Life Change Events Research Articles

Stress and the urge to drink

Objective: Understanding why people drink alcohol is important for the health and safety of individuals and the public. The aim of this study was to examine from a cognitive point of view the hypothesized link between drinking and stress. Methods: 25 scenarios were constructed by combining two items, either two life-change events or a social situation and an emotional state. In the initial three experiments, 159 male and 43 female alcoholics and 157 male and 93 female nonalcoholics in France judged the degree to which these scenarios were stressful and subsequently the degree to which they stimulated an urge to drink. In the final experiment, 126 of the male alcoholics were studied at the beginning and end of an inpatient alcohol rehabilitation program. Results: The alcoholics and nonalcoholics, regardless of gender, assigned similar stress values to the scenarios and used the same cognitive rules for combining the stress associated with two items (disjunctive rules for two life-change events and additive ones for a personal emotion combined with a social situation). They differed, however, in how they judged the urge to drink. The nonalcoholics reported little stimulus to drink from any combination of items, whereas the alcoholics not only perceived the individual items as stimulating an urge to drink but also used the same cognitive rule in judging the combined urge to drink of two items as they used in judging the combined stress. After completing rehabilitation, the alcoholics judged the combinations of life-change events as stimulating less stress and less urge to drink. Nevertheless, they continued to use a disjunctive combination rule. Conclusions: Stress and drinking are linked at a fundamental cognitive level among alcoholics, though not among nonalcoholics. Alcoholics should be helped to recognize this link, to reduce their feelings of stress, and to find outlets other than drink.

Abnormal Pap test results and the rurality factor.

To review the published socio-cultural determinants that put women in rural areas at greater risk of having an abnormal Pap test result. Literature review. An Australian woman is at increased risk of developing cervical dysplasia if she lives in a rural area, identifies as an Indigenous Australian or is from a non-English speaking country. Being aged over 50 years, increases the risk of cervical cancer but not cervical intra-epithelial neoplasia (CIN) 1, which peaks in the 20-24 year age group. Other connections with cervical dysplasia relate to a woman or her partner's sexual history, her nutritional status and possibly even her personality type. Smoking, social isolation, high negative life change events and having lived a 'troubled' life are all identified in the literature as increasing a woman's risk of having an abnormal Pap test result. Receiving an abnormal Pap test result often leads to feelings of fear, anxiety, guilt, shock, vulnerability, powerlessness, depression, shame and feeling dirty for the woman concerned. Compounding these negative feelings are social, practical and financial difficulties that have to be addressed. It is argued that social and medical models of health must complement each other to improve the well being of rural women experiencing an abnormal Pap result.

Factors associated with depression in navy recruits.

The age of onset for depression is decreasing and seems to be linked with major life events. This study examined predisposing and concomitant factors related to Navy recruit basic training, and consisted of 443 recruits (200 with depressive symptoms and 243 matched comparison subjects). Two hypotheses were proposed, and both were supported by results of the study. Depressed recruits were more likely to be separated from the Navy and not complete training. They had significantly more predisposing factors than comparison recruits including family history of mental illness, family history of alcohol abuse, and history of psychiatric problems. They also had significantly more concomitant factors such as higher levels of stress, more loneliness, more life-change events, lower sense of belonging, more emotion-oriented coping, and less task-oriented coping. Although the study examined Navy recruits, the findings are applicable to depression in young people. This study adds to understanding the role of life stressors, interpersonal functioning, and development of depressive symptoms.

Low-Income African-American Women Talk About Stress

Research on stress has focused primarily on life-change events and daily hassles as sources of stress that can affect physical and mental health. There is evidence, however that chronic conditions causing stress may be more characteristic of the lives of poor, African Americans. For this study, 45 African-American women living in low-income neighborhoods participated infocus group discussions about sources of stress in their lives. Major categories of stressors were coded from transcripts and notes of each discussion. The women’s descriptions of their sources of stress help to shed light on the phenomenology of stress among poor, African American women. Correspondence between the emergent categories from these discussions and the categories outlined by D. Watts-Jones (1990) was also analyzed. The most often discussed source of stress for the participants was lack of adequate resources and the consequences of this. Other categories receiving considerable attention by the participants were role-functioning, relationship conflict, and health concerns.

Life change events, hope, and self-care agency in inner-city adolescents.

Little is known about the relationships among life change events, hope, and self-care agency in inner-city adolescents Adolescents (N = 202) attending two inner-city high schools in Miami (M = 15.9 years; 85% African-Americans; 55% females). Measures used included the Adolescent Life Change Events Questionnaire, Miller Hope Scale, and Denyes Self-Care Agency Instrument. A significant positive correlation was found between hope and self-care agency. No correlations were found between life change events and hope or life change events and self-care agency. Hope accounted for 20.8% of the variability in self-care agency. Hope is a significant factor in self-care agency and may be a coping strategy for inner-city adolescents who experience multiple life change events.

Stress and genital herpes recurrences in women.

BackgroundResults of several studies suggest that psychological stress and negative mood can trigger genital herpes recurrences, but results are inconsistent.ObjectiveTo determine whether short-term or persistent psychological stress or specific negative moods are predictive of genital herpes recurrences in women.MethodsA prospective cohort study followed up participants for 6 months using weekly assessments of stress and mood, monthly assessments of life change events, and diary reports of genital herpes recurrences confirmed by medical examination when feasible. The community sample consisted of 58 women, aged 20 to 44 years, with a 1- to 10-year history of visible genital herpes recurrence and at least 1 recurrence in the previous 6 months.ResultsPersistent stress predicted recurrence in the subsequent week (odds ratio, 1.08 per unit increase in stress; 95% confidence interval, 1.01-1.15; P = 03. After adjusting for recurrence in the previous week, the more weekly persistent stress reported, the greater the likelihood of recurrence the following week. Also, an increased recurrence rate occurred after the month during which participants experienced their highest levels of anxiety (P = 03). There were no significant associations between recurrence and short-term stress, life events, depressive mood, anger, or phase of menstrual cycle.ConclusionsPersistent stressors and highest level of anxiety predicted genital herpes recurrence, whereas transient mood states, short-term stressors, and life change events did not. Women with herpes can be reassured that short-term stressful life experiences and dysphoric mood states do not put them at risk for increased outbreaks of recurrent genital herpes.

Persistent Stress as a Predictor of Genital Herpes Recurrence

Results of several studies suggest that psychological stress and negative mood can trigger genital herpes recurrences, but results are inconsistent. To determine whether short-term or persistent psychological stress or specific negative moods are predictive of genital herpes recurrences in women. A prospective cohort study followed up participants for 6 months using weekly assessments of stress and mood, monthly assessments of life change events, and diary reports of genital herpes recurrences confirmed by medical examination when feasible. The community sample consisted of 58 women, aged 20 to 44 years, with a 1- to 10-year history of visible genital herpes recurrence and at least 1 recurrence in the previous 6 months. Persistent stress predicted recurrence in the subsequent week (odds ratio, 1.08 per unit increase in stress; 95% confidence interval, 1.01-1.15; P=.03). After adjusting for recurrence in the previous week, the more weekly persistent stress reported, the greater the likelihood of recurrence the following week. Also, an increased recurrence rate occurred after the month during which participants experienced their highest levels of anxiety (P =.03). There were no significant associations between recurrence and short-term stress, life events, depressive mood, anger, or phase of menstrual cycle. Persistent stressors and highest level of anxiety predicted genital herpes recurrence, whereas transient mood states, short-term stressors, and life change events did not. Women with herpes can be reassured that short-term stressful life experiences and dysphoric mood states do not put them at risk for increased outbreaks of recurrent genital herpes.

Differential Immune System Changes with Acute and Persistent Stress for Optimists vs Pessimists

This study investigated whether acute and persistent stressors and life change events were followed by changes in immune status, and whether dispositional optimism moderated these relationships. Thirty-nine healthy women ages 18–45 were followed prospectively for 3 months, with weekly assessment of acute and persistent stressors and monthly assessment of life events and immune parameters (NK cell cytotoxicity, and CD4 and CD8 T cell subsets). The study used an autoregressive linear model to examine how weekly appraised acute and persistent stress levels were associated with immune parameters in the subsequent week. Analyses revealed that the immune outcomes were differentially affected by acute and persistent stressors. Further, the association between acute stress and subsequent immune parameters was buffered by an optimistic perspective. However, when stress persisted at high levels, optimists showed more subsequent immune decrements than pessimists.

Life changes scaling for the 1990s

Three decades ago, results from a proportionate scaling study of life change events was published in this journal. The events, listed by rank order of their mean life change values, comprised the Social Readjustment Rating Scale (SRRS). Ten years later, 42 of the 43 original events were rescaled. In this second study, an additional 44 events were added to the original list. In the present report, the original plus the later-developed events were scaled once again by persons chosen to closely approximate subjects enrolled in the initial study. Comparing the average life change intensity scores across 30 years, a 45% increase in mean values was seen. These recently derived life change magnitudes, for both the original list of events plus the later-developed events, provide values appropriate for use in the 1990s. In the original study, effects of subjects' demographic characteristics were noted briefly in a table. In the present investigation, varying influences of gender, age, marital status, and education were explored in more detail. Several significant differences were discovered, with gender showing a very pronounced influence on scaling results. Discussion of these results included composition requirements for a life changes questionnaire.

Suicide Ideation, Depression, and Stressful Life Events among Gifted Adolescents

Differences in life-change events, life stress, depression, and suicide ideation were investigated in a mixed-ethnic sample of gifted (n = 34) and nongifted (n = 38) urban junior high school students. Results indicated that gifted students reported experiencing significantly fewer life-change events. The perceived stressfulness of the life-change events, levels of depression, and suicide ideation were similar among gifted and nongifted participants. Suicide ideation among the entire sample was significantly and positively correlated both with level of depression and with levels of past and recent stress. Recent stress and use of drugs or alcohol significantly predicted suicide ideation. Implications for counseling and for future research are discussed.

The life change inventory and the MMPI depression subscale in predicting failure in the compulsory conscript service

This study was performed to examine how two different inventories can predict failure in the compulsory conscript service. The study was organized in the Turku Coastal Regiment in Finland during 1991–92. All 693 recruits who came to do their military service during 1 year took part in the study. We used a 35-item short form of the Life Change Inventory (La) and a 22-item subscale of the Minnesota Multiphasic Personality Inventory depression scale (MMPI). Each life change event was assigned a numerical value ranging from 11 to 65 Life Change Units (LCU). A large number of LCUs and positive answers in the MMPI were statistically significantly associated with failure in the military service. Furthermore, both inventories included many questions that were significantly associated with exemptions from military service. When the study population was divided into 5 different risk groups, the probability of failure in military service was 45 times higher in the highest risk group than it was in the lowest risk group. Accordingly, it is possible to form different risk groups by using these two inventories, with the failure risk in military service being at most 67%. The possibility of forming different risk groups provides better opportunities to make recommendations and offer increased support and counseling to an individual conscript. It also gives a clearer argument on which to base the decision to exempt a youth from military service in advance.

Coronary heart disease: a review of the role of psychosocial stress and social support.

The role of psychosocial factors in the aetiology of coronary heart disease continues to be debated. Despite public perception of a major role for their effect, scientific opinion on their relevance remains divided. This paper reviews the literature on the influence of social support and life stress on coronary heart disease incidence and mortality. Observational studies published in English, based on over 100 human subjects from the general population, investigating life stress or social support were considered. Fourteen studies derived from MEDLINE searches on MeSH headings: coronary disease; stress, psychological; social support; social isolation; life change events. An equivalent search of BIDS and studies referenced by papers identified using these sources was carried out. The review concludes that both life stress and social support were found to have an influence on coronary heart disease, social support more so than stress. Both have a stronger influence on coronary heart disease mortality than on initial incidence of clinical disease. Measures of the quality of support, in particular emotion support, show the largest effects. The review highlights problems in drawing conclusions from the available literature; in particular, the inconsistency in measures used to define the psychosocial factors. Further studies are needed to investigate interrelationships between stress and social support, and a recommendation is made to adopt pragmatic measures in future studies, which if proven to have an effect, may be open to modification.

Predicting completeness of symptom relief after major heart surgery.

The authors hypothesized that the same biopsychosocial factors that raise the risk of illness incidence would influence the speed and completeness of relief from physical symptoms during recovery following cardiac surgery. This multicenter prospective study involved 463 patients aged 35 to 69 years who underwent coronary artery bypass graft or cardiac valve surgery. Predictor data were gathered 1 to 3 days before surgery, and outcome measures were collected 6 months postoperatively. The following predictors were associated with postoperative freedom from cardiac symptoms: fewer preoperative cardiac hospitalizations; low levels of angina, dyspnea, fatigue, and sleep problems; low levels of anxiety, depression, hostility, and life-change events; and high levels of psychosocial well-being, hopefulness, overall satisfaction, and social support. The predictors of not requiring daytime bed rest because of cardiac symptoms during the 6th postoperative month were male gender, higher education, less cardiac disability preoperatively, low levels of angina, dyspnea, sleep problems, depression and fatigue, and absence of Type A behavior and of intraoperative hypotension. By using separate multiple logistic regression equations, the authors identified the variables printed in bold face as independent significant contributors to prediction. Many of the predictors are strong enough and simple enough to be used in clinical practice. Many of them may also predict recovery after acute illnesses and injuries involving other organ systems.

Quantifying and predicting recovery after heart surgery.

The validity of the biopsychosocial approach to the study of health and illness is reaffirmed by the prospective findings of the Recovery Study. This is a multidisciplinary examination, conducted in four teaching hospitals, of the predictors of symptoms of cardiac illness in 463 patients 6 months after coronary artery bypass or cardiac valve surgery. We found that the following preoperative measures predict freedom from cardiac symptoms 6 months after surgery: low levels of all of the following: angina pain, shortness of breath, fatigue and sleep problems, lifetime cigarette usage, and preoperative hospitalization for cardiac treatment; low levels of anxiety, depression, and hostility, and few life change events; high levels of all of the following: self-esteem, well-being, vigor; prevalence of activities and hobbies, social participation, and social support. The six variables in bold print contributed independently in a multiple regression equation that accounted for 21% of the variance of the symptoms score and was associated with an estimated 45% difference in success of recovery. The statistical strength and general nature of many of the predictors indicate that the predictors may also be important in recovery from other health crises. Psychosocial and biomedical factors correlate across time (predictively), as well as cross-sectionally, indicating that psychological, social, and biological mechanisms may be parts of a single general multifaceted process influencing recovery of health. A clinical trial could determine if psychological, social, or behavioral interventions will hasten and improve recovery from physical illness or trauma.

Clinical issues in psychosocial rehabilitation for spouses with physical disabilities

Numerous experiences and disturbances in life can cause stress. Concerns related to the physical environment, social and interpersonal relations, one's perception of various aspects of daily life, and a non-disabled spouse who suffers a debilitating injury that results in paralysis and dependence have all been known to be stressful life experiences. Examined are a multiplicity of factors which have been recognized through clinical research and experience as relevant to the spouse who is physically disabled. Specific issues related to life change events, their applicability to personality theory and recent clinical research are explored. In addition, relevance of current measures of stressful life events and suggested revisions are discussed. Finally, issues in the treatment of the spouse who is physically disabled and family members are explored.

Coping behaviour and degree of discrepancy between retrospective and prospective self-ratings of change in quality of life in type 1 diabetes mellitus.

Quality of life and metabolic control were examined in 74 adults with Type 1 diabetes mellitus in 1988. Sixty-six of the persons were followed up in 1990 with the aim of studying more closely the subgroup that showed a 'major' discrepancy between 'retrospective' and 'prospective' quality of life change ratings. 'Prospective' quality of life change was defined as the difference in assessed quality of life status between 1990 and 1988. 'Retrospective' quality of life change was assessed directly by subjects in 1990 covering the same time period. Data on quality of life, well-being, sociodemographics and metabolic control were collected on both occasions. Recent life-change events and long-term complications were also recorded in 1990. Subjects with 'major' discrepancy reported greater retrospective quality of life improvement, higher quality of life, and greater well-being, as well as lesser occurrence of negative and greater occurrence of positive recent life-change events, than did those with 'minor' discrepancy, despite their exhibiting poorer metabolic control and a higher prevalence of incipient nephropathy. The results are discussed in terms of possible coping and defence strategies.

Adolescent stress and coping: a longitudinal study.

The purpose of this longitudinal panel study was to investigate developmental and gender influences on stress and coping in adolescents attending a suburban high school in Tennessee. Data were collected from the same 167 subjects during the freshman year and again during the senior year. Life events stress was measured through the Adolescent Life Change Event Scale (ALCES) and ways of coping were categorized from data gathered from an open-ended questionnaire. Girls reported more life events stress at both testings than boys. Life events stress was greater at senior testing for both girls and boys, but girls' scores increased more. The "gender intensification" phenomenon may account for the greater disparity in types of stress reported by boys and girls as seniors. Girls generally reported more life events associated with interpersonal and family relationships. Both girls and boys reported coping with stress mostly through active distraction techniques such as exercise. However, girls' use of active distraction decreased over time, while passive distraction increased. Self-destructive and aggressive coping behaviors increased for boys. There were no relationships between amounts or types of life events stress and ways of coping for subjects at either time.

Identification of predictor variables of a postpartum emotional reaction

Clinical observations and research suggest that postpartum emotional reactions (PEREA) are a widespread phenomenon. Prenatal identification of women who are at risk is essential if health professionals are to intervene and prevent long-term problems for the mother and her family. Health status, previous psychiatric history, locus of control, psychosocial assets, and life change events, as well as maternal adaptation to pregnancy and motherhood were examined in this study as possible predictor variables of a postpartum emotional reaction. Twenty-seven expectant women were assessed once prenatally and twice in the postpartum period. The data revealed that 59% of the participants, both primiparas and multiparas, experienced an increase in negative affect at some stage of the pregnancy and/or within 4 to 6 weeks postpartum. There were no significant differences between those who developed a PEREA and those who did not on the following variables: planned versus unplanned pregnancy, desired versus undesired pregnancy, attendance at prenatal class, and feeding plans. There was a significant association (p less than .01) between breastfeeding and the occurrence of a PEREA at 4 to 6 weeks postpartum among the primiparas. The study demonstrated that there was no single cause but several factors that, if present in combination, were predictive of an emotional reaction postpartum. Locus of control and existing emotional reactions, especially prenatal depression, were the most important predictor variables. The individual's ability to adapt to day-to-day life was influenced by the presence or absence of a combination of factors. These included preexisting emotional reactions, perceived locus of control, health status, and/or stress.(ABSTRACT TRUNCATED AT 250 WORDS)

Couple therapy and chronic headache: a preliminary outcome study.

This brief report examines the factors that led to successful completion of couple therapy with 8 chronic headache patients and their spouses, as opposed to another 8 couples who dropped out of treatment. Overall, the couples who successfully completed therapy were in less strifeful marriages and were confronted with specific life change events as opposed to the couples who dropped out, who gave evidence of chronic marital difficulties. Family and couple therapy for chronic headache sufferers is recommended on a selective basis.

Predictors of classroom stress and burnout experienced by gifted and talented students

Classroom stress and burnout experienced by 121 gifted and talented students were assessed in combination with seven background variables (i.e., sex, age, IQ, etc.), five personal variables (i.e., creative personality typology, locus of control, family environment, other-rated behavioral, academic self-esteem, and self-rated self-esteem), three general anxiety and stress variables (i.e., state/trait anxiety, life change events), and two organizational variables (i.e., classroom tedium and quality of school life). The student's age, sex, birth order, IQ, and achievement level bore little relationship to either stress or burnout. Poor self-esteem, an externalized locus of control, high levels of state and trait anxiety, poor school life quality, and tedium proved to be significant predictors of classroom stress. These, plus problems in the family environment and high classroom stress levels, predicted significant levels of classroom burnout. Males reported a greater number and different types of stress and burnout sources than did females, indicating differentiated sex-related problems with stress and burnout.