women who had never been married (1.16; 1.04–1.29) and among men (1.47; 1.18–1.82) and women (1.30; 1.05–1.61) who have never been employees. The lower risk of Parkinson's disease among men who had experienced life events was unexpected but might suggest a general “risk avoidance behavior” in Parkinson's patients. © 2010 Movement Disorder Society     

Associations between major life events, traumatic incidents, and depression among Buffalo police officers

Police officers are considered to be a highly stressed population due to the nature of the work they perform. Repeated exposures to work stress and stressful life events can affect one's psychological and physiological well-being. The objective of this study was to determine whether negative life events and traumatic police incidents are associated with depression in police officers. One hundred randomly selected urban officers completed a series of self-report measures as part of a cross-sectional pilot study. Using four negative life event categories (none, low, medium, and high) a J-shaped pattern was observed with mean depression scores (+/- SD) of 9.26 (+/- 7.41), 6.21 (+/- 5.94), 8.17 (+/- 7.42), and 14.64 (+/- 8.04), respectively (test for linear trend p = 0.0186). Adjustment for age (p = 0.0209), then age, gender and ethnicity together (p = 0.0184) did not alter this pattern appreciably. No association between traumatic police incidents and depression was observed. Results indicate that exposure to multiple negative life events is significantly associated with elevated depression scores among this sample. Police agencies should consider developing psychological assistance efforts to help affected officers cope with these events and deal with depression.     

Family history,life events and the factorial structure of depression in a Nigerian sample of inpatients

The aims of the study were to examine the frequency of a family history of depression among 96 patients with subtypes of ICD-10 depression, their life event scores, and compare the factors of depression with other studies. Subjects were assessed using the PSE-9, 23-item HDRS, BPRS and life event schedule. Family history was significantly commoner for psychotic depression. There were no significant differences in life event scores. The HDRS factors -- core depression, endogenous, insomnia and psychic anxiety -- were similar to those of previous studies. Combining the HDRS and BPRS yielded factors that were more representative of the dimensions of depression. While family history distinguishes psychotic depression, life events are important with increasing age, but require interaction with predisposing factors. Although depression is heterogeneous, there are core clinical features which are stable across cultures and time. Family history is more associated with the severer forms of the disorder, and combining relevant questionnaires maybe more useful in research on symptom profiles.     

Biological risk factors in late life depression.

A number of biological risk factors have been tentatively identified for unipolar and bipolar disorder in the elderly. The list includes genetic factors as well as medical illness in general and vascular disease in particular. Most of these risk factors have been identified on the basis of cross sectional studies rather than longitudinal studies. There is a need for long term epidemiologic and prevention studies (in the case of modifiable risk factors). The modifiable risk factors include medical illness in general and vascular disease in particular. An example is the use of antidepressants following stroke to prevent the onset of depression. Of particular interest is the role of vascular risk factors and MRI changes suggesting subtle cerebrovascular disease in the development of depression and bipolar disorder in late life. The changes have been established using both clinical samples and in the case of depression in cross sectional epidemiologic samples. The location of these cerebrovascular changes has contributed to our understanding of the regions of the brain implicated in the pathophysiology of depression. Further longitudinal and preventive studies are needed to conclusively demonstrate these as biological risk factors.     

The interrelationship of neuroticism, sex, and stressful life events in the prediction of episodes of major depression

OBJECTIVE: Three potent risk factors for major depression are female sex, the personality trait of neuroticism, and adversity resulting from exposure to stressful life events. Little is known about how they interrelate in the etiology of depressive illness. METHOD: In over 7,500 individual twins from a population-based sample, the authors used a Cox proportional hazard model to predict onsets of episodes of DSM-III-R major depression in the year before the latest interviews on the basis of previously assessed neuroticism, sex, and adversity during the past year; adversity was operationalized as the long-term contextual threat scored from 15 life event categories. RESULTS: In the best-fit Cox model for prediction of depressive onsets, neuroticism, female sex, and greater adversity all strongly increased risk for major depression. An interaction was seen between neuroticism and adversity such that individuals with high neuroticism were at greater overall risk for major depression and were more sensitive to the depressogenic effects of adversity. An interaction was also seen between adversity and sex, as the excess risk for major depression in women was confined to individuals with low stress exposure. CONCLUSIONS: Psychosocial adversity interacts both with neuroticism and with sex in the etiology of major depression. The impact of neuroticism on illness risk is greater at high than at low levels of adversity, while the effect of sex on probability of onset is the opposite--greater at low than at high levels of stress. Complete etiologic models for major depression should incorporate interactions between risk factor classes.