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The relationship between response qualities of life change events and future illness rates.

A prospective study over three months explored whether measures of response "qualities" of life change events (e.g., whether the event was positive or negative in its subjective impact) enhance the ability of a simple counting of recent life change events to predict near future illness rates. Thirty-four nursing students were studied. Results confirm previous reports that future illness rates increase positively and significantly in direct relationship to the accumulation of recent past life change events. A simple count of the number of untimely or unexpected life stresses (31% of total life changes) or a simple count of the number of negative life events (53.8%) were as potent predictors as the total count of recent life changes. The total number of times each event occurred did not add to the predictive power of a count of the number of events experienced. Anticipated life events were poor predictors of future illness rates. The subjective life change unit scaling system (SLCU) did not add to the predictive power of a simple count of the number of events. Social support availability did not significantly lower illness rates.

Adaptation, Psychological

A comparison of the scaling of Afro-Americans' life-change events.

Research using the Recent Life Change Questionnaire is being conducted with various ethnic, economic, and cultural groups. The findings of studies using comparable forms have indicated that economic conditions and cultural differences have a minimal effect upon the overall concordant rankings of most groups. In this paper, cultural and economic variables which influence the rankings of poverty-level Afro-Americans are compared with data from a previous study. The significant items related to employment, health, and family problems were found to influence the subject's life conditions, and those related to interpersonal relationships were found to be based on cultural values. The author discusses the importance of recognizing economic and cultural variables which are salient to the measure of life changes by selecting a scoring system which allows for the influence of these variables.

Adult

Life change events and mental illness: an overview.

The use of recent life change measurement in the lives of persons developing mental disorders parallels the measurement of risk factors by epidemiologists to understand disease distribution. Examples are given of these parallels, along with critical commentary on methodological issues in life changes research. The principal studies documenting the association of recent life change and depression, schizophrenia, and neurosis are reviewed. Recent life changes appear to be an important element in explaining illness onset. Future advances in the area of life change and illness await the development of reliable and valid measures of an individual's stress tolerance characteristics, such as social support systems, psychological defenses, coping capabilities, and illness behavior tendencies.

Depression

Life change events, ballistocardiography and coronary death.

Thirty-six men and women who experienced a documented myocardial infarction, half of whom ultimately died from their disease and half of whom survived over a six-year period, provided longitudinal recent life changes and ballistocardiographic data. The 18 patients who died from their coronary disease indicated a significant buildup in life changes which peaked approximately one year prior to death; their serial ballistocardiograms indicated a significant buildup in average force of contraction which was seen to peak approximately six months prior to death. The 18 post-infarction patients who survived the six-year follow-up showed neither a buildup in life change nor a buildup in the ballistocardiographic index of cardiac contraction force. These findings of a life change peak preceding ballistocardiographic evidence of an "overworked" heart are discussed in terms of their possible medical and psychophysiological significances.

Adult

Perception of life change events by the elderly.

The perception of the amount of adjustment necessitated by the occurrence of common life events was assessed for 41 members of a senior citizens' club who ranged in age from 65 to 84. Significant agreement was found between the elderly subjects and the normative sample with regard to rank ordering of the life events. Markedly significant differences were found between the elderly and the normative sample in the magnitudes assigned to the life events, with the elderly group assigning the larger magnitude to most items.

Aged

Spouse adaptation to mate's CABG surgery: 1-year follow-up.

OBJECTIVE: The purpose of this study was to describe spouses' life stressors, supports, perceptions of illness severity, role strain, physical and mental symptoms of stress, and marital quality 1 year after the mate's coronary artery bypass graft surgery. METHODS: This descriptive study was the third component of a longitudinal panel investigation. (The first component was a period within 48 hours of surgery, and the second was 6 weeks after discharge.) One year after the mate's surgery, spouses received the following instruments in the mail: the Family Inventory of Life Events and Changes, the Norbeck Social Support Questionnaire, the Cantril Ladder Scale, the Strain Questionnaire, the Role Strain Scale and the Dyadic Adjustment Scale. Subjects were a convenience sample of 49 women whose husbands were alive 1 year after their first bypass surgery. Of the women in the sample (n = 49), 98% were white, and the mean age was 56 years. RESULTS: Social support was moderate and significantly less 1 year after surgery than during the first two components (48 hours and 6 weeks after surgery). Women still perceived their husbands to have some illness severity 1 year after surgery. They continued to have physical and mental symptoms of stress and had significantly greater role strain than during the first two periods. Marital quality was average. Spouses reported making several life-style changes. DISCUSSION: During the first year after the patient's bypass surgery, spouses experienced many changes. Although physical and mental symptoms of stress remained the same, role strain increased and social support decreased. The findings suggest testing of such interventions as stress management and time management techniques, support groups, and other psychoeducational interventions. CONCLUSIONS: Although the situation remains difficult for the spouse 1 year after the patient's surgery, nurses and physicians can foster and support spouses through many adjustments and changes.

Activities of Daily Living

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

Life events and prisoners.

This study explores retrospectively the relationship of the accumulation of life events as it relates to prison incarceration and extends further the concept that coping with increasing environmental changes results in a variety of overt behaviors. The prison sample comprised 176 male inmates of a federal prison (McNeil Island, Washington) and a state penitentiary (Walla Walla, Washington). Life change scores were derived from the Schedule of Recent Experience (SRE). There was an escalation of annual life change scores of prisoners, indicating the mounting frequency of occurrence of life events prior to incarceration. The SRE may have value in the prediction of socially deviant behavior as with health changes. Variables seen as influencing life change scores were race, age, and education. Analyses of life event frequencies as compared to a normative group indicated that prisoners have evolved a coping life-style that reflects antisocial and criminal behavior.

Adult

Life changes. Do people really remember?

The question, "How well do people remember life changes?" was approached in a longitudinal study of nearly 400 healthy men in a responsible profession. Three scales for assessing life changes were administered by questionnaire at two examinations nine months apart. The subjects were asked to report life change events occurring during a specific six-month period--that which immediately preceded the first examination. For all three life change scales there was substantial forgetting over the interval between reports, with a second report yielding total scores 34% to 46% less than those from the first report for the same period. The amount of change over time varied greatly across persons. These findings raise serious questions about the validity of retrospective studies of life change and illness when the period being reported is greater than six months in the past. They do not, however, jeopardize the potential of the method for prospective studies.

Adult

Daily self-reports on activities, life events, moods, and somatic changes during the menstrual cycle.

Thirty-three undergraduate students (11 males, 11 females taking oral contraceptives, and 11 females not taking oral contraceptives) filled out daily self-reports on pleasant activities, stressful events, moods, and somatic changes for 35 consecutive days. By randomly assigning each male a "pseudo" cycle, the data were analyzed to compare the three samples across the three phases of the menstrual cycle. The results indicated that males reported somewhat more stable but less positive experiences than females. While males reported a stable, low level of pain and water retention throughout the study, both female samples reported increases during the premenstrual and menstrual phases. Reports of negative affect, impaired concentration, and stressful events did not differ by samples, but significant sample by cycle interactions reflected differential increases in the two female samples during the premenstrual and menstrual phases. Subsequent analyses indicated that the experience of stressful events accounted for more of the variance than did cycle phase for these negative mood factors, but not for pain and water retention.

Attention

Life graphs and life events.

The present study investigates changes in personal satisfaction over the whole life course by means of life graphs and their determinants. The life graphs were administered within a 4-year interval to 371 individuals (age 45-70). A modified version of the Holmes and Rahe life events scale, administered in the second interview, was used to ascertain the occurrence of four kinds of events: (1) children leaving home, (2) ill health, (3) death of family or friends, and (4) changes in work. Differences in height between the peak of the graph and the height at the current age is the measurement technique used with the life graphs. Events are found to play a different role at different stages of life and seem to be measured against an implicit schedule according to which the events are seen as traumatic or acceptable. Thus, the same event has different effects on perception of emotional state according to age.

Age Factors

Large bowel disorders. I. Illness configuration and life events.

Stressful life events preceding disease onset were investigated in a consecutive series of 60 patients with large bowel disorders (ulcerative colitis, irritable bowel syndrome and appendicitis), using Paykel's methodology. Ulcerative colitis and irritable bowel syndrome were frequently preceded by events generally regarded as undesirable and involving losses or exits from the social field, which would be specific of a depressed population, while appendicitis seemed to reflect more generic psychosocial difficulties.

Appendicitis