Major Stressful Life Events Research Articles

Effects of psychosocial treatment in prolonging cancer survival may be mediated by neuroimmune pathways.

Research has provided growing evidence of links between the social environment and cancer progression. Indeed, social support in the form of marriage, frequent daily contact with others, and the presence of a confidant may all have protective value against cancer progression. Furthermore, retrospective data suggest that major stressful life events are more prevalent in patients with relapse or malignancy, and thus may contribute to cancer morbidity. Initial studies of the effects of psychosocial intervention with cancer patients have provided some promising results. In three randomized prospective trials, protective effects of psychosocial interventions on cancer progression have been confirmed, while one matching and one randomized study showed no survival effect after psychosocial treatment. Though more research is clearly needed in this area, this body of evidence suggests that psychosocial factors have potentially powerful modulating effects on the course of disease. Here we review evidence of one possible mechanism whereby psychosocial factors may influence disease-resistance capabilities: the neuroimmune connection. Suppressive effects of stress on immune function are well documented, and these effects have been shown to be modulated by social support. Thus, it is reasonable to hypothesize that supportive social relationships may buffer the effects of cancer-related stress on immunity, and thereby facilitate the recovery of immune mechanisms that may be important for cancer resistance. Data addressing this hypothesis are reviewed.

Mastery of stress in mothers of preterm infants.

To explore the relationships among stress, social support, mastery, and depression. Descriptive correlational study. 60-bed, Level 3 NICU in an urban medical center in a Mid-Atlantic state. 31 mothers who delivered infants born between 26 and 36 weeks gestation. Inclusion criteria included no maternal illness or complications requiring hospitalization beyond four days, and no report of a recent major stressful life event other than the birth of the child. The Mastery of Stress Instrument, the Account of Social Resources Inventory, and the Center for Epidemiologic Studies-Depression Scale. Social support was positively related to mastery and inversely related to depression. Mothers of preterm infants experienced significant levels of stress and depression in the early postpartum period.

Psychological factors in the diagnosis and pathogenesis of stiff-man syndrome

Retrospective psychological evaluation of nine patients with stiff-man syndrome (SMS), seven of whom evidenced autoimmune disease, revealed a characteristic set of psychological symptoms or features: Major stressful life events preceded the development of permanent symptoms by 6 months or less (seven patients); transient motor symptoms occurred in emotionally distressing situations months or even years before the onset of a permanent motor deficit (five patients); after onset, similar situations specifically precipitated or augmented stiffness and spasms (five patients). We also found task-specific fear resembling agoraphobia (six patients) and loss or invalidation of one or both parents, or loss of home, in childhood (seven patients). Eight patients were initially misdiagnosed as having psychogenic movement disorder. We conclude that the common misdiagnosis of SMS as a psychogenic movement disorder is due to the compelling association of a set of salient psychological features, bizarre and fluctuating motor symptoms, and lack of approved neurologic signs.

Mortality after death of spouse in relation to duration of bereavement in Finland.

(1) To assess the extent to which death of a spouse causes excess mortality by controlling for the effects of confounding and other sources of bias. Three possible sources of bias are considered: accidents common to spouses, common socioeconomic environment, and common lifestyles. (2) To assess the duration specific effects of death of a spouse on mortality. Prospective study of mortality in Finland among all 35-84 year old married Finnish men and women (1,580,000 people). Baseline sociodemographic measurement from the 1985 census records. Follow up by computerised record linkage to death certificate registers for the period 1986-91 (about 116,000 deaths, of which almost 10,000 among the bereaved) using personal identification codes. (1) After controlling for confounding effects, excess mortality was 17% in men and 6% in women. (2) Excess mortality was higher for short durations than long durations of bereavement. (3) Excess mortality after bereavement was higher in men than women. Controlling for confounding does not seem to have a crucial modifying effect on the relationship between spousal bereavement and mortality. It seems that death of a spouse has a causal effect on mortality. However, although spousal bereavement is a major stressful life event, this causal effect seems to be relatively small and short lived.

Levels of Meaning in Family Stress Theory

Major stressful life events, particularly those that have chronic hardships, create a crisis for families that often leads to reorganization in the family's style of functioning. A major factor in this reorganization is the meaning the family gives to the stressful event. Often the meaning extends beyond the event itself and leads to a changed view of the family system and even to a changed view of the world. Building on other family stress models, we elaborate the family's definition of the stressor into three levels of family meanings: (1) situational meanings, (2) family identity, and (3) family world view. Examples from clinical work and studies of families adapting to chronic illness are used to illustrate the relationship between these three levels of meaning, particularly as they change in response to crisis. Implications for clinical and empirical work are discussed.

The role of stressful life events in the persistence of primary headache: major events vs. daily hassles

This study investigated the role of major stressful life events vs. minor life events (i.e., daily hassles) in the persistence of primary headache. It was hypothesized that chronic headache patients ( n = 83) would be characterized not so much by exposure to a continued surfeit of inherently major life events as by a tendency to appraise cognitively and emotionally any ongoing microstressor or daily hassle as being more arousing or impactful than headache-free controls ( n = 51). As predicted, chronic headache patients reported a significantly higher frequency ( P < 0.01) and density ( P < 0.01) of daily hassles, but not of major life events, than controls. Furthermore, minor life events were significantly correlated with headache frequency ( P < 0.001) and density ( P < 0.001) but not with gender, age and headache history. In terms of item content, health-related hassles (e.g., trouble relaxing) were perceived as being the most stressful. Significant differences between headache subgroups (chronic tension-type headache, migraine, mixed headache) were found, with tension-type and mixed headache sufferers reporting a higher incidence and density of daily hassles than migrainous patients. It was concluded that daily hassles were significantly associated with the persistence of headache and might be a better life event approach to chronic headache than major stressful events.

Parent and child stress and symptoms: An integrative analysis.

This study assessed major and daily stressful life events and psychological symptoms in a sample of young adolescents and their parents. The relation between major life events and symptoms was mediated by daily stressors for parents and their young adolescent children. Children's emotional and behavioral problems were associated with fathers' psychological symptoms but not with mothers' symptoms. Both mothers' and fathers' symptoms were associated with their sons' daily stressors, but girls' daily stressors were related only to their mothers' symptoms. Mothers' symptoms were associated with their husbands' daily hassles in families of young adolescent boys, and both parents' symptoms were associated with their spouses' hassles in families of adolescent girls. Highlights the importance of studying stress processes between individuals.

Childhood factors in ulcerative colitis and Crohn's disease. An international cooperative study.

This international case control study was conducted in 14 centers in 9 countries to investigate factors in childhood which may have a bearing on the etiology or pathogenesis of ulcerative colitis (UC) and Crohn's disease (CD). 197 patients with UC and 302 with CD (499 with inflammatory bowel disease (IBD] whose disease started before age 20 years and whose age at time of study was less than 25 years were investigated, with two age- and sex-matched controls for each patient. All subjects were studied with uniform questionnaires. Eczema was found significantly more frequently in patients with CD (p less than 0.005) and in their fathers (p less than 0.025), mothers (p less than 0.002), and siblings (p less than 0.01) as compared with their respective controls. IBD was significantly more frequent in parents, siblings, cousins, grandparents, and uncles of patients than in their respective controls. The fathers of patients with UC had significantly more major gastrointestinal and cardiovascular diseases at the time of the patient's birth than the fathers of controls. In North America mothers of patients with UC and CD took vitamin, mineral, and iron preparations during pregnancy significantly less frequently than mothers of controls. Patients with CD and UC consumed a lower residue diet than controls. Recurrent respiratory infections were more frequent in patients with UC and CD (p less than 0.001); it is uncertain whether this preceded disease. Hospitalization for respiratory diseases was more frequent in patients than controls, and the use of antibiotics more frequent in patients with CD. Smallpox vaccination was less frequent (p less than 0.05) in patients with CD, and chickenpox infection was less common in patients with UC (p less than 0.01). No significant differences were found between patients and controls in relation to various human and non-human contacts during childhood. Number of siblings, being an only child, and birth order did not differ markedly between patients and controls, and we could not confirm the 'sheltered child' hypothesis in IBD. The parents of controls were slightly better educated and their social class tended to be higher than those of parents of patients. There were significant associations between some of the main factors investigated in this study. No significant differences were found between patients and controls in the frequency of breast feeding, cereal consumption, sugar added to milk in infancy, gastroenteritis in childhood, major stressful life events, and many other factors.(ABSTRACT TRUNCATED AT 400 WORDS)

The role of stress in recurrent tension headache.

SYNOPSISThis study investigated the role of stress in recurrent tension headache. Although recurrent tension headache sufferers (N=117) and matched headache‐free controls (N=174) reported similar numbers and types of stressful life events, headache sufferers reported a greater number of chronic everyday stresses or daily hassles than did controls. Recurrent tension headache sufferers also appraised the stressful events they experienced more negatively than did controls, and employed less effective coping strategies in their efforts to manage stressful events. When the potential impact of a stressful event was ambiguous, recurrent headache sufferers appraised this event more negatively and themselves as having less control over the event than did headache‐free controls. In their coping efforts, recurrent tension headache sufferers also placed greater reliance on the relatively ineffective coping strategies of avoidance and self‐blame, and made less use of social support than did controls. These findings suggest that research on the role of stress in tensionheadaches should focus not on the occurrence of major stressful life events, but on the recurrent headache sufferer's cognitive appraisals of stressful events and efforts to cope with stress.