Acute Stressful Life Events Research Articles

When you avoid your feelings, you may feel even worse: how depersonalization puts you at risk of depression.

The clinical form of depersonalization affects approximately 1%-2% of the adult population. This study aimed to describe the symptoms of depersonalization in a non-clinical sample and to operationalize depersonalization as a regulatory mechanism. This article introduces the Depersonalization Mechanism Scale, 41-item measure developed to assess one's tendency for depersonalization in response to overstimulation. The aim of the study is to explore how depersonalization mechanism is associated with cognitive and behavioral emotion regulation strategies, depression, and anxiety. The study included a sample of 300 Polish adults (149 men) from the general population, ranging in age from 18 to 60. Participants were administered the following questionnaires: Depersonalization Mechanism Scale (DMS), Behavioral Emotion Regulation Questionnaire (BERQ), Cognitive Emotion Regulation Questionnaire (CERQ), Occupational Depression Inventory (ODI), Patient Health Questionnaire (PHQ), and Trait Anxiety Scale (SL-C). An exploratory factor analysis revealed a two-factor structure of Depersonalization Mechanism Scale, with very high reliability coefficients for both subscales and full scale. A regression analysis revealed that depersonalization mechanism is a significant predictor of depressive symptoms. Depersonalization mechanism is strongly correlated with maladaptive regulation strategies such as withdrawal, ignoring, rumination, catastrophizing, self-blame, and blaming others. Weaker but significant connections were identified with certain adaptive strategies: acceptance, positive refocusing, putting into perspective, and seeking social support. Women were more prone to depersonalization than men. Further research on depersonalization in non-clinical samples may improve understanding of this mechanism in the general population. This knowledge, combined with greater education about non-clinical forms of depersonalization, may support preventive programs against depression and professional assistance for people facing acute or chronic stressful life events.

A case report of Acute and transient psychotic disorder precipitated by Reiki practise

IntroductionATPD is defined in the ICD‐10 as a polymorphic, predominantly delusional, or schizophreniform psychotic condition characterized by an acute onset (≤2 weeks) and rapid remission (expected within 1–3 months), which is often associated with acute stressful life events. A woman in her 30s was brought to the emergency department in an acute psychotic state. Her mental health had deteriorated rapidly following her attendance to Reiki training two weeks ago (Reiki is a form of alternative medicine called energy healing). She presented as agitated, confused and had disorganised thoughts. She had paranoid, referential, misidentification and bizarre delusions.ObjectivesThis paper reports the case of a 37-year-old woman with stress-induced new-onset psychosis instigated by Reiki practise.MethodsA female patient is described who developed an acute and transient psychosis with polymorphic symptomatology after meditating. Physical examinations, paraclinical testing, and neuroimaging excluded an organic cause of symptoms.ResultsIn this case, we wanted to present an example of acute and transient psychosis episodes in which individuals with low psychosis threshold experienced recipient factors such as insomnia, dopaminergic agent (modafinil), practising reiki and meditation.While the family history of the patient, fragile personality structure suggest that the threshold of psychosis may be low; physical fatigue, insomnia, which is common in all 3 episodes, may have triggered acute psychosis.ConclusionsOur patient recovered completely within 1week after a brief admission and treatment with haloperidol. The real question here is whether the patient needs psychotropic medication for life.DisclosureNo significant relationships.

Suicide attempt risks among hotline callers with and without the coronavirus disease 2019 related psychological distress: a case-control study

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic profoundly impacts on mental health, yet it is still unclear whether COVID-19 distress makes people more vulnerable to suicidal behavior. The present study aims to examine the association between COVID-19 related psychological distress and risk for suicide attempt, and moderators of this association, among hotline callers.MethodsThis case-control study was conducted at the largest psychological support hotline in China. Hotline callers who sought help for psychological distress and reported whether or not they attempted suicide in the last 2 weeks (recent suicide attempt) were analyzed. The primary predictor of recent suicide attempt was the presence or absence of COVID-19 related psychological distress. Demographic variables and common risk and protective factors for suicidal behavior were also studied. Callers with COVID-19 related distress (COVID-19 callers) and those without such distress (non-COVID-19 callers) were compared on these variables. Recent suicide attempt was regressed on COVID-19 related distress and the other variables, and significant interaction terms of aforementioned predictors by COVID-19 related distress, to identify variables that moderate the association of COVID-19 related distress and recent suicide attempt.ResultsAmong 7337 included callers, there were 1252 COVID-19 callers (17.1%) and 6085 non-COVID-19 callers (82.9%). The COVID-19 callers were less likely to report recent suicide attempt (n = 73, 5.8%) than the non-COVID-19 callers (n = 498, 8.2%, P = 0.005). The COVID-19 callers were also less likely to have high scores on depressive symptoms (22.6% vs 26.3%, P < 0.001) and psychological distress (19.5% vs 27.3%, P < 0.001), and were more likely to have high hopefulness scores (46.5% vs 38.0%, P < 0.001). Tests of moderating effects showed that acute life events were associated with one-half lower risk (P = 0.021), and a trend that suicide attempt history was associated with two-thirds greater risk (P = 0.063) for recent suicide attempt, among COVID-19 callers than non-COVID-19 callers.ConclusionsThe COVID-19 calls are from individuals with lower suicide-related risk compared to more typical callers. Acute stressful life events provided a key context for suicide attempt in non-COVID-19 callers, i.e., more typical calls.

Stressful Life Events in Different Social Contexts Are Associated With Self-Injury From Early Adolescence to Early Adulthood.

Self-injury often arises as a maladaptive coping strategy used to alleviate distress. Past research has typically examined how chronic stressors in a specific context are associated with self-injury. Little is known about the unique and cumulative associations between acute stressful life events that occur in different social contexts and self-injury among adolescents. This is especially the case for males, for whom the etiology of self-injury is understudied. We examine the unique and cumulative contributions of stressful life events in the contexts of adolescents' school life, peer networks, intimate relationships, and family life to self-injurious behavior in males and females from the community. Our data comes from a prospective-longitudinal community-representative study, the Zurich Project on the Social Development from Childhood to Adulthood (z-proso). Our sample consists of 1,482 adolescents (52% male) assessed at ages 13, 15, 17, and 20. At each age, adolescents reported whether they had engaged in self-injury during the previous month. They also reported stressful life events in the school, peer, intimate relationships, and family contexts, typically since the last assessment. Stressful life events in the peer context were consistently associated with self-injury. In the contexts of school, intimate relationships, and family, some associations were age- or sex-specific. For example, mid-adolescent females were more likely than mid-adolescent males to use self-injury when faced with stressful events in school and intimate relationships. With respect to risk accumulation, females' risk of self-injury increased with each additional life event between the ages of 13 and 17, beginning at 2+ events. This pattern did not hold for males. In early adulthood, 4+ life events were associated with an increased risk of self-injury, which suggests that the thresholds for the number of life events needed to trigger self-injury increased from adolescence to young adulthood. Our findings suggest that reducing risk of stressful events in different social contexts, and improving young people's coping skills could help reduce their risk of self-injury. New or revised theoretical models may be needed to better understand the emergence of self-injury in males.

How Midlife Chronic Stress Combines with Stressful Life Events to Influence Later Life Mental and Physical Health for Husbands and Wives in Enduring Marriages.

Objectives: To investigate how midlife chronic stress (40-50years) and subsequent acute stressful events (50-65years) influence husbands' and wives' later life mental and physical health (65+years). Methods: Dyadic structural equation modeling was used with prospective data over 25years from 256 husbands and wives in enduring marriages. Results: For both spouses, midlife chronic stress influenced the occurrence of subsequent acute stressful life events, which in turn influenced both depressive symptoms and poor physical health in later years. For both spouses, midlife chronic stress also directly influenced depressive symptoms. Wives' midlife chronic stress also directly influenced their own poor physical health and husbands' depressive symptoms in later years. Discussion: These findings enhance our knowledge about the long-term joint influence of midlife chronic stress and acute stressful life events on health outcomes of husbands and wives in later years and identify dependencies between spouses, which can inform health preventive intervention programs.

Longitudinal changes of inflammatory biomarkers moderate the relationship between recent stressful life events and prospective symptoms of depression in a diverse sample of urban adolescents

This study investigated whether longitudinal changes in inflammatory physiology moderated the relationship between recent stressful life events and subsequent depressive symptoms in adolescence. A diverse sample of adolescents representative of an urban community (N = 129; Age at baseline = 12.5 years; 48.8% female; 55.0% African American) completed measures of stressful life events, depressive symptoms, and two annual blood draws (BD1 and BD2). Controlling for inflammatory activity at BD1, depression at BD1, demographics and the time between assessments, increases in interleukin-6 (IL-6; b = 0.878, p = .007) and C-reactive protein (CRP; b = 0.252, p = .024) from BD1 to BD2 interacted with recent stressful life events before BD1 to predict severity of depressive symptoms at BD2. Similar associations were evident for IL-6 (b = 2.074, p = .040) and CRP (b = 0.919, p = .050) when considering acute stressful life events that had occurred within the two weeks before the first blood collection. More frequent stressful life events before BD1 predicted significantly more severe depressive symptoms at BD2, but only for adolescents with moderate (50th percentile) and high (84th percentile) levels of IL-6 and CRP at BD2. In conclusion, adolescents who experienced both recent stressful life events and larger increases in inflammatory activity following these stressors were at increased risk for more severe depressive symptoms after approximately one year. The findings indicate that the interaction of stress and larger changes in inflammatory activity following these stressors are prognostic risk factors for depression severity in adolescents.

Independent and relative effects of stress, depressive symptoms, and affect on college students' daily health behaviors.

Stress and depressive symptoms are associated with maladaptive health behavior practices such as unhealthy eating, sedentary behavior, insufficient sleep, and substance use. The relative and interactive effects of stress and depressive symptoms on health behavior practices are less well understood. The present study examined these processes in a daily diary study of 127 college students. Results from hierarchical generalized linear models indicated that depressive symptoms, and chronic and daily stress, but not acute stressful life events, were significantly associated with a composite score of daily maladaptive health behavior engagement (depressive symptomsb=.01, SE= .00, p < .01; chronic stress, b = .03, SE= .01, p < .01; daily stress, b = .01, SE= .01, p = .02); unexpectedly, the effect of stress on health behaviors was not moderated by depressive symptoms. Additionally, results demonstrated that the effect of depressive symptoms on health behaviors was mediated by fluctuations in daily negative affect. These results bear implications for intervention during a crucial period in the development of mental and physical health.

Aberrant brain grey matter volume patterns differ among Chinese Han drug-naïve depression patients with acute and chronic stress.

Chronic or acute stress can induce structural changes and brain alterations associated with the neural mechanisms of depression. Aimed to investigate the GMV alterations in the drug-naïve depression patients with chronic and acute stress experience,we enrolled fifty depression patients with acute stress experience, fifty five depression patients with chronic stress experience and forty seven healthy controls(HC) to participant in the present study. We used voxel-based morphometry to analyze the brain grey matter volume (GMV) alterations. Compared with the HC, the patients with acute stress and those with chronic stress exhibited a distinct GMV impairment pattern. Widespread, decreased GMV was detected in most of the cerebral cortex in all the depression patients. Importantly, the greatest finding in our study is that the decreased GMV in the depression patients with chronic stress was more widespread than that in the patients with acute stress. All brain regions with decreased GMV participated in the regulation of emotions, memory, and executive function processing, which is consistent with previous findings. There was no significant difference between the major depression disorder patients with acute stressful life events and those with chronic stressful life events, and this finding largely weakens the support of our current conclusion. Thus, we cannot confirm this postulation. However, our findings probably indicate that GMV may be more sensitive to major depression disorder patients when compared to healthy controls, it did not sensitive when in the comparison of patient's group. Overall, our findings provide important information for the use of appropriate treatment methods to address acute stress and alleviate chronic stress in patients with depression, and such treatments can delay the deterioration of the affected brain regions and improve remission rates. More importantly, all the inexplicable findings in the present study encourage us to conduct a follow-up study to describe the developmental trajectory of the pathological brain features of depression patients and explore therapeutic targets for future personalized treatment.

Perceived weight discrimination and chronic medical conditions in adults with overweight and obesity.

This study investigated whether perceived weight discrimination is associated with increased risk for major chronic medical conditions and whether the associations persist after adjusting for other stressful life events in addition to BMI, physical activity and sociodemographic variables. The study included 21357 overweight/obese adults (52.9% women) from the 2001 to 2002 and 2004 to 2005 National Survey of Alcohol and Related Conditions. Perceived weight discrimination was significantly associated with risk for arteriosclerosis, diabetes, high cholesterol, myocardial infarction, minor heart conditions and stomach ulcers. Perceived weight discrimination was associated with reporting more stressful life events. After adjusting additionally for stressful life events in the final multiple logistic regression, associations with arteriosclerosis, diabetes and minor cardiac conditions remained significant. Gender-stratified analyses revealed that perceived weight discrimination was associated with different medical conditions in women than men, and many associations became non-significant when adjusting for stressful life events, particularly for women. Among overweight/obese adults, perceived weight discrimination is associated with significantly increased risk for obesity-related chronic medical conditions even after adjusting for BMI, physical activity and sociodemographic variables. Accounting for other acute stressful life events may also be important in understanding the health effects of perceived weight discrimination. Such added health risk of overweight/obesity posed by perceived weight discrimination warrants public health and policy interventions against weight discrimination to reduce the socioeconomic burden of obesity.

Chronic migraine: risk factors, mechanisms and treatment.

Chronic migraine has a great detrimental influence on a patient's life, with a severe impact on socioeconomic functioning and quality of life. Chronic migraine affects 1-2% of the general population, and about 8% of patients with migraine; it usually develops from episodic migraine at an annual conversion rate of about 3%. The chronification is reversible: about 26% of patients with chronic migraine go into remission within 2 years of chronification. The most important modifiable risk factors for chronic migraine include overuse of acute migraine medication, ineffective acute treatment, obesity, depression and stressful life events. Moreover, age, female sex and low educational status increase the risk of chronic migraine. The pathophysiology of migraine chronification can be understood as a threshold problem: certain predisposing factors, combined with frequent headache pain, lower the threshold of migraine attacks, thereby increasing the risk of chronic migraine. Treatment options include oral medications, nerve blockade with local anaesthetics or corticoids, and neuromodulation. Well-defined diagnostic criteria are crucial for the identification of chronic migraine. The International Headache Society classification of chronic migraine was recently updated, and now allows co-diagnosis of chronic migraine and medication overuse headache. This Review provides an up-to-date overview of the classification of chronic migraine, basic mechanisms and risk factors of migraine chronification, and the currently established treatment options.

Chronic environmental stress and the temporal course of depression and panic disorder: A trait-state-occasion modeling approach.

Both acute stressful life events and ongoing strains are thought to confer vulnerability to emotional disorders. Unremitting stressful conditions may be particularly pathogenic, but prior research has struggled to delimit chronic versus transient stressful experiences. We aimed to isolate stable stressors-theorized to be indicators of a latent stress proneness trait-and to examine their effects on the temporal course of depression and panic disorder. We recruited 677 patients diagnosed with an emotional disorder and administered interviews for psychopathology and life stress 3 times over 12-month intervals. Trait-state-occasion modeling revealed that 74% of the variance in life stress was stable over the follow-up period. These stable stressors were associated with a more refractory course of depression and, to a smaller degree, panic disorder over time. In addition, neither gender nor participation in cognitive-behavioral therapy affected the persistence of environmental stress over the study time frame. We discuss implications of these findings for explaining depression recurrence, improving psychological interventions for emotional disorders, and the measurement and evaluation of stress proneness.

TPH2 variant rs7305115 and its interaction with acute stressful life events in etiology of suicide attempt in Serbian psychiatric patients

Introduction: Suicide attempt (SA) is in the middle of continuum of complex suicidal behavior phenotype. Psychiatric disorders and acute stressful life events (SLEs) are triggers for suicidal behavior. Serotonin system genes are often implicated in suicidal behavior. Tryptophan hydroxylase 2 (TPH2), exclusively expressed in the brain, is the rate-limiting enzyme for serotonin biosynthesis. TPH2 may be enrolled in stress-response mechanisms via hypothalamic–pituitary–adrenal axis, while TPH2 variant rs7305115 has been reported to affect gene expression in postmortem human pons. To date, only poor examination of this variant in etiology of suicidal behavior has reported conflicting results. The aim of the present study was to assess rs7305115 main effect and its interaction with acute SLEs in SA pathology among Serbian psychiatric patients. Methods: 165 suicide attempters and 188 suicide non-attempters, suffering from major psychiatric disorders, participated in the study. Acute SLEs score was assessed using the List of Threatening Experiences Questionnaire. Variant rs7305115 was genotyped using TaqMan-based allelic discrimination assay. Statistical analyses were done in SNPstats by applying logistic regression adjusted by psychiatric diagnoses. Results: Variant rs7305115 was not associated with SA in Serbian psychiatric patients, neither alone, nor in combination with acute SLEs, for all five models of inheritance tested (P>0.05). Discussion: Our finding does not support the main and moderating implication of TPH2 variant rs7305115 in SA liability among Serbian psychiatric patients. Further examination in larger samples of this variant in SA patology is necessary due to its functional relevance.

Appraisals of Stressful Life Events as a Genetically-Linked Mechanism in the Stress–Depression Relationship

Variation in the promoter region of the serotonin transporter gene (5-HTTLPR) has been linked to various cognitive-affective indices of stress sensitivity hypothesized to underlie vulnerability to depression. The current study examined the association of 5-HTTLPR with appraisals of naturally occurring acute life stressors in a community sample of 384 youth at elevated risk for depression due to oversampling for maternal depression. Interview measures administered at youth age 20 were used to assess subjective and objective (assigned by an independent rating team) appraisals of the negative impact of recent acute stressful life events. The presence of at least one S allele was associated with elevated subjective appraisals of the negative impact of acute stressors (P = 0.03). Consistent with an endophenotype perspective, support was found for a 5-HTTLPR-stress appraisals-depression mediation model both concurrently and longitudinally. Results indicate that enhanced stress sensitivity may act as an intermediate phenotype through which 5-HTTLPR affects risk for depression.

Deliberate self harm in children

To study the nature of deliberate self-harm (DSH) in children and to identify the associated factors. Child Guidance Clinic attached to the Department of Pediatrics of a teaching hospital in South India. Children with history of deliberate self harm who were referred to the CGC for psychological evaluation during a 10 year period. Children and parents were interviewed together and separately and details regarding age, sex, family and school environment, stresses and nature of self harm were documented. Psychiatric diagnosis was made based on DSM IV diagnostic criteria. Among the 30 children included in the study, 21 were boys and 9 were girls. Majority of children were between the ages of 11 and 13 years, the youngest being 6 years old. 76%of children had history of acute stressful life events and 62%of them had chronic ongoing stress. 62%of children had stress in the family and 41%had stress at school. Stress in the family included death of a parent, conflicts with parents or siblings, mental illness in the family, parental alcoholism and parental disharmony. Stress at school included conflicts with classmates, punishment or negative comments by teachers and learning problems. Psychiatric disorders were present in 52%of children, the commonest being depressive disorder. The commonest mode of DSH was self poisoning, and rat poison (zinc phosphide) was the commonest substance used. Deliberate self harm occurs in young children and the risk factors are comparable to those in adolescents.

Adverse experience during early life and adulthood interact to elevate tph2 mRNA expression in serotonergic neurons within the dorsal raphe nucleus

Anxiety disorders, depression and animal models of vulnerability to a depression-like syndrome have been associated with dysregulation of brain serotonergic systems. These effects could result from genetic influences, adverse early life experiences (ELE), or acute stressful life events, all of which can alter serotonergic neurotransmission and have been implicated in determining vulnerability to neuropsychiatric disorders. To evaluate the effects of ELE, adverse experiences during adulthood, and potential interactions between these factors on neuronal tryptophan hydroxylase 2 (tph2) mRNA expression, we investigated in rats the effects of maternal separation (MS)(separation from the dam for 180 min/day from postnatal day 2–14; MS180, a model of vulnerability to a depression-like syndrome), neonatal handling (separation from the dam for 15 min/day from postnatal day 2–14; MS15, a model of decreased stress sensitivity), or normal animal facility rearing (AFR) control conditions, with or without subsequent exposure to adult social defeat, on tph2 mRNA expression in the dorsal raphe nucleus (DR). Among rats exposed to social defeat, MS180 rats had increased tph2 mRNA expression in the DR, while MS15 rats had decreased tph2 mRNA expression compared to AFR rats. Social defeat increased tph2 mRNA expression, but only in MS180 rats and only in the “lateral wings” of the DR, a subdivision of the DR that is part of a sympathomotor command center. Overall, these data demonstrate that ELE and stressful experience during adulthood interact to determine tph2 mRNA expression. These changes in tph2 mRNA expression represent a potential mechanism through which adverse ELEs and stressful life experiences during adulthood may interact to increase vulnerability to stress-related psychiatric disease.

Serotonergic Systems, Anxiety, and Affective Disorder

Depressed suicide patients have elevated expression of neuronal tryptophan hydroxylase 2 (TPH2) mRNA and protein in midbrain serotonergic neurons, as well as increases in brain serotonin turnover. The mechanisms underlying these changes are uncertain, but increased TPH2 expression and serotonin turnover could result from genetic influences, adverse early life experiences, or acute stressful life events, all of which can alter serotonergic neurotransmission and have been implicated in determining vulnerability to major depression. Emerging evidence suggests that there are several different stress-related subsets of serotonergic neurons, each with a unique role in the integrated stress response. Here we review our current understanding of how genetic and environmental factors may influence TPH2 mRNA expression and serotonergic neurotransmission, focusing in particular on the dorsomedial part of the dorsal raphe nucleus. This subdivision of the dorsal raphe nucleus is selectively innervated by key forebrain structures implicated in regulation of anxiety states, it gives rise to projections to a distributed neural system mediating anxiety states, and serotonergic neurons within this subdivision are selectively activated by a number of stress- and anxiety-related stimuli. A better understanding of the anatomical and functional properties of specific stress- or anxiety-related serotonergic systems should aid our understanding of the neural mechanisms underlying the etiology of anxiety and affective disorders.

Chronic life stress, acute stress events, and substance availability in relapse

This study evaluated additive and interactive models of the effects of acute stressful life events, chronic life stressors, and immediate substance availability on substance use following alcohol and drug treatment. One hundred and two veterans meeting DSM-IV criteria for alcohol, cannabis, or stimulant dependence at treatment entry completed quarterly interviews for one year. Severe chronic stressors and substance availability predicted an increased risk of initiating substance use posttreatment (OR = 5.18 and 3.18, respectively). However, the chronic stressors and immediate substance availability were associated with less protracted substance use (F (2, 67) =17.30, p < 0.001). Substance availability also predicted fewer total drinks consumed. In contrast to chronic stressors, recent stressful life events were not predictive of posttreatment substance initiation or severity. None of the interactions between stress and substance availability were significant. These findings support a model where chronic stressors and substance availability independently add to the risk for alcohol or drug use following treatment.

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.

Emotional distress among HIV-positive individuals: the roles of acute negative life events and psychological diatheses

The present study investigated the impact of negative life events and psychological diatheses (neuroticism, low self-esteem, and dysfunctional attitudes) on emotional distress among HIV-positive patients. Fifty-two participants completed questionnaires assessing acute stressful life events, psychological diatheses, perceived stress, and depressive symptoms. The following hypotheses were tested: (a) negative life events would predict depressive symptoms and perceived stress; (b) HIV-specific life events would be more strongly associated with depressive symptoms and perceived stress than general life events; and (c) psychological diatheses would moderate the relationship between acute life events and depressive symptoms, as well as the relationship between life events and perceived stress. Results indicated that both general and HIV-specific life events predicted depressive symptoms and perceived stress. However, no support was found for the hypothesis that HIV-related life events would be more potent. Psychological diatheses moderated the impact of life events on perceived stress, such that life events had a greater impact on those with lower levels of vulnerability. These results remained significant after controlling for biological markers of disease progression.

Types of stressors that increase susceptibility to the common cold in healthy adults.

Two-hundred seventy-six volunteers completed a life stressor interview and psychological questionnaires and provided blood and urine samples. They were then inoculated with common cold viruses and monitored for the onset of disease. Although severe acute stressful life events (less than 1 month long) were not associated with developing colds, severe chronic stressors (1 month or longer) were associated with a substantial increase in risk of disease. This relation was attributable primarily to under- or unemployment and to enduring interpersonal difficulties with family or friends. The association between chronic stressors and susceptibility to colds could not be fully explained by differences among stressed and nonstressed persons in social network characteristics, personality, health practices, or prechallenge endocrine or immune measures.