Health locus of control: a potential moderator variable for the relationship between life stress and psychopathology

Although research indicates that stressful life events commonly precede the onset of a variety of psychological disorders, reported correlations have consistently been only moderately strong. The present study examined the possibility that the health locus of control (HLC) mediates the relationship between life event stress and psychopathology. Subjects were 81 male volunteers between the ages of 21 and 62. The SCL-90-R was utilized to measure psychological symptom status. Subjects' perceptions regarding the desirability and controllability of experienced events were examined. Life events which were perceived to be both undesirable and uncontrollable were significantly correlated with the indices of psychopathology only for subjects who were external in HLC. Externals also showed significant correlations between events which were perceived as being undesirable but under personal control and psychological symptoms. The results suggest that externals are more vulnerable to life event stress than internals. Practical implications for health psychologists are discussed.     

Risk for recurrence in depression

Depression is a highly recurrent disorder with significant personal and public health consequences. Prevention of recurrence would be extremely desirable, and thus researchers have begun to identify risk factors that are specific to recurrence, which may be different from risk factors for first onset of depression. Methodological issues in this area of research are briefly reviewed (e.g., the various definitions of "recurrence" and "depression"), followed by a review of studies on specific risk factors, including demographic variables (gender, socio-economic status, and marital status), clinical variables (age at first onset, number of prior episodes, severity of first/index episode, and comorbid psychopathology), family history of psychopathology, and psychosocial and psychological variables (level of psychosocial functioning, cognitions, personality, social support, and stressful life events). In addition, scar theories are evaluated for their potential to explain how these variables and recurrent depression are linked. Our review suggests that recurrent depression reflects an underlying vulnerability that is largely genetic in nature and that may predispose those high in the vulnerability not only to recurrent depressive episodes, but also to the significant psychosocial risk factors that often accompany recurrent depression.     

Long sleepers sleep more and short sleepers sleep less: a comparison of older adults who sleep well

To determine some of the risks and benefits of being a long or short sleeper, psychological adjustment, lifestyle, and sleep parameters were investigated in 239 older adults. Responses of people who slept well and who were either long or short sleepers were studied on 48 variables investigating sleep parameters and sleep-related affect and beliefs; daytime fatigue and sleepiness; demographic factors, including age, sex, and income satisfaction; sleep lifestyle factors, including naps, bedtimes, arising times, and the regularity of these; general lifestyle factors, including regularity of mealtimes, overall daytime pleasantness, perceived busyness, diversity and valence of daily activities, and potentially stressful major life events. In addition, 14 variables evaluated aspects of psychological adjustment, including cognitive and somatic arousal, nocturnal tension, anxious, negative, unpleasant and worrying self-talk, depression, anxiety, overall psychopathology, neuroticism, and life satisfaction. Overall, the results indicate that short sleepers get up earlier, spend less time in bed, and have lower sleep efficiencies than their long sleeper counterparts. They eat breakfast earlier, and of course, they sleep less. Only one of the 14 psychological adjustment variables was significant. In view of the many differences between short and long sleepers described in prior research, the lack of differences observed between long and short sleepers is noteworthy.     

Major and minor life events as predictors of psychological distress: Further issues and findings

Current trends in research on stressful life events and disease have been to focus upon other psychosocial factors that may be associated with stress and illness relationships. Recently, the study of relatively minor life events or situations (e.g., daily hassles) has provided a promising alternative avenue of inquiry into basic stress measurement and the relationship of stress to disorder. While initial findings in this area of research appear encouraging, several methodological and procedural issues currently preclude definitive conclusions. The present paper outlines several of the most important limitations of existing research on this topic and provides further data taking these limitations into account for the role of minor life events as predictors of psychological distress. The results of the present prospective study indicate that undesirable minor events (e.g., hassles) significantly predict psychological symptoms, even once initial symptom status is controlled for statistically. Additionally, hassles were uniformly better predictors of subsequent psychological symptoms than were major life event categories; potentially important interactive effects (e.g., hassles x prior symptoms; hassles x prior major events) were also tested and their implications are discussed. Finally, basic associations between major and minor events were examined. The findings are discussed specifically in the context of recent advances in this area and more generally in relation to clarifying our understanding of psychosocial predictors of disorder.     

Long Sleepers Sleep More and Short Sleepers Sleep Less: A Comparison of Older Adults Who Sleep Well

To determine some of the risks and benefits of being a long or short sleeper, psychological adjustment, lifestyle, and sleep parameters were investigated in 239 older adults. Responses of people who slept well and who were either long or short sleepers were studied on 48 variables investigating sleep parameters and sleep-related affect and beliefs; daytime fatigue and sleepiness; demographic factors, including age, sex, and income satisfaction; sleep lifestyle factors, including naps, bedtimes, arising times, and the regularity of these; general lifestyle factors, including regularity of mealtimes, overall daytime pleasantness, perceived busyness, diversity and valence of daily activities, and potentially stressful major life events. In addition, 14 variables evaluated aspects of psychological adjustment, including cognitive and somatic arousal, nocturnal tension, anxious, negative, unpleasant and worrying self-talk, depression, anxiety, overall psychopathology, neuroticism, and life satisfaction. Overall, the results indicate that short sleepers get up earlier, spend less time in bed, and have lower sleep efficiencies than their long sleeper counterparts. They eat breakfast earlier, and of course, they sleep less. Only one of the 14 psychological adjustment variables was significant. In view of the many differences between short and long sleepers described in prior research, the lack of differences observed between long and short sleepers is noteworthy.     

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.     

Stress and life events during childhood and adolescence

Research concerned with life events and stress during childhood and adolescence is reviewed. Models of stress and life events and measures of stressful events during childhood and adolescence are described. Although problems in each of these areas are noted, recent progress in measurement is encouraging. Cross-sectional studies have found a consistent, although modest, correlation of stressful events with psychological, behavioral, and somatic problems. However, recent prospective studies provide greater support for the role of chronic strains and daily Stressors than major life events in the development of psychological and behavioral difficulties during adolescence. Directions for future research are outlined.     

自我概念,生活事件与心理健康

目的：本研究试图检验大学生自我概念与心理健康之间的关系，以及生活事件对大学生自我概念的影响，以探讨改善大学生心理健康状况的途径；方法：采用田纳西自我概念量表，大学生生活事件调查表及ＳＣＬ－９０对１９０名大学生被试进行测试，结果：总体自我概念及其各个特定方面，包括生理自我，道德／伦理自我，心理自我，家庭自我和社会自我，均与个体心理健康状况有显著关联，自我概念较积极的被试其心理健康状况良好；社会适应不     

Stressful life events and skin diseases: disentangling evidence from myth

The possibility of a causal influence of emotional stress, especially of stressful life events, on the course of various skin diseases has long been postulated. Clinical wisdom and experience, as well as many anecdotal observations and uncontrolled case series, support this opinion. We reviewed the available evidence on the role of stressful life events in triggering or exacerbating skin diseases. The role of stressful events in vitiligo, lichen planus, acne, pemphigus and seborrhoeic dermatitis was either controversial or insufficiently explored. The role of stressful events in psoriasis, alopecia areata, atopic dermatitis and urticaria was apparently clearer. However, only a few studies met acceptable methodological standards for stress measurement. Also, few studies considered common potential confounding factors (e.g. age, duration of illness, familial factors), and no study controlled adequately for the influence of other crucial factors (e.g. discontinuation of treatment, seasonal effects). Adding that the large majority of studies were retrospective, it seems wise to conclude that only preliminary evidence has been published so far on the role of stressful life events in bringing on or worsening any dermatological disease. Further research is mandatory, either in the form of prospective studies or, more feasibly, of well-designed case-control studies with adequate statistical power. Future studies should also pay more attention to protective as well as vulnerability factors in stressful events. Further, it would be important to investigate other sources of psychological stress, such as chronic stress and everyday stress. Measuring stress appraisal, although difficult, would also be important.     

Childhood trauma and psychosis: evidence, pathways, and implications

There is currently a growing body of research examining environmental factors in the etiology of psychosis. Much recent interest has focused on the relationship between childhood trauma and the risk of developing psychotic experiences later in life. Numerous studies of psychiatric patients where the majority are diagnosed psychotic indicate that the prevalence of traumatic experiences in this group is high. This body of research now includes many large-scale population-based studies controlling for possible mediating variables, which together provide persuasive evidence of a dose-response association and are indicative of a causal relationship. Several psychological and biological models have been proposed which offer credible accounts of the processes by which trauma may increase risk of psychotic experience. Clinically it is imperative to routinely inquire about traumatic experiences, to respond appropriately and to offer psychosocial treatments to those who report traumatic life events in the context of psychotic experiences.     

Stress and psychosis: towards the development of new models of investigation

The experience of stress is commonly implicated in the onset and maintenance of psychotic disorders such as schizophrenia. Previous studies that have addressed this relationship have had mixed results and serious methodological flaws associated with study design are common. One central limitation is the over-reliance on the experience of life events as a measure of the experience of stress. Research in the general stress literature suggest that attention also needs to be paid to the experience of other types of stressful events (such as 'hassles') as well as qualitative appraisals of events to fully understand the relationship between stressful experiences and mental health problems such as psychosis. Investigation of the experiences of stress by young people who are identified as being at heightened risk of developing a psychotic disorder would also result in a more complete understanding of the relationship between the experience of stress and the onset of psychotic disorder.     

Using cluster analysis to assess the effects of stressful life events: Probing the impact of parental alcoholism on child stress and substance use

Cluster analysis was used to categorize stressful life events into groups based on the effect (or mediational) pattern linking each event to external criteria defined within an overarching conceptual model. To illustrate the utility of “effect size clustering,” we examined the structure of stressful life events that may function to mediate, in part, the relation between parental alcoholism, parental psychopathology, and adolescent substance use. The analyses were conducted by forming clusters based on how each of 29 individual stressors related with 13 other variables considered relevant to the mediational process under investigation, rather than using the inter-item correlation matrix to determine event similarity. Using data on 326 families, four clusters were obtained that were labeled (a) family-related conflict, (b) general child relationship problems, (c) parent problems, and (d) major illness/bereavement. These exploratory analyses revealed that the family-related conflict cluster of events were of key importance in accounting for the link between paternal alcoholism and child substance use. Advantages and limitations of using effect size clustering for examining life event data, as well as data used in other community-oriented and program evaluation applications, are discussed. ©1998 John Wiley & Sons, Inc.     

Stressors and child and adolescent psychopathology: evidence of moderating and mediating effects

This paper reviews studies that have tested for moderators or mediators of the relation between stressors and child and adolescent psychopathology. Many studies have tested for moderation, but results of research studying moderators have been inconclusive. There have been few theory-based studies and there have been few consistent findings. Far fewer studies have tested for mediation effects, but these studies have generally been theory-driven, have more often built upon one another in an incremental fashion, and have yielded consistent results. In particular, there is substantial evidence for the mediating role of family relationship in the relation between stressors and child and adolescent psychological symptoms. Future studies should integrate moderator and mediator research by testing for specific mediators in relation to particular moderating contexts, so that we can better understand the complex ways in which stressful life experiences affect the well-being of children and adolescents.     

Severity of stressful life events in first and subsequent episodes of depression: the relevance of depressive subtype

BACKGROUND: Recent studies have reignited debate concerning the relationship between stressful life events and depressive subtypes, particularly in relation to first versus subsequent episodes. AIMS: To investigate the relationship between stressful life events and variably defined melancholic/non-melancholic depressive subtypes, and the import of such life events to first compared with subsequent episodes across those subtypes. METHOD: Acute and chronic stressful life events were rated in 270 patients with DSM-IV Major Depressive episodes who were allocated to melancholic and non-melancholic groups separately as defined by DSM-III-R, DSM-IV, the Newcastle criteria and the CORE system. RESULTS: Severe stressful life events (both acute and chronic)-as defined by DSM-III-R axis IV-were more likely to occur prior to first rather than subsequent episodes, particularly for those with non-melancholic depression. LIMITATIONS: Dependence or independence of life events was not assessed. Genetic vulnerability to depression was not determined. Life events in first and subsequent depressive episodes were compared cross-sectionally between groups, not prospectively in the same cohort of patients. There were no differences in the number of severe life events-as defined by clinician consensus-between the first and subsequent episodes. CONCLUSIONS: These findings are consistent with other studies in suggesting an enhanced sensitisation of depressed patients to subsequent episodes of depression, but suggest that any such phenomenon is specific to non-melancholic depression, in comparison to one key previous study.     

Interpersonal relatedness and self-definition: Two prototypes for depression

This paper reviews recent research that indicates the importance of differentiating subtypes of depression based on two types of experiences that lead individuals to become depressed: (a) disruptions of interpersonal relations and (b) threats to self-integrity and self-esteem. We review research with clinical and nonclinical samples that investigated the relationships of these distinctions to the quality of current interpersonal relationships and to differential sensitivity to various types of stressful life events, as well as to aspects of early life experiences, especially the quality of the parent-child relationship. We also evaluate research evidence that considers the role of these two dimensions in clinical depression. In addition to proposing an etiologic model about aspects of the onset and recurrence of depression based on the interaction between personality predispositions and types of stressful life events, we place these observations about depression in a broad theoretical context of contemporary personality theory which defines two primary dimensions of personality development and psychopathology.     

Stress, anxiety, and cognitive buffering.

Cognitive theories of psychopathology and therapy maintain that attitudes and beliefs mediate one's affective responses to life events. Anxiety and depression are thus consequences, not of an individual's circumstances, but of the distorted, irrational perspective from which these are viewed. Similarly, although less often considered, adaptive cognitions should serve as buffers against stressful life events. This proposition has received little attention, and the single study that attempted to address it directly failed to do so. The present investigation sought to reassess the buffering hypothesis. Ninety-seven subjects were evaluated as to (1) the levels of stress they had experienced in the recent past; (2) their current feelings of anxiety and depression; and (3) the extent to which they endorsed illogical, unrealistic attitudes. Dysfunctional attitudes demonstrated strong direct relations with psychological distress. Two of the several indices of life stress, total and negative scores on the Life Experiences Survey, also correlated with distress. There was no significant interaction between the attitude and stress measures. Cognitions, at least on the functional-dysfunctional dimension, did not moderate the impact of life events. Rather, both attitudes and life stresses were strong independent variables that, in additive fashion, provided considerable power for predicting distress.     

Life events and illness onset: A review

Investigations attempting to show a correlation between life events and the onset of any illness are reviewed. A brief discussion of the main methodologic problems in this area of research is also presented. Investigations of the sick role and the effect of stress upon illness behavior indicate that greater control of these variables is desirable. To gain this, it is suggested that in future studies, illness be more adequately documented than it has been to date. In the studies reviewed here, the data are not sufficiently sound to warrant any firm conclusions conceming the relationship between life events and illness onset.     

Posttraumatic growth among children and adolescents: a systematic review

Stress and trauma research has traditionally focused on negative sequelae of adversity. Recently, research has begun to focus on positive outcomes, specifically posttraumatic growth (PTG) - “positive change experienced as a result of the struggle with trauma” - which emphasizes the transformative potential of one's experiences with highly stressful events and circumstances. The positive changes of PTG are generally thought to occur in five domains: new possibilities, relating to others, personal strength, appreciation of life, and spiritual change. The study of PTG has, for the most part, been centered on adults, and not until very recently has there been sufficient research on PTG among children and adolescents to justify a review. The current systematic review of the literature on PTG among children and adolescents included 25 studies that tested associations between PTG and conceptually-relevant variables found to be associated with PTG in adults and hypothesized to play similar roles in young people, including environmental characteristics, distress responses, social processes, psychological processes, positive outcomes, and demographic variables. Links were made between a theoretical model of PTG among youth and findings of the current review. Limitations and recommendations for future research are discussed.     

Stressors and Child and Adolescent Psychopathology: Measurement Issues and Prospective Effects

This article reviews existing research on the association between stressors and symptoms of psychopathology in children and adolescents with a focus on measurement issues and prospective effects. The first half of the article focuses on the measurement of stressors, emphasizing checklists and interviews. Available measures of stressful experiences are reviewed and critiqued. Results of this review reveal both substantial progress (i.e., development of valid stressor assessment tools) and remaining problems (i.e., inconsistent measurement across studies). The second half of this article reviews studies that have tested for prospective associations between stressors and symptoms of psychopathology in children and adolescents. Studies that have examined the prospective effects of recent or prior stressors on current psychological symptoms, while controlling for prior psychological symptoms, are reviewed. Results overall suggest that stressors predict changes in rates of symptoms of psychopathology in children and adolescents over time. Results also suggest that symptoms of psychopathology predict changes in rates of stressors over time. Implications of these findings are that conclusive evidence now exists for the importance of stressors in the development of child and adolescent psychopathology.     

Stressors and child and adolescent psychopathology: measurement issues and prospective effects.

This article reviews existing research on the association between stressors and symptoms of psychopathology in children and adolescents with a focus on measurement issues and prospective effects. The first half of the article focuses on the measurement of stressors, emphasizing checklists and interviews. Available measures of stressful experiences are reviewed and critiqued. Results of this review reveal both substantial progress (i.e., development of valid stressor assessment tools) and remaining problems (i.e., inconsistent measurement across studies). The second half of this article reviews studies that have tested for prospective associations between stressors and symptoms of psychopathology in children and adolescents. Studies that have examined the prospective effects of recent or prior stressors on current psychological symptoms, while controlling for prior psychological symptoms, are reviewed. Results overall suggest that stressors predict changes in rates of symptoms of psychopathology in children and adolescents over time. Results also suggest that symptoms of psychopathology predict changes in rates of stressors over time. Implications of these findings are that conclusive evidence now exists for the importance of stressors in the development of child and adolescent psychopathology.