Number Of Life Events Research Articles

Life events and suicidality in adolescents with schizophrenia

Suicide is the leading cause of premature death in patients with schizophrenia. Studies have shown a weaker association between suicidal behavior and stressful life events in schizophrenic than in nonschizophrenic subjects. The aim of the present study was to further investigate the complicated relationship of suicide attempts and life events in adolescent schizophrenic patients. Forty adolescents with a diagnosis of schizophrenia, including 20 who had attempted suicide and 20 who had not, were compared with 20 age-matched subjects with no psychiatric history. The instruments used for the assessment were the Life Events Checklist, the Suicidal Risk Scale, the Sexual Abuse in Childhood Questionnaire, and the Beck Depression Inventory. Control subjects reported fewer life events in general, and fewer negative events, events of sexual abuse, and events associated with impaired family functioning than the schizophrenic patients. Within the schizophrenic group, the suicidal patients reported fewer life events than the nonsuicidal patients, but there was no difference between the groups in the number of negative or sexual-abuse events. However, the proportion of negative life events out of total life events was higher in the suicidal group, and their perceived impact was stronger. Levels of depression and suicidality were higher in the suicidal schizophrenic patients than in the nonsuicidal patients. In adolescent patients with schizophrenia, suicidal behavior is associated less with the number of life events and more with their perception of the events as negative and the impact of these events on the individual.

Predicting externalizing problems in Moroccan immigrant adolescents in the Netherlands

Although an increasing proportion of the population in Western countries originates from non-Western parts of the world, little research has been conducted on predictors of externalizing problems in immigrant adolescent samples. This study on the predictors of externalizing problems in Moroccan immigrant adolescents in the Netherlands was aimed to contribute to the knowledge in this field. We obtained 415 parent-reports, 376 self-reports and 238 teacher-reports on problem behavior in a general population sample of randomly selected 11- to 18-year-old Moroccan immigrant adolescents, using the Child Behavior Checklist, Youth Self-Report and Teacher's Report Form. The data revealed a clear relation between externalizing problems and several child (gender, internalizing problems), proximal family (parental monitoring and affection, support from father and mother, and parent-child conflict), contextual family (conflicts between parents about parenting, destructive communication between parents, and total number of life-events), school/peer (problems at school, involvement with deviant peers, hanging out), and migration variables (adolescent's perceived discrimination). Hardly any association was observed between externalizing problems and parental psychopathology, and between externalizing problems and global family variables (e.g., family employment level). Most findings matched results found in earlier studies on non-immigrant youth. Our results suggest that the child, school/peer, and proximal family factors are essential in models predicting the development of externalizing behavior. The impact of the migration factor on externalizing problems turned out to be relatively small.

Life events, psychopathology, and suicidal behavior in Chinese adolescents

Background Little is known about risk factors of suicidal behavior among Chinese adolescents. This study examined the associations between negative life events, psychopathology, and suicidal behavior in rural adolescents of China. Methods A total of 1362 adolescent students in a rural prefecture of China completed a self-administered questionnaire concerning suicidal behavior, psychopathology, life events, and demographics. Data analyses were conducted using multivariate logistic regression modeling. Results Females were more likely to report suicidal ideation than males (22.0% vs. 17.5%). While the rate of suicide attempt was slightly higher in younger males (12–15 years) than in females (4.7% vs. 3.1%), the rate was higher in older females (16–18 years) than in males (12.7% vs. 9.5%). Suicide attempters reported more negative life events during the past year than suicidal ideators and non-suicidal adolescents. Academic stress and family conflicts were the major stress domains of adolescents at risk for suicidal behavior. A significant dose–response relationship was observed between the number of life events and suicidal behavior. Negative life events were also associated with increased risk for internalizing and externalizing problems. Both internalizing and externalizing problems were significantly associated with elevated risk for suicidal behavior after negative life events were controlled. Limitations This is a cross-sectional study. Longitudinal study is warranted to examine the roles of life stress in adolescent suicidal behavior. Conclusions Adolescents who experienced more negative life events are at increased risk for suicidal behavior. Both internalizing and externalizing problems mediate the effect of life events on adolescent suicidal behavior.

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.

Differences in negative life events between patients with anxiety disorders, depression and hypochondriasis

This study investigated whether some categories of adverse life events are differentially associated with specific types of emotional disorders. A life self-report measure of major life events was completed by 42 subjects with diagnoses of anxiety disorders, 46 subjects with major depression, 26 subjects with hypochondriasis and 73 nonclinical subjects (controls). As predicted, the onset of anxiety disorders, depression, and hypochondriasis appears to be differentially related with life stress of ‘threat’, ‘loss’, and ‘health’, respectively, previously experienced by the clinical subjects. Also, there were significant differences between clinical and nonclinical subjects on both perceived life stress and number of life events reported. Findings suggest a differential implication of psychosocial stress categories in particular emotional disorders (i.e., anxiety, depressive and hypochondriacal disorders). These results expand previous findings that have demonstrated an association between negative life events and psychopathology.

Psychological status at the menopausal transition: an Italian epidemiological study

Objectives: To provide epidemiological data about psychological symptoms derived from a large Italian non-clinical sample, and to investigate the correlation with psychosocial factors. Methods: The study design was a cross-sectional postal survey of a sample of menopausal women recruited from the General Registry Office in Ferrara’s province. Four thousands and seventy-three women were sent a questionnaire designed on the basis of the Women Health Questionnaire (WHQ). Together with the WHQ, women were asked to fill out a personal file to define social status, cultural level, family’s characteristics, recent menstrual cycles, gynaecological history and operations, drug’s assumption, life events in the last year and lifetime depression. Results: Factor analysis resulted in eight clusters of symptoms. Among psychiatric symptoms, three different clusters were identified: depressive symptoms, depressed mood with anxiety symptoms, and anxiety. The cluster “depressive symptoms” was more evident in the postmenopausal period with respect to the premenopausal one. Conclusion: The cluster “depressive symptoms” is significantly different in the premenopausal group with respect to the postmenopausal group, with greater levels of symptomatology in the postmenopausal group. On the contrary, the factor “depressed mood with anxiety symptoms” is present to the same extent in the pre-, peri- and postmenopausal groups. Prior depression is the most predictive variable of subsequent depression in postmenopausal women. Factors related to more pronounced depressive symptoms are number of life events, postmenopausal status, place of residence in rural areas and lower cultural level.

Hospital and community-based care for patients with chronic schizophrenia in Hong Kong--quality of life and its correlates.

There have been few studies on the impact of de-institutionalization on psychiatric patients' lives in Chinese culture. The objectives of the present study were: (1) to compare quality of life (QOL) of Chinese patients with schizophrenia living in three different treatment settings (hospital, long-stay care home and half-way house) in Hong Kong, and (2) to identify factors associated with patients' subjective well-being. A matched-group design was used. Subjects (n = 204) living in the three treatment settings were matched according to age, sex, educational level, marital status, length of psychiatric illness and number of previous psychiatric admissions. Multiple measures for the evaluation of QOL included the Satisfaction With Life Scale (SWLS), WHO Quality of Life Measure-Abbreviated version-Hong Kong (WHOQOL-BREF-HK), Life Event List (LEL) and the Global Assessment Scale (GAS). Psychiatric symptoms were evaluated with the Brief Psychiatric Rating Scale (BPRS). Significant differences in objective QOL indices (global level of functioning, number of life events and income) between subjects staying in hospital and community-based residential services were found in favour of the less restrictive community settings. However, with respect to global life satisfaction, subjects preferred the more secure settings despite their restrictiveness. Predictors of subjective well-being were educational level, negative life events and the BPRS items of somatic concern, anxiety and guilt feelings. The impact of negative life events on subjective well-being decreased over time. In a cohort of Chinese patients with chronic schizophrenia, community-based treatment settings had a positive impact on objective QOL indices but not on subjective well-being. Negative life events, education level, and the BPRS items of somatic concern, anxiety and guilt feelings were predictors of subjective well-being which seemed to adapt to external circumstances over time.

Patient-Physician Relationship and Service Utilization: Preliminary Findings.

BACKGROUND: Difficult physician-patient encounters pose a challenge in all aspects of health care. Characteristics of both physicians and patients affect the office encounter and utilization of services. The objectives of this study were to explore the impact of patients' characteristics and the patient-physician relationship on service utilization. METHOD: A sample of 22 family practice patients and their physicians completed questionnaires prior to and/or after an office visit. Chart review yielded demographic information and history. The number of office visits and phone calls were obtained from billing records. RESULTS: The number of patient-reported physical problems was correlated with negative affect (r = 0.63, p <.002), the number of phone calls to the office (r = 0.52, p <.02), and the difficulty of the encounter as perceived by the physician (r = 0.58, p <.005). The number of phone calls also correlated with the number of life events (r = 0.43, p <.05) and the patient's perception of the physician's warmth (r = 0.48, p <.03) and understanding (r = 0.44, p <.04). CONCLUSION: Life stress, negative affect, physical complaints, and the patients' perception of their physician impact utilization. Armed with information about patient characteristics prior to the office visit, the physician can increase efficiency and facilitate a more productive encounter.

Association of negative life event stress with coagulation activity in elderly Alzheimer caregivers.

Part of the excess coronary disease rate and overall mortality reported with caregiving stress could relate to a hypercoagulable state. Physiological responses to the chronic distress of caregiving may involve hyperactive sympathetic nervous system responses to superimposed stressors. We wondered whether negative life stress might affect hemostatic function in caregivers. The three procoagulant measures thrombin-antithrombin III complex (TAT), fibrin D-dimer (DD), and von Willebrand factor (vWF) antigen were assessed in 54 spousal Alzheimer caregivers (mean age, 73 +/- 6 years). Subjects completed a semistructured interview (Psychiatric Epidemiologic Research Interview, PERI) that assessed for non-caregiving-related life stress (ie, number of negative life events) over the 4-week period before blood sampling. Caregivers reported an average of 2.6 negative life events (range, 0-6). The number of negative life events showed a direct association with plasma DD levels (p =.010). In multiple regression analyses, body mass index (BMI) and life stress were the only significant predictors of DD. Together, BMI, hypertension status, gender, and depression accounted for 23% of the variance in DD (p =.022). After these variables had been controlled for, life stress explained an additional 9% (p =.021) of the variance in DD. On the other hand, the number of life-events did not significantly predict TAT or vWF. The findings suggest that superimposed life stress on top of the chronic stress of Alzheimer caregiving may elicit a hypercoagulable state that could contribute to coronary disease and to increased overall mortality in this population.

Longitudinal analysis of factors influencing direct costs of schizophrenia treatment

In a prospective longitudinal study with 5 points of measurement the direct service costs as well as the clinical and social characteristics of 307 outpatients with the diagnosis of schizophrenia (ICD 10 F 20.0) were assessed over a period of 2.5 years. A random-effect regression model was computed for the assessment of the impact of clinical and social variables on cost variance. Within-effect and between-effect of independent variables on the cost variance were identified by comparing of within and between effect models. Results of the study show that 10 % of the within variance and 32 % of the between variance were explained by the random effect model. Significant within effects were found for a deterioration of emotional health status and for general level of functioning. Significant between effects were found for living situation, partnership, number of inpatient episodes, psychopathological symptoms, depression, alcohol abuse and number of life events. The study results suggest that interventions aiming at the reduction of direct costs should not be restricted to medical treatment but must also include psychosocial interventions for the enhancement of general functioning. However, the explained proportions of within and between variance reveal that the possibilities of manipulating direct treatment costs by means of patient-related interventions may be limited.

Life events preceding suicide by young people.

Life events are often reported to precede suicide. This paper aims to determine the frequency, timing and type of life events preceding suicide by young people and those with and without a mental illness. Informants, usually family members, were interviewed for a sample of young (less than 35 years) suicides. Information was recorded on events occurring in the 6 months before death. Equivalent information was obtained for living controls who had been matched for age and gender and obtained through the general practices of the suicides. Suicide was associated with life events in the previous 3 months, and particularly in the previous week. Specifically, interpersonal and forensic (being arrested, charged or sentenced) events distinguished suicides and controls. The number of life events in the different time periods under study did not distinguish suicides with and without severe mental illness, although more suicides without a severe mental illness had a reported life event in the week before their death. Adverse life events frequently precede suicide in young people with and without severe mental illness. However, recent life events may have a lesser causal role in those with severe mental illness. Clinical and health promotion measures to improve the way that young people cope with interpersonal problems and other crises may be an important part of any suicide prevention strategy.

Stress, healthiness and health behaviours: An exploration of the role of life events, daily hassles, cognitive appraisal and the coping process

In a study of 220 participants, the relationship between life events, daily hassles, cognitive appraisal and coping, stress and general healthiness was investigated utilizing a self report methodology. The different aspects of healthiness and health behaviour/lifestyle appear to be related to different appraisal and coping styles. The role of daily hassles and life events in the process also vary across different aspects of health, illness and health behaviours. In fact the number of life events experienced appear to contribute more to hardiness than to vulnerability. It is proposed that to understand the process an integrative model is required which allows for flexibility in analysis.

The effect of adverse life events on glycaemic control in children with insulin dependent diabetes mellitus.

Forty-five children aged 6 to 14 years with insulin-dependent diabetes mellitus were recruited from a paediatric diabetic clinic. Glycaemic control, child emotional and behavioural problems, and maternal mental state were assessed at recruitment and after 12 months. Life events were measured at 12 months using a standardised semi-structured interview schedule. A between-groups comparison design was used to explore the effect of life events, child emotional and behavioural problems, and maternal mental state on glycaemic control. The children had relatively high rates of emotional and behavioural problems. Overall, the children had a similar number of life events to healthy children in the general population, but proportionally, experienced fewer desirable events. Children who had experienced at least one event in a family setting, or a disappointing event, were more likely to have high glycated haemoglobin levels afterwards than were children who had not experienced such events. Linear regression models showed that only disappointments, family events and glycated haemoglobin at the start of the study made important independent contributions to glycated haemoglobin at 12 months. Child age, emotional and behavioural problems, and maternal mental state, had no effect on glycaemic control.

Reliability of biographical data, their relations to personality variables and their influence on life-events

Background: First, this study aims to investigate the reliability of biographical and personality data, i.e. analysing the impact of depressive mood on these variables. Second, the influence of early life experience and personality on the reporting of life events was examined. Methods: Self-reporting questionnaires were administered for a sample of 250 depressive subjects at the beginning, and to assess the influence of depressive mood on the reporting of biographic data at the end of inpatient treatment we used a random sample of 50 subjects out of the 250 patients. Results: Biographical data, unlike personality data, are not significantly influenced by depressive mood and depressive cognition. The number of life-events, and their mean subjective stress, neuroticisms and aim-relatedness are on a direct path strongly influenced by biographical data. That means that the more negatively primary socialisation was reported, the more life-events were communicated, with corresponding increases in the reporting of their subjective stress, and more neuroticism and less aim-relatedness, and vice versa. Neuroticism strongly influences in a positive way, and aim-relatedness negatively influences in a medium way, the number of life-events and their subjective stress. That means the higher neuroticism and the lower aim-relatedness were reported, the more life-events and higher stress were communicated, and vice versa. Conclusion: Linear causal processes from mood-independent factors (e.g. biographical factors, vulnerability) may be the beginning of cyclic causal processes, i.e. vicious circles between life-events and mood-dependent factors (e.g. personality variables). Limitations: According to the design of the investigation there is no differentiation possible between personality and depression. Clinical relevance: To avoid vicious circles between life-events and mood-dependent factors, preventive psychotherapeutic intervention seems to be necessary to avoid the genesis of harmful life-events.

Stress-coping and other psychosocial risk factors:: a model for smoking in grade 6 students

Smoking uptake by adolescents is best studied by a following a cohort of children as they proceed through adolescence. In this analysis of the first stage of such a study, several hypotheses about psychosocial factors that may modify the initiation of smoking in adolescents were examined in 1,552 11- and 12-year-olds in a school system in Scarborough, Canada. Investigation of the stress-coping hypothesis and other possible effect modifiers as they relate to ever-smoking revealed that stress (measured by number of life events) was important for both males and females ( p = .0163 and .0056, respectively). However, the mechanisms underlying smoking appear to be different for males and females, even at this young age. In models adjusting for several factors simultaneously, rebelliousness was found to be the most important factor ( p = .0001) followed by attitudes toward the effect of second-hand smoke ( p = .0063) for males, whereas for females, mother smoking was the most important factor ( p = .0001) followed by rebelliousness ( p = .0102). Implications for design of prevention programs are discussed.

Life events, social support and depression in haemodialysis patients

This study examined the effects of life events and social support on depression in 200 dialysis patients. The instruments used included the Beck Depression Inventory, a modified version of Sarason's Life Experiences Survey and a Social Support Inventory (SSI) constructed by the authors. The SSI consisted of five quantitative measures and three measures of perceived social support. These measures were found to be internally consistent and stable over time. Results showed that clinically depressed dialysis patients reported fewer positive life events and appraised life events more negatively than non-depressed patients. The total number of life events and the number of negative life events were not found to differentiate between depressed and non-depressed patients. With regard to social support variables, results showed that depressed patients reported less frequent actual contact and telephone contact with others and perceived a smaller amount and less availability of social support and less satisfaction with perceived social support along the functional dimensions of emotional, informational, appraisal and instrumental support and social companionship. The results were found to provide support for a main effect model of social support and not for a buffering model. Copyright © 1999 John Wiley & Sons, Ltd.

LIFE EVENTS AND PSYCHOLOGICAL WELL-BEING IN WOMEN SENTENCED TO PRISON

There have been no systematic analyses of the factors that influence the development of psychological well-being in women sentenced to prison. This study identified relationships among life events, coping resources, and psychological well-being (indicated by the absence of anxiety and depression). A descriptive correlational design was used in a convenience sample of 62 incarcerated female offenders. The respondents were in their early 30s, single, unemployed, and receiving financial support from a variety of sources. They reported an average of 10 life events in the 12 months preceding incarceration and accumulated an average of 354 life change units. A positive correlation between the number of life events and depression was identified (r =. 24, p <. 05). The women in this study had high levels of depression as measured by the Center for Epidemiologic Studies Depression Scale (L. Radloff, 1977; M = 31) and anxiety as measured by the State-Trait Anxiety Inventory (C. D. Spielberger, 1983; M = 46). Nursing interventions to reduce psychological distress at the time of admission to a correctional facility may reduce of loss, inadequacy, and powerlessness that the might otherwise have to endure.

Do pre-, early, and mid-pregnancy life events influence gestational length?

The aim of this study was to determine whether the frequency and quality of reported life events during the 6 months before pregnancy to mid-pregnancy influence gestational age at birth.Seventy nulliparous women were studied at 12 and 25 gestational weeks with a 64-item self-rated life event questionnaire developed for obstetric groups. Life events were categorised into eight psychosocial areas according to the diagnostic and statistic manual (DSM-III-R). The women rated each experienced event as strainful or not strainful. Gestational age was determined by ultrasound biometry before 20 gestational weeks. The number of life events during the following periods was recorded from 6 months before pregnancy to 12 gestational weeks, from 12 gestational weeks to 25 gestational woks, and from 6 months before pregnancy to 25 gestational weeks.No significant relationships were found between the number of reported life events and pregnancy duration. Life events in different psychosocial areas also did not influence gestational age at birth. A non-significant relationship (p = 0.06) was found between pregnancy duration and the number of strainful events reported from 6 months before pregnancy to 25 gestational weeks, shorter pregnancy duration being found in women reporting many strainful events. Our findings suggest that life events in general do not influence pregnancy duration. However, if they are perceived as strainful, pregnancy length tends to decrease.

Effects of Psychological Stress on Human Semen Quality

We investigated the relationship between psychological stress and sperm concentration, motility, and morphometry in a prospective study of 157 volunteers who were enrolled in a prepaid health plan. We measured psychological job stress and life-event stress by telephone interview. Sperm-kinematic and nuclear-morphometric variables were measured using computer-assisted image analyses. Sperm concentration, percent motility, and semen volume were determined by objective visual methods. We performed multiple linear regression for each semen variable to examine its relationship to stress, controlling for potential confounders. Stress at work and total number of life events were not related to differences in semen quality. However, the recent death of a close family member was associated with a reduction in straight-line velocity (P = 0.002) and percent of progressively motile sperm (P = 0.02); it was also marginally associated with an increase in the fraction of sperm with larger and more tapered nuclei. These findings suggest that the fecundity of men experiencing the stress of a family member's death might be temporarily diminished.

Life events and disability in rheumatoid arthritis: a European cohort.

The objective was to study the relationship between life events (LE) and the clinical status of patients suffering from recently diagnosed rheumatoid arthritis (RA) in a 2 yr follow-up. As part of a multicentre European cohort study, 370 French and Dutch patients were questioned three times at 1 yr intervals about LE which had occurred in the previous year. Three criteria were used to quantify the degree of disease activity (Ritchie's index), the level of functional disability [Health Assessment Questionnaire (HAQ)] and perceived health [Overall Evaluation of Health (OEH)]. Total LE and desirable LE showed a weak negative correlation with the HAQ scores. On the other hand, death-related LE did not seem to modify patient status. The higher the number of health-associated LE, the greater the deterioration in HAQ and OEH scores. The results indicate that LE do not affect the course of early RA in a spectacular manner.