Life events and psychiatric impairment.

Abstract

This is a report on relationships between life crises and psychiatric impairment in a community sample of 938 adults in New Haven, Connecticut.It is part of a longitudinal study of the population of a community mental health center catchment area. The theoretical framework for the paper finds its roots in two bodies of socio-medical literature, namely, stress research and epidemiological field studies of mental illness. The specific research question is to determine whether or not there is a relationship between the occurrence of life events, the patterning of such events and the degree of psychological impairment. As in other field studies, we discovered a significant amount of psychiatric impairment in the community. Eighteen per cent of the adults interviewed were classified as having a high symptom level (very impaired), 47 per cent as a medium symptom level (moderately impaired), and 35 per cent as a low symptom level (unimpaired). More important, we found significant relationships between these scores and the occurrence of life events in the year previous to our interview. First, the greater the degree of impairment the more likely is the individual to have experienced at least one of 62 life events for which we gathered information. Equally important, there is a very strong association between the number of events experienced and the individual's mental status: the greater the number of events reported by respondents, the greater the proportional difference between the percentage of unimpaired and the percentage of very impaired who experienced that number of events. When events are categorized according to type of social activity, changes in the respondent's social field and degree of desirability impairment are strongly and positively related to the experiencing of life crises. Finally, similar patterns are found for each of the individual life events with the exception of several biopsychosocial situations associated with the family developmental cycle.Certain cultural and social factors, particularly role expectations and values, are discussed as possible factors helping to account for the relationshipsfound above between life crises and psychiatric impairment.