Adult Life Events Research Articles

Major stressful life events in adulthood and risk of multiple sclerosis

It is unclear whether psychological stress is associated with increased risk of multiple sclerosis (MS). We studied the association between major stressful life events and MS in a nationwide cohort study using death of a child or a spouse or marital dissolution as indicators of severe stress. We created two study cohorts based on all Danish men and women born 1950-1992. One cohort consisted of all persons who became parents between 1968 and 2010, and another cohort consisted of all persons who married between 1968 and 2010. Members of both cohorts were followed for MS between 1982 and 2010 using data from the National Multiple Sclerosis Registry. Associations between major stressful life events and risk of MS were evaluated by means of MS incidence rate ratios (RR) with 95% confidence interval (CI) obtained in Poisson regression analyses. During approximately 30 million person-years of follow-up, bereaved parents experienced no unusual risk of MS compared with parents who did not lose a child (RR=1.12 (95% CI 0.89 to 1.38)). Likewise, neither divorced (RR=0.98 (95% CI 0.89 to 1.06)) nor widowed (RR=0.98 (95% CI 0.71 to 1.32) persons were at any unusual risk of MS compared with married persons of the same sex. Our national cohort study provides little evidence for a causal association between major stressful life events (as exemplified by divorce or the loss of a child or a spouse) and subsequent MS risk.

Life stress as a determinant of emotional well-being: development and validation of a Spanish-Language Checklist of Stressful Life Events

Objectives: To develop a screening instrument for investigating the prevalence and impact of stressful life events in Spanish-speaking Peruvian adults. Background: Researchers have demonstrated the causal connection between life stress and psychosocial and physical complaints. The need for contextually relevant and updated instruments has been also addressed. Methods: A sequential exploratory design combined qualitative and quantitative information from two studies: first, the content validity of 20 severe stressors (N = 46); then, a criterion-related validity process with affective symptoms as criteria (Hopkins Symptom Checklist (HSCL-25), N = 844). Results: 93% of the participants reported one to eight life events (X = 3.93, Mdn = 3, SD = 7.77). Events increase significantly until 60 years of age (Mdn = 6). Adults born in inland regions (Mdn = 4) or with secondary or technical education (Mdn = 5) reported significantly more stressors than participants born in Lima or with higher education. There are no differences by gender. Four-step hierarchical models showed that life stress is the best unique predictor (β) of HSCL anxiety, depression and general distress (p < .001). Age and gender are significant for the three criteria (p < .01, p < .001); lower education and unemployment are significant unique predictors of general distress and depression (p < .01; p < .05). Previously, the two-factor structure of the HSCL-25 was verified (Satorra–Bentler chi-square, root-mean-square error of approximation = 0.059; standardized root-mean-square residual = 0.055). Conclusion: The Spanish-Language Checklist of Stressful Life Events is a valid instrument to identify adults with significant levels of life stress and possible risk for mental and physical health (clinical utility).

Gene–environment interactions in common mental disorders: an update and strategy for a genome-wide search

A decade of research has demonstrated the explanatory potential of interplay between genetic variants and environmental factors in the development of common mental disorders. Initial findings have undergone tests of replicability and specificity. Some gene-environment interactions have been confirmed, some have not replicated and yet other turned out to be more specific than initially thought. Specific and complementary roles of genetic factors have been delineated: a common functional length polymorphism in the serotonin transporter gene (5-HTTLPR) moderated the effect of childhood maltreatment on chronic depression in adulthood, but did not substantially influence the effects of adult stressful life events on the onset of new depressive episodes; in contrast, a common functional polymorphism in the brain-derived neurotrophic factor gene (BDNF) moderated the effect of stressful life events in adulthood in triggering new depressive episodes, but did not influence the effects of childhood maltreatment. Molecular mechanisms underlying gene-environment interactions are being uncovered, including DNA methylation and other epigenetic modifications. New gene-environment interactions continue to be reported, still largely from hypothesis-driven research. Statistical and biological prioritization strategies are proposed to facilitate a systematic discovery of novel gene-environment interactions in genome-wide analyses.

Adults with psychosis or psychotic experiences may report adverse life events prior to the onset of symptoms but direction of causality cannot be inferred

Question: Are stressful events during adulthood associated with the onset of psychosis? Outcomes: First-episode psychosis or subclinical psychotic experiences. Outcome criteria were not further specified a priori. The observational studies...

Life Events and Psychosis: A Review and Meta-analysis

Introduction:Recent models of psychosis implicate stressful events in its etiology. However, while evidence has accumulated for childhood trauma, the role of adult life events has received less attention. Therefore, a review of the existing literature on the relationship between life events and onset of psychotic disorder/experiences is timely. Methods: A search was conducted using PsychInfo, Medline, Embase, and Web of Science to identify studies of life events and the onset of psychosis or psychotic experiences within the general population. Given previous methodological concerns, this review included a novel quality assessment tool and focused on findings from the most robust studies. A meta-analysis was performed on a subgroup of 13 studies. Results: Sixteen studies published between 1968 and 2012 were included. Of these, 14 reported positive associations between exposure to adult life events and subsequent onset of psychotic disorder/experiences. The meta-analysis yielded an overall weighted OR of 3.19 (95% CI 2.15–4.75). However, many studies were limited by small sample sizes and the use of checklist measures of life events, with no consideration of contextual influences on the meaning and interpretation of events. Conclusions: Few studies have assessed the role of adult life events in the onset of psychosis. There was some evidence that reported exposure to adult life events was associated with increased risk of psychotic disorder and subclinical psychotic experiences. However, the methodological quality of the majority of studies was low, which urges caution in interpreting the results and points toward a need for more methodologically robust studies.

The interaction between child maltreatment, adult stressful life events and the 5-HTTLPR in major depression

Both childhood maltreatment and adult stressful life events are established risk factors for the onset of depression in adulthood. However, the interaction between them can be viewed through two conflicting frameworks. Under a mismatch hypothesis stressful childhoods allow ‘adaptive programming’ for a stressful adulthood and so can be protective. Only when childhood and adulthood do not match is there a risk of behavioural problems. Alternatively, under the cumulative stress hypothesis we expect increased risk with each additional stressor. It has also been suggested that an individual's genetic background may determine the extent they undergo adaptive programming, and so which of these two hypotheses is relevant. In this study we test for an interaction between exposure to childhood maltreatment and adult stressful life events in a retrospective sample of 455 individuals, using major depression as the outcome. We also test whether this interaction differs by genotype at the 5-HTTLPR, a candidate for an individual's plasticity to adaptive programming.Early maltreatment and stressful life events in adulthood interacted to produce increased risk for depression over each individually (p = 0.055). This supports the cumulative stress hypothesis over the mismatch hypothesis, at least with respect to severe environmental risk factors. This effect was not altered by 5-HTTLPR allele, suggesting there was no difference by genotype in adaptive programming to these events. We suggest that the apparent additional vulnerability to stressful events of those who have experienced maltreatment has clinical relevance, highlighting the importance of providing support beyond the immediate aftermath of maltreatment into adulthood.

Negative life events and corticotropin-releasing-hormone receptor1 gene in recurrent major depressive disorder

Major depressive disorder (MDD) is a long-term, recurrent condition that often takes a chronic course. It seems imperative that research should be focused on gaining a better understanding of what predicts recurrent MDD. As a major mediator of the stress response, corticotropin-releasing-hormone receptor 1 (CRHR1) has been demonstrated to be an important contributor to the pathogenesis of MDD. In this study, we show a significant increase in the G-allele (rs242939) of the CRHR1 gene in the recurrent MDD group compared with the control group, and an overrepresentation of G-G-T hyplotype of the CRHR1 gene in recurrent MDD. We also demonstrate the interaction of the CRHR1 gene and negative life events in recurrent MDD. These results suggest that the CRHR1 gene could modify the susceptibility to developing recurrent MDD following negative life events in adulthood.

Are childhood and adult life adversities differentially associated with specific symptom dimensions of depression and anxiety? Testing the tripartite model

BackgroundDifferent types of adverse events may have general or specific effects on depression and anxiety symptomatology. We examined the effects of adversities on the dimensions of the tripartite model: general distress, anhedonic depression and anxious arousal. MethodsData were from 2615 individuals from the Netherlands Study for Depression and Anxiety (NESDA), with or without depressive or anxiety disorders. We analysed associations of childhood trauma, childhood life events (childhood trauma interview), and recent life events (List of Threatening Events Questionnaire, LTE-Q) with anhedonic depression, anxious arousal, and general distress (assessed by the adapted Mood and Anxiety Symptoms Questionnaire, MASQ-D30). ResultsWe controlled for co-occurrence of adversities. Regarding childhood trauma, only emotional neglect was associated with all three symptom dimensions. Psychological and sexual abuse were associated with general distress and anxious arousal, whereas physical abuse was associated only with anxious arousal. Particularly strong associations were seen for emotional neglect with anhedonic depression and for sexual abuse with anxious arousal. Childhood life events showed no associations with symptom dimensions. The recent life events ‘Serious problems with friend’, ‘Serious financial problems’, and ‘Becoming unemployed’ were associated with all three dimensions. The recent life event ‘death of parent/child/sibling’ was associated with anxious arousal. Several associations remained significant when controlled for current diagnosis of depression or anxiety. LimitationsOur cross-sectional analyses do not allow for causal interpretation. ConclusionsDistinct childhood traumas had different effects on the symptom dimensions, whereas most recent adult life events were associated with all three symptom dimensions. Our observations help to understand the often reported associations of these adversities with depressive and anxiety symptomatology. In addition, symptom dimensions of the tripartite model were shown to capture effects of adverse events on top of those captured by diagnostic categories.

Postnatal Aversive Experience Impairs Sensitivity to Natural Rewards and Increases Susceptibility to Negative Events in Adult Life

Evidence shows that maternal care and postnatal traumatic events can exert powerful effects on brain circuitry development but little is known about the impact of early postnatal experiences on processing of rewarding and aversive stimuli related to the medial prefrontal cortex (mpFC) function in adult life. In this study, the unstable maternal environment induced by repeated cross-fostering (RCF) impaired palatable food conditioned place preference and disrupted the natural preference for sweetened fluids in the saccharin preference test. By contrast, RCF increased sensitivity to conditioned place aversion (CPA) and enhanced immobility in the forced swimming test. Intracerebral microdialysis data showed that the RCF prevents mpFC dopamine (DA) outflow regardless of exposure to rewarding or aversive stimuli, whereas it induces a strong and sustained prefrontal norepinephrine (NE) release in response to different aversive experiences. Moreover, the selective mpFC NE depletion abolished CPA, thus indicating that prefrontal NE is required for motivational salience attribution to aversion-related stimuli. These findings demonstrate that an unstable maternal environment impairs the natural propensity to seek pleasurable sources of reward, enhances sensitivity to negative events in adult life, blunts prefrontal DA outflow, and modulates NE release in the reverse manner depending on the exposure to rewarding or aversive stimuli.

The enduring impact of borderline personality pathology: risk for threatening life events in later middle-age.

Both neuroticism and borderline personality disorder (BPD) are associated with increased frequency of stressful life events in young adults. It is not clear, however, whether this effect extends to later life because BPD is apparently diminished in frequency and severity when people reach middle adulthood. This issue was examined in a representative, community sample of men and women between the ages of 55 and 64 (N = 1,234). Ten DSM-IV PDs and neuroticism were assessed at baseline using a semistructured interview (SIDP-IV) and questionnaire (NEO-PI-R). Life events were measured 6 months later with a self-report questionnaire (LTE-Q) followed by a telephone interview. BPD features and neuroticism predicted increased frequency of life events, based on both self and interviewer-adjusted reports of negative life events. Avoidant and paranoid PD features predicted decreased frequency of negative life events. Approximately 42% of events reported on the LTE-Q were discounted following the telephone interview; higher scores on BPD symptoms were associated with more adjustments to self-report of threatening experiences. These findings indicate that symptoms of BPD and neuroticism continue to have a harmful impact on the lives of older adults.

Life events and their associations with depression and anxiety in older people with intellectual disabilities: Results of the HA-ID study

People with intellectual disabilities (ID) may be exposed to more life events due to different living circumstances and limited coping abilities. The frequency of life events may increase with age due to age-related decline, loss of significant others and forced relocations. We studied the occurrence of life events in adults with mild to profound ID aged ≥ 50 years and their association with depression and anxiety. Occurrence and burden of life events were assessed with a checklist of 28 items, completed by professional caregivers. Depression and anxiety were assessed with self-report and informant-report screening instruments (n=988) and with a psychiatric interview (n=286). Associations with depression and anxiety were studied for life events in general and for specific life events. 97% of the participants had been exposed to multiple life events during the preceding year and 72% had been exposed to one or more negative life events. The frequency was significantly higher in participants aged 65 years or over, in participants with mild or moderate ID and in participants with depression or anxiety. Minor physical illness and problems with a fellow resident were significantly associated with depression and anxiety, decline or loss of mobility and loss of leisure-time activities with depression and change at work or from work with anxiety. This study was cross-sectional and therefore lacks reliable information about causality. Given the high prevalence of life events and their association with depression and anxiety, life events should be better monitored and, if possible, prevented.

Psychosocial risk factors, weight changes and risk of obesity: the Copenhagen City Heart Study

The aim of the study was to establish the effects of a range of psychosocial factors on weight changes and risk of obesity. The study population consisted of the 4,753 participants in the third (1991-1994) and fourth wave (2001-2003) of the Copenhagen City Heart Study, Denmark. At baseline the participants were asked comprehensive questions on major life events, work stress, vital exhaustion, social network, economic hardship, and intake of sleep medication. Weight and height were measured by health professionals. Weight changes and incident obesity was used as outcome measures. The participants on average gained 2 kg of weight and 8% became obese during follow-up. The experience of major life events in childhood, work life and adult life was associated with weight gain and obesity in women, but not in men. Vital exhaustion was associated with weight gain in a dose-response manner in men (P = 0.002) and younger women (P = 0.02). Persons with high vital exhaustion gained approximately 2 kg more during follow-up compared to those with no vital exhaustion. Women with high vital exhaustion were also more likely to become obese during follow-up (OR = 2.39; 95% CI: 1.14-5.03). There were no clear patterns in the associations between social network, economic hardship and weight gain or obesity. The number of psychosocial risk factors, as an indicator for clustering, was not associated with weight gain or obesity. In conclusion, major life events and vital exhaustion seem to play a role for weight gain and risk of obesity, especially in women.

Neonatal maternal separation in male rats increases intestinal permeability and affects behavior after chronic social stress

Prolonged maternal separation in rats has several effects on health and behavior. Here we investigated how maternal separation might interact with social stress in adulthood on behavior and gastrointenstinal permeability. The effects of either daily 180min long term pup-dam separation (LMS) during the stress hyporesponsive period or daily 10min brief maternal separation (BMS) on behavior, corticosterone and intestinal permeability were investigated, compared to a non-handling (NH) condition in male offspring. The animals from each separation condition were then randomly assigned to adult stress and control conditions, where the stress condition was exposure to 14days of social instability (CSI). Sucrose preference, elevated plus maze behavior and corticosterone were measured. Colitis was experimentally induced by dextran sulfate sodium for 7days, followed by measurement of intestinal permeability using the 51CrEDTA method. Granulocyte marker protein was measured in feces and colons were examined histologically for inflammation. Prior to the social stress, the LMS offspring showed elevated corticosterone levels, lower elevated plus maze activity and less fluid consumption. After social stress, corticosterone levels were suppressed in LMS animals and again they showed less fluid consumption. LMS animals had significantly higher intestinal permeability, but only when also exposed to the social stress in adulthood. The current results support a two-hit model, whereby early life events interact with adult life events in altering animals' vulnerability.

Neonatal Exposure to Estradiol/Bisphenol A Alters Promoter Methylation and Expression of Nsbp1 and Hpcal1 Genes and Transcriptional Programs of Dnmt3a/b and Mbd2/4 in the RatProstate Gland Throughout Life

Evidence supporting an early origin of prostate cancer is growing. We demonstrated previously that brief exposure of neonatal rats to estradiol or bisphenol A elevated their risk of developing precancerous lesions in the prostate upon androgen-supported treatment with estradiol as adults. Epigenetic reprogramming may be a mechanism underlying this inductive event in early life, because we observed overexpression of phosphodiesterase 4D variant 4 (Pde4d4) through induction of hypomethylation of its promoter. This epigenetic mark was invisible in early life (postnatal d 10), becoming apparent only after sexual maturation. Here, we asked whether other estrogen-reprogrammable epigenetic marks have similar or different patterns in gene methylation changes throughout life. We found that hypomethylation of the promoter of nucleosome binding protein-1 (Nsbp1), unlike Pde4d4, is an early and permanent epigenetic mark of neonatal exposure to estradiol/bisphenol A that persists throughout life, unaffected by events during adulthood. In contrast, hippocalcin-like 1 (Hpcal1) is a highly plastic epigenetic mark whose hypermethylation depends on both type of early-life exposure and adult-life events. Four of the eight genes involved in DNA methylation/demethylation showed early and persistent overexpression that was not a function of DNA methylation at their promoters, including genes encoding de novo DNA methyltransferases (Dnmt3a/b) and methyl-CpG binding domain proteins (Mbd2/4) that have demethylating activities. Their lifelong aberrant expression implicates them in early-life reprogramming and prostate carcinogenesis during adulthood. We speculate that the distinctly different fate of early-life epigenetic marks during adulthood reflects the complex nature of lifelong editing of early-life epigenetic reprogramming.

Reminiscence and adaptation to critical life events in older adults with mild to moderate depressive symptoms

Objectives: The role of reminiscence as a way of adapting to critical life events and chronic medical conditions was investigated in older adults with mild to moderate depressive symptoms. Reminiscence is the (non)volitional act or process of recollecting memories of one's self in the past. Method: 171 Dutch older adults with a mean age of 64 years (SD = 7.4) participated in this study. All of them had mild to moderate depressive symptoms. Participants completed measures on critical life events, chronic medical conditions, depressive symptoms, symptoms of anxiety and satisfaction with life. The reminiscence functions included were: identity, problem solving, bitterness revival and boredom reduction. Results: Critical life events were positively correlated with identity and problem solving. Bitterness revival and boredom reduction were both positively correlated with depressive and anxiety symptoms, and negatively to satisfaction with life. Problem solving had a negative relation with anxiety symptoms. When all the reminiscence functions were included, problem solving was uniquely associated with symptoms of anxiety, and bitterness revival was uniquely associated with depressive symptoms and satisfaction with life. Interestingly, problem solving mediated the relation of critical life events with anxiety. Discussion: This study corroborates the theory that reminiscence plays a role in coping with critical life events, and thereby maintaining mental health. Furthermore, it is recommended that therapists focus on techniques which reduce bitterness revival in people with depressive symptoms, and focus on problem-solving reminiscences among people with anxiety symptoms.

Understanding ethnic differences in the migration of young adults within Britain from a lifecourse perspective

This paper is situated at the confluence of two emerging areas of research: a lifecourse approach in internal migration studies and in geography more broadly and studies of sub‐populations within lifecourse research. The paper aims to better understand the complexities of ethnic group migration in Britain, in particular why young adults of some ethnic groups are more residentially mobile than others. The paper draws on theories of norms of transition to adulthood. UK Census microdata of migration within Britain by age and ethnic group are used. The paper shows ethnic similarities: internal migration patterns that are distinct in young adulthood compared with other ages and many common characteristics of residential mobility. However, there are also differences between ethnic groups in levels of internal migration and in how young adult life events are associated with migration. In particular, partnership brings increased residential mobility for White British young adults but reduced mobility for South Asian young adults with females in both cases being the ‘partnership movers’. Being a student increases residential mobility for White British and Chinese young adults but reduces mobility for young adults from Black and South Asian ethnic groups (particularly for females in the Pakistani ethnic group). This raises issues of access to higher education. The paper concludes that a lifecourse perspective provides an understanding of ethnic differences in internal migration that were previously lacking from ‘segregation’ perspectives.

Self-Reported Life Events, Social Support and Psychological Problems in Adults with Intellectual Disabilities

Background: Several studies have reported relationships between life events and psychological problems in people with intellectual disabilities. In contrast to the general literature, data have consistently been collected via proxy informants and putative moderator variables such as social support have not been examined. Materials and Methods: Thirty-eight adults with intellectual disabilities completed three psychological measures in a semi-structured interview setting: the Bangor Life Events Schedule for Intellectual Disabilities Self-Report, the Brief Symptom Inventory, and the Social Network Map. Results: Exposure to life events was positively associated with measures of psychological problems. Social support was generally not found to be associated with psychological problems, although more psychological problems were reported by participants who also reported more criticism of them by others. Conclusion: Findings are broadly consistent with the proxy-report literature, though self-report measures may prove more sensitive. A number of methodological issues, clinical implications, and future research directions are discussed.

Life stress, 5-HTTLPR and mental disorder: findings from a 30-year longitudinal study.

Recent meta-analyses have raised concerns about the replicability of gene × environment interactions involving the serotonin transporter gene (5-HTTLPR) in moderating the associations between adverse life events and mental disorders. To use data gathered over the course of a 30-year longitudinal study of a New Zealand birth cohort to test the hypothesis that the presence of short ('s') alleles of 5-HTTLPR are associated with an increased response to life stress. Participants were 893 individuals from the Christchurch Health and Development Study who had complete data on: the 5-HTTLPR genotype; psychiatric disorders up to the age of 30; and exposure to childhood and adult adverse life events. A series of 104 regression models were fitted to four mental health outcomes (depressive symptoms, major depression, anxiety disorder and suicidal ideation) observed at ages 18, 21, 25 and 30 using 13 measures of life-course stress that spanned childhood and adult stressors. Both multiplicative and additive models were fitted to the data. No evidence was found that would support the hypothesis that 's' alleles of 5-HTTLPR are associated with increased responsivity to life stressors. The present findings add to the evidence suggesting that it is unlikely that there is a stable gene × environment interaction involving 5-HTTLPR, life stress and mental disorders.

The epidemology of schizophrenia: replacing dogma with knowledge

Major advances have been made in our understanding of the epidemiology of schizophrenia. We now know that the disorder is more common and severe in young men, and that the incidence varies geographically and temporally. Risk factors have been elucidated; biological risks include a family history of the disorder, advanced paternal age, obstetric complications, and abuse of drugs such as stimulants and cannabis. In addition, recent research has also identified social risk factors such as being born and brought up in a city, migration, and certain types of childhood adversity such as physical abuse and bullying, as well as social isolation and adverse events in adult life. Current research is focussing on the significance of minor psychotic symptoms in the general population, gene-environmental interaction, and how risk factors impact on pathogenesis; perhaps all risk factors ultimately impact on striatal dopamine as the final common pathway.

Coexisting Psychiatric Problems and Stressful Life Events in Adults With Symptoms of ADHD—A Large Swedish Population-Based Study of Twins

Objective: To explore the associations of subtypes of adult ADHD with other psychiatric problems, stressful life events, and sex differences. Method: Odds ratios were calculated using information from 17,899 participants from a population-based survey of adult twins born in Sweden between 1959 and 1985. Results: Symptoms of attention deficit hyperactivity disorder (ADHD) were associated with an increased risk for symptoms of (odds ratio [95% confidence interval]): generalized anxiety disorder (5.6 [4.3; 6.5]), major depression (2.8 [2.4; 3.2]), bipolar disorder (8.0 [5.1; 12.6]), obsessive-compulsive disorder (3.9 [3.1; 4.9]), and alcohol dependence (2.6 [2.2; 3.1]). Symptoms of ADHD were found to be associated with an increased risk for stressful life events (1.8 [1.3; 2.4]). No significant difference in comorbidity was observed between the two sexes. Conclusion: Both women and men with ADHD are at increased risk for symptoms of other psychiatric disorders. They are also at increased risk for stressful life events.