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 life events among adolescents in Wuhan, China: Associations with smoking, alcohol use, and depressive symptoms

The associations among stress and adolescent smoking, alcohol use, and depression have been well documented in the United States, but few studies have evaluated the evidence for these associations in Asian cultures. This study developed a scale of stressful life events among 7th-grade adolescents in Wuhan, China. The events reported as most frequent involved bad grades or punishment at school, and the events reported as most severe involved disruptions in family life, such as death, divorce, or disability of parents. Associations were observed between life events (especially negative school-related events) and smoking, alcohol use, and depressive symptoms. Results indicate that school-related stress may lead to substance use and mental health problems among Chinese adolescents.     

Smokeless tobacco use in adolescent females: Prevalence and psychosocial factors among racial/ethnic groups

From a stratified, random sampling of Southeastern, nonurban high schools, survey data on smokeless tobacco use and potential psychosocial risk factors were obtained from 5683 adolescent females. Of the 15.3% who reported trying smokeless tobacco, most (75%) reported only experimental use. Factor analysis of the psychosocial items resulted in four factors: perceived negative consequences, substance use, modeling, and active lifestyle. Discriminant analysis on use indicated that modeling influences and use of other substances were the strongest predictors of initial smokeless tobacco use. Level of use, however, was most strongly associated with lower perceived negative consequences for use and the use of other substances. Separate analyses on American Indian, Black, and White subgroups suggested that factors associated with initial use were similar but that substantial differences exist between subgroups on risk factors for level of smokeless tobacco use.The research was funded by a grant from the American Society of Dentistry for Children.     

Stressful life events among homeless people: Quantity,types, timing,and perceived causality

This article describes the stressful life events suffered by a multicenter, randomized sample of 262 homeless adults in Madrid, Spain. Subjects were interviewed with the List of Threatening Experiences (Brugha and Cragg, 1990), supplemented by nine additional items specifically related to homelessness. Participants then rated each life event in regard to its causal contribution to their homeless situation. Findings showed that homeless people have suffered a mean of 9.1 important stressful events in their lives. Most of these events occurred Before (45% of the episodes), or During (39%), the first homelessness episode. In regard to the perceived causality of the stressful events, we found that homeless people have a multicausal view of their own problems. In fact, three categories of events were subjectively related to their current homeless condition: economic problems, breakdown of social ties, and mental illnesses. We discuss the implications of these data in light of Daly's (1994) typology of causal factors involved in homelessness: Economic, Affective/Relationship, Personal, and Institutional. © 1999 John Wiley & Sons, Inc.     

Stressful life events as a link between problems in nonverbal communication and recurrence of depression

BACKGROUND: Interpersonal difficulties and stressful life events are important etiological factors in (recurrence of) depression. This study examines whether stressful life events mediate the influence of problems in nonverbal communication on recurrence of depression. METHODS: We registered nonverbal expressions of involvement from videotaped behavior of 101 remitted outpatients and their interviewers. During a 2-year follow-up, we assessed stressful life events and recurrence of depression. RESULTS: The less congruent the levels of nonverbal involvement behavior of participants and interviewers, the higher the incidence of stressful life events, and -via these - the risk of recurrence. LIMITATIONS: Nonverbal behavior was measured in an experimental setting. CONCLUSIONS: The results suggest that lack of nonverbal congruence during social interaction contributes to the occurrence of stressful life events, which in turn may trigger depression.     

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.     

Stressful life events, psychological appraisal and coping style in postmenopausal women

Objectives

The study aim was to investigate what life events postmenopausal women attending a menopause clinic, report as stressful and how psychological appraisal of these events, menopausal symptoms and general stress mediate coping style.

Methods

An observational design was used to recruit 179 postmenopausal women attending a menopause clinic for the first time. Data was collected using self-report questionnaires assessing socio-demographic information, menopausal symptoms, perceived stress, named stressful event, psychological appraisal and coping styles employed.

Results

All of the women were postmenopausal, with a mean age of 50.74 years (SD = 4.75). Stressful events were categorised into family problems, menopause symptoms, work problems, daily hassles and other health problems. The most commonly reported coping styles were in order, catharsis (68%), direct action (66%), and seeking social support (63%). Logistic regression was used to determine what predicts coping style. Socio-demographic variables, menopausal symptoms and general stress levels were not predictive of coping styles in this study. Specific aspects of psychological appraisal were predictive of distraction, direct action, catharsis and seeking social support.

Conclusions

Coping styles most commonly implemented were also the ones predicted by psychological appraisal of the stressful event in this study and tend to be used more so by older women. This information could be used to develop more appropriate interventions for postmenopausal women.     

中国生活事件调查——(一)紧张性生活事件在正常人群中的基本特征

采用自编紧张性生活事件评定量表,对中国16岁以上正常人群4054人进行了调查,发现最严重的刺激因素是丧偶,家庭主要成员死亡;最轻微的刺激是生活琐事与人争吵,违章罚款或扣发奖金。中国正常成年人一年内承受心理紧张压力最大的事件是被人误会、错怪、子女管教困难,生活环境受噪音干扰,家庭主要成员患急、重病,家庭经济困难,工作中遇到困难等。从事件类别来看,健康和法律与政治方面的问题刺激强度偏重,人际关系、环境问题是主要的心理紧张刺激类别,也是发生频度最高的我国生活中常见心理紧张刺激源。本文还发现,高强度心理紧张刺激因素发生频度偏低,而低强度心理紧张刺激因素发生频度偏高。大约95%的16岁以上的中国正常人,一年内承受的心理压力可能不会超过60分,99%的人可能不会超过74分。     

Developmental changes in the sleep electroencephalogram of adolescent boys and girls

The sleep electroencephalogram (EEG) changes across adolescence; however, there are conflicting data as to whether EEG changes are regionally specific, are evident in non‐rapid eye movement (NREM) and rapid eye movement (REM) sleep, and whether there are sex differences. The present study seeks to resolve some of these issues in a combined cross‐sectional and longitudinal analysis of sleep EEG in adolescents. Thirty‐three healthy adolescents (18 boys, 15 girls; 11–14 years) were studied on two occasions 6–8 months apart. Cross‐sectional analysis of data from the initial visit revealed significantly less slow‐wave sleep, delta (0.3 to <4 Hz) and theta (4 to <8 Hz) power in both NREM and REM sleep with advancing age. The age–delta power relationship was significant at the occipital site, with age accounting for 26% of the variance. Longitudinal analysis revealed that NREM delta power declined significantly from the initial to follow‐up visit, in association with declining delta amplitude and incidence (P < 0.01), with the effect being greatest at the occipital site. REM delta power also declined over time in association with reduced amplitude (P < 0.01). There were longitudinal reductions in theta, alpha and sigma power in NREM and REM sleep evident at the occipital site at follow‐up (P < 0.01). No sex differences were apparent in the pattern of change with age for NREM or REM sleep. Declines in sleep EEG spectral power occur across adolescence in both boys and girls, particularly in the occipital derivation, and are not state‐specific, occurring in both NREM and REM sleep.     

Infant birthweight in the US: the role of preconception stressful life events and substance use

The purpose of this study was to determine the relationships among preconception stressful life events (PSLEs), women’s alcohol and tobacco use before and during pregnancy, and infant birthweight. Data were from the Early Childhood Longitudinal Study-Birth Cohort (n?=?9,350). Data were collected in 2001. Exposure to PSLEs was defined by indications of death of a parent, spouse, or previous live born child; divorce or marital separation; or fertility problems prior to conception. Survey data determined alcohol and tobacco usage during the 3 months prior to and in the final 3 months of pregnancy. We used staged multivariable logistic regression to estimate the effects of women’s substance use and PSLEs on the risk of having a very low (<1,500 g, VLBW) or low (1,500–2,499 g, LBW) birthweight infant, adjusting for confounders. Women who experienced any PSLE were more likely to give birth to VLBW infants (adjusted odds ratio [AOR]?=?1.35; 95 % confidence interval [CI]?=?1.10–1.66) than women who did not experience any PSLE. Compared to women who never smoked, women who smoked prior to conception (AOR?=?1.31; 95 % CI?=?1.04–1.66) or during their last trimester (AOR?=?1.98; 95 % CI?=?1.56–2.52) were more likely to give birth to LBW infants. PSLEs and women’s tobacco use before and during pregnancy are independent risk factors for having a lower birthweight baby. Interventions to improve birth outcomes may need to address women’s health and health behaviors in the preconception period.     

Risk factors for adolescent substance abuse and dependence: data from a national sample

A national household probability sample of 4,023 adolescents aged 12 to 17 years was interviewed by telephone about substance use, victimization experiences, familial substance use, and posttraumatic reactions to identify risk factors for Diagnostic and Statistical Manual of Mental Disorders--(4th ed.; American Psychiatric Association, 1994) defined substance abuse/dependence. Age and ethnicity data were available for 3,907 participants. Major findings were (a) adolescents who had been physically assaulted, who had been sexually assaulted, who had witnessed violence, or who had family members with alcohol or drug use problems had increased risk for current substance abuse/dependence; (b) posttraumatic stress disorder independently increased risk of marijuana and hard drug abuse/dependence; and (c) when effects of other variables were controlled, African Americans, but not Hispanics or Native Americans, were at approximately 1/3 the risk of substance abuse/dependence as Caucasians.     

Life events and treatment outcomes among individuals with substance use disorders: A narrative review

Substance use disorders are characterized by a variable course, in which multiple treatment attempts and relapses are typical. Consistent with conceptualizations of substance use and relapse, life events have been implicated in contributing to poor substance use disorders treatment outcomes. However, inconsistencies in empirical findings regarding the life events-substance use disorders outcome literature have been previously observed. This review provides an updated critique of the literature since the previous review published in 1987 (O'Doherty & Davies, 1987), examining the relationship between life events and substance use disorders treatment outcome among clinical samples of individuals. Review of 18 peer-reviewed articles suggested that data on the life events-outcome relationship continue to be inconclusive. Inconsistencies across studies in the operationalization of life events and substance use treatment outcomes and lack of theoretically driven designs may be contributing to differences in findings. Recommendations for future research that will increase the clinical utility of the life events construct are provided.     

Mental illness, neuroticism and life events in a Dutch village sample: a follow-up

In a 5-year follow-up of 32 patients identified during a survey of a Dutch village in 1969, approximately two-thirds were found to have recovered. This result was reflected in the scores on a self-reporting questionnaire. A control group showed little change over those years. The persistence of psychiatric problems was related to life experience, as measured by a life-event interview.     

Panel attrition and external validity in adolescent substance use research.

Panel attrition threatens external validity in adolescent substance use research. A 7-year adolescent panel was examined to determine whether attrition effects varied by (a) type of substance assessed and (b) method of measurement and type of statistical analysis. Chi-squares and multivariate analyses of variance revealed that study dropouts were more likely to use substances and reported higher mean use of substances at baseline than stayers; attrition effects varied by substance; and mean use comparisons were more likely to detect attrition effects than use-nonuse comparisons. Implications of these findings for adolescent substance use research are discussed.     

Discrimination, distrust, and racial/ethnic disparities in antiretroviral therapy adherence among a national sample of HIV-infected patients

OBJECTIVE: Although discriminatory health care experiences and health care provider distrust have been shown to be associated with health care disparities, little is known about their contribution to racial/ethnic disparities in antiretroviral therapy adherence. We therefore sought to assess the extent to which discriminatory health care experiences and health care provider distrust influence treatment-related attitudes, beliefs, and self-reported adherence in a national sample of HIV-infected patients. STUDY DESIGN: This secondary analysis used data from the HIV Cost and Services Utilization Study. We used structural equation modeling to identify pathways from minority status to adherence through discrimination, distrust, and treatment-related attitudes and beliefs. PARTICIPANTS: The sample was the 1886 participants who completed the baseline and 2 follow-up interviews and were prescribed antiretroviral therapy at the second follow-up interview (54% white, 28% black, 14% Hispanic, and 3% others). RESULTS: Minorities were less likely to report perfect adherence than whites (40% vs. 50%, P < or = 0.001). Over one third (40%) of all participants reporting ever having discriminatory health care experiences since having HIV, and 24% did not completely or almost completely trust their health care providers. The effect of minority status on adherence persisted in the full model. More discrimination predicted greater distrust, weaker treatment benefit beliefs, and, in turn, poorer adherence. Distrust affected adherence by increasing treatment-related psychological distress and weakening treatment benefit beliefs. CONCLUSIONS: The relationship between minority status and adherence was not fully explained by patient-level factors. Future studies should consider conceptualizing minority status as a contextual factor rather than predictor.     

Stressful life events and onset of mood disorders in children of bipolar parents during 14-month follow-up

BACKGROUND: Although multiple studies have examined the association between stressful life events (SLEs) and the development of mood disorders, the exact nature of the association and the degree to which it is independent from familial loading (FL) and gender-specific are still not fully elucidated. AIMS: To study the association between person-independent and -dependent SLEs and first onset or recurrence of a DSM-IV mood disorder episode (MDE) in offspring of bipolar parents. To examine interaction effects of SLEs with familial loading and gender. METHOD: Offspring of bipolar parents (N=132) were assessed with the K-LEDS, the FHRDC and the K-SADS. Logistic regression analysis was used to examine main and interaction effects of various operationalizations of SLEs, familial loading and gender. RESULTS: Dependent SLEs were more likely to occur before onset among the 13 offspring who had a MDE onset during the 14-month follow-up (39%) than in a comparable period among the 67 controls without any lifetime diagnosis (10%). Associations were slightly stronger for first onsets than for recurrences. The association between SLEs and MDE onset/recurrence was independent of socio-demographic characteristics and familial loading, but disappeared when adjusted for baseline anxious/depressive symptoms. Gender and familial loading did not modify the influence of any SLE measure on the development of mood disorders. CONCLUSIONS: In this sample of bipolar offspring dependent stressful SLEs triggered the onset of MDEs, but this association disappeared after adjustment of prior anxious/depressive symptoms, indicating that the association between SLEs and MDE is probably a spurious association. No interaction was found between SLE and FL and gender. Prior anxious/depressive symptoms seem to increase the risk for both occurrence of dependent SLEs and MDE onset or recurrence. LIMITATIONS: Limited statistical power due to small number of MDE onsets.     

Testing a developmental cascade model of adolescent substance use trajectories and young adult adjustment

Developmental models highlight the impact of early risk factors on both the onset and growth of substance use, yet few studies have systematically examined the indirect effects of risk factors across several domains, and at multiple developmental time points, on trajectories of substance use and adult adjustment outcomes (e.g., educational attainment, mental health problems, criminal behavior). The current study used data from a community epidemiologically defined sample of 678 urban, primarily African American youth, followed from first grade through young adulthood (age 21) to test a developmental cascade model of substance use and young adult adjustment outcomes. Drawing upon transactional developmental theories and using growth mixture modeling procedures, we found evidence for a developmental progression from behavioral risk to adjustment problems in the peer context, culminating in a high-risk trajectory of alcohol, cigarette, and marijuana use during adolescence. Substance use trajectory membership was associated with adjustment in adulthood. These findings highlight the developmental significance of early individual and interpersonal risk factors on subsequent risk for substance use and, in turn, young adult adjustment outcomes.