Association Of Life Events Research Articles

The Association of Life Events Outside the Workplace and Burnout: A Cross-Sectional Study on Nursing Assistants.

Background: Burnout, by definition, is related to adverse chronic workplace stressors. Life events outside the workplace have been associated with an increased risk of psychiatric morbidity. However, it is unknown whether life events outside the workplace increase the severity of burnout. Purpose: The aim of the study was to investigate the association between burnout and life events outside the workplace in nursing assistants. Methods: In an observational, cross-sectional, single-site study of 521 nursing assistants at a university hospital, we assessed burnout with the Maslach Burnout Inventory-Human Services Survey, and life events with the Social Readjustment Rating Scale. We constructed equations of multiple linear regression analyses that included each burnout subscale as the dependent variable and a domain of life events as the independent variable. Results were adjusted for potential confounders, including gender, no religion or faith, years of work, and depression. Results: An increase in the number of life events in the domain of personal changes or difficulties (e.g., personal injury or illness, sexual difficulties, change in recreation, church activities, social activities, sleeping habits, eating habits and revision of personal habits) was associated with increased severity of emotional exhaustion. An increase in the number of life events in the domain of changes in familial situation and in the domains of death of relatives or friends were associated with increased severity of depersonalization. Those associations were independent of work-related life events and other potential confounders. Conclusions: Life events outside the workplace may increase the levels of burnout in nursing assistants.

First-appearing islet autoantibodies for type 1 diabetes in young children: maternal life events during pregnancy and the child's genetic risk.

Psychological stress has long been considered a possible trigger of type 1 diabetes, although prospective studies examining the link between psychological stress or life events during pregnancy and the child's type 1 diabetes risk are rare. The objective of this study was to examine the association between life events during pregnancy and first-appearing islet autoantibodies (IA) in young children, conditioned by the child's type 1 diabetes-related genetic risk. The IA status of 7317 genetically at-risk The Environmental Determinants of Diabetes in the Young (TEDDY) participants was assessed every 3months from 3months to 4years, and bi-annually thereafter. Reports of major life events during pregnancy were collected at study inception when the child was 3months of age and placed into one of six categories. Life events during pregnancy were examined for association with first-appearing insulin (IAA) (N = 222) or GAD (GADA) (N = 209) autoantibodies in the child until 6years of age using proportional hazard models. Relative excess risk due to interaction (RERI) by the child's HLA-DR and SNP profile was estimated. Overall, 65% of mothers reported a life event during pregnancy; disease/injury (25%), serious interpersonal (28%) and job-related (25%) life events were most common. The association of life events during pregnancy differed between IAA and GADA as the first-appearing autoantibody. Serious interpersonal life events correlated with increased risk of GADA-first only in HLA-DR3 children with the BACH2-T allele (HR 2.28, p < 0.0001), an additive interaction (RERI 1.87, p = 0.0004). Job-related life events were also associated with increased risk of GADA-first among HLA-DR3/4 children (HR 1.53, p = 0.04) independent of serious interpersonal life events (HR 1.90, p = 0.002), an additive interaction (RERI 1.19, p = 0.004). Job-related life events correlated with reduced risk of IAA-first (HR 0.55, p = 0.004), particularly in children with the BTNL2-GG allele (HR 0.48; 95% CI 0.31, 0.76). Specific life events during pregnancy are differentially related to IAA vs GADA as first-appearing IA and interact with different HLA and non-HLA genetic factors, supporting the concept of different endotypes underlying type 1 diabetes. However, the mechanisms underlying these associations remain to be discovered. Life events may be markers for other yet-to-be-identified factors important to the development of first-appearing IA.

Car Use: Intentional, Habitual, or Both? Insights from Anscombe and the Mobility Biography Literature

Policy-makers have recognized that changing travel behavior is important. People, however, do not change their behavior so readily, particularly the use of the car. A central concept that has been invoked to account for this has been the concept of habit. However, various studies also present people as having concrete reasons for driving: Their choices are intentional. This interdisciplinary study attempts to reconcile these two understandings of travel behavior by drawing on insights from the philosopher Anscombe and a growing body of travel research termed the mobility biography literature. It applies some of Anscombe’s insights from Intention to the act of driving. With regard to the mobility biography literature, it draws out conceptual implications both from theoretical and empirical aspects: In particular, the characterization of travel decisions as nested in a hierarchy of life decisions and the association of life events with changes in travel decisions. It concludes that a broader conceptualization of human behavior leads to a broader view as to what policy-makers can do. It reminds us that transport is ‘special’, that transport and policy are inextricable, and that the importance of infrastructure provision should not be ignored.

The association of life events and mental ill health in older adults with intellectual disability: results of the wave 3 Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing.

Exposures to life events are associated with emotional, psychological and behavioural problems in those with intellectual disability (ID). Older adults with ID may experience different life events given differences in living circumstances, cognitive decline, greater dependency on others and less autonomy. This study examines the relationship of life events and mental ill health in an older ID population in Ireland. The study was part of 'The Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing'. The frequency of life events was assessed using a 20-item checklist, and the level of stress experienced was assessed using a three-point Likert scale measuring the burden of the life event. The associations of life events with factors associated with mental ill health were measured using a variety of self-report and proxy completed questionnaires. For the study population, 88.1% had been exposed to at least one life event in the preceding 12months and 64.5% to two or more life events. Frequency and burden of life events were significantly higher in individuals living in institutional settings and in individuals with any current psychiatric condition, increased depressive and anxiety symptoms, challenging behaviour and reported poorer self-rated mental and physical health. More life events were significantly associated with new psychiatric diagnoses as well as initiation and increased dosage of mood stabilising, hypnotic and sedative medications. Life events are significantly associated with mental ill health in the older ID population. Service providers must focus on limiting the exposure to these events and, in situations where they cannot be avoided, should support and manage individuals compassionately and effectively, prioritising their mental and physical well-being.

ADHD symptoms in healthy adults are associated with stressful life events and negative memory bias

Stressful life events, especially Childhood Trauma, predict ADHD symptoms. Childhood Trauma and negatively biased memory are risk factors for affective disorders. The association of life events and bias with ADHD symptoms may inform about the etiology of ADHD. Memory bias was tested using a computer task in N = 675 healthy adults. Life events and ADHD symptoms were assessed using questionnaires. The mediation of the association between life events and ADHD symptoms by memory bias was examined. We explored the roles of different types of life events and of ADHD symptom clusters. Life events and memory bias were associated with overall ADHD symptoms as well as inattention and hyperactivity/impulsivity symptom clusters. Memory bias mediated the association of Lifetime Life Events, specifically Childhood Trauma, with ADHD symptoms. Negatively biased memory may be a cognitive marker of the effects of Childhood Trauma on the development and/or persistence of ADHD symptoms.

Association of life events and depressive symptoms among early postmenopausal Chinese women in Hong Kong.

This study examined the occurrence of stressful life events (SLEs) and its association with the risk of developing depressive symptoms in midlife women. A total of 518 Hong Kong Chinese postmenopausal women aged 50 to 64 years were recruited through random telephone dialing. Information on sociodemographic, health, and lifestyle variables was obtained through face-to-face interviews at baseline, and at 3-year (T1) and 5-year (T2) follow-up. A Centre of Epidemiological Study Depression scale (CES-D) score ≥16 was used to indicate high depressive symptoms. At T2, SLEs were assessed by a 21-item life-event scale, adapted from the Holmes and Rahe Social Readjustment Rating Scale for Adults. Potential confounders were controlled for in the multivariable logistic regression analysis on the relation between SLEs and high depressive symptoms among 379 women without CES-D score ≥16 at T1. 87.6% had experienced SLEs since T1 and 11.9% had CES-D score ≥16 at T2. Compared with those without SLEs, women with one to three SLEs had 2.7-fold (95% CI, 0.6-12.1) increased risk of having CES-D score ≥16, whereas those with four to nine SLEs had 5.2-fold (95% CI, 1.1-25.4) increased risk. A dose-response relationship was observed (P for trend = 0.005). Each additional SLEs experienced was associated with a 28% (95% CI, 1.07-1.54) increased risk of high depressive symptoms. Hong Kong Chinese women encounter many SLEs at midlife. Multiple episodes of SLE had a cumulative effect on the onset of depressive symptoms. Our findings have important implications for the identification and management of midlife women with high depressive symptoms.

Measuring Life Events and Their Association With Clinical Disorder: A Protocol for Development of an Online Approach.

BackgroundSevere life events are acknowledged as important etiological factors in the development of clinical disorders, including major depression. Interview methods capable of assessing context and meaning of events have demonstrated superior validity compared with checklist questionnaire methods and arguments for interview approaches have resurfaced because choosing the appropriate assessment tool provides clarity of information about gene-environment interactions in depression. Such approaches also have greater potential for understanding and treating clinical cases or for use in interventions.Objective(1) To argue that life events need sophisticated measurement not satisfactorily captured in checklist approaches. (2) To review life-events measures and key findings related to disorder, exemplifying depression. (3) To describe an ongoing study with a new online measure and to assess its psychometric properties and the association of life events in relation to disorder and educational outcomes.MethodsThe Computerised Life Events Assessment Record (CLEAR) is under development as a tool for online assessment of adult life events. Based on the Life Events and Difficulties Schedule interview, CLEAR seeks to assess life events to self and close others, link these to other events and difficulties, and utilize calendar-based timing, to improve upon checklist approaches.ResultsThe CLEAR study is in the preliminary stages and its results are expected to be made available by the end of 2015.ConclusionsThere is currently no sophisticated technological application of social risk factor assessment, such as life events and difficulties. CLEAR is designed to gather reliable and valid life-event data while combating the limitations of interviews (eg, time consuming and costly) and life-event checklists (eg, inability to accurately measure severity and independence of life events). The advantages of using such innovative methodology for research, clinical practice, and interventions are discussed.

Differential sensitivity to life stress in FMR1 premutation carrier mothers of children with Fragile X Syndrome.

The premutation of the FMR1 gene (defined as between 55 and 200 CGG repeats) is estimated to affect 1 in 149 females and 1 in 643 males, and some people who carry the FMR1 premutation display signs of impairment. This study focuses on 82 premutation carrier mothers (M age = 51.4 years; SD = 7.7) of adolescent and adult children with fragile X syndrome (FXS). A Gene × Environment interaction approach examined the ways in which the experience of negative life events interacts with genetic vulnerability to predict depressive symptoms, anxiety, and daily cortisol levels. The associations of life events with all 3 dependent measures were associated with CGG repeat length but in a curvilinear manner. Mothers with midsize CGG repeats who experienced above-average numbers of negative life events in the previous year had more depressive symptoms and anxiety and had a blunted cortisol awakening response, as compared with those with higher or lower repeat lengths. However, mothers with midsize CGG repeats who experienced below-average numbers of negative life events in the previous year had the lowest levels of depressive symptoms and anxiety, and they exhibited the typical cortisol response to awakening, meeting the criteria for differential susceptibility. This research extends our understanding of the phenotypic effects of the expansion of the FMR1 gene, and it adds to the growing literature on the curvilinear relationship between CGG repeat length and mental and physical health.

Life events and hippocampal volume in first-episode major depression

BackgroundThere are many studies on life events in depression and also several studies examining brain structural changes in the hippocampus of depressed patients. However, only few studies have focused on the association of life events and hippocampal volume in depression. The hypothesis of a significant negative association between life events and hippocampal volumes in first episode depression was examined. Methods28 in-patients with a first episode of major depression were examined with high-resolution magnetic resonance imaging measuring hippocampal volumes. The precourse of depression was assessed with the Interview for the Retrospective Assessment of the Onset and Course of Schizophrenia and Other Psychoses (IRAOS) and life events by using the Munich Interview for the Assessment of Life Events and Conditions (MEL). ResultsA significant negative correlation between major life events three month before the onset of depression and the left hippocampal volume was found for male patients. In female patients no significant association between major life events and hippocampal volumes could be found. ConclusionsThe results support the hypothesis that the hippocampus plays a crucial role in the pathogenesis of major depression in the early phase of the disorder particularly for male patients.

Genes and Environment in Suicidality

Back to table of contents Previous article Next article EditorialFull AccessGenes and Environment in SuicidalityElliot S. Gershon M.D.Elliot S. Gershon M.D.Search for more papers by this authorPublished Online:1 Oct 2007https://doi.org/10.1176/appi.ajp.2007.07071065AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail This issue of the Journal has two articles on suicidal ideation, defined broadly according to DSM-III-R (recurrent thoughts of death or dying, recurrent suicide ideation without a plan, or a suicide attempt or suicide plan). The two articles study this single symptom of depression from two separate perspectives: as an outcome of life events in a population sample and as a gene association study of emergence of the same symptom in patients being treated for depression. Keller, Neale, and Kendler, studying individuals in the population-based Mid-Atlantic Twin Registry, looked at persons with dysphoric episodes in the preceding 12 months. These episodes met DSM-III-R symptom criteria for major depression but without the requirement for sadness or anhedonia being one of the symptoms, and with a duration criterion of at least 5 days. From retrospective ratings of both symptoms and life events for the preceding 12 months, the authors found that the symptoms of depression correlated broadly with the life events the subjects associated with their depression, and that this was true even when the same individual had more than one episode during the preceding year. Most interestingly for comparison with the second article, “appetite gain, fatigue, psychomotor retardation, and thoughts of harming oneself were prominent symptoms among those who indicated that nothing caused their episodes, while appetite loss, sadness, and poor concentration were not.”This might suggest suicidality as a behavioral marker of a less environmentally caused depression and by implication a more genetically caused depression. But that interpretation, not proposed by the investigators, would take the data too far. It would not take into account the problems of retrospectively reported data on two independent variables (clinical diagnosis and life events) that are popularly confounded with each other. Furthermore, there are associations of life events with depression that go back to childhood. Also, suicidality as a surrogate for suicide risk is hardly an established connection. Nonetheless, this is the first study to associate specific depressive symptoms with specific life events in a systematic way, and it will surely be followed by new research with prospective observations.Laje et al. searched for genetic associations of treatment-emergent suicidal ideation in patients receiving citalopram for major depressive disorder. They tested 768 single nucleotide polymorphisms from various candidate genes and found significant allelic or genotypic association with two markers, which reside within the genes GRIA3 and GRIK2, respectively. Both these genes encode ionotropic glutamate receptors. The biological meaning of these variations remains to be established; they are not part of coding exons of the genes. This study has the methodologic virtues of prospectively collected clinical data and independence of the clinical data from the experimental variables (genotypes). It is very strongly suggestive, and as the authors state, if replicated it would be a major clinical and biological advance if a dangerous clinical event were associated with specific genetic variations. These two studies, and other recent studies in which life events and individual genotypes were studied in the same individuals at risk for depression (1) , give the field grounds for optimism. The goals that now appear feasible are a comprehensive understanding of genetic and environmental components of depression and related clinical advances in treatment of depression and avoidance of suicidality. Address correspondence and reprint requests to Dr. Gershon, Foundations Fund Professor of Psychiatry and Human Genetics, Department of Psychiatry, University of Chicago, 5841 S. Maryland Ave., M/C 3077, Chicago, IL 60637; [email protected] (e-mail). Editorial accepted for publication July 2007 (doi: 10.1176/appi.ajp.2007.07071065).Dr. Gershon reports no competing interests.Reference1. Caspi A, Sugden K, Moffitt TE, Taylor A, Craig IW, Harrington H, McClay J, Mill J, Martin J, Braithwaite A, Poulton R: Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Science 2003; 301:386–389Google Scholar FiguresReferencesCited byDetailsCited byPrevalence and risk factors of suicidal ideations among patients with obsessive-compulsive disorder in Egypt10 February 2021 | Middle East Current Psychiatry, Vol. 28, No. 1Neuropsychiatry, Vol. 1, No. 4Psychiatry Research, Vol. 170, No. 2-3Acta Psychiatrica Scandinavica, Vol. 118, No. 4 Volume 164Issue 10 October, 2007Pages 1460-1461THE AMERICAN JOURNAL OF PSYCHIATRY October 2007 Volume 164 Number 10 Metrics PDF download History Published online 1 October 2007 Published in print 1 October 2007

The effects of life events and interpersonal loss on exercise adherence in older adults.

Associations of life events and interpersonal loss with participation in home- and group-based exercise were studied in 97 older adults (64 % women, 70.2 +/- 4.1 years). Life events were assessed with a modified Social Readjustment Rating Scale at baseline and 6 and 12 months. Exercise logs and class-attendance records documented exercise participation. Participants experienced 3.62 +/- 3.56 unique life events over the course of the study, and 28 participants reported an interpersonal loss (5 men, 23 women). Number of life events was negatively associated with home-based exercise participation (p <.05); among women, this association approached significance (p =.06) for class-based exercise. Women who experienced an interpersonal loss had lower class-based participation than those who did not (p =.02), but home-based participation rates were unaffected. Life events, particularly interpersonal loss, appear to have a negative impact on exercise in women, and this effect appears greater for class-based than for home-based exercise.

Association of life events and psychosocial factors with early but not late onset depression in the elderly: implications for possible differences in aetiology

Depression occurring for the first time in later life (after age 60, late onset depression (LOD)) may have a different, more organic, aetiology from early onset depression (EOD). We investigated the possible role of life events, the presence of a confidante and personality factors in the aetiology of depression in the elderly, testing the hypothesis that these factors would be associated with EOD but not LOD. Subjects consisted of 66 elderly patients (aged over 60) with DSM-IV Major depression (30 EOD, 33 LOD; groups matched for age) and 38 age and sex matched controls. Life events in the 12 months prior to onset of depression (or prior to interview for controls) were recorded using a previously validated 12-item scale. Personality was assessed using the Eysenck Personality Questionnaire (EPQ). Subjects with EOD reported having a close confidente significantly less frequently (52%) than controls (82%, p < 0.05) or LOD (80%, p < 0.05). Bereavement life events occurred significantly more frequently in EOD (52%) than LOD (16%, p < 0.01) and were also more frequent in controls (42%) than LOD (p < 0.05). Higher EPQ 'extraversion' and 'neuroticism' were found in both EOD and LOD compared to controls, with no differences between EOD and LOD. LOD was associated with fewer bereavement life events and more frequent presence of a confidente than EOD. This supports a greater role for psychosocial factors in the aetiology of EOD and different, probably neurobiological, factors in LOD. Personality attributes may have a greater relevance for both EOD and LOD than previously recognized.

Association of life events and psychological distress in family caregivers of dementia patients

Relationships between life events and psychological distress were investigated for 197 dementia caregivers and 218 non-caregivers. Participants indicated which events on the Louisville Older Persons Events Scale they had experienced over the past six months. Life events were then classified as associated or unassociated with care-giving using differences in incidence rates between caregivers and non-caregivers. Primary care-giving stressors and associated life events were most predictive of psychological distress among caregivers. Among non-caregivers, unassociated negative life events were the strongest predictors of depression and life satisfaction. Implications for the assessment of life events and caregiver interventions are discussed.

Racism, racial life events and mental ill health

The association of life events with the onset of various psychiatric disorders is well-known. The body of evidence has highlighted the impact of negative or positive life events on the genesis of common mental disorders, especially depression. These findings have been replicated across different cultures, although the impact of different life events varies between cultures. In addition, the roles of chronic difficulties (defined in Life events and psychiatric disorders, below) and resulting ongoing chronic stress have been shown to contribute to vulnerability to certain mental illnesses. However, data on the impact of life events, especially those perceived as racial, on members of minority ethnic groups are rather sparse. The questions that need to be addressed concern the perception of life events as racial, the role of pervasive and perceived institutional and individual racism, and chronic difficulties.

Life events and increase in immature defense style during transition to adulthood

People use psychological defenses to prevent anxiety from forcing its way to consciousness. In normal maturation, the previously developmentally immature defenses tend to decrease. Increase in immature defense style has been found to predict mental disturbance among young adults, but the association of life events with this increase is unknown. We investigated whether increase in immature defenses in transition to young adulthood would associate with life events occurring during that time period. The subjects comprised 636 high school adolescents:young adults (408 females, 228 males), who completed questionnaires in 1990 and 1995. Subjects (27% of females and 21% of males) reporting increase in immature defense style as assessed with the Defense Style Questionnaire were compared with the other subjects in terms of life events. No associations were found, except the marginal association of serious illness of a close person among females. Among these high school students the development of immature defense style tended to be independent of life events during transition to adulthood.

Life events and completed suicide in schizophrenia: a comparison of suicide victims with and without schizophrenia.

Adverse life events are an established risk factor in completed suicide. However, few studies have examined life events and suicide in schizophrenia. We investigated and compared schizophrenia suicide victims and age- and sex-matched victims without schizophrenia as part of a psychological autopsy study of all suicides in Finland over a 12-month period. Recent life events were examined retrospectively by interviewing next of kin using a structured life event questionnaire. Overall, nearly half (46%) the schizophrenia subjects had had adverse life events before suicide, significantly less than the nonschizophrenia subjects (83%). In both groups, however, suicide was preceded by life events independent of the victims' own behavior, such as death of a close person or illness in the family. Life events overall were more common among schizophrenia outpatients (52%) than inpatients (22%), and the association of life events with suicide was clearest among a subgroup of outpatients in residual phase who had used neuroleptic medication regularly. Overall, the prevalence of recent adverse life events varied between clinical subgroups of victims with schizophrenia, which may have implications for suicide prevention.

Life events, mental health functioning and the use of health care services by the elderly.

The association of life events and mental health impairment was studied in a community-based population of the elderly (n = 986). A crude estimate of the relative risk for mental health impairment given life events larger than or equal to 150 (as measured by the Schedule of Recent Events) was 2.14. A relative risk of 1.73 (p < .01) was estimated when a binary regression procedure was used, controlling for physical health, economic status, social support, and age. Increased life events were associated with health seeking behavior, even when physical and mental health functioning were controlled. The associations between increased life events and both mental health functioning and health seeking behavior were small, suggesting that life events, as measured by the Schedule of Recent Events may not be important risk factors for elderly living in the community.