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Symptoms, hassles, social supports, and life events: Problem of confounded measures

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Abstract

Recent stressful life events are related to a wide variety of psychological and physical disorders, but the relations have tended to be minimal. This has led investigators to introduce such factors as "hassles" and "social supports" in expanded investigations of life-stressed processes. As with life events scales, however, questions have been raised about whether the conceptual and operational distinctions have been clear enough to permit clear investigation of interrelations among these factors and adverse health changes. The present study examined judgments by 371 clinical psychologists of the extent to which items in leading stress instruments are likely to be symptoms of psychological disorder. Results indicate that each of the stress measures was confounded with measures of psychological distress, the Hassles Scale and the Instrumental-Expressive Support Scale more so than the Social Readjustment Rating Scale. Types of life events and social supports are discussed in terms of their relative dependence on personality and psychopathology. (32 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)

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... Kohn and colleagues [17] developed an 85-item questionnaire for students combining objective stressor items from existing scales and additional items. The perceived impact of the stressor is assessed separately by the reported extent to which each stressor was experienced during the past month ( It has been criticized, however, that many of the existing microstressor scales do not exclusively focus on objective (i.e., observable) stressors, but also include items assessing cognitions, emotions, consequences of stress or symptoms, which may confound with other questionnaires assessing the same constructs and may consequently result in spurious associations [5,7,14,15,[18][19][20][21]. For example, the 'Daily Hassles and Uplifts Scale' [11], also includes items about inner concerns (e.g., 'trouble making decisions' or 'concern about meaning of life'). ...
... In order to avoid this methodological issue, it has been suggested to strictly focus on objective (i.e., observable) situations instead of subjective aspects, such as interpretations, cognitions, emotions or symptoms [5,18,19,21]. This allows for an unconfounded analysis of the impact of microstressors on the outcome in question, e.g., perceived distress or physical health. ...
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BACKGROUND Many of the existing scales for microstressor assessment do not differentiate between objective (i. e., observable) stressor events as opposed to stressful cognitions or concerns and often mix these items with other aspects of stress, such as perceived stressor severity, the evoked stress reaction or further consequences on health. This may result in spurious associations with other questionnaires measuring such constructs. Since most scales were de-veloped several decades ago, modern life stressors may not be represented. OBJECTIVE To develop a questionnaire that a) focuses on the retrospective assessment of objective microstressors over a one-week period and b) separates stressor occurrence from perceived stressor severity. METHODS Cross-sectional (N=109) and longitudinal studies (N=10 and N=70) were conduct-ed. In the longitudinal studies, Ecological Momentary Assessment (EMA) was used to com-pare stressor data, collected five times per day for 30 days, with retrospective reports (end-of-day, -week). Pearson correlations and multilevel-modelling were used in the analyses. RESULTS High correlations were found between the end-of-week, end-of-day and EMA data for microstressor occurrence (counts) (r ≥ .69 for comparisons per week, r ≥ .83 for cumulated data) and for mean perceived microstressor severity (r ≥ .74 for comparisons per week, r ≥ .85 for cumulated data). The end-of-week questionnaire predicted the EMA assessments suf-ficiently (counts: b= .03, 95% CI= .02 to .03, P<.001; severity: b= .67, 95% CI= .52 to .82, P<.001), the association did not change significantly over the period of four subsequent weeks. CONCLUSIONS Our results provide evidence for the ecological validity of the MIMIS questionnaire. CLINICALTRIAL none
... measures! [21].!!! ! Since! the! problem! of! ...
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Stress remains popular as a psychological construct. Different aspects of stress are emphasized depending upon the environmental issue, target population, and measure used. Existing measures are often confounded between causes of stress and effects of stress and also may emphasize a particular perspective on stress. Here we evaluate the empirical method of item selection as an alternative for developing a stress scale, using salivary cortisol levels as the empirical criterion. Items were adapted from measures of perceived stress, daily hassles, and life events as used in two studies of stress that measured salivary cortisol. Correlations with cortisol levels led to the retention of 75 items of the pool of 535, which were administered to a third sample of 28 medical students. The 75-item scale did not correlate with cortisol levels. Of 15 individual items that did, six correlated in the opposite direction to that predicted. Results illustrate the dangers of empirical item selection methods.
... Criterion A (Table 1) focuses on the stressors. Careful choice of stressful life events avoids the confounding of events with psychiatric symptoms, a problem that has long been recognized as a limitation of commonly used scales (Dohrenwend et al., 1984). ...
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Allostatic load reflects the cumulative effects of stressful experiences in daily life and may lead to disease over time. When the cost of chronic exposure to fluctuating or heightened neural and systemic physiologic responses exceeds the coping resources of an individual, this is referred to as "toxic stress" and allostatic overload ensues. Its determination has initially relied on measurements of an interacting network of biomarkers. More recently, clinical criteria for the determination of allostatic overload, that provide information on the underlying individual experiential causes, have been developed and used in a number of investigations. These clinimetric tools can increase the number of people screened, while putting the use of biomarkers in a psychosocial context. The criteria allow the personalization of interventions to prevent or decrease the negative impact of toxic stress on health, with particular reference to lifestyle modifications and cognitive behavioral therapy.
... The availability of pure construct measures is required for theory testing because, if measures show construct overlap, then any observed relationship between those constructs may be spurious. This problem of contaminated items and measures has been discussed regarding psychological constructs (Dohrenwend, Dohrenwend, Dodson, & Shrout, 1984; Lazarus, DeLongis, Folkman, & Gruen, 1985; Nicholls, Licht, & Pearl, 1982). It can become a serious problem if existing atheoretical measures (i.e., measures not related to theory) are used to assess new theoretical constructs as these measures frequently tap multiple constructs. ...
... Por otro lado, el estudio no está exento de las críticas que subrayan la confusión existente entre lo que se supone que deben medir las escalas de evaluación del estrés y lo que deberían predecir, a saber, los problemas psicológicos, y que señalan el solapamiento existente entre medidas antecedentes y consecuentes del estrés (Dohrenwend, Dohrenwend, Dodson & Shrout, 1984;Lazarus, DeLongis, Folkman & Gruen, 1985). En este sentido, investigaciones futuras deberían tratar de diferenciar los componentes vinculados a la percepción del estrés de los vinculados a las reacciones ante el estrés. ...
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Despite the link between migration and stress, there are no questionnaires that assess perceived stress in the country of arrival and the country of origin. This study aims to obtain a valid factor structure of the two measures (general and recent) of the Perceived Stress Questionnaire (PSQ; Levenstein et al., 1993), applied to the migration process (pre and post-migration stress), allowing their comparison. The questionnaire was administered to a sample of 350 Peruvian migrants settled in Santiago of Chile. The results demonstrate large and medium correlations between the indexes of post-migration stress and most of the mental health symptoms considered in the Talbieh Brief Distress Inventory (TBDI; Ritsner, Ravinowitz, & Sluzberg, 1995). Internal consistency for the obtained scales was moderate to high. Discussion: The abbreviated version of PSQ seems to be a reliable and structurally valid instrument to assess perceived stress in adult migrants.
... Following victim precipitation theory, Depue and Monroe (1986) and Dohrenwend et al. (1984) suggested that people high in negative affect (NA), including anxious, depressive and neurotic symptoms, through their own behaviour create or enact adverse circumstances. They may, therefore, bring about or contribute to the development of problems and conflicts at work. ...
... While this cross-sectional study represents a first step in examining the moderation effects of ACEs, future studies should employ methods that allow for testing causality (e.g., ecological momentary assessment approaches). Casual inference is also limited by our use of self-reported ACEs, discrimination, and mental health, given known confounds between mental health status and reports of adverse experiences and limitations of same-source reporting bias (Dohrenwend et al., 1984;Meyer, 2003). Retrospective self-report scales may also be prone to recall bias (Hardt and Rutter, 2004). ...
Article
Background : Adverse childhood experiences (ACEs) and day-to-day discrimination (hereafter, “discrimination”) both contribute to mental health symptomatology in young adulthood, but how these constructs interact and whether they are associated with mental health remains unclear. This study evaluated whether the relation between discrimination in young adulthood and mental health symptomatology varied as a function of ACEs exposure. Methods : Undergraduates (n = 251) completed self-report measures related to ACEs, discrimination, and mental health symptomatology (i.e., depression, anxiety, somatization, and psychological distress). Linear and logistic regression models were implemented to test for potential exacerbation effects of ACEs on the relation between discrimination and mental health symptomatology. Results : Participants with greater discrimination exposure and ACEs reported significantly more depression, anxiety, and somatic symptoms, along with more psychological distress, relative to those with less discrimination exposure and few or no ACEs. Limitations : Data were cross-sectional, thus, causality cannot be inferred. ACEs and discrimination measures examined ACE counts and general discrimination, respectively, which did not allow for examination of possible differences across specific ACEs (e.g., childhood sexual abuse vs. neglect) or specific types of discrimination (e.g., sexual-orientation-based discrimination vs. race-based discrimination). Conclusions : These results are among the first to inform the conceptualization of ACEs and discrimination in etiological models of young adults’ mental health. Both ACEs and discrimination, rather than exposure to only one of these stressors, may be synergistically associated with young adults’ mental health symptomatology. Clinicians could address stress-sensitive mental health issues by assessing for both ACEs and discrimination exposure.
... Any excitement about those findings, however, should be tempered by the realization that the literature surveyed is characteristically of very poor quality and that substantial improvements need to be introduced before definitive statements can be made on the issue. Many of the problems that characterize this area of research are the same ones that plague the stress-health literature in general, which have been periodically lamented (Cohen, 1985;Craig & Brown, 1984;Depue & Monroe, 1986;Dohrenwend, Dohrenwend, Dodson, & Shrout, 1984;Kasl, 1978Kasl, , 1987Leventhal & Tomarken, 1987;Rabkin & Struening, 1976), and which have been most recently articulated by Suls, Wan, and Blanchard (1994) and by Whitehead (1994). ...
... Thus, this section will first briefly review definitions and types of stress, then examine the types of stressors faced by children and adolescents, and then adults at different life stages. l f r r l v e " s (Dohrenwend, Dohrenwend, Dodson, & Shrout 1984), or if rhe appraisal of stress resulted from the interaction or transaction between the individual and the environment (Lazarus & Folkman, 1984). This transactional model is currently dominantnamely, that there are individual differences in appraisals of stress rhat nonerheless reflect environmental contingencies (see Aldwin, 2007, for an explication of these arguments). ...
... Aldag, Barr and Brief, 1981;Aldag and Brief, 1979;Kahn et al., 1964;Kasl, 1973;Payne and Pugh, 1976;Staw, 1975) and how each of these measures are related to distress (e.g. Brief et al., 1981;Dohrenwend, Dohrenwend, Dodson and Shrout, 1984;Dohrenwend and Shrout, 1985;Kasl, 1978;Payne et al., 1982); (2) rather than assuming researchers'apriori labels ofjob conditions as stressful are plausible, there is a need to examine how workers themselves label the conditions of their work (e.g. Folkman and Lazarus, 1985;Segouis, Bhagat and Coelho, 1985); (3) rather than merely theorizing about how workers cope with stressful working conditions, coping needs to be investigated empirically (e.g. ...
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How workers perceive, label, and cope with stressful job conditions and how job produced strains relate to overall psychological well-being are identified as research, agenda items for organizational stress researchers. Occurrences which are construed as attacking the financial status of people are suggested to be underattended to critical work events.
... Our intervention was aimed to help them reduce negative emotions (e.g., anxiety, depression, and stress) and promote well-being within a short period of time, given that freshmen may be particularly vulnerable to psychological stress (Dyson & Renk, 2006). For freshmen, entering university for the first time can bring a variety of difficult experiences within a short time; these experiences may induce physical illness (Cohen, Tyrrell, & Smith, 1993;Dohrenwend, Dodson, & Shrout, 1984) and have a sustained influence on the student's future development (Dyson & Renk, 2006;Margolis, 1981). Therefore, freshmen become severely in need of an immediate assistance and the single-session intervention may be a helpful option. ...
Article
Purpose To investigate the efficiency of a single-session character-strength-based cognitive intervention on enhancing freshmen’s adaptability. Method A randomized trial, pretest, posttest, follow-up intervention was employed using repeated-measures analyses to evaluate the effect. This 90-min intervention contained four activities with 52 undergraduate freshmen (age 17–20) randomly assigned to the intervention and control group, 38 of whom completed all the programs (19 of each group). Results Compared with the control group, the intervention group showed a remarkable increase in well-being and a significant reduction in depression and anxiety at post and follow-up assessment. The stress level of the intervention group significantly decreased only at the follow-up test. Time effect and the interaction between time and group were significant in anxiety and stress. Conclusions This intervention can quickly reduce negative affect and elevate well-being for freshmen. It expands the role of social worker in the prevention of mental illness among college population.
... Having intimate relationships, building and maintaining social networks, deriving satisfaction from any aspect of life, as well as how each of these is reported, all relate to self-esteem, independent of any stress reduction effect (Dohrenwend, Dohrenwend, Dodson, & Shrout, 1984). Consequently, rather than indicating a relation between social support and satisfaction, studies may be indicating that people who enjoy a positive view of self are also likely to be satisfied with their relationships and enjoy a number of such meaningful contacts (Hansson et al., 1984;Jourard, 1971;Rosenberg, 1965). ...
... Thus, this section will first briefly review definitions and types of stress, then examine the types of stressors faced by children and adolescents, and then adults at different life stages. l f r r l v e " s (Dohrenwend, Dohrenwend, Dodson, & Shrout 1984), or if rhe appraisal of stress resulted from the interaction or transaction between the individual and the environment (Lazarus & Folkman, 1984). This transactional model is currently dominantnamely, that there are individual differences in appraisals of stress rhat nonerheless reflect environmental contingencies (see Aldwin, 2007, for an explication of these arguments). ...
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Examination of stress and coping across the lifespan clearly reflects the principles of lifespan development. Stress and coping processes change across the lifespan, require a multidisciplinary perspective to understand that change, are affected by the social context, and demonstrate individual differences in trajectories of change. How stress changes across the lifespan depends upon how stress is defined. For example, stress defined in terms of traumas largely reflects the sociohistorical context, while stress defined in terms of life events and hassles reflects an individual's life stage and social roles. In contrast, coping follows a more developmental progression, especially in childhood. Problem-focused coping in early childhood depends upon the neurological development underlying executive function, and increases in specificity and effectiveness increase with age. Very young children rely primarily on their parents for emotion regulation, and gradually increase their ability to use cognitive strategies and become independent regulators. The developmental progress in adulthood is less clear, but there is some evidence to suggest that older adults use more nuanced coping strategies and may be better at emotion regulation than young or middle-aged adults, especially in interpersonal situations.
... Checklists request participants to report whether a number of events occurred during a target time interval, while rating scales instruct them to assess the extent to which these events are stressful. The rating scales based on the subjective evaluation were questioned in several studies (e.g., Dohrenwend et al. 1984), as they can be influenced by health status and personality factors. In this vein, they do not permit to disentangle the contribution of life events on health outcomes from the effect of health and emotional status on the subjective evaluation of stress-related events. ...
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The present study was aimed at investigating the protective role of Global Self-Esteem (GSE) on the relationship between stressful life events and depression. A longitudinal research design, including two measurement occasions with a two-month interval was applied on a sample of 95 university students (80 females) with a mean age of 22.49 (SD = 6.77). A series of scales were administered in both occasions: the Daily Event Checklist (DEC), the Rosenberg Self-Esteem Scale(RSES) and the Center of Epidemiological Study Depression Scale (CES_D). Longitudinal moderated regression models were performed, including DEC, RSES and their interaction (DEC x RSES) as predictors, the baseline level of CES_D as a covariate and the final level of CES_D as criterion. Results showed a negative and significant interaction between predictors, indicating that the prospective effect of stressful life events on depression become weaker as self-esteem increases. Specifically, the detrimental effect of stressful daily life events was observed only at low levels of self-esteem. Similar results were found when a bi-factorial model was applied to the RSES, with the aim to obtain an unbiased estimate of GSE, controlling for potential method effects due to item wording. The main strengths and weaknesses of the study were discussed.
... One of the best ways to examine the microprocesses of the gender-distress relationship is to follow people on a daily basis and record how they traverse fluctuations of daily stressors and the emotional concomitants of these stressors. One problem of previous gender role research was that measures of stressors were based on retrospective and subjective evaluations, thereby leading to potential confounds between stressors and distress; one such problem is reporting bias associated with preexisting emotional impairment in scales of daily stressors that require recall over a week or a month (for a discussion, see Dohrenwend, Dohrenwend, Dodson, & Shrout, 1984;Lazarus, DeLongis, Folkman, & Gruen, 1985). The diary design minimizes this problem by focusing on objective external events and by permitting respondents to report on experiences sooner after their occurrence (Stone, Kessler, & Haythomthwaite, 1991). ...
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This article examines gender differences in psychological distress by assessing men's and women's experience of daily stressors and psychological distress in a sample of 166 married couples. Respondents completed a structured daily diary each day over the course of 42 days. Results showed that women reported a higher prevalence of high distress days and a lower prevalence of distress-free days than men. Gender differences in daily distress were attributable largely to women experiencing more onsets of distress episodes rather than being more likely to continue in a distress state from one day to subsequent days. Results from hierarchical linear models (HLM) indicated that the significant gender differences diminished after respondents' daily stressors were taken into account. Implications of these findings for gender role and rumination theories are discussed.
... Por otro lado, el estudio no está exento de las críticas que subrayan la confusión existente entre lo que se supone que deben medir las escalas de evaluación del estrés y lo que deberían predecir, a saber, los problemas psicológicos, y que señalan el solapamiento existente entre medidas antecedentes y consecuentes del estrés (Dohrenwend, Dohrenwend, Dodson & Shrout, 1984;Lazarus, DeLongis, Folkman & Gruen, 1985). En este sentido, investigaciones futuras deberían tratar de diferenciar los componentes vinculados a la percepción del estrés de los vinculados a las reacciones ante el estrés. ...
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Pese al vínculo entre migración y estrés, no existen cuestionarios que valoren el estrés percibido tanto en el país de llegada como en el país de origen. Este estudio pretende obtener una estructura factorial válida de las dos medidas (general y reciente) del Cuestionario de Estrés Percibido (Perceived Stress Questionnaire, PSQ; Levenstein et al., 1993), aplicadas al proceso migratorio (estrés pre y post-migratorio), que permita su comparación. El instrumento fue aplicado a una muestra de 50 migrantes de nacionalidad peruana. Los resultados muestran correlaciones altas y medias entre el estrés post-migatorio y la mayoría de los síntomas de salud mental del Talbieh Brief Distress Inventory (TBDI; Ritsner, Ravinowitz, & Sluzberg, 1995). La consistencia interna para las escalas obtenidas, fue entre alta y moderada. Conclusión: la versión abreviada del PSQ aparece como un instrumentofiable y estructuralmente válido para evaluar el estrés percibido en los migrantes.
... The first issue concerns the traditional validity notion in measurement theory vs. the logic of reasoning in the study of relationships. Although a potential problem of measurement confounding has been noted by researchers for decades (e.g., Hocevar, 1979;Dohrenwend et al., 1984), 1 the issue continues to slip by unwitting investigators, defile research results, and ruin research designs in the absence of a thorough methodological treatment. Despite all kinds of claims of discovery and validation of the relationships between and among various theoretical constructs, methodologists generally have not been able to look beyond such issues as spurious effects in causal modeling and such strategies as damage control in research design or statistical analysis (Greenland and Morgenstern, 2001). ...
Chapter
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Abstract. This chapter reviews some measurement and analysis issues that are fundamental to social and behavioral sciences research and critical to quantitative study of social support and health. By distinguishing between two basic kinds of research and focusing on issues facing relational analysis, the potential role of traditional validity requirement in causing measurement confounding is exposed. Amendment is made with modified validity (MV) for the study of relationships between theoretical constructs, requiring mutual exclusiveness or clarification of the impact of conceptual overlapping on relational/causal findings. The need for unidimensionalization in composite measurement is also revisited by highlighting its implications to theory development, and systematic treatment including learning from engineering science via the Chen Approaches to Unidimensionalized Scaling (CAUS) reviewed. Implications are discussed by advocating for trying multiple measures, with the measurement effectiveness (ME) principle proposed as an overall performance indicator for comparing the results of various approaches under the guidance of the MV and the CAUS. These ideas are illustrated step by step with an empirical study example to demonstrate how different measures/scales would affect the analysis results of potential relationships. Specific conditions and strategies for achieving the clarified goals in relational research are shown in detail, specifically regarding social support, stress, and depression. Keywords: Quantitative research; relational analysis; validity; theoretical construct; Chen Approaches to Unidimensionalized Scaling (CAUS); measurement effectiveness (ME); social support; stress; depression
... Given various claims of discovery and validation of the relationships among theoretical constructs in social and behavioral sciences, methodologists have not been able to look beyond such issues as spurious effects and statistical control in analytical modeling. Although a potential problem of measurement confounding has been noted by researchers (e.g., Dohrenwend et al., 1984), the issue continues to slip by unwitting investigators, defile research designs, and ruin analysis results in the absence of a thorough methodological treatment. On the other hand, a theorist believing in a construct in its own right never or rarely clarifies its affinities with all other constructs. ...
Chapter
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This article is concerned with the validity of empirical results and the logic of theoretical reasoning behind them. By distinguishing between two kinds of research, the potential role of the validity requirement from psychometrics in causing confounding in relational research is exposed. A modified validity (MV) requirement and conditions for achieving it are articulated. Despite the psychometric purpose of establishing universal scales, the MV subjects all scales used in relational research to modification or the results to further explanation when any overlapping in content occurs. For this reason and for the ultimate purpose of relational research, the criterion of success is not psychometric validity but measurement effectiveness (ME) in a specific analytical setting. By treating measurement and analysis as an integral topic and utilizing the Chen Approaches to Unidimensionalized Scaling (CAUS), a multiple and optimal approach to measurement effectiveness in a relational setting is illustrated with the use of empirical data. Given various claims of discovery and validation of the relationships among theoretical constructs in social and behavioral sciences, methodologists have not been able to look beyond such issues as spurious effects and statistical control in analytical modeling. Although a potential problem of measurement confounding has been noted by researchers (e.g., Dohrenwend et al., 1984), the issue continues to slip by unwitting investigators, defile research designs, and ruin analysis results in the absence of a thorough methodological treatment. On the other hand, a theorist believing in a construct in its own right never or rarely clarifies its affinities with all other constructs. With an overwhelming supply of such theoretical products, confusions persist and cry for a better understanding of the conceptual relationships. This paper is concerned with the validity of empirical results and the logic of theoretical reasoning behind them, an issue fundamental to the social and behavioral sciences. By distinguishing between two kinds of research (Chen, 1998a), the potential role of the validity requirement from psychometrics in causing confounding in relational research will be exposed. By targeting such "misuse of data with a legitimate reason," the paper will explicate the modified validity (MV) requirement and the idea of measurement effectiveness (ME) proposed by Chen (1998b). By treating measurement and analysis as an integral topic and utilizing the Chen Approaches to Unidimensionalized Scaling (CAUS), a multiple and optimal approach to measurement effectiveness in a relational setting is illustrated with the use of empirical data. [Citation: Sheying Chen and Ning Yang Sullivan (2000). Confounding in relational research and its root in psychometrics: The Modified Validity (MV) requirement and the Measurement Effectiveness (ME) Principle. In: Blasius, J., Hox, J., de Leeuw, E., & Schmidt (eds.) (2000), Social Science Methodology in the New Millennium (CD-ROM). Germany: Leske & Budrich.]
... Following victim precipitation theory, Depue and Monroe (1986) and Dohrenwend et al. (1984) suggested that people high in negative affect (NA), including anxious, depressive and neurotic symptoms, through their own behaviour create or enact adverse circumstances. They may, therefore, bring about or contribute to the development of problems and conflicts at work. ...
... The stressor creation mechanism Depue and Monroe (1986) and Dohrenwend et al. (1984) suggested that high NA people by their behavior create or enact adverse circumstances (see also Brief et al., 1988). They may, therefore, create job stressors for themselves. ...
... With its focus on employees' actual experience of stress in the presence of time-related work pressures (Bouckenooghe et al., 2017), this study complements extant research on the consequences of employees' perceptions of workload or role overload for their negative work behaviors (Chen and Spector, 1992;Chiu et al., 2015;Penney et al., 2003;Spector and Fox, 2005;Tucker et al., 2009). In particular, by considering the impact of felt time stress that might result from role overload, this paper details a more proximate cause of CWB: the actual negative emotions experienced, instead of the causes of those emotions (Dohrenwend et al., 1984;Fida et al., 2014;Koys and DeCotiis, 1991). In doing so, this contribution also extends studies that consider other, remote sources of stress as antecedents of negative work behaviors, such as perceived organizational unfairness (Skarlicki et al., 1999), contract breaches (Henderson and O'Leary-Kelly, 2012), organizational politics (Wiltshire et al., 2014) or job insecurity (Chirumbolo, 2015). ...
Article
Purpose With a basis in the conservation of resources theory, the purpose of this paper is to investigate the relationship between employees’ experience of time-related work stress and their engagement in counterproductive work behavior (CWB), as well as the invigorating roles that different deviant personality traits might play in this process. Design/methodology/approach Two-wave survey data with a time lag of three weeks were collected from 127 employees in Pakistani organizations. Findings Employees’ sense that they have insufficient time to do their job tasks spurs their CWB, and this effect is particularly strong if they have strong Machiavellian, narcissistic or psychopathic tendencies. Originality/value This study adds to extant research by identifying employees’ time-related work stress as an understudied driver of their CWB and the three personality traits that constitute the dark triad as triggers of the translation of time-related work stress into CWB.
... In addition, while participants completed distinct measures at home and in person, it is possible that practice effects might have occurred. Finally, casual inference is also limited by our use of self-reported sexism and mental and behavioral health risks, given known confounds between mental health status and reports of stress experiences as well as limitations of same-source reporting bias (Dohrenwend et al., 1984;Meyer, 2003). ...
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Gender-based stressors (e.g., sexism) are rooted in hegemonic masculinity, a cultural practice that subordinates women and stems from patriarchal social structures and institutions. Sexism has been increasingly documented as a key driver of mental and behavioral health issues among women, yet prior research has largely focused on heterosexual women. The current study examined associations between sexism and mental health (i.e., psychological distress) and behavioral health (i.e., alcohol- and drug-related consequences) among sexual minority women (SMW). We also examined whether these associations might be more pronounced among SMW who identify as gender minorities (e.g., gender nonbinary, genderqueer) or are masculine-presenting compared to those who identify as cisgender women or are feminine-presenting. Participants included 60 SMW (ages 19-32; 55.0% queer, 43.3% gender minority, 41.7% racial and ethnic minority) who completed self-report measures of sexism, psychological distress, and alcohol- and drug-related consequences. Results indicated that sexism was positively associated with psychological distress, alcohol-related consequences, and drug-related consequences, respectively. In addition, sexism was associated with worse mental and behavioral health outcomes among SMW who identify as gender minorities or are masculine-presenting compared to SMW who identify as cisgender or are feminine-presenting. Findings provide evidence that the health impact of gender-based stressors among SMW may differ based on whether SMW identify as gender minorities and based on the extent to which SMW violate traditional gender norms.
... The stressor creation mechanism Depue and Monroe (1986) and Dohrenwend et al. (1984) suggested that high NA people by their behavior create or enact adverse circumstances (see also Brief et al., 1988). They may, therefore, create job stressors for themselves. ...
Chapter
Despite literally thousands of research reports on the relationship between stressful circumstances and the onset or exacerbation of illness (Holmes, 1979), controversy remains about their importance. Some investigators claim that there is no compelling evidence for a causal association between stressful circumstances and illness outcomes. In his award-winning lecture to the American Psychopathological Association, Leonard Heston (1988) put these sentiments in strong terms, claiming that “the facts make it clear that searches for specific environmental factors external to the body juices are likely to prove dead ends. Such research has been done too long and too intensely with no result” (p. 212). According to Heston, we need to reorient the direction of our research towards a major redistribution of “human and material resources to hard ball biology” (p. 212).
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This chapter provides a conceptual framework for integrating the life-course research paradigm (Elder, George, & Shanahan, 1996) with the study of late-life stress effects. We discuss and integrate a series of studies, conducted by the authors and associates, that consider diverse ways in which lifelong Stressors and trauma may impact on psychological well-being in later life and on adaptation to old age. The conceptual framework we propose recognizes both temporal and spatial dimensions of Stressors and of their impact on late-life well-being. We also explore temporal and spatial dimensions of resistance resources and of stress impact as we propose a life-course-relevant stress paradigm.
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The investigation of stress and stress-buffering effects has been central to research on psychosocial determinants of mental illness since at least the early 1960s. Most of the early work in this tradition focused on the gross effects of life events (Dohrenwend & Dohrenwend, 1974). There was little interest in stress-buffering effects, although some consideration was given to the modifying effects of social class (Langner & Michael, 1963). More recent research has broadened this focus to consider a much larger range of individual differences and processes that might play a part in modifying the effect of stress on mental health, including personality (Cohen & Edwards, 1989), social support (House, Landis, & Umberson, 1988) and coping (Eckenrode, 1991).
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Sixteen years ago in Mexico Holmes and Rahe's Social Readjustment Rating was validated with 199 women and 223 men between 18 and 38 years old of low and high social class. The purpose was to re-obtain scores used to quantify the degree of stress produced by each life event with a bigger sample. 403 women and 304 men between 20 and 88 years old, of low, middle and high social class participated. Results showed the order of severity of life events was similar to the previous study. Judges 50 years or older, women and those from low social class judged some events as more stressful. © Editorial El manual moderno Fotocopiar sin autorización es un delito.
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Reactivity as a concept (Strelau, 1983) is the psychological obverse of strength of the nervous system (Nebylitsyn, 1972a). Thus, highly reactive people, ones with a weak nervous system, are sensitive to weak stimulation, have a low optimum level of stimulation and arousal, are distractible and lack “functional endurance.” The last term means that they are less able than others to respond adaptively to increasingly intense, prolonged, or repetitive stimulation. Their reaction time, for example, should stop quickening and, in fact, slow down in response to increasingly loud auditory stimuli at a lower volume than is characteristic of low reactives. In technical language, high reactives have a lower “threshold of transmarginal inhibition” than other people (Keuss & Orlebeke, 1977; Nebylitsyn, 1972a). Low reactives, persons with strong nervous systems, of course, show the opposite characteristics.
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There has been recent concern about the degree to which posttraumatic stress disorder (PTSD) symptomatology influences reports of prior exposure to highly stressful life events. In this longitudinal study of 2.942 male and female Gulf War veterans, the authors documented change in stressor reporting across 2 occasions and the association between change and PTSD symptom severity. A regression-based cross-lagged analysis was used to examine the relationship between PTSD symptom severity and later reported stressor exposure. Shifts in reporting over time were modestly associated with PTSD symptom severity. The cross-lagged analysis revealed a marginal association between Time 1 PTSD symptom severity and Time 2 reported stressor exposure for men and suggested that later reports of stressor exposure are primarily accounted for by earlier reports and less so by earlier PTSD symptomatology.
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Some of the major themes developed in the sociology of mental health and in psychiatry are presented here specifically from the point of view of how the family has been perceived over the 20th century. Historically, the family was initially considered the "cause" of mental health problems. Today, in the age of psychiatric desinstitutionalization, it has become a "solution" for keeping patients in their natural living environment. Thus, a major paradigm shift has occurred in going from a pathological model of the family to that of qualified caregiver. With a critical eye, the author presents the stages that have operated this transformation. The family's long journey through the past 100 years will take us to the two topics of research most frequently explored today, namely, caregiver burden and expressed emotion. What we know about families that care for a severely mentally disordered loved one at home remains very limited, however, and the dynamics between families and professionals continue to be characterized by a certain animosity. Even though it is considered a key element in the policy aimed at caring for patients in the community, the family is still only in part recognized as a potentially positive source of influence in the treatment trajectory.
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In recent years many studies have been published on the role played by environmental and behavioral factors in the onset of affective disorders. These studies provide clear evidence that specific kinds of life events, especially those categorized as “threatening” (Brown et al. 1973) or “undesirable” (Paykel et al. 1970), along with chronic difficulties, are related to the onset of depressive episodes and disorders (Brown and Harris 1978, Paykel 1979, Dohrenwend and Dohrenwend 1981, Surtees and Rennie 1983, Paykel 1983). Similar relationships have been suggested by Finlay-Jones and Brown (1983) with respect to the onset of anxiety disorders. Because the statistical relationship between life events and the onset of an affective or anxiety disorder is usually judged to be rather weak (Rabkin and Struening 1976, Dohrenwend et al. 1984), researchers have focused more on factors that may affect the impact that life events have on the subject. A very elaborate, albeit controversial (Tennant and Bebbington 1978), study of this kind (Brown and Harris 1973) suggests the existence of so-called vulnerability factors that increase the risk of depression after the occurrence of life events or difficulties. In the group of women studied, the researchers identified four main vulnerability factors: (1) presence of several children, (2) absence of a confidant relationship, (3) work outside of the home, and (4) loss of mother before the age of 11 (Brown and Harris 1978). A number of other factors have also been investigated. Miller and Ingham (1985) studied the interrelationship of life events with one another (the so-called additive-effect); other researchers discussed the concepts of life strains, the role of the appraisal process in producing stress, the subject’s coping responses to life situations and the role of the social support system (Lin et al. 1981, Billing and Moos 1981, Henderson 1983). Further, Lazarus and Delongis (1983) pointed out the importance of minor everyday life events, the so-called daily hassles. They found the strategy of measuring psychosocial stress superior to the traditional life event approach.
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Introduction: We investigate the relationship between life events stress and psychiatric disorders in a random sample of urban population older than 16 in the Tenerfe Island. Method: A two-stage cross-sectional study was conducted. In the first stage 660 persons were interviewed using the GHQ-28 as a screening questionnaire and the DSM-III-Axis IV for the psychosocial stressors valoration. In the second stage were interviewed all persons screening positive on the GHQ and similar number of the screening negative ones, using the Clinical Interview Schedule. Results: The psychosocial stressors prevalence was 36,5% and the pathology psychiatric prevalence was 12,90%: among 3.3% of the people who do refer psychiosocial stress and 29.5% of the people who do refer. Conclusion: We confirmed a significant relationship between psychosocial stress and psychiatric disorders in both sexes.
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The purposes of this study were to propose a definition of social support as supportive and helping behavior by significant others, and to indicate the importance of identifying specific relationships between the receiver and the provider of support using the subjects of undergraduate students. In study 1, a new measure of perceived availavility of social support based on specific relationships (DSSI) was designed, and its factor structure and reliability were examined. The results showed that DSSI contained four factors (emotional support, advice and guidance, practical support, and behavioral interactions) and had good internal consistency. In study 2, subjects completed DSSI and two measures of psychological distress (depression and loneliness). The main results were that supports from father and mother were negatively correlated with depression, whereas support from same-sex friends were mainly correlated with loneliness. The implications of these findings for the future directions of the study on social support were discussed.
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Importance: Gender minority adults experience higher rates of sexual violence (SV) than cisgender adults. How this disparity extends to youths, including perpetration rates, is unknown. Objective: To compare rates of experience and perpetration of SV by gender identity and investigate characteristics associated with odds of perpetration within gender identity categories. Design, setting, and participants: This cross-sectional study used baseline data from a national online longitudinal survey collected in 2018 to 2020. Eligible participants were youths ages 14 to 16 years who read English and had internet access. Data were analyzed in November 2021 and March 2022. Exposures: Youth characteristics included stressors associated with being marginalized (eg, internalized transphobia), general stressors (eg, trauma not associated with experiencing SV), other marginalized statuses (eg, identifying as a girl), factors associated with protection (eg, social support), environmental characteristics (eg, community violence exposure), and risk factors associated with SV (eg, consumption of violent pornography). Main outcomes and measures: Self-reported rates of experiencing and perpetrating SV, defined as sexual assault, rape, attempted rape, and coercive sex, among cisgender, transgender, and nonbinary youths. Results: Among 4193 youths in the sample (mean [SD] age, 14.8 [0.7] years), 3282 participants (78.3%) were cisgender, 329 participants (7.9%) were transgender, and 582 participants (13.9%) were nonbinary. The odds of SV perpetration were not statistically significantly different for transgender boys and girls (odds ratio [OR], 0.90; 95% CI, 0.57-1.41; P = .64) or nonbinary youths (OR, 0.78; 95% CI, 0.54-1.12; P = .18) compared with cisgender boys and girls. By contrast, transgender boys and girls (OR, 2.31; 95% CI, 1.83-2.91; P < .001) and nonbinary youths (OR, 2.37; 95% CI, 1.98-2.83; P < .001) were more than 2-fold as likely as cisgender boys and girls to report experiencing SV. Aggressive behavior was associated with higher odds of SV perpetration for transgender boys and girls (adjusted OR [aOR], 1.87; 95% CI, 0.75-4.65; P = .18) and nonbinary youths (aOR, 1.61; 95% CI, 0.78-3.32; P = .20). Indications of hostile masculinity were associated with higher odds of SV perpetration among cisgender youths (ie, positive attitudes for boys to engage in rape behaviors: aOR per unit increase in score, 1.15; 95% CI, 1.07-1.25; P < .001; sexual dominance: aOR per unit increase in score, 1.03; 95% CI, 1.01-1.04; P < .001) but not among transgender or nonbinary youths. Conclusion and relevance: These findings may suggest an important foundation for the development of inclusive, research-based SV prevention programs and methods for incorporating gender identity effectively into SV research.
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Whereas class theory and research have offered evidence showing the significant effect of class on the individual's well-being, some researchers think that class has no impact on people in modern society because of reduced inequality in education and profession. In such a modern society as Hong Kong, further arguments suggest that people have vague images of class. This controversy may arise because of the failure to operationalize class. To amend this shortcoming, this study operationalized class by using Wright's (1985) definition. With data from 138 marital couples, it tested a causal model predicting the husband's and wife's well-being by class, through the mediation of problem-solving confidence, received social support, work alienation, pleasant and stressful life events, and income. Analysis via structural equation modeling indicated that well-being was significantly associated with a higher class position. That work alienation mediated the relationship between class and received social support, problem-solving confidence, and well-being supports the significance of class theory.
Chapter
The origins of stress date back to antiquity. In the 14th century, the term stress described social hardship and economic adversity prevalent at the time. The concept of stress remained relatively obscure until physical science adopted the term. Inspired by the work of Robert Hooke, 18th-century physicist Thomas Young defined stress as the “ratio of force within the elastic body, which balances an external applied force, to the area over which the force acts” (Engel, 1985).
Chapter
After we review the basic distinctions among types of stress, and between the biological and engineering models for stress, we elaborate a two-way classification of stressors, based on the chronicity of the stressor and the level of social context at which the stressor occurs. This classification allows a conceptual map of most of the kinds of events and social conditions commonly thought of as stressors. We consider the development of stress research since 2000, with special attention given to the impact of macroevents such as 9/11 on the direction of stress research. We argue that these events have especially directed attention to the study of contextual stressors and traumatic stressors. At the same time, there has also been a steady increase in the study of chronic stressors, in part, due to the affinity between chronic stress and related concepts that echo the problem of structurally based continuous stress—“stress in other words.”
Chapter
Die Zahl der Untersuchungen zu den Themen soziale Unterstützung und soziales Netzwerk hat in den letzten Jahrzehnten stark zugenommen Es ist noch schwierig einzuschätzen, welchen Erkenntniszuwachs die boomartig eingesetzte Konjunktur dieser Konzepte bringen wird. Eine Mischung aus Optimismus und Skepsis ist der Grundton vieler Übersichtsarbeiten (Wellman 1982b; Udris 1982; Keupp u. Rerrich 1982). Soziale Unterstützung wird meist als Schutzfaktor betrachtet, der in den unterschiedlichsten Lebensbereichen die Auswirkungen streßhafter Belastungen abmildert, u.a. auch durch eine Stärkung des Immunsystems (Cassell 1976). Untersucht wurde das menschliche Leben in dieser Hinsicht, wie Udris (1982) es in einer Übersicht ausgedrückt hat, von der Wiege bis zur Bahre. Tatsächlich haben erwünschte Kinder ein höheres Geburtsgewicht als unerwünschte (erwähnt in Cobb 1979, S. 95); dagegen stellt sich der Tod früher ein, wenn die soziale Umgebung verarmt ist (Berkman u. Syme 1979). Was soziale Unterstützung intuitiv ist, kann man sich am besten am Beispiel des Kindes klarmachen, dessen Qualen auf dem Zahnarztstuhl dadurch vermindert werden, daß die Mutter dabei ist.
Chapter
In studies on unemployment and poor health, parameters which are also the topics of research in social, cognitive, and clinical psychology are being investigated.
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Living and coping effectively with HIV-1 infection is an enormous challenge, not only because of the potential lethality of the infection but also because of the chronic nature of illness episodes, which often include frequent hospital stays, and the potential for social discrimination. For the asymptomatic seropositive person infected with HIV-1, the potential for a long latency period (the interval from seroconversion to first symptoms of AIDS) translates the threat of developing AIDS into a chronic Stressor commonly leading to psychological distress. For those who are not infected with the virus but who perceive themselves as being at risk for infection or continue to place themselves at risk because of their high-risk behavior, the threat of AIDS is viewed as a profound Stressor.
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Marriage is associated with reductions in both perceived stress and depressive symptoms, two constructs found to be influenced by common genetic effects. A study of sibling twins was used to test whether marriage decreases the proportion of variance in depressive symptoms accounted for by genetic and environmental effects underlying perceived stress. The sample consisted of 1,612 male and female twin pairs from the University of Washington Twin Registry. The stress-buffering role of marriage was tested relative to two unmarried groups: the never married and the divorced. Multivariate twin models showed that marriage reduced genetic effects of perceived stress on depressive symptoms but did not reduce environmental effects. The findings suggest a potential marital trade-off for women: access to a spouse may decrease genetic effects of perceived stress on depressive symptoms, although marital and family demands may increase environmental effects of perceived stress on depressive symptoms.
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The comorbidity between depression and substance use problems is well-documented, yet little research has investigated how stigma associated with one's depression might relate to alcohol and drug use. The current study examined the association between depression-related stigma and substance use coping and considered the role of emotion dysregulation (i.e., difficulty in monitoring, evaluating, and modulating one's emotional reactions) as a mechanism underlying this association. A sample of individuals who self-identified as having current or remitted depression (N = 218) completed self-report measures of depression-related stigma, emotion dysregulation, and tendency to rely on alcohol or drugs to cope with psychological distress. Depression-related stigma was positively associated with emotion dysregulation, which was in turn associated with a greater tendency to engage in substance use coping. These findings provide initial support for the role of stigma as a contributor to maladaptive coping responses, such as substance use, among people living with depression. Further, they underscored the potential utility of targeting emotion dysregulation in stigma coping and substance abuse prevention intervention efforts.
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Community inclusion refers to equal opportunities for people to participate in the community and willingness to welcome and active community attitude. The opportunity to participate in the community is both a medical necessity and a rights issue. This concept provides a novel theoretical framework for the advancement of mental health policies, programs, and global practices that enable the development of the well-being and health of people with mental disorders. Eleven fundamentals for promoting community inclusion of individuals with serious mental illnesses that are supported by key conceptual, theoretical, and research evidence. These fundamentals reflect beliefs and schemas that need to be present to truly prioritize and facilitate inclusion, intervention strategies and achieve the most impactful objectives that were expected. The greater inclusion, greater community participation, which includes work, education, religion and spiritual participation, and other domains associated with having a life that makes sense, all of which generates physical, cognitive and mental benefts for anyone, disregarding the presence or absence of a mental disorder. The concept of community inclusion offers a transformative next step in the delivery of mental health services that clearly articulates community participation in meaningful areas as the target for promoting full health and wellness.
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Introduction: Despite the understanding of allostatic load (AL) as a consequence of ongoing adaptation to stress, studies of the stress-AL association generally focus on a narrow conceptualization of stress and have thus far overlooked potential confounding by personality. The present study examined the cross-sectional association of objective and subjective stress with AL, controlling for Big Five personality traits. Methods: Participants comprised 5,512 members of the Copenhagen Aging and Midlife Biobank aged 49-63 years (69% men). AL was measured as a summary index of 14 biomarkers of the inflammatory, cardiovascular, and metabolic system. Objective stress was assessed as self-reported major life events in adult life. Subjective stress was assessed as perceived stress within the past four weeks. Results: Both stress measures were positively associated with AL, with a slightly stronger association for objective stress. Adjusting for personality traits did not significantly change these associations. Conclusions: The results suggest measures of objective and subjective stress to have independent predictive validity in the context of personality. Further, it is discussed how different operationalizations of stress and AL may account for some of the differences in observed stress-AL associations.
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Background: Many existing scales for microstressor assessment do not differentiate between objective (ie, observable) stressor events and stressful cognitions or concerns. They often mix items assessing objective stressor events with items measuring other aspects of stress, such as perceived stressor severity, the evoked stress reaction, or further consequences on health, which may result in spurious associations in studies that include other questionnaires that measure such constructs. Most scales were developed several decades ago; therefore, modern life stressors may not be represented. Ecological momentary assessment (EMA) allows for sampling of current behaviors and experiences in real time and in the natural habitat, thereby maximizing the generalization of the findings to real-life situations (ie, ecological validity) and minimizing recall bias. However, it has not been used for the validation of microstressor questionnaires so far. Objective: The aim is to develop a questionnaire that (1) allows for retrospective assessment of microstressors over one week, (2) focuses on objective (ie, observable) microstressors, (3) includes stressors of modern life, and (4) separates stressor occurrence from perceived stressor severity. Methods: Cross-sectional (N=108) and longitudinal studies (N=10 and N=70) were conducted to evaluate the Mainz Inventory of Microstressors (MIMIS). In the longitudinal studies, EMA was used to compare stressor data, which was collected five times per day for 7 or 30 days with retrospective reports (end-of-day, end-of-week). Pearson correlations and multilevel modeling were used in the analyses. Results: High correlations were found between end-of-week, end-of-day, and EMA data for microstressor occurrence (counts) (r≥.69 for comparisons per week, r≥.83 for cumulated data) and for mean perceived microstressor severity (r≥.74 for comparisons per week, r≥.85 for cumulated data). The end-of-week questionnaire predicted the EMA assessments sufficiently (counts: beta=.03, 95% CI .02-.03, P<.001; severity: beta=.73, 95% CI .59-.88, P<.001) and the association did not change significantly over four subsequent weeks. Conclusions: Our results provide evidence for the ecological validity of the MIMIS questionnaire.
Thesis
This thesis investigates some putative relationships between relevant psychosocial fectors (PSFs) and two types of dental disorder, namely, inflammatory periodontal diseases and tooth wear. The first study investigated possible associations between a number of PSFs and adult onset rapidly progressive periodontitis (RPP). It was shown that there was a significant relationship between the combined PSFs and the three periodontal diagnoses of RPP, routine chronic adult periodontitis (RCAP) and no significant periodontal destruction (control group). The RPP group presented significantly more depression and loneliness than the RCAP and control groups. The second study investigated whether a number of PSFs could predict dental plaque levels in a group of patients with two forms of chronic periodontitis (CP): RPP and RCAP. Because gender, smoking and education have been associated with neglect of oral hygiene, their role as predictors of plaque was also examined. In addition, this study investigated whether RPP and RCAP patients differ significantly on plaque and smoking, before their periodontal treatment. It was found that the PSFs were not significant predictors of plaque, and that only gender contributed significantly to the prediction of plaque. Females had significantly less plaque than males, and the RPP and RCAP patients did not differ significantly on plaque. However, RPP patients smoked significantly more than RCAP patients, and there was a marginally significant correlation between depression and smoking. The third study investigated putative associations between a number of PSFs and tooth wear with a significant component of attrition. The results suggested that attrition-tooth-wear patients differed significantly fi-om controls only on trait anxiety. Overall, it was concluded that the PSFs are not equally associated with different forms of CP, they may be of importance to periodontal destruction via a mechanism other than neglect of oral hygiene, and trait anxiety might worsen attrition. Suggestions were made for further research.
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Background: Stress is a major risk factor for the impairment of psychological well-being. The present study aimed to evaluate the empirical evidence of the Transactional Stress Model proposed by Lazarus and Folkman in patients with psychosomatic health conditions. Methods: A structural equation model was applied in two separate subsamples of inpatients from the Department of Psychosomatic Medicine (total n = 2,216) for consecutive model building (sample 1, n = 1,129) and confirmatory analyses (sample 2, n = 1,087) using self-reported health status information about perceived stress, personal resources, coping mechanisms, stress response, and psychological well-being. Results: The initial model was created to reflect the theoretical assumptions by Lazarus and Folkman about their transactional stress concept. This model was modified until a sufficient model fit was reached (sample 1: CFI = 0.904, TLI = 0.898, RMSEA = 0.072 [0.071-0.074], SRMR = 0.061). The modified model was confirmed in a second sample (sample 2: CFI = 0.932, TLI = 0.928, RMSEA = 0.066 [0.065-0.068], SRMR = 0.052). Perceived external stressors and personal resources explained 91% of the variance of the stress response, which was closely related to symptoms of depression (63% variance explained). The attenuating effect of resources on stress response was higher (standardized β = -0.73, p < 0.001) than the impact of perceived stressors on stress response (standardized β = 0.34, p < 0.001). Conclusion: The empirical data largely confirmed the theoretical assumption of the Transactional Stress Model, which was first presented by Lazarus and Folkman, in patients with a wide range of psychosomatic conditions. However, data analyses were solely based on self-reported health status. Thus, proposed inner psychological mechanisms such as the appraisal process could not be included in this empirical validation. The operationalization and understanding of coping processes should be further improved.
Article
Background: Sexual minority men report high rates of childhood sexual abuse (CSA) and adulthood suicidality. However, mechanisms (e.g., PTSD symptoms) through which CSA might drive suicidality remain unknown. Objective: In a prospective cohort of sexual minority men, we examined: (1) associations between CSA and suicidal thoughts and behaviors; (2) prospective associations between CSA-related PTSD symptoms and suicidal ideation; and (3) interpersonal moderators of these associations. Participants and setting: Participants included 6305 sexual minority men (Mage = 33.2, SD = 11.5; 82.0% gay; 53.5% White) who completed baseline and one-year follow-up at-home online surveys. Methods: Bivariate analyses were used to assess baseline demographic and suicidality differences between CSA-exposed participants and non-CSA-exposed participants. Among CSA-exposed participants, multivariable logistic regression analyses were used to regress passive and active suicidal ideation at one-year follow-up on CSA-related PTSD symptoms at baseline. Interactions were examined between CSA-related PTSD symptoms and interpersonal difficulties. Results: CSA-exposed sexual minority men reported two-and-a-half times the odds of suicide attempt history compared to non-CSA-exposed men (95% CI = 2.15-2.88; p < 0.001). Among CSA-exposed sexual minority men, CSA-related PTSD symptoms were prospectively associated with passive suicidal ideation (adjusted odds ratio [aOR] = 1.38; 95% CI = 1.19; 1.61). Regardless of CSA-related PTSD symptom severity, those with lower social support and greater loneliness were at elevated risk of active suicidal ideation at one-year follow-up. Conclusions: CSA-related PTSD symptom severity represents a psychological mechanism contributing to CSA-exposed sexual minority men's elevated suicide risk, particularly among those who lack social support and report loneliness.
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