Stressful life events

Andy Smith

Aims of talk

Provide information about the history, conceptualisation, description, modelling and practical relevance of psychological research on life events and adjustment to them.

I will focus on negative life events mainly because we know more about this topic than we do about positive events and associated processes and states.

Starting point

History - 40 years ago Life events research

Social Readjustment Rating Scale (SRRS) Holmes & Rahe (1967):

Social readjustment: “the intensity and length of time necessary to accommodate to a life event, regardless of the desirability of this event…”

400 people ranked 43 commonly reported events in order of

disruption. Scaled values out of 100.

Resulted in Life Change Units (LCU)

Social Readjustment Rating Scale Death of spouse 100 Divorce 75 Marriage 50 Being fired from work 47 Son or daughter leaving home 29 Christmas 12 Rahe (1974): >LCU, > risk of ill-health among 89

physicians. Of 96 major health changes reported, 89 took place in people who reported over 150 LCUs. 70% of those who reported 300 LCUs became ill. <150 LCUs, no evidence of ill-health

Life events – a more recent studyKozora et al. (2005):

measures of depression, mood, perceived health, stressful life events, coping, and social support.

Depressive symptoms were associated with major life-threatening events, disengage coping, and emotional coping.

.

Problems of SRRS Many listed events may not be applicable at certain

times of life Some may not occur sufficiently frequently to impact on

life Some vague (change of social activities)

Perhaps more central: Most studies that show SRRS to be associated with

illness are retrospective Daily hassles may be more important than infrequent

major stresses

Life Events or Daily hassles Death of spouse Divorce Jail term Marriage Pregnancy

Too many things to do Not enough time Too many

responsibilities Troubling thoughts Problems with children Job dissatisfaction

But hassles seem to be more important…Kraaij, Arensman & Spinhoven (2002):

Meta-analysis of 25 studies, the relationship of both specific types of negative life events and the total number of experienced events to depression in old age was studied.

Almost all negative life events appeared to have a modest but significant relationship with depression.

Correlation - negative life events levels and depression : 0.15 Correlation - daily hassles and depression 0.41

A more current view - stress as a processStress is a process and one must consider:

Exposure to stressful experiences/job characteristics.

Perceptions of stress.

Psychological resources that allow one to cope with the above.

Health outcomes induced by the above.

Appraisal or Perceived Stress

Stress occurs when demands exceed the ability to cope

Important to measure perceived stress Also link with psychosocial resources that

help you cope

Stressor------------Perceived ---------Stress Stress Response

Stress and Coping

Primary appraisal- Is this a threat?

Secondary appraisal(Coping)- What can I do about it?

Stress occurs when there is an imbalance between primary and secondary appraisal of a situation

Coping Evoked by distress…

Broadly divided into: Emotion focused: Attempt to reduce

emotional distress – avoidance, cognitive re-appraisal etc

Problem focused: Attempt to change the nature of the problem causing distress - problem solving strategies

A simple model…

Stimulus event Primary appraisal

Benign/irrelevant

Ignore – no action or emotion

Relevant/potentially harmful + secondary appraisal

Coping response

Emotional response

Stress as loss of resourcesHobfoll’s (1989) conservation of resources model proposed that mentaland physical health are determined by the amount of resources available to the individual.

Resources may be: social (for example, family support) structural (such as housing) psychological (for instance, coping skills, perceived control).

A large number of resources are health protective.

Reduced resources place an individual at risk for mental health problems.

Social Support – a majorPsychosocial resource.

Berkman & Syme; Am J Epid; 1979

Men Women0

5

10

15

20I. LeastII.III.IV. Most

Connections

Gender

% D

ied

fro

m A

ll C

ause

s

PERCEIVED SOCIAL SUPPORT& THE STRESS-BUFFERING HYPOTHESIS

TYPICAL QUESTIONS

• Is there someone you can talk to about intimate problems?

• Is there someone who will loan you money when you are in need?

Cohen & Wills; Psych Bull; 1985

Low HighLow

High Low socialsupport

High socialsupport

Stress

Sy

mp

tom

s

Low HighLow

High Low socialsupport

High socialsupport

Stress

Sy

mp

tom

s

Low HighLow

High Low socialsupport

High socialsupport

Stress

Sy

mp

tom

s

Social Integration

PsychologicalStates

Infor-mation

Health Promoting Behaviorse.g., medical adherence, diet, exercise

Neuro-endocrineResponse

Health-Relevant Biological Influencese.g., endocrine, immune, or cardiovascular effects

Physical Disease Psychiatric Disease

ServicesSocial

Influence

Cohen, Gottlieb, & Underwood; 2000

Things are more complicated! Many other factors must be considered –

especially individual differences. New models are being developed and tested

(see Mark and Smith, 2008).

THE DRIVE MODEL AND STRESS AT WORK

Moderating Effect of Job Resources on Job Demands

Work Demands & Work Resources

Job Stress

Health Outcomes &Job Satisfaction

Individual Characteristics & Personal Resources & Demands

Work Resources

Main Effect

Moderating EffectX

Y

ZMediating effect of Y, between X and Z

1211

1098

765

4

3

2

1

Prevention and management

On the basis of such models one can design different types of interventions (e.g. organisational or individual).

We should move away from a “one size fits all approach”.

However, a process based approach can provide a framework that accounts for individual variation but has a firm theoretical basis.