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 study Kozora 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 process Stress 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 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

Relevant/potentially harmful + secondary appraisal A simple model… Stimulus event Primary appraisal Relevant/potentially harmful + secondary appraisal Benign/irrelevant Ignore – no action or emotion Emotional response Coping response

Stress as loss of resources Hobfoll’s (1989) conservation of resources model proposed that mental and 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 major Psychosocial resource.

Berkman & Syme; Am J Epid; 1979

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

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 X Y Z Mediating effect of Y, between X and Z 12 11 10 9 8 7 6 5 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.