Life Events,Perceived Control and Illness: The Role of Uncertainty

Abstract

The health implications of recognizing the difference between situations that are controllable and those that are not has been noted by a variety of sources. With this notion in mind, the present study examined the relationship between perceptions of control and desirability of life events and subsequent health in a college student sample. Subjects indicated which of a list of life events had occurred to them over a three-month span and also specified how desirable each was and to what extent they were in control of its occurrence. Illness was reported for the following month. The results indicated that both undesirable uncontrollable events and undesirable events of uncertain controllability were significantly related to the occurrence of illness. Of greatest interest was the finding that the occurrence of events of uncertain controllability was more strongly related to illness than events perceived as totally uncontrollable. The results are discussed in terms of research and theory stressing the adaptive significance of the ability to discriminate controllable situations from uncontrollable ones.     

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.     

The relationship between life events and mental health in homosexual men

In a study to determine the extent to which stigmatization influences mental health in homosexual men, 80 homosexual men were administered the General Health Questionnaire and the Gay Affect and Life Events Scale. Data indicated that there were significant associations between life events and mental health; events related to AIDS had the highest correlations. However, general life event scales that included Finances and Work also were associated significantly with mental health, as previously reported in the general population. These data suggest that the impact of life events may be amplified by stigmatization and that degree of life change is associated closely with psychological dysfunction. It is concluded that life events that are related to both stigmatization and life change and related emotional distress are significant predictors of psychology dysfunction.     

Global Perceived Stress Level as a Moderator of the Relationship between Negative Life Events and Depression

Abstract

The present research investigated the proposal that global perceived stress level moderates the degree of relationship between negative life events and depression. Accordingly, subjects in this study completed the Beck Depression Inventory (BDI), the Life Experiences Survey (LES), and the Perceived Stress Scale (PSS). The PSS provides a measure of global perceived stress level, or the general tendency to view one's life as being unpredictable, out of control, and overwhelming. Consistent with past research, the findings revealed an increase in depression level as negative life change scores increased. Of special importance, however, was the finding that global level of stress significantly moderated the relationship between depression and negative life events. For those low on perceived stress, negative life changes had only a minimal impact on depression level. In contrast, for those high on perceived stress, the relationship was more pronounced. These findings were then discussed with regard to the possible role of cognitive appraisals in enhancing the symptoms of psychopathology experienced by individuals high on global level of perceived stress.     

Stressful life‐events exposure is associated with 17‐year mortality,but it is health‐related events that prove predictive

Objectives Despite the widely‐held view that psychological stress is a major cause of poor health, few studies have examined the relationship between stressful life‐events exposure and death. The present analyses examined the association between overall life‐events stress load, health‐related and health‐unrelated stress, and subsequent all‐cause mortality. Design This study employed a prospective longitudinal design incorporating time‐varying covariates. Methods Participants were 968 Scottish men and women who were 56 years old. Stressful life‐events experience for the preceding 2 years was assessed at baseline, 8–9 years and 12–13 years later. Mortality was tracked for the subsequent 17 years during which time 266 participants had died. Cox's regression models with time‐varying covariates were applied. We adjusted for sex, occupational status, smoking, BMI, and systolic blood pressure. Results Overall life‐events numbers and their impact scores at the time of exposure and the time of assessment were associated with 17‐year mortality. Health‐related event numbers and impact scores were strongly predictive of mortality. This was not the case for health‐unrelated events. Conclusions The frequency of life‐events and the stress load they imposed were associated with all‐cause mortality. However, it was the experience and impact of health‐related, not health‐unrelated, events that proved predictive. This reinforces the need to disaggregate these two classes of exposures in studies of stress and health outcomes.     

Plasma concentrations of 25-hydroxyvitamin D among Jordanians: Effect of biological and habitual factors on vitamin D status

Background

Stress as a cause of illness has been firmly established. In public health and stress research a retrospective biomarker of extended stress would be an indispensible aid. The objective of this pilot study was to investigate whether concentrations of cortisol in hair correlate with perceived stress, experiences of serious life events, and perceived health in young adults.

Methods

Hair samples were cut from the posterior vertex area of (n = 99) university students who also answered a questionnaire covering experiences of serious life events, perceived Stress Scale and perceived health during the last three months. Cortisol was measured using a competitive radioimmunoassay in methanol extracts of hair samples frozen in liquid nitrogen and mechanically pulverised.

Results

Mean cortisol levels were significantly related to serious life events (p = 0.045), weakly negatively correlated to perceived stress (p = 0.025, r = -0.061) but nor affected by sex, coloured/permed hair, intake of pharmaceuticals or self-reported health. In a multiple regression model, only the indicator of serious life events had an independent (p = 0.041) explanation of increased levels of cortisol in hair. Out of four outliers with extremely high cortisol levels two could be contacted, both reported serious psychological problems.

Conclusions

These findings suggest that measurement of cortisol in hair could serve as a retrospective biomarker of increased cortisol production reflecting exposure to major life stressors and possibly extended psychological illness with important implications for research, clinical practice and public health. Experience of serious life events seems to be more important in raising cortisol levels in hair than perceived stress.     

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     

Life event stress and coping style as contributors to psychopathology

Despite the nearly universal finding that life event stress is related to psychopathology, the strength of these relationships is weak. In an attempt to increase the strength of the correlation between life event stress and psychopathology, this study evaluated the simultaneous contribution of life event stress and coping style, as well as the independent contribution of each, to psychopathology. Seventy-six male and 74 female college students served as primary subjects, while an additional 57 male and 60 female college students served as a cross validation sample. Each subject completed the Life Experiences Survey, the Coping Strategies Inventory, and the MMPI. Sex differences were found in the type of coping style related to psychopathology, the relative contributions of coping style and negative life stress to psychopathology, and the percentage of variance accounted for in psychopathology. Future research was recommended to include other variables, such as chronic life stress and physiological reactivity, and to control better for such methodological problems as response sets.     

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.     

Life events and psychopathology severity: comparisons between psychiatric outpatients and inpatients

Relationships between life events stress variables and seven indices of psychopathology severity for a group of 97 never-hospitalized outpatients were compared with those of a previously studied group of 217 first-admission functional disorder psychiatric inpatients from the same geographical catchment areas. The hypotheses tested were that degree of life events stress would be correlated positively with indices of psychopathological severity and that the magnitudes of association would be higher for the outpatients. Bivariate correlations and stepwise multiple regression with other potential demographic and prognostic moderator variables provided evidence for significant, but somewhat differing, patterns in outpatient vs. inpatient stress/pathology relationships. Contrary to prediction, the magnitudes of significant and near-significant associations between life events and pathology severity were not different in the two samples.     

劳务工骨折患者应激相关因素对焦虑情绪的效应分析

目的探讨劳务工骨折患者状态焦虑的原因,为焦虑情绪预防性心理干预提供科学的理论依据。方法采用生活事件量表、状态焦虑量表、领悟社会支持量表、防御方式问卷和艾森克个性问卷等多种方式对110名劳务工骨折患者进行心理评估,通过回归方差分析,研究个体状态焦虑与生活事件、领悟社会支持、人格特征、防御方式等因素是否有关。结果家庭支持、内外向、成熟、朋友支持、生活事件对状态焦虑有直接和间接影响(F=25.58,P0.05),反映其直接影响强度的通路系数依次分别为-0.169、-0.158、-0.254、-0.220、0.417。结论生活事件、领悟社会支持、人格特征、防御方式等社会心理因素是影响劳务工骨折患者情绪障碍发生、发展的重要原因。     

Platelet monoamine oxidase activity and life stress as predictors of psychopathology and coping in a community sample

The present study, using a diathesis-stress model, attempted to confirm prior findings with platelet monoamine oxidase (MAO) activity and stress in a middle-aged, non-clinic population. One hundred and seventy-eight adult males from a statewide community club were tested for platelet MAO activity and stressful life events and were also given a variety of psychological measures of both psychopathology and psychosocial coping. The data were examined both for correlations across the total sample and for a comparison of high-risk groups (top and bottom 15% of MAO activity) with a middle MAO group. Low platelet MAO activity was related to a higher incidence of contact with mental health professionals, and more frequent use of alcohol and cigarette smoking. High MAO activity was related to higher levels of anxiety and somatization. High levels of stress were related to increased psychosocial problems reported for female and family members, higher scores on two schizophrenia-related MMPI scales (schizophrenia and paranoia subscales), but fewer idiosyncratic associations, elevated hypomanic, depression, and anxiety scores, increased alcohol use, and increased use of prescribed antianxiety and sedative medication. Neither MAO nor stress were related to current levels of psychosocial coping. Moreover, no interaction effects were uncovered for MAO activity and stress combined.     

Social Adversity Experience and Blood Pressure Control Following Antihypertensive Medication Use in a Community Sample of Older Adults

Background

Psychosocial stress is a risk factor for hypertension and has been shown to affect response to treatment for psychiatric illnesses.

Purpose

We investigate the relationship between a history of social adversity experience and blood pressure control following antihypertensive medication use.

Methods

A total of 1,186 participants selected from the European Prospective Investigation into Cancer-Norfolk study (531 men and 655 women, aged 42 to 80 years) had attended two health checks at which blood pressure measurements were taken; were taking antihypertensive medication at the second, but not the first health check; and had completed a questionnaire assessment of their social and psychological circumstances which included details of traumatic experiences in childhood and of adverse life events, long-term difficulties, and perceived stress in adulthood.

Results

Experience of recent loss events in adulthood was associated with a smaller reduction in systolic blood pressure after starting hypertension treatment (β?=?1.78, 95 % confidence interval 0.15–3.40, per life event), independently of age, sex, preexisting health conditions, cigarette smoking history, alcohol consumption, physical activity, and obesity.

Conclusion

Results from this study suggest that stress caused by recent losses may be associated with reduced effectiveness of treatment for hypertension. Subject to replication, these findings may help determine the specific physiological mechanisms by which medication treatment effectiveness is affected by stress.     

Impact of maternal trauma-related psychopathology and life stress on HPA axis stress response

To understand and curb intergenerational transmission of stress-related disorder, it is important to identify how trauma-related psychopathology in mothers impacts their psychophysiological stress regulation, particularly in the context of parenting their infants. In this study we investigated associations between mothers’ trauma-related psychopathology and life stress and HPA axis response to a personally relevant stressor (infant separation stress) in a non-clinical sample followed longitudinally postpartum. A community sample of low-income mothers (n = 73) and their infants completed laboratory sessions at 3, 6, 12, and 18 months postnatal, and salivary cortisol samples collected before and after dyadic stress tasks at the latter three sessions. These tasks were used to assess HPA function. A three-level hierarchical linear model of repeated cortisol measures nested within sessions within mother-infant dyads did not reveal significant main effects of trauma-related psychopathology on maternal cortisol response, but there was evidence that both a clinical interviewer-rated diagnosis of PTSD and ongoing self-reported trauma symptoms blunted effects of life events on cortisol reactivity. Region of significance analyses indicated that current life stress predicted more pronounced cortisol reactivity only among mothers without trauma-related psychopathology; for those with trauma-related psychopathology, life stress did not relate to cortisol response. Effects held when controlling for childhood trauma and previous (prenatal) maternal distress symptoms, suggesting they did not reflect ongoing impacts of past trauma exposure and/or psychopathology. Blunting effects of trauma-related psychopathology on maternal life stress responsiveness may help clarify how stress sensitivities and mental health are transmitted from parent to child.

     

Relationships among life stress, perceived family environment, and the psychological distress of spina bifida adolescents

Fifty-three teen-agers with spina bifida participated in a mail survey and completed measures of recent life events, perceived family environment, and psychological distress. Low levels of perceived family conflict and control served as life stress buffers in the prediction of distress, whereas a high level of perceived independence served as a life stress exacerbator. These interaction effects differ from those obtained for a normal sample of adolescents in the lone previous study (Burt, Cohen, & Bjorck, 1988) that reported comparable analyses. The results suggest that the process by which family environments moderate stress adjustment differs for able-bodied vs. spina bifida adolescents.     

The relationship of social support to perceived control and subjective mental health in adolescents

This study investigated the link between social support and positive constructs, specifically, psychological well-being and the perceived ability to obtain and savor positive life events. Eighty-two high school students were surveyed. Social support was significantly related to positive dimensions of subjective mental health (happiness, gratification, and self-confidence), but not to its negative components (vulnerability, strain, and uncertainty), and was also significantly related to respondents' perceived ability to obtain and savor positive life events, but not to their perceived ability to avoid or cope with negative events. Future theory and research should examine the link between social support and positive constructs such as psychological well-being and positive life experience.     

40例医学生失眠症患者心理健康影响因素的通径分析

目的：探讨医学生失眠者心理健康的影响因素及其相互作用方式。方法：通过对40例医学生失眠者和53例非失眠者心理健康状况及相关因素的调查，采用单因素相关分析和通径分析的方法研究心理健康影响因素的作用方式和途径。结果：学习压力是医学生中主要的生活应激性事件，通过间接作用影响了失眠者的心理健康；情绪稳定性的高低可能是影响心理健康的个性素质因素，具有直接作用和间接作用两个方面；应付方式是生活应激性事件、个性影响心理健康的中间环节。结论：加强认知心理治疗和改变医学生失眠者的不良应付方式可能是治疗和预防其心理问题的根本途径。     

The association between dispositional mindfulness,psychological well‐being,and perceived health in a Swedish population‐based sample

Objectives. There is increasing recognition of the links between mindfulness, decreased stress, and healthier psychological functioning. However, the majority of this research has been conducted in US samples and the mechanisms through which mindfulness decreases stress and increases well‐being are not well understood. The aim of this study was to examine the relations between mindfulness and psychological functioning in a general population sample in Sweden. Design. This cross‐sectional study examined the association of mindfulness and five subscales of mindfulness with depression, anxiety, positive states of mind (PSOM), and perceived health. Methods. In the spring of 2007, a random population‐based sample of N= 1,000 individuals aged 18–60 years in Sweden was contacted by mail with a request to participate in the study. Results. Mindfulness and some of its subscales, in particular Acting with awareness and Non‐reactivity to inner experiences, were strongly related to PSOM and perceived health, and inversely related to depression and anxiety. Tests of the moderating role of mindfulness showed that the associations of perceived stress with depression and perceived health were diminished for those with higher levels of mindfulness. Conclusions. Mindfulness is strongly related to well‐being and perceived health. Results suggest that dispositional mindfulness might buffer against the negative influence of perceived stress on psychological well‐being. These findings give additional support for the use of mindfulness training as a way of improving psychological functioning among people experiencing stress.     

A new approach to psychopathology

A new approach to psychopathology based on the psychology of integration as applied to psychological states is outlined. Because all raw behavior occurs only in the form of psychological states, all formulations of psychopathology must refer to integrative disorders that are postulated to underlie all pathological or defective behaviors. Disintegration is the one common factor found in all mental disorders. Lack of integration underlies most inadaptability. The classical field of psychopathology, which formerly was limited to the consideration of formal psychiatric disorders, now is expanded to include deficits, imbalances and disintegrations of acute or chronic nature that result in erroneous or less than perfect judgments. Judgment is considered to reflect the quality of underlying integrative processes. Judgmental defects that lead to maladaptive decisions inevitably must result in maladjustment and/or less than perfect performance. It is necessary to differentiate between (a) integrative disorders per se, and (b) the personal-social effects of positive or negative integrations organized by healthy or unhealthy factors. Criminals may be well integrated in their asocial activities, but socially undesirable because organized about the criminal ethic. Postulates are presented that outline the theoretical assumptions upon which integrative psychopathology is based. This approach utilizes classic theories such as the Freudian psychopathology of everyday life when valid and relevant within the larger framework of integrative psychology. A differentiation is made between hierarchical levels of increasingly complex factors that may organize integration.     

Bereavement and social support at the climacteric

The relationship between life events and symptoms was examined in a general population sample of Scottish climacteric women within the framework of the concepts and methods developed in the field of life event research. It was found that at least some of the increase in symptoms at that time of life was due to the occurrence of stressful life events. This relationship was a complex one as different types of life events were associated with symptoms in a differential way. In particular, the occurrence of a bereavement involving a close family member and the consequent loss of social support, were found to be significant factors in provoking physical symptoms, but only in the presence of other life stress. These results are discussed in the context of the findings of other life event researchers.