Role Of Life Events Research Articles

Stressful life events and tinnitus : Reflections and speculations.

The role of life events has not been extensively studied in the context of tinnitus. There is, however, evidence about the psychological impact of tinnitus and about the influence of psychological processes as mediators of the tinnitus experience. On the basis of this evidence, the possibility that stressful life events can act as atrigger for tinnitus is discussed; although the evidence is fragmentary and indirect, the possibility cannot be discounted. It is argued that the onset of tinnitus and the associated clinical encounters can constitute an acute stressful life event, and the ongoing experience of tinnitus can be regarded as achronic stressful life event. Interactions between ongoing tinnitus and other life events are discussed. Possible mechanisms in terms of stress influencing predictive processing and signal detection judgments are considered.

A Person × Environment approach to Borderline Personality Disorder features in young people: The role of life events, parental support, and self-esteem

Introduction: This study aimed at examining the concurrent associations between stressful life events and borderline personality disorder (BPD) features in a clinical sample of young people. The moderating role of parental support and self-esteem was investigated (i.e., stress buffering). In a subsample, short term changes in BPD features were examined at a 6-month follow-up. Method: The total sample consisted of 318 young people (ages 12-26). Regression analyses were conducted to examine the link between stressful events, parental support, self-esteem, and BPD features. Prospective regression analyses were conducted in a subsample (N = 138). Results: Results indicate that stressful life-events and (low) self-esteem were related to more BPD features at wave 1. However, these associations did not hold in the prospective analyses. Also, no support was found for a stress-buffering effect. Discussion: The discrepancy between the concurrent and the prospective findings suggest that stressful events and self-esteem may be intertwined with BPD features, rather than predictive of change in BPD features 6 months later.

The role of life events in obsessive-compulsive disorders

Background: A small number of studies are available to assess the role of stressful life events (SLEs) in obsessive-compulsive disorder (OCD). The previous studies have reported contradictory results and they have methodological limitations. Aims and Objectives: The objectives of our study are (i) to find out the frequency of life events in patients with OCD in comparison to their matched healthy controls and (ii) to find out the impact of life events on the severity of the disorder. Materials and Methods: Sixty patients fulfilling Diagnostic and Statistical Manual of Mental Disorder, 5th edition (DSM-V) criteria of OCD were rated with Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Hamilton Rating Scale for Anxiety (HAM-A), Hamilton Rating Scale for Depression (HAM-D), and Presumptive Stressful Life Events Scale (PSLES). A group of 60 normal controls were also rated on PSLES. Finally, both groups were compared in terms of life events. Results: The frequency of life events, past 1 year (t=5.307, P=0.006) and lifetime (t=11.527, P<0.001), were significantly higher in the patient group in comparison to controls. PSLES scores showed asignificant correlation with Y-BOCS total scores, Y-BOCS obsession scores, and HAM-A scores. There was a positive correlation between past 1 year PSLES score and HAM-D scores. Step-wise linear regression analysis showed PSLES scores significantly positively predicted Y-BOCS total score, Y-BOCS obsession score, and Y-BOCS compulsion score. Conclusion: Life events were significantly more frequent in OCD patients both past 1 year and lifetime, as compared to healthy controls. The severity of obsessive compulsive symptoms was found to be directly proportional to the number of SLEs experienced in the past 1 year and lifetime.

SOCIAL CONNECTEDNESS ACROSS THE LIFE COURSE: CORE NETWORKS AND EVERYDAY SOCIAL INTERACTIONS OF AMERICAN ADULTS

Abstract Scholars have been monitoring the signs of social isolation and weakening of family ties among Americans. This paper asks: (1) Do Americans socially disengage from society as they age? (2) Are family ties replaced by work or friends as Americans grow out of their original family? Using a state representative sample of egocentric network data (Person to Person Study: P2P) and a national representative sample of time dairy data (American Time Use Survey: ATUS) during 2018-2021, we found that although people spent less social time with others as they age, they maintained a stable sized core network of confidants for discussing important and health matters. This refutes the view that old age has a universal negative influence on social connectedness. We found little evidence that family ties are replaced by non-kins at any age in both core network and daily social contact. By combining core network and time dairy data, we found that although people spent substantial time with coworkers daily when they enter the workforce, they rarely included even a single coworker into their core network. This suggests that people’s core network is less influenced by current daily social interactions than many theories on social contact would predict. We speculate that people may organize their core network based on cumulative time they spend with a particular person over the life course rather than current time. The roles of life events and age in shaping changes in daily interactions and core network over the life course are further discussed.

Role of life events and personality in alcohol dependent individuals: a study

Role of life events and personality in alcohol dependent individuals: a study

Life Events in the Etiopathogenesis and Maintenance of Restrictive Eating Disorders in Adolescence.

Life events (traumatic and protective) may be critical factors associated with eating disorders and their severity. To date, there is little literature concerning the role of life events in adolescence. The main goal of this study was to explore in a sample of adolescent patients with restrictive eating disorders (REDs) the presence of life events in the year before enrolment and to characterize them according to timing. Furthermore, we investigated correlations between REDs severity and the presence of life events. In total, 33 adolescents completed the EDI-3 questionnaire to assess RED severity using EDRC (Eating Disorder Risk Composite), GPMC (General Psychological Maladjustment Composite), and the Coddington Life Events Scales-Adolescent (CLES-A) questionnaires to define the presence of life events in the last year. Of these, 87.88% reported a life event in the past year. A significant association emerged between elevated clinical GPMC and the presence of traumatic events: patients who had experienced at least one traumatic life event in the year before enrolment presented higher clinically elevated GPMC compared to patients who had not. These results suggest that obtaining early information about traumatic events in clinical practice may help prevent the occurrence of new events and improve patient outcomes.

Awareness of age-related change in the context of major life events

Although gains and losses are an integral part of human development, the experience of change and readjustment that often comes with major life events may be particularly influential for an individual's subjective aging experience and awareness of age-related change (AARC). Thus, this study focused on the role of life events in the domains of family and health for an individual's awareness of age-related gains and losses. Specifically, we differentiated between the experience of specific life events (e.g., entering a new romantic relationship; hospital stay) and the cumulative experience of multiple life events. Furthermore, we differentiated between life events experienced at an expected time in life and life events experienced relatively early or relatively late compared to established social norms. Data came from the Innovation Sample of the German Socio-Economic Panel (SOEP-IS) and consisted of 1,612 participants aged 16 to 93 years (M = 54.1; SD = 18.2). Life events were assessed annually and retrospectively for the last 2 years. Propensity score matching provided evidence for an association of specific family life events and a higher awareness of age-related gains, as well as specific health life events and a higher awareness of age-related losses. Results furthermore indicated that the cumulative experience of family life events was associated with a higher awareness of age-related gains. Conversely, the cumulative experience of health events was associated with higher awareness of both age-related losses and age-related gains. Moreover, it was not only life events happening at an expected age, but also those happening relatively early and particularly those happening late in life, which were associated with AARC. In summary, life events and the change they may bring seem to be reflected in individuals' awareness of age-related losses and awareness of age-related gains.

The Broken Heart: The Role of Life Events in Takotsubo Syndrome.

The onset of Takotsubo syndrome (TTS), also known as stress cardiomyopathy, is thought to be associated with some life events. This study focuses on clarifying life event characteristics and the role of triggers in the onset of TTS. Participants with TTS (n = 54) were compared to those with acute myocardial infarction (AMI; n = 52) and healthy individuals (n = 54). Using a modified version of the Interview for Recent Life Events, information about general life events perceived as stressful and triggers preceding the onset of a cardiac syndrome was collected. The assessment included the impact of these events as indicated by the participants and estimated by the interviewer; finally, the objective impact was considered. Although the number of events and the objective impact did not differ among the groups, patients with TTS reported a more negative perceived impact. Moreover, 61% of these patients objectively and subjectively reported a more stressful trigger before the onset of the disease (in the 24 h preceding the cardiac event) than those reported by patients with AMI. The dynamic between life events and individual responses could help differentiate TTS from other cardiovascular events, such as AMI. This study suggests that patients’ perception of some life events (whether triggers or general life events) could represent a possible marker of TTS.

Taking Up and Terminating Leisure-Time Physical Activity over the Life Course: The Role of Life Events in the Familial and Occupational Life Domains.

Leisure-time physical activity (LTPA) is associated with various health-promoting effects. However, little is known about the relationship between life events and changes in LTPA over the life course, especially when multiple life events occur simultaneously. Therefore, this study examines taking up and terminating LTPA associated with life events in the familial and occupational life domains over 16 years of 16–76-year-old Swiss inhabitants (n = 1857) in a retrospective longitudinal cohort design, using a validated telephone survey and multilevel discrete-time event-history analyses. The results show that taking up LTPA was more likely when ending a relationship and retiring and less likely when becoming a parent; terminating LTPA was more likely when ending a job, starting vocational training after 30 years, a relationship ended for men, and becoming a mother with increasing age. If experiencing multiple life events simultaneously, the greater the number of life events, the more likely persons aged 45–70 years were to take up LTPA and, conversely, the more likely persons aged 15–44 years to terminate LTPA. The relationship between life events and changes in LTPA over the life course was often age dependent, especially when experiencing multiple life events simultaneously. The findings should be considered when promoting LTPA.

Quality of Life, Stressful Life Events and Pathways to Care among Patients with Common Mental Disorders in Primary Health Care

Context: Stressful life events have an impact on common mental disorders. It is also essential to assess the quality of life and pathway of care to mental health to provide a comprehensive picture of these disorders and plan community mental health services. Aims: This study was done to assess the quality of life and stressful life events among patients diagnosed with common mental disorders. We also assessed the pathways to mental health care. Settings and Design: A2 stage cross-sectional study was conducted- first stage of screening followed by 2nd stage of detailed assessment among diagnosed patients in a rural community in Karnataka, South India Method and Material: Patients diagnosed with CMDs were assessed using WHO QOL BREF scale, Presumptive Stressful Life events scale and Pathway to care study pack. Statistical Analysis Used: Descriptive data was analyzed as proportion and pathway to care is presented as diagrammatic representation. Anovaand correlation coefficients were used to assess determinants of quality of life and the role of life events respectively. Results: Financial loss or problems were the most common life events. Mean social relationship domain score was significantly lower and stressful life events in the past 1 year was significantly higher in females. Overall QOL, work capacity, social relationship and environmental domain scores were significantly higher among those who had sought some form of care. Stressful life events experienced ever in lifetime was positively correlated with HAM D score and significant somatic symptoms. Delay after seeking care from general practitioner was much lower compared to other systems of care. Conclusions: QOL and stressful life events were significantly associated with gender. Care seeking in the past had led to improvement of quality of life among the patients.

Nonsuicidal Self-Injury and Suicide: The Role of Life Events in Clinical and Non-Clinical Populations of Adolescents.

BackgroundNonsuicidal self-injury (NSSI) is highly prevalent in clinical and non-clinical populations of adolescents. Several studies have supported both the distinction and the strong association between NSSI and suicidal behavior. Although there is a great deal of data on the role of life events in both suicidal behavior and NSSI, few studies have assessed the role of life events in the NSSI–suicidal behavior relationship. Our aims were to explore the relationship between NSSI and suicidal behavior, and the possible moderating role of stressful life events in a clinical and non-clinical adolescent population.MethodA clinical (n = 202) and a nonclinical (n = 161) population of adolescents, aged 13–18 years were assessed. The Mini International Neuropsychiatric Interview Kid, Deliberate Self-Harm Inventory and the Life Events List were used. Group differences related to suicidal behavior, NSSI, and life events were tested with Wilcoxon tests. Two- and three-way interactions were tested with negative binomial regression models including zero-inflation parameter.ResultsThe prevalence of suicidal behavior (W = 7,306, p < .001), NSSI (W = 9,652, p < .001) and life events (W = 10,410 p < .001) were significantly higher in the clinical than in the non-clinical group. Between number of life events and NSSI, a moderate effect size (.38, 95%CI [.28,.46]) was found. The main effect of NSSI (χ2(1) = 109.65, p < .001) and group membership (χ2(1) = 39.13, p < .001) predicted suicidal behavior; the main effect of quantity of life events did not explain suicidal behavior. The interaction between NSSI and number of life events (χ2(1) = 10.49, p < .01) was associated with suicidal behavior. Among interpersonal, non-interpersonal events and adverse childhood circumstances, only interpersonal events were associated with both suicidal behavior (χ2(1) = 6.08, p < .05) and had a moderating effect (χ2(1) = 8.59, p < .01) on the NSSI–suicidal behavior relationship. Patterns of the effects of life events on the NSSI–suicidal behavior relationship did not differ in the two groups.ConclusionOur results confirm the importance of prevention and intervention of NSSI, considering its high prevalence and frequent co-occurrence with suicidal behavior in both clinical and non-clinical adolescent populations. Moreover, to support NSSI and suicide prevention, we would like to highlight the importance of stressful life events, especially those associated with interpersonal conflicts, require special attention.

Using the life course approach to explain the onset and continuity of preventive health-care behaviors: A comparative study across four countries

ABSTRACTThe objective of this research is to examine the factors that promote the onset and continuity of preventive health-care behaviors over the course of one’s life. Using the life course paradigm as an overarching conceptual framework, hypotheses are developed that relate to the role of life events that trigger processes responsible for the initiation and discontinuation of three preventive health-care behaviors: exercising, using dietary supplements or vitamins, and having regular physical exams. The samples used are drawn from the United States, Thailand, South Korea, and Brazil. Results suggest that experience of life events and consequential life-course adaptation processes (socialization, stress and coping, and human development) are important predictors of initiation and discontinuation of preventive health-care behaviors. The relative influence of these explanatory variables varies across cultures, suggesting the importance of contextual factors in explaining preventive health-care behaviors. Implications for further research are also suggested.

Biological stress response in women at risk of postpartum psychosis: The role of life events and inflammation

BackgroundPostpartum psychosis (PP) is the most severe psychiatric disorder associated with childbirth, and the risk is particularly high in women with a history of bipolar disorder, schizoaffective disorder or in those who have suffered previous episodes of PP. While studies in patients with psychosis not related to the puerperium have demonstrated that abnormalities in stress response are important risk factors for psychosis, it remains unknown whether this is also the case for PP. MethodsThis study includes 30 postpartum women, assessed, on average, at postpartum week 14.8 ± 10.1 either with a current episode of PP (n = 14), or at-risk of PP because of a history of bipolar/schizoaffective disorder but who were well (n = 16), and a group of healthy women (n = 26). Details about recent stressful life events were obtained using the List of Threatening Experiences questionnaire, while perceived stress was evaluated using the Perceived Stress Scale. We estimated hypothalamic-pituitary adrenal (HPA) activity by measuring salivary cortisol at awakening; at 15, 30, and 60 min after awakening; at noon; and at 8 pm. An Area Under the Curve analysis was performed to assess the awakening response (AUCi) and cortisol levels during the day (AUCg). Immune markers, including high sensitivity C-Reactive Protein (hs-CRP) and Interleukin (IL)-1a, IL-1b, IL-2, IL-4, IL-6, IL-8, IL-10, Tumor Necrosis Factor (TNFa), Vascular Endothelial Growth Factor (VEGF), Interferon gamma (INFγ), Monocyte Chemoattractant Protein 1 (MCP-1), and Epidermal Growth Factor (EGF) were evaluated from peripheral blood samples. ResultsWomen with current PP reported more frequent recent stressful life events, and higher perceived stress than healthy women. They also showed an activation of the stress and immune response, with higher levels of cortisol AUCg and hs-CRP (but not of other inflammatory markers) than healthy controls. Women at-risk of PP who remained well had values on these measures that were intermediate between those of women with a current episode of PP and those of healthy women. Stress measures and markers of stress and immune response explained 78 % of the variance of in group status between PP and healthy women, and 46 % of variance of in group status between women at-risk and healthy women. ConclusionThese findings suggest that an immune-HPA axis dysregulation, together with current stress may represent an important underlying pathophysiological mechanism in the onset of psychosis after childbirth in vulnerable women.

Longitudinal changes in transport-related and recreational walking: The role of life events

Walking is a common form of physical activity and has a considerable impact on public health. Walking behavior may change over time due to life events, including residential relocation. Only a few studies based on longitudinal data have examined the impacts of life events on walking behavior. The present study investigated the extent to which life events lead to changes in transport-related and recreational walking duration, by analyzing longitudinal panel data from the Netherlands Mobility Panel (MPN) for the years 2013 and 2015. In total, 1185 respondents aged 18 or older who completed both survey waves were included in our sample. Multilevel mixed-effects Tobit regression models were fitted and showed that both childbirth and relocation to less urbanized areas were related to an increase in transport-related walking over time. No significant associations of life events with recreational walking were observed. Findings suggest that transport-related walking is more likely to be influenced by changes in the household composition and residential relocation than recreational walking. Further longitudinal research is needed to verify our findings and gain insight into the mechanisms underlying these relationships.

The role of life events and context in type of car share uptake: Comparing users of peer-to-peer and cooperative programs in Oslo, Norway

This paper builds on a survey of existing users of two car sharing schemes in Oslo, namely Nabobil (peer-to-peer scheme P2P) and Bilkollektivet (cooperative scheme Coop), to understand how the following factors lead to active (or passive) car sharing – i. key life-events; ii. adoption/retention challenges; iii. acceptability; and iv. infrastructural needs. The conceptual framework of this study is informed by mobility biographies and social practice theory. A web-based questionnaire was distributed by the two service providers to their members, and approximately 1,724 users of P2P and 1,117 users of Coop participated in the survey. The survey collected information on travel behaviour, preferences, life-stages, mobility biography of the household, and life-events possibly leading to car sharing. Results highlight that using P2P scheme emerged as statistically significant for students moving to Oslo and for employees starting in new jobs. For the Coop members, the birth of first or later children were statistically significant events in households’ decision to start with car sharing. Along with differences in meanings, skills, materiality and practices of carsharing, users of the two schemes varied with respect to spatial details as well – proximity to transit-stops, access to high-frequency public transport services, walking/cycling infrastructure and, parking facilities. Further, for carsharing to become popular, ample institutional trust, capable of off-setting any lack of trust that users may have, needs to be built.

The \u201cClinician\u2019s illusion\u201d and the epidemiology, diagnosis and treatment of depressive disorders

BackgroundDepression often occurs in association with stressful events. However, people with depressive disorders may experience episodes in response to minor stressors or “out of the blue.” Similar episodes can occur in people who do not have a disorder in response to severe events. This plurality of symptom patterns, occurring as it does in the absence of precise demarcation from normality has led to controversy over how depressive disorders should be defined, how common they are, and when treatment should be offered. Much of the controversy, however, may be illusory, arising from a tendency to view depressive disorders as defects or disease processes (the “clincian’s illusion”). Avoiding the illusion involves understanding depression as a defense rather than a defect and requires consideration of aspects of signal detection theory and the associated “smoke detector” principle. This perspective may help to understand aspects of depressive disorders that are otherwise puzzling and controversial.MethodsIn this paper, implications of signal detection theory and the “smoke detector principle” are explored: (1) conceptually, (2) using calculations performed in a spreadsheet and (3) using an agent-based model. Depressive episodes are conceptualized or represented as all-or-nothing phenomena activated in response to stressful life events. These events occur in an environment that also includes variable levels of baseline stress, creating a signal detection problem. The agent-based framework allows interaction with the environment as agents attempt to achieve an ideal level of adaptation.ResultsThe smoke detector principle, if valid, may explain otherwise puzzling and controversial features of the depressive disorders, such as their lack of precise demarcation from normality, the role of life events and stressors and their patterns of prevalence.ConclusionsSignal detection concepts help to avoid the “clinician’s illusion” in which aspects of functioning of the body’s defenses are mistaken for a disease entity or defect. These principles emphasize inevitable difficulties that are encountered in attempts to conceptualize depressive disorders without reference to the environment in which they occur, and without addressing possible stochastic (randomly varying) elements. Because of the “clinicians illusion”, current research priorities, as well as diagnosis and treatment strategies, may be flawed.

Migrants at risk of psychosis in France: different contexts of increased vulnerability

Background The association between migration and psychosis is well established in many European countries (Jongsma et al., 2017). However, this risk varies across the different ethnic groups and countries, suggesting the role of life events related to the migration process and social adversity in the host country (Bhugra, 2004). Migration in France is characterized by many waves since the 19th century, with different profiles (asylum seekers, economic migration) and origins of migrant groups. Given this, it is important to identify the different contexts and exposures associated to higher vulnerability for psychosis, and the related migrant groups. Methods We will present new data on psychosis among migrants in the general population, as well in groups exposed to high psychological distress, such as homeless and asylum seekers. Results Studies in general population show increased incidence and prevalence of psychosis among first and second-generation migrants in comparison to natives. This risk is influenced by socio-economic disadvantage. Among migrants in increased social disadvantage (homelessness), associated risk factors for psychosis and psychotic like experiences are more related with recent life events than with childhood adversity. Finally, data on psychiatric evaluations of recent arrived asylum seekers on the Parisian refugee camp identify important psychological distress related to traumatic experiences before and during migration, great rates of psychotropic prescription, referral to outpatient mental health services and acute hospitalization. Conclusion We observe in France an association between migration and psychosis. However, this risk is related to different stressful exposures across the different migrant groups and contexts. To identify local and specific risk factors will help to better organize tailored mental health care.

Novel psychoactive substance use among treatment-seeking opiate users: The role of life events and psychiatric symptoms.

Over the past 5years, a shift to the use of novel psychoactive substances (NPS) has been observed among opioid users. The aim of this study was to assess the potential reasons for NPS use among treatment-seeking patients receiving opiate substitution therapy. A structured questionnaire was filled out by a sample of 198 opiate dependent patients of Hungary's National Institute of Psychiatry and Addiction. This questionnaire assessed demographics, treatment characteristics, lifetime substance use, potential reasons for NPS use, negative life events (Life Events Scale), and psychiatric symptoms (Brief Symptom Inventory). The most frequent reasons for NPS use were curiosity, replacing other drugs, and easy availability. The majority of the respondents used synthetic cathinones and chose practical reasons, not psychopharmacological preferences. A series of binary logistic regressions indicated that lifetime amphetamine use (OR=4.64, 95% CI [2.16, 9.96]) and more severe psychiatric symptoms (OR=1.89, 95% CI [1.18, 3.04]) may predict NPS use. Time spent in treatment was a minor protective factor (OR=0.92, 95% CI [0.86, 0.99]). Synthetic cathinones might still substitute amphetamine-derivatives, although these NPS are no longer legal. There is a need for the regular screening of psychiatric symptoms and the use of family therapy among participants on opioid substitution programs.

Schizoaffective disorder and life events

IntroductionThe schizoaffective disorder is multifactorial. Several factors almost unquestioned, even indisputable, participate in the episodes’ decompensation and affect various fields: biological, pharmacological or neurobiochemical.ObjectivesDraw up the sociodemographic and clinical profile of patients treated for schizoaffective disorder and determine the role of life events in the onset of the disorder.MethodsThis is a retrospective study of 52 patients hospitalized in the psychiatric department of Mahdia diagnosed with schizoaffective disorder according to DSM-IV-TR during the period from January 2014 until June 2014. The information was collected using a preset sheet with 35 items.ResultsA total of 52 records was gathered. The average age was 38 years. The sample was predominantly male, of rural origin in 61.5% of cases. The level of education was low in 59.6% of cases. More than half were without profession and single in 46.2% of cases. The mean age at onset of the disorder was 25.2 years. The presence of life events preceding the onset of the disorder was noted in 22 patients, that to say, 42.3% of the sample. Family and emotional events were most frequently encountered with respective rates of 48.2 and 24.7%, followed by the professional events (20%) and social ones (6%).ConclusionLife events are due to chance but also to the environment. The complexity of the “event” concept was again underlined in a new perspective, breaking social rhythms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Changes to commute mode: The role of life events, spatial context and environmental attitude

It has been suggested that commuting behaviours become habitual and that changes to commute mode are more likely at the time of major life events. However, evidence to support this has so far been limited to analyses of small-scale samples. To address this evidence gap, we use two waves of panel data from the UK Household Longitudinal Study (2009/10 and 2010/11) to identify and explain the prevalence of individual change in commute mode from year to year amongst a representative sample of the English working population (n=15,200). One third of those that cycle or get the bus to work, and one quarter of those that walk to work, are shown to change commuting mode by the following year. Car commuting is more stable, with only one in ten car commuters changing mode by the following year. Commute mode changes are found to be primarily driven by alterations to the distance to work which occur in association with changing job or moving home. Switching to non-car commuting becomes much more likely (9.2 times) as the distance to work drops below three miles. High quality public transport links to employment centres are shown to encourage switches away from car commuting and mixed land uses are shown to encourage switches to active commuting (walking and cycling). Switches away from car commuting are found to be more likely (1.3 times) for those with a pro-environmental attitude. The attitude orientation is shown to precede the behaviour change, demonstrating evidence of ‘cause and effect’. Overall, the study shows that changes in commuting behaviour are strongly influenced by life events, spatial context and environmental attitude.