Surviving conflict.

Traumatic life events, as defined by DSM-IV, are common among persons with severe mental illnesses (SMI) such as schizophrenia. Limited evidence suggests concomitantly high rates of posttraumatic stress disorder (PTSD) in this population. However, conceptual models do not exist for understanding the interactions between trauma, PTSD, and SMI. We propose a model, which is an extension of the stress-vulnerability model, in which PTSD is hypothesized to mediate the negative effects of trauma on the course of SMI. Our model posits that PTSD influences psychiatric disorders both directly, through the effects of specific PTSD symptoms including avoidance, overarousal, and re-experiencing the trauma, and indirectly, through the effects of common correlates of PTSD such as retraumatization, substance abuse, and difficulties with interpersonal relationships. We discuss the evidence supporting this model, and consider several intervening variables that are hypothesized to moderate the proposed relationships between PTSD and SMI, including social support, coping and competence, and antisocial personality disorder. Theoretical and clinical implications of the model are considered, as well as several methodological and nosological issues. We conclude with a brief discussion of directions for future research aimed at evaluating components of the model.

Adaptation, Psychological↗

PubMed2002

Stress-related eating and drinking behavior and body mass index and predictors of this behavior.

BACKGROUND: Earlier studies on stress and obesity have not considered coping in situations involving stress. This study examines the associations between stress-related eating and drinking and obesity and the factors predicting this behavior. Predictive factors include risk factors for adult obesity, longitudinal socioeconomic status, and perceived social support. METHODS: A longitudinal, population-based study of 2,359 men and 2,791 women born in 1966 in Northern Finland was conducted. RESULTS: The body mass index at 31 years was highest among stress-driven eaters and drinkers, especially among women. Stress-driven eaters tended to eat sausages, hamburgers and pizza, and chocolate more frequently than other people. Stress-driven eaters consumed more alcohol than other people. The best predictors of stress-related eating and drinking among men age 31 years were being single or divorced, a long history of unemployment, an academic degree, and a low level of occupational education. Among women, the best predictor was a lack of emotional support. CONCLUSION: Programs aimed at preventing and treating obesity should cover the way in which people deal with emotions, ways of achieving greater emotional support, and strategies for handling stress caused by unemployment or work.

Adaptation, Psychological↗