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.     

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)     

Stressful life events, anxiety sensitivity, and internalizing symptoms in adolescents.

Anxiety sensitivity represents a robust risk factor for the development of anxiety symptoms among both adolescents and adults. However, the development of anxiety sensitivity among adolescents remains inadequately understood. In this study, the authors examined the role of stressful life events as a risk factor for the development of elevated anxiety sensitivity. Anxiety sensitivity was then examined in a longitudinal design as a mechanism linking stressful life events to changes in anxiety symptoms. Stressful life events, anxiety sensitivity, and internalizing symptoms were assessed in a diverse community sample of adolescents (N = 1,065) at 3 time points spanning 7 months. The results indicated that stressful life events were longitudinally associated with increases in anxiety sensitivity and that certain types of stressful life events, specifically events related to health and events related to family discord, were differentially predictive of increases in anxiety sensitivity. Moreover, anxiety sensitivity mediated the longitudinal relation between stressful life events and anxiety symptoms. Evidence was also found for the predictive specificity of anxiety sensitivity to symptoms of anxiety but not depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender differences in life events prior to onset of major depressive disorder: The moderating effect of age.

Theoretical models attempting to explain why approximately twice as many women as men suffer from depression often involve the role of stressful life events. However, detailed empirical evidence regarding gender differences in rates of life events that precede onset of depression is lacking, due in part to the common use of checklist assessments of stress that have been shown to possess poor validity. The present study reports on a combined sample of 375 individuals drawn from 4 studies in which all participants were diagnosed with major depressive disorder and assessed with the Life Events and Difficulties Schedule (Bifulco et al., 1989), a state-of-the-art contextual interview and life stress rating system. Women reported significantly more severe and nonsevere, independent and dependent, and other-focused and subject-focused life events prior to onset of depression than did men. Further, these relations were significantly moderated by age, such that gender differences in rates of most types of events were found primarily in young adulthood. These results are discussed in term of their implications for understanding the etiological role of stressful life events in depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship of daily stress and health-related behaviors to adolescents' cholesterol levels

It has been well established that some of the major risk factors for coronary heart disease are related to lifestyle, that is, behaviors that are potentially modifiable. Although studies have identified psychosocial stress as a factor associated with elevated cholesterol levels in adults, this relationship has not been thoroughly examined in adolescents. The present study investigated the relationship between daily life events and total cholesterol levels among 104 high school students. The contributions of health-related behaviors, such as dietary patterns, physical activity, smoking, and television viewing, were also examined. Hierarchical multiple regression analyses showed that scores on a scale of daily life events explained a significant portion of the variance in cholesterol measurements. However, when the sample was stratified by gender, this effect remained significant for adolescent females but not males. Overall, females reported a greater degree of negative health behaviors than did males. Implications of these findings are discussed.     

Effects of stressful daily events on mood states: relationship to global perceived stress

This study used experience sampling methodology to examine the relationship between stressful daily events and mood. Eighty-five male white-collar workers completed self-reports 10 times a day for 5 days. Controlling for individual differences in mood levels, multilevel regression analyses showed that events were followed by increases in negative affect (NA) and agitation (Ag) and by decreases in positive affect (PA). More unpleasant events were associated with greater changes in all three mood dimensions; controllability mitigated the effects of events on NA and PA. Prior events had persistent effects on current mood. High perceived stress (PS) was associated with greater reactivity of NA and PA to current events, whereas trait anxiety moderated reactivity of Ag. Results indicate that PS is related not only to a higher frequency of reported events but also to more intense and prolonged mood responses to daily stress.     

Stressful life events and symptoms: A longitudinal model.

245 males (mean age 46.8 yrs) and 248 females (mean age 44 yrs) were readministered the Social Readjustment Rating Scale, measures of personal functioning, and a social background index 12–15 mo after their initial assessment. There was some evidence for temporal consistency in the number and type of events Ss experienced as well as for a relationship between initial symptoms of depression (among males) and the more frequent occurrence of later events. After controlling for Ss' initial symptom levels and propensity to experience stressful events, an increase in negative events during the follow-up period was related to an increase in symptoms. Among several gender differences, negative events were found to have more impact on females than males. The confounding of the measurement of discrete stressful events and ongoing life strain is identified as potentially underlying the consistency of "events" as well as contributing to the difficulty in interpreting the relationship between "events" and functioning. (53 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender differences in anxiety disorders and anxiety symptoms in adolescents.

Gender differences in anxiety were examined in a large sample of adolescents that included 1,079 who had never met criteria for any disorder, 95 who had recovered from an anxiety disorder, and 47 who had a current anxiety disorder. Participants were examined on a wide array of psychosocial measures. There was a preponderance of females among current and recovered anxiety disorder cases, but not among those who had never experienced an anxiety disorder. The female preponderance emerges early in life, and retrospective data indicate that at age 6, females are already twice as likely to have experienced an anxiety disorder than are males. Psychosocial variables that were correlated with both anxiety and gender were identified. Statistically controlling for these variables did not eliminate the gender differences in prevalence or anxiety symptom means. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reports of stress: a comparison between eating disordered and non-eating disordered adolescents

This study utilizes a unique method to examine reports of stressful life events provided by eating disordered and non-eating disordered adolescents. Subjects (all females) participated in a standardized procedure to obtain reports of stressful life events. The Life Events and Coping Inventory (LECI) was used to categorize reported stressors. Eating disorder subjects discussed more stressors than non-eating disorder subjects only when eating disorder events were included. Furthermore, eating disorder subjects reported more events that could not be classified within the LECI and were rated as non-normative. The findings point to the importance of qualitative rather than purely quantitative approaches to stressful life events assessment with adolescents.     

Amino acids as RNA ligands: a direct-RNA-template theory for the code''s origin

Gender differences in anxiety were examined in a large sample of adolescents that included 1,079 who had never met criteria for any disorder, 95 who had recovered from an anxiety disorder, and 47 who had a current anxiety disorder. Participants were examined on a wide array of psychosocial measures. There was a preponderance of females among current and recovered anxiety disorder cases, but not among those who had never experienced an anxiety disorder. The female preponderance emerges early in life, and retrospective data indicate that at age 6, females are already twice as likely to have experienced an anxiety disorder than are males. Psychosocial variables that were correlated with both anxiety and gender were identified. Statistically controlling for these variables did not eliminate the gender differences in prevalence or anxiety symptom means.     

Stressful life events and adolescent substance use and depression: conditional and gender differentiated effects

Stressful life circumstances have myriad influences on human health and behavior. Early research focused on the variable distribution of stress and its effects by socioeconomic status, race, and gender. More recent research indicates that variation by age is also an important consideration. For example, adolescent reactions to stressful life events are often inconsistent with adult reactions to similar life situations and transitions. Moreover, since most studies assess only a single outcome--usually depression--they risk classification bias since analyses exclude other potential stress-related outcomes. This paper assesses the gender distinct effects of stressful life events on two outcomes among adolescents, substance use and depressive symptoms. The results of a second-order regression model indicate that life events affect female, but not male, depressive symptoms, especially when self-esteem is low or mastery is high. Furthermore, life events affect substance use when peer drug use is high, or when parental support is low, but this latter effect is limited to female adolescents.     

Negative life events, perceived stress, negative affect, and susceptibility to the common cold.

After completing questionnaires assessing stressful life events, perceived stress, and negative affect, 394 healthy Ss were intentionally exposed to a common cold virus, quarantined, and monitored for the development of biologically verified clinical illness. Consistent with the hypothesis that psychological stress increases susceptibility to infectious agents, higher scores on each of the 3 stress scales were associated with greater risk of developing a cold. However, the relation between stressful life events and illness was mediated by a different biologic process than were relations between perceived stress and illness and negative affect and illness. That these scales have independent relations with illness and that these relations are mediated by different processes challenges the assumption that perceptions of stress and negative affect are necessary for stressful life events to influence disease risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender differences in fire fighter job stressors and symptoms of stress

This study described gender differences in fire fighter appraisal of job stressors and symptoms of stress. A sample of 670 male and 41 female fire fighters responded to an anonymous mail survey consisting of three standardized and investigator-developed questionnaires. Male and female fire fighter respondents were more similar than different on both job stressor and symptoms of stress measures. Five job stressors were ranked the most "bothersome" by both males and females during the last 10 shifts worked. These were: sleep disturbance, wage/benefit concerns, job skill concerns, substandard equipment, and safety concerns. Of these five job stress factors, only one gender difference was noted. Female fire fighters reported significantly higher scores than males on job skill concerns. Job discrimination reported by female respondents was significantly higher than for males (t = 3.51, p < .0001) even though it was not ranked among the five most stressful factors. Partial correlations computed between job stressors and symptoms of stress, while controlling for the number of years as a fire fighter, were of moderately high magnitude for both genders and similar to simple correlations computed. These results suggest that the number of years of service did not account for gender differences reported.     

Stress resilience in early marriage: Can practice make perfect?

As all couples experience stressful life events, addressing how couples adapt to stress is imperative for understanding marital development. Drawing from theories of stress inoculation, which suggest that the successful adaptation to moderately stressful events may help individuals develop a resilience to future stress, the current studies examined whether experiences with manageable stressors early in the marriage may serve to make the relationship more resilient to future stress. In Study 1, 61 newlywed couples provided data regarding their stressful life events, relationship resources (i.e., observed problem-solving behaviors), and marital satisfaction at multiple points over 2? years. Results revealed that among spouses displaying more effective problem-solving behaviors, those who experienced moderate stress during the early months of marriage exhibited fewer future stress spillover effects and reported greater increases in felt efficacy than did spouses who had less experience with early stress. Study 2 examined stress resilience following the transition to parenthood in a new sample of 50 newlywed couples. Again, spouses who experienced moderate stress during the early months of marriage and had good initial relationship resources (i.e., observed support behaviors) reported greater marital adjustment following the transition to parenthood than did spouses who had good initial resources but less prior experience coping with stress. Together, results indicate that entering marriage with better relationship resources may not be sufficient to shield marital satisfaction from the detrimental effects of stress; rather, couples may also need practice in using those resources to navigate manageable stressful events. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Stress and anxious-depressed symptoms among adolescents: Searching for mechanisms of risk.

This study was an examination of the possible mechanisms of risk among adolescents (n?=?55) exposed to the stress associated with the diagnosis of cancer in a parent. Girls whose mothers had cancer reported significantly more anxious-depressed symptoms than girls whose fathers were ill or boys whose mothers or fathers had cancer. Increased family responsibilities and the use of ruminative coping were examined as possible mechanisms leading to increased distress in girls with ill mothers. Although girls reported the use of more ruminative coping, rumination did not account for the impact of maternal cancer on girls' distress. Girls whose mothers were ill reported more stressful events reflecting family responsibilities. Furthermore, family responsibility stress fully accounted for the interaction of gender of the ill parent and gender of the adolescent in predicting anxious-depressed symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress-coping factors in adolescent substance use: test of ethnic and gender differences in samples of urban adolescents

Investigated group differences in the relationship between stress-coping variables and substance (cigarette, alcohol, and marijuana) use with samples of inner-city students in sixth through eighth grades (N = 1,289) and metropolitan-area students in seventh through ninth grades (N = 1,702). Measures included affect, life events, parental support, and coping patterns. African-American adolescents had the lowest rate of substance use, Hispanics were intermediate, and Whites had the highest rate; there was no gender difference in overall substance use. Multiple regression analysis showed the strength of predictive relationships for stress-coping variables was lower for African Americans and was greatest for Whites; four methodological tests showed these differences were not attributable to statistical artifacts. Hispanic adolescents showed greater vulnerability than Whites at younger ages but this effect reversed at later ages. Implications for prevention research are discussed.     

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)     

Stressful life events, personality, and health: An inquiry into hardiness.

Studied personality as a conditioner of the effects of stressful life events on illness onset. Two groups of middle- and upper-level 40–49 yr old executives had comparably high degrees of stressful life events in the previous 3 yrs, as measured by the Schedule of Recent Events. One group of 86 Ss suffered high stress without falling ill, whereas the other group of 75 Ss reported becoming sick after their encounter with stressful life events. Illness was measured by the Seriousness of Illness Survey (A. R. Wyler et al 1970). Discriminant function analysis, run on half of the Ss in each group and cross-validated on the remaining cases, supported the prediction that high stress/low illness executives show, by comparison with high stress/high illness executives, more hardiness, that is, have a stronger commitment to self, an attitude of vigorousness toward the environment, a sense of meaningfulness, and an internal locus of control. (43 ref) (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)     

Life events and subsequent illness

The objective was to examine for relationships between stress, as measured by life events, and hospitalization or death during the following 6 to 12 months, using a case-control design. As part of the Community Mental Epidemiology Program, life events data for the preceding year were gathered on a random sample of the population at two sites, and health data for the interval between interviews were collected at follow-up. A case is defined as anyone becoming ill and being hospitalized or dying during the interval between interviews. Each case was individually matched by several variables to a control who had neither been sick nor hospitalized. There were no significant demographic differences between cases and control in either site or between sites. When life events were examined by various scoring methods, there were no differences between cases and controls. This finding is important since most longitudinal studies that have shown a positive relationship between life events and subsequent illness have had methodologic limitations or have been based on healthy, young, male populations who generally did not become seriously ill during the study period. The results of this study plus the lack of generalizability of previous findings and their somewhat conflicting results raise serious questions about the etiologic relationship of life events to subsequent illness.