Is life stress more likely to provoke depressive episodes in women than in men?

One of the most consistent findings in psychiatric research is that rates of major depression are at least twofold higher among women than among men. Although there is considerable agreement in the literature that life events play a role in producing, triggering, or maintaining episodes of depression, less is known about the relationship among gender, life events, and depression. In the present study, we compared the rates, focus ("interpersonal" vs. "non-interpersonal"), and timing of stressful life experiences reported in rigorous interviews of male and female patients with unipolar recurrent depression and nondepressed contrast subjects. Consistent with hypotheses, female patients were more likely to experience stressful life experiences than their male counterparts; rates of stressful life experiences did not differ between female and male controls. Unexpectedly, rates of interpersonal stress did not differ among males and females regardless of patient or control status. We also found no significant differences in the timing of pre-onset events: stressful events were generally concentrated in the period immediately preceding onset for both men and women. Thus, although these data suggest that life stress may play a larger role in the provocation of recurrent episodes of depression for women than for men, there do not seem to be sex differences in the extent to which interpersonal vs. noninterpersonal events and difficulties are associated with depression onset or in the temporal distribution of events. Implications of these results are discussed in the context of research on other putative factors contributing to gender differences in rates of depression.     

Youth depression and early childrearing: Stress generation and intergenerational transmission of depression.

Objective: Broadening the concept of stress generation beyond acute life events, the current study explores predictors of the creation of stressful environments—specifically, selection into early childrearing by age 20. It was predicted that youth with early onset depressive disorders would be at higher risk for early childrearing accompanied by greater depression and parenting maladjustment. Additional analyses tested hypotheses about the roles of interpersonal vulnerability and intergenerational transmission of depression and examined gender differences. Method: A community sample of 706 adolescents and their mothers were studied at ages 15 and 20. The sample was originally selected to oversample families with depressed mothers. Results: Results confirmed the hypotheses for women but not men: Young women with depression by age 15 were at greater risk for interpersonal difficulties at age 15 and early childrearing, accompanied by further depression and parenting dysfunction at age 20. The effects of (grand)maternal depression were evident in predicting youth early onset depression and interpersonal difficulties, as well as higher rates of depression among their daughters who had children by age 20. Conclusions: The study expands the definition of stress generation to include the role of past depression and other risk factors as predictors of selection into a stressful childrearing environment. The findings also describe aspects of the intergenerational transmission of depression. The results highlight potentially important targets for interventions in young women to prevent recurrence of major depression and parenting dysfunction. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Gender differences in cognitive diathesis-stress domain match: Implications for differential pathways to depression.

The frequency of cognitive diathesis-stress match was compared in a sample of depressed women and men to investigate hypotheses positing gender differences in the relation of cognitive diathesis-stress factors to depression. Depressed women were more likely to have experienced a match between a cognitive diathesis and a preonset negative stressor compared with depressed men. Comparisons of women and men on the cognitive and stress variables singly yielded differences in stress variables but not in cognitive variables. Depressed women were more likely to have experienced a negative severe event before the onset of depression and had a greater frequency of negative interpersonal events. Results supported the hypothesis of gender differences in pathways to depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The direct and interactive effects of neuroticism and life stress on the severity and longitudinal course of depressive symptoms.

The direct and interactive effects of neuroticism and stressful life events (chronic and episodic stressors) on the severity and temporal course of depression symptoms were examined in 826 outpatients with mood and anxiety disorders, assessed on 3 occasions over a 1-year period (intake and 6- and 12-month follow-ups). Neuroticism, chronic stress, and episodic stress were uniquely associated with intake depression symptom severity. A significant interaction effect indicated that the strength of the effect of neuroticism on initial depression severity increased as chronic stress increased. Although neuroticism did not have a significant direct effect on the temporal course of depression symptoms, chronic stress significantly moderated this relationship such that neuroticism had an increasingly deleterious effect on depression symptom improvement as the level of chronic stress over follow-up increased. In addition, chronic stress (but not episodic stress) over follow-up was uniquely predictive of less depression symptom improvement. Consistent with a stress generation framework, however, initial depression symptom severity was positively associated with chronic stress during follow-up. The results are discussed in regard to diathesis–stress conceptual models of emotional disorders and the various roles of stressful life events in the onset, severity, and maintenance of depressive psychopathology. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Psychiatric history and stress: Predictors of severity of unipolar depression.

Unipolar depression is frequently a recurrent or chronic disorder. In studies on predicting its course, outcomes are typically linked to either psychiatric features or stressful life events. In order to integrate the 2 approaches, 51 unipolar patients were assessed periodically over at least 1 yr for symptoms, stressful events, and chronic stressors. It was hypothesized that adverse family history and early age of onset impair role functioning and coping capabilities, thereby contributing to stressful circumstances that predict severity of depressive reactions. Results of causal modeling analyses supported a model in which background factors were associated with severity of depressive outcomes as mediated by their effects on stress variables. Such a model implicates the self-perpetuating nature of clinical depression, both for the individual and across generations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social-environmental factors in unipolar depression: Comparisons of depressed patients and nondepressed controls.

Examined the role of stress and coping factors in depression by comparing a group of 409 Ss (over age 18) entering psychiatric treatment for unipolar depression with a sociodemographically matched group of 409 nondepressed Ss. In addition to reporting significantly more stressful events than controls, depressed Ss also experienced more severe life strains associated with their own and their family members' physical illness, their family relationships, and their home and work situations. Depressed Ss were less likely to use problem-solving and more likely to use emotion-focused coping responses and had fewer and less supportive relationships with friends, family members, and co-workers. These group differences were consistent for both depressed women and men. Findings indicate the value of expanding the consideration of psychosocial factors in depression to include individuals' chronic strains and acute stressors as well as their coping responses and social resources. (53 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress and illness in adolescence: issues of race and gender

There is an abundance of information on the association between stressful life events and illness within the adult population. In contrast, research on this relationship among adolescents is limited. This study evaluated the role of individual differences (gender and race) on the stress-illness relationship within the adolescent population. Participants were 119 adolescents (54 females and 65 males), recruited from two public high schools located in the southeast, who were administered four questionnaires designed to measure levels of stress, anxiety, and illness. Overall, correlational analysis revealed that stress and anxiety were positively correlated with reported illness. However, racial and gender differences did emerge. Although no gender differences were found with regard to the experience of stress, African-American athletes reported a higher frequency of stressful life events than did their Euro-American counterparts. Further, African-American adolescents reported a lower frequency of illness than did the Euro-Americans. Females reported more illnesses than did males. Possible explanations for individual differences in reported stress and illness are discussed.     

Predicting depressive symptomatology: Cognitive-behavioral models and postpartum depression.

170 women (mean age 26.6 yrs), seen in their 2nd trimester of pregnancy, were followed-up about 3 mo postpartum. Level of depression (Beck Depression Inventory) was just as high during pregnancy as during the postpartum period. Several variables assessed during pregnancy and during the postpartum period were significant predictors of postpartum depression level, including measures of prepartum depression, attributional style, delivery stress, and stressful life events. The predictor variables accounted for about 40% of the variance in level of postpartum depression. Predictor variables from earlier research such as history of menstrual problems, parity, education, and income did not account for significant variance in postpartum depression level. These findings provide some evidence for the role of cognitive-behavioral factors and stressful life events in depression. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Generation of stress in the course of unipolar depression.

The effect of stressful events on depression has been amply demonstrated, but the opposite relation is also important. The author examined event occurrence over 1 yr in 14 women with unipolar depression who were compared with demographically matched groups of women with bipolar disorder (n?=?11), chronic medical illness (n?=?13), or no illness or disorder (n?=?22). Interview assessments of life events, severity, and independence of occurrence confirmed the hypothesis that unipolar women were exposed to more stress than the normal women, had significantly more interpersonal event stress than all others, and tended to have more dependent events than the others. The implication is that unipolar women by their symptoms, behaviors, characteristics, and social context generate stressful conditions, primarily interpersonal, that have the potential for contributing to the cycle of symptoms and stress that create chronic or intermittent depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-complexity as a cognitive buffer against stress-related illness and depression.

This prospective study tested the self-complexity buffering hypothesis that greater self-complexity moderates the adverse impact of stress on depression and illness. This hypothesis follows from a model that assumes self-knowledge is represented in terms of multiple self-aspects. As defined in this model, greater self-complexity involves representing the self in terms of a greater number of cognitive self-aspects and maintaining greater distinctions among self-aspects. Subjects completed measures of stressful events, self-complexity, depression, and illness in two sessions separated by 2 weeks. A multiple regression analysis used depression and illness at Time 2 as outcomes, stressful life events and self-complexity at Time 1 as predictors, and drepression and illness at Time 1 as control variables. The Stress?×?Self-Complexity interaction provided strong support for the buffering hypothesis. Subjects higher in self-complexity were less prone to depression, perceived stress, physical symptoms, and occurrence of the flu and other illnesses following high levels of stressful events. These results suggest that vulnerability to stress-related depression and illness is due, in part, to differences in cognitive representations of the self. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stressful life events, bipolar disorder, and the "kindling model".

A common misconception is that bipolar disorder is an endogenous process. However, previous research suggests a role for life events in the onset of and recovery from bipolar episodes. Yet there remains some question as to whether the relationship between life events and onset changes over the course of the disorder as a result of the number of episodes an individual has experienced. Using a rigorous interview measure of stressful life events, the current study tested the kindling model (R. M. Post, 1992), which theorizes that major life events play a diminishing role over the course of illness in bipolar patients. Analyses revealed that the number of episodes experienced does not appear to have a significant effect on bipolar 1 patients' reactivity to external stressors. In addition, the results suggest that a more complex relationship exists among age, stress, and onset of new episodes than can be adequately explained by the kindling model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex differences and adolescent depression.

This study investigates the role of certain psychosocial variables—sex, age, body image/self-esteem, self-consciousness, stressful life events, and the degree to which an individual identifies with the cultural stereotype of masculinity—as correlates and antecedents to depression in adolescents and explores possible intraindividual mediators of the stress–depression relationship in adolescents. A battery of self-report measures was administered to public high school students in Grades 9–12 in their classrooms at two different times 1 month apart. Female adolescents reported more depressive symptoms, self-consciousness, stressful recent events, feminine attributes, and negative body image and self-esteem; no age effects were obtained. Results suggest a model of adolescent depression in which body image/self-esteem and stressful recent events are significant contributors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Initial symptom levels and the life-event–depression relationship.

93 undergraduates selected for diversity of initial depression levels were studied longitudinally to explore the relation between stressful events and depression. Ss were chosen on the basis of their scores on an information-processing procedure, the Beck Depression Inventory, the Schedule for Affective Disorders and Schizophrenia—Lifetime Version, and the SCL-90. After the initial screening, Ss completed a 2-hr interview covering current and lifetime diagnostic status and stressful life-event occurrence in the previous 12 mo. Following this, they participated in 4 regular monthly follow-ups. Regression analyses and inspection of individual patterns supported the hypothesis that initial depression status is a critical factor in depression–event associations and that concurrent high-impact negative events contribute significantly but modestly to outcomes. It appeared that nonsymptomatic Ss were relatively resistant to onset even when exposed to high-impact stress events, whereas a subset of initially symptomatic Ss continued to have both more depression and more high-impact events over time. It is suggested that future research on event–depression associations should carefully consider these different outcome patterns: symptom resistance and symptom onset in nondepressed persons and symptom remission and symptom maintenance or recurrence in initially depressed persons. (43 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress reactivity following brief treatment for depression: Differential effects of psychotherapy and medication.

Psychotherapy and medication treatments are both effective in reducing depressive symptoms. However, only psychotherapy provides an enduring effect by reducing depressive vulnerability following treatment termination. This differential efficacy may reflect mode-specific effects on the longitudinal relationship between depression and stress. The current study examined posttreatment data from 153 outpatients enrolled in the Treatment of Depression Collaborative Research Program. Longitudinal analyses using the latent difference score (LDS) framework (a structural modeling technique that combines features of latent growth curve and cross-lagged regression models) evaluated the temporal relationship between severity of depression and frequency of stressful life events, assessed by interviewers at treatment termination and at 6, 12, and 18 months following treatment. Results supported a stress reactivity model in that stressful events led to elevations in the rate of depression change. Furthermore, multigroup LDS analysis indicated that this longitudinal stress reactivity occurred only for outpatients in the medication conditions. Results demonstrate that the enduring impact of psychotherapy involves the development of enhanced resiliency to stressful life events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Vulnerability to specific life events and prediction of course of disorder in unipolar depressed patients.

Tested a cognitive-life stress integrative model that predicted depressive symptoms following stressful life events when the negative events were personally meaningful to the individual, and likely to be interpreted as depletions or failure in the domain of central relevance to self-worth. 27 unipolar depressed outpatients completed a sociotropy-autonomy scale and were followed prospectively for periods of up to 2 yrs, with periodic assessments of life events and symptoms. As predicted, Ss' periods of worst symptoms followed a 3-mo period in which life event stress that matched their personally relevant domain significantly exceeded that of the nonrelevant domain. For Ss who experienced an onset following a symptom-free period, the severity of symptoms was significantly predicted by the interaction of their autonomy score and achievement events; however, the same pattern did not occur for sociotropy score and interpersonal events. (French abstract) (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Life stress and adjustment: Effects of life events experienced by young adolescents and their parents.

A longitudinal design was used to test the effects of life events experienced by young adolescents and their parents. The criteria were the adolescents' depression, anxiety, and self-esteem. The longitudinal analysis revealed a significant effect for the adolescents' controllable, but not uncontrollable, negative events. However, causal analyses revealed that this effect was the result of the significant relation between initial adjustment and the subsequent occurrence of controllable life stress (e.g., school suspension). The longitudinal analysis also revealed the stress-protective role of positive events, but only with respect to girls' self-esteem. There was no longitudinal support for the role of the parents' negative life events. These findings do not support the etiological importance of an accumulation of relatively discrete negative events experienced by early adolescents and their parents, but they do suggest the need (a) to conceptualize (controllable) life stress as a dependent variable in future research on developmental psychopathology; (b) to examine gender differences in early adolescent life stress; and (c) to develop more sophisticated measures of family life stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of life and job stress on information search behaviors of organizational members.

Examined the relationship of stressful life events in and out of work to role-relevant information search. It was suggested that stressful life events lead a person to question the appropriateness of typical modes of role enactment resulting in increased role-relevant information search. 44 adults (mean age 37.7 yrs) employed in a wide variety of organizations completed the Social Readjustment Rating Scale and the Organizational Readjustment Rating Scale that measure 2 types of stressful events (life and work), and role-related information search was assessed in 2 settings (on and off the job). Results show that stressful events significantly predicted information search activities. However, work-related stressful events predicted information search conducted on the job, whereas life stress predicted off-the-job search. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social problem solving as a moderator of stress-related depressive symptoms: A prospective analysis.

Previous research has suggested that problem-solving skills serve to moderate the likelihood that individuals will experience depressive symptoms as a function of negative stressful life events. The present study attempted both to replicate this finding and to provide for a more rigorous test of this hypothesis by (a) using a prospective design, (b) controlling for prior level of depression, (c) incorporating two measures of problem solving, and (d) including several methodological controls to increase the validity of the assessment of stressful life events. Results from both the cross-sectional and prospective analyses involving data collected from 150 university students provided support for the hypothesis that problem solving moderates stress-related depressive symptoms. More specifically, for both measures of problem solving, results indicated that effective problem solvers under high levels of stress reported significantly lower depression scores than ineffective problem solvers under similar levels of stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study.

We present evidence from a 5-year longitudinal study for the prospective associations between loneliness and depressive symptoms in a population-based, ethnically diverse sample of 229 men and women who were 50–68 years old at study onset. Cross-lagged panel models were used in which the criterion variables were loneliness and depressive symptoms, considered simultaneously. We used variations on this model to evaluate the possible effects of gender, ethnicity, education, physical functioning, medications, social network size, neuroticism, stressful life events, perceived stress, and social support on the observed associations between loneliness and depressive symptoms. Cross-lagged analyses indicated that loneliness predicted subsequent changes in depressive symptomatology, but not vice versa, and that this temporal association was not attributable to demographic variables, objective social isolation, dispositional negativity, stress, or social support. The importance of distinguishing between loneliness and depressive symptoms and the implications for loneliness and depressive symptomatology in older adults are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Partners' stress underestimations lead to women's distress: A study of pregnant inner-city women.

The authors examined how men's underestimation of the stress that their pregnant female partners reported influenced women's psychological distress and their sense that they were not supported. Participants included 68 pregnant inner-city women and their partners, among whom African Americans and European Americans were represented. Women who reported a greater number of stressful life events had increased depression if their partners did not report them as encountering these events. However, if their partners reported them as encountering a high number of stressful events, the otherwise negative impact of stress was buffered. Partners' stress report had no appreciable effect when women reported a low number of stressful events. This partner underestimation effect was independent of the influence of women's report of social support. (PsycINFO Database Record (c) 2010 APA, all rights reserved)