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PubMed1993

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.

Adaptation, Psychological↗
PubMedDate not supplied

Life crisis as a precursor to child abuse.

A number of theories have been proposed on the causation of child abuse, and many of these theories assign some role to stress. Stress is variously conceptualized as a continuous state resulting from poverty, poor housing, and the like, or as an immediate crisis such as an argument or the breakdown of an appliance. An alternate perspective on stress identifies it with life change events which require readjustment in the lifestyle of a person. When an excessive number or magnitude of such life change events occur, the person affected may be said to be in a state of life crisis. Such states of life crisis have been found to be associated with the onset of physical illness and with the occurrence of accidents and injuries. In this study, a questionnaire was administered to 35 abusing parents and 35 matched controls who had experienced problems with their children but had not been abusive. The two groups were compared for their life change scores on the Social Readjustment Rating Scale for the year before their abuse or problems began with their children. The mean score of the nonabusers was 124, which does not indicate a life crisis. For the abusers, the mean score was 234, which indicates a moderate life crisis. These means are significantly different at the .001 level by the t test. The role of symbiosis, an emotiontional attachment in which a person seeks to be taken care of by another person, was also explored. It is argued that abusive parents are competing with each other and with their children for the role of being cared for. This kind of behavior seems to make the person particularly vulnerable to life changes, which in turn produce stress. Support for this view was found in the responses to the questionnaire. Prevention strategies aimed at reducing change and stress might include better provision of crisis-intervention services, measures aimed at reducing unemployment or lack of opportunity, effective health maintenance services, and greater provision of counseling and mental health services. Use of the Social Readjustment Rating Scale in a preventive program of early intervention is also possible.

Child↗
PubMed1983

Social intimacy: an important moderator of stressful life events.

Two studies were conducted to explore the role of social intimacy in predicting the individual's response to stress. In the first study the experimenter reinforced the experimental subjects' verbalizations during an interview on a fixed schedule for the first 3 minutes, withdrawing reinforcement for the final 4 minutes. The control group received reinforcement on a fixed schedule for the total 7 minutes. Subjects scoring low on a measure of intimacy disclosed less personal material during the withdrawal period in the experimental condition than in the control condition in contrast to high scoring subjects who maintained their level of disclosure for both parts of the interview. In the second study, previously experienced life change events were assessed. Individuals lacking a current intimacy were found to be prone to higher levels of emotional disturbance especially when many previous negative or few positive life change events had occurred.

Adult↗
PubMed1999

Persistent stress as a predictor of genital herpes recurrence.

BACKGROUND: Results of several studies suggest that psychological stress and negative mood can trigger genital herpes recurrences, but results are inconsistent. OBJECTIVE: To determine whether short-term or persistent psychological stress or specific negative moods are predictive of genital herpes recurrences in women. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Adult↗
PubMed1980

Power motivation, stress and physical illness.

College students reporting a large number of life change events in the past six months also reported significantly more frequent and more severe instances of physical illness and more affective symptoms in the same time period. These relationships, however, were modified in an interesting way by type of life change and by individual differences. Life change events were classified as involving power, affiliative or other stresses. Individuals scoring high in the need for Power (n Power), in inhibition, and in the number of power stresses (HHH subjects), reported more severe physical illness and affective symptoms than all other subjects or, in particular, subjects low in n Power, power stress and inhibition (LLL subjects). Individuals scoring high in Power and high in either inhibition or power stress also reported significantly more severe physical illness than other subjects. Among subjects high in inhibition, affiliative stress in combination with high n Power was associated with more severe physical illness, but, among subjects low in inhibition, affiliative stress in combination with high n Affiliation was associated with more physical illness. Affiliative stress was unrelated to affective symptoms. Other stress was unrelated either alone or in combination with other variable to physical illness or affective symptoms. The findings are interpreted as consistent with the hypothesis that subjects in the HHH category compared with other subjects are characterized by chronically high sympathetic activity which has immunosuppressive effects, making them more illness prone.

Affective Symptoms↗
PubMed1981

The stress of children's births: gender differences in the impact on alcoholics.

Previously reported gender differences regarding the role of discrete life change events in the onset of alcoholism are examined through a systematic evaluation of the histories of 586 alcoholics. Several methodological features of this research distinguish it from investigations reported in the past. The use of a structured, topically organized interview protocol eliminated possible biases introduced by gender differences in the tendency to attribute the onset of alcoholism to life change. The application of an actuarial analytic procedure allowed an examination of the temporal relationship between life change (births of children) and the onset of alcoholism and a restriction of the period of risk for the onset of alcoholism following discrete life change to two years. The focus on a single type of life change event, births of children, reflects an established concern with the role of gynecological events in the onset of alcoholism among women and allows of the general comparisons. Results indicate that, among those ever at risk of first experiencing alcohol-related problems during the two year period following the birth of a child, males show a statistically significantly higher percentage with the onset of alcoholism during this time period than do females. The birth of a first child was found to be most strongly related to the development of problem drinking. Among males, but not among females, the birth of a first child was also found to follow the onset of alcoholism by two years in a significant number of cases.

Alcoholism↗
PubMed1983

Dysfunctional uterine bleeding and prior life stress.

Dysfunctional uterine bleeding (DUB) that occurs between menarche and menopause is often described but poorly understood. Relatively few studies have tried to associate DUB with life change and stress. In this present case-control study, questionnaires measuring life change events and self-scored life stress were administered to 26 patients with DUB and 31 controls. The participants were matched for age, gravidity, and contraceptive use. The participants were all aged between 18 and 35 years, and none were perimenopausal. A statistically significant relationship was found between DUB and recent prior life changes and experienced stress from those changes. In particular, personal-social and health stresses showed the widest differences between the patients with DUB and controls. These findings persisted when statistical corrections were made for use of various contraception devices. This study may help to focus on a more specific cause of DUB. In addition, it may assist the family physician in diagnosing and treating this condition.

Adolescent↗
PubMed1981

Moderator variables for the relationship between life change and disorders.

The correlation between life change events and occurrence of disorders was investigated with the use of moderator variable measures of Jungian types, health locus of control, and optimal stimulation level. One hundred and twenty-four graduate and undergraduate men and women at Oregon College of Education were Ss. The following levels of moderator variables produced significant correlations: Introvert, Thinking, Feeling, Judgment, rational functions, and external health locus of control. The suggested rationale for integrating these findings is that high correlations between life change events and occurrence of disorders result from low levels of awareness and limited choices, accompanied by high degrees of conditionability.

Adolescent↗
PubMed1989

Longitudinal analysis of hope in community-based older adults.

Clinicians usually agree that hope helps older persons to cope with stressful life events and changes in their life, and that hope may even affect their health. However, little research has examined whether hope functions as a psychosocial factor in modifying the relationship between stress and health. Older adults experience many events, which may make them more vulnerable than younger persons to loss of hope. These events may involve changes in their health, roles, self-concept, social support, housing, and income. If we know how these events affect hope, we may be able to detect and avert lapses in hope among our older patients, and even shape interventions that enhance hope.

Adaptation, Psychological↗
PubMed1992

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.

Adaptation, Psychological↗
PubMed1980

Characteristics of life events and psychiatric impairment in rural communities.

This household survey of a random sample of 713 rural adults (ages 18 to 60) examined the influence of event characteristics upon the relationship between life change events and impairment. Data were obtained on the occurrence of events, event characteristics, demographic characteristics, and psychiatric impairment (using the General Well-Being Schedule and the Center for Epidemiologic Studies Depression Scale). Analysis indicated that individuals experiencing higher proportions of undesirable, unanticipated, unpreventable, and disruptive events or events having minimal social support manifested higher levels of psychiatric symptomatology. Although total number of events was consistently the best predictor of impairment, it did not diminish the effects of the event characteristics on impairment. The independent effects of these event characteristics are discussed.

Adolescent↗
PubMed1984

Life events, familial stress, and coping in the developmental course of schizophrenia.

Recent studies have isolated some socioenvironmental factors that seem to predict the onset of schizophrenic episodes in vulnerable persons. In particular, stressful life events have been found to cluster in the 3- to 4- week period preceding a schizophrenic episode in some patients. Many persons with a schizophrenic disorder also seem to contribute to additional stressful life change events--for example, by high geographic mobility--thereby playing an active role in precipitating the onset of illness episodes. Within the family environment, hostile, critical, and emotionally overinvolved attitudes toward the patient by relatives have been found to be related to relapses. Irregularities in the communication style of parents also predict the subsequent development of schizophrenia spectrum disorders among disturbed adolescents. Many schizophrenic patients also seem to be deficient in the coping skills required to remediate the losses brought on by life events or to deal effectively with stressful relatives. Thus, they may experience greater and more prolonged stress than most others due partially to inadequate social and problem-solving skills and less supportive social networks. These findings have important implications for the design of clinical interventions as well as the development of a comprehensive vulnerability/stress model for the course of schizophrenic disorders.

Adaptation, Psychological↗
PubMed1997

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.

Adult↗
PubMed1996

Extension of the life table to repeating and changing events.

Estimation of cumulative and adjusted occurrence of life events and measures over time is often important in settings where study subjects have incomplete or different follow-up periods. Well-known methods to do this, such as the life table and age adjustment, exist for binary nonrecurrent events (i.e., death). However, a general approach to evaluate recurrent life events (e.g., repeated infections), life events with different durations (e.g., hospitalization days), costs, or changing life measures (e.g., body weight) is not available. This paper develops the "Life-Event Table," an analog of the life table that can analyze occurrence of diverse types of events and measures when the observation periods of subjects are incomplete and different. This method, based on a central limit theorem for incomplete multivariate data, obtains point estimates and variances for cumulative incidence, age-adjusted expectation, and other quantities. Simple hypotheses tests and comparisons are possible with this approach. Three applications are presented. The Life-Event Table may facilitate use of currently available robust multivariate analysis methods. Further research into other multivariate methods that take advantage of this Life-Event Table's specific covariance/variance structure may be warranted.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

The impact of life events on patients with rheumatoid arthritis: a psychological myth?

OBJECTIVE AND METHODS: A large number of studies from the field of "psychorheumatology" have investigated the relationship between critical life events and disease parameters with varying results. In the present study 48 patients with rheumatoid arthritis (RA) (mean age 57.8; range 32-78 years) were questioned about life events within the past two years using an "inventory for assessing life change events"-ILE (1). In contrast to previous studies, this inventory not only assesses the number of life events, but also captures the extent of subjectively experienced stress caused by these events. Since psychosocial factors such as social support and coping strategies influence subjectively experienced stress, these factors were taken into consideration for the definition of "life event". Furthermore, a series of objective medical parameters as well as the patient's and the physician's subjective impression of disease activity were assessed. RESULTS: The results show that patients with RA in the earlier stages of the disease cannot be differentiated from severely affected patients in later stages on the basis of life event parameters. In addition, no differences in the life event data could be observed between patients with and those without subjectively experienced episodes of illness in the two years immediately preceding the study. CONCLUSION: Our results suggest that the course of RA is influenced neither by the number of life events nor by the extent of stress caused by these life events. Therefore, the role of life events should not be overemphasized, at least as far as the disease parameters in RA is concerned.

Aged↗
PubMed1983

Recent life events and accidents: the role of sex differences.

In order to investigate how gender may moderate the manner in which life change affects behavior, 110 men and 54 women who had had industrial accidents were interviewed to assess what life change events they had experienced during the years before and after their injuries. For both sexes, increases in life events and associated stress had occurred prior to their accidents. Females reported higher levels of work-related events two years pre-accident, whereas men experienced a sharp increase in work events one year pre-accident. Post-accident, both males and females reported the greatest number of live changes with men experiencing more medical sequelae and women more separations from spouses and resumption of school. Results are discussed in terms of the possible effects of changing social and sex role expectations.

Accidents, Occupational↗
PubMed2004

Cognitive reorganization and stigmatization among persons with HIV.

BACKGROUND: A diagnosis of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is a life-changing event, where persons must deal with a life-threatening, debilitating disease and its associated stigma and isolation. Studies over the past decade have shown that writing and talking about stressful and traumatic experiences, such as a life-threatening illness, causes emotions surrounding the trauma to change and to become cognitively reorganized. The result is a reduction in inhibition and change in basic cognitive and linguistic processes, which have contributed to meaningful behavioural, psychological, and physical health benefits across a variety of populations. AIMS: To describe the construction of the Integrated Model of Health Promotion for persons with HIV/AIDS, and present initial empirical support of the model from a feasibility pilot study of women with HIV/AIDS. APPROACH: The Integrated Model of Health Promotion is described and relevant literature in the field is reviewed. The model is implemented in a feasibility pilot study utilizing the emotional writing disclosure intervention. RESULTS: Participants in the experimental condition demonstrated a promising pattern of cognitive reorganization, a reduced perception of stigma, and an improvement in mental health scores compared with the control condition. CONCLUSION: Implications of these findings are discussed within the framework of the Integrated Model of Health Promotion. The model explores health and behavioural benefits associated with emotional writing in individuals with HIV/AIDS. The limited sample size of this pilot study precludes testing for significance. Further studies are required prior to the development of practice guidelines.

Adolescent↗