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Prenatal exposures to chemical and psychosocial stressors can impact the developing brain, but few studies have examined their joint effects. We examined associations between prenatal phthalate exposures and child behavior, hypothesizing that prenatal stressful life events (PSLEs) may exacerbate risks. To do so, we harmonized data from three U.S. pregnancy cohorts comprising the ECHO-PATHWAYS consortium. Phthalate metabolites were measured in single mid-pregnancy urine samples. When children were ages 4-6 years, mothers completed the Child Behavior Checklist (CBCL), from which a Total Problems score was calculated. Mothers additionally provided recall on their exposure to 14 PSLEs during pregnancy. Primary models examined problem behaviors in relation to: (1) phthalate mixtures calculated through weighted quantile sums regression with permutation test-derived p-values; and (2) joint exposure to phthalate mixtures and PSLEs (counts) using interaction terms. We subsequently refitted models stratified by child sex. Secondarily, we fit linear and logistic regression models examining individual phthalate metabolites. In our main, fully adjusted models (n = 1536 mother-child dyads), we observed some evidence of weak main effects of phthalate mixtures on problem behaviors in the full cohort and stratified by child sex. Interaction models revealed unexpected relationships whereby greater gestational exposure to PSLEs predicted reduced associations between some phthalates (e.g., the metabolites of di-2-ethylhexyl phthalate, di-n-octyl phthalate, di-iso-nonyl phthalate) and problem behaviors, particularly in males. Few associations were observed in females. Additional research is needed to replicate results and examine potential mechanisms.

Background: Offspring of parents with affective disorders (OAD) are at risk of developing a wide range of mental disorders. Deficits in the rearing environment and high levels of stress are well‐known risk factors for negative outcomes in OAD. Building on prior research, we aim to examine the longitudinal relationships between family dysfunction, stressful life events, and mental health in OAD and control offspring of parents with no affective disorder. In the present study, we hypothesized that high levels of family dysfunction would be associated with more internalizing and externalizing problems across time in OAD than in controls, and that family dysfunction would mediate the relationship between stressful life events in adolescence and poor mental health in adulthood, particularly in OAD. Methods: As part of the TRacking Adolescents' Lives Survey (TRAILS), 2230 participants (51% female, Mage = 11.1 years, SD = 0.6, at baseline) and their parents completed measures across six time points, spanning 15 years. Mental health, family dysfunction, and stressful life events were assessed with the Youth and Adult Self‐Report, Family Assessment Device, and an in‐house measure, respectively. Results: Multi‐group structured equation modeling revealed that family dysfunction was linked to internalizing and externalizing problems in OAD, but not controls, across time. Risk status did not moderate family dysfunction's mediation of the relationship between stressful life events and negative outcomes in adulthood. Conclusions: OAD show high sensitivity to dysfunction in the rearing environment across childhood and adolescence, which supports the use of family based interventions to prevent the development of mental disorders in high‐risk youth. [ABSTRACT FROM AUTHOR]

With the gradual penetration of the Internet into the study and life of college students, the Internet not only brings convenience to young adults but also becomes a new channel for them to engage in deviant behaviors. This study explores the relationship between stressful life events and college students' online deviant behaviors, as well as the mediating role of negative automatic thoughts and the moderating role of perceived social support. Data is drawn from 448 college students (Mage = 20.10, SDage = 1.74). Results showed that stressful life events were significantly positively correlated with online deviant behaviors, and negative automatic thoughts mediated the relationship between stressful life events and online deviant behaviors. The relationship between stressful life events and online deviant behaviors, as well as that between negative automatic thoughts and online deviant behaviors, were both moderated by perceived social support. This study provides a practical guiding value for effectively preventing and intervening in college students' online deviant behaviors and maintaining the regular order of the online society. [ABSTRACT FROM AUTHOR]

In this study, we investigate how the accumulation of stressful life events and chronic stressors experienced in adolescence predict young adults' future self-identification (i.e., connectedness, vividness, and valence of the future self) in a sample of 1482 Swiss youth. Furthermore, we investigate future self-identification as a source of resilience mediating the association between accumulated stressful life events on the one hand, and increased delinquency and less educational attainment on the other. In line with our hypothesis, we found that experiencing more stressful life events predicted reduced future self-connectedness. This was not the case for vividness and valence of the future self. Furthermore, we found that future self-connectedness partially mediated the association between stressful life events and low educational attainment. Lastly, latent class trajectories revealed that there was no association between the timing of stressful life events – whether in early or late adolescence – and future self-identification. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsResultsConclusionThis paper focuses on the relationship between stressful life events experienced by young refugees and their reports of psychological and somatic stress symptoms and well-being. It examines whether this relationship is mediated by personal and social resources and by acculturation hassles experienced in the host country.Path analyses were calculated based on data from 147 adolescents aged 11 to 18 years from the Middle East after their flight to Germany to test the proposed mediation model.The number of experienced stressful life event types was directly linked to current psychological and somatic stress symptoms. The association with psychological stress symptoms was partially mediated by acculturation hassles experienced in the host culture. Well-being was not related to stressful life events but showed significant associations with available social resources. A closer inspection of the mediation by acculturation hassles showed that discrimination hassles and socio-cultural adaptation hassles are important mediators in the relationship between stressful life events and the included outcome variables.The results indicate that stressful life events as well as resources and acculturation hassles should be considered in measures to improve the adjustment of young refugees. [ABSTRACT FROM AUTHOR]

Resumen: Antecedentes: La adolescencia es un periodo importante del desarrollo en el que pueden aparecer problemas psicológicos, incluyendo conducta suicida. Además, experimentar acontecimientos vitales estresantes (AVEs) puede contribuir a su aparición, aunque el impacto de distintos tipos de AVEs ha sido escasamente examinado. Este estudio pretende analizar asociaciones entre diferentes AVEs, problemas psicológicos, bienestar subjetivo y conducta suicida en adolescentes. Se desarrolló un nuevo instrumento -Stressful Life Events Checklist for Adolescents (SLECA)- donde los AVEs se clasificaron como: leves/graves, dependientes/independientes, interpersonales/no-interpersonales y crónicos/episódicos. Método: Se incluyeron dos oleadas. 5.610 adolescentes participaron en la primera y 2.312 en la segunda. Resultados: Los AVEs graves-dependientes-interpersonales-episódicos se asociaron fuertemente a problemas exteriorizados; los AVEs graves-dependientes-no-interpersonales-episódicos mostraron la más alta relación con problemas de atención e hiperactividad; y los AVEs graves-independientes-crónicos se asociaron tanto a bajo bienestar subjetivo como a problemas interiorizados. Los AVEs académicos y relacionados con problemas con los iguales se relacionaron con problemas psicológicos y bajo bienestar subjetivo. Controlando por variables de salud mental, la conducta suicida se asoció a AVEs graves-independientes-crónicos y los relacionados con la victimización y problemas con la sexualidad. Conclusiones: El SLECA es un instrumento útil para evaluar AVEs en adolescentes, desenredando las interrelaciones entre AVEs, salud mental y conducta suicida. [ABSTRACT FROM AUTHOR]

Background: Stressful life events are associated with higher odds of suicidal thoughts and behaviors. Furthermore, stressful life events can trigger specific symptoms, including the suicidal narrative and suicide crisis syndrome, resulting in an increased risk of suicidal thoughts and behaviors. This study examined the moderating role of suicide risk in the relationship between stressful life events, the suicidal narrative, and the suicide crisis syndrome. Methods: 2,260 adults completed an online survey recruited through advertisements on social media. The level of emotional distress was assessed through the Suicide Narrative Inventory, Suicide Crisis Inventory-2, Stressful Life Events Questionnaire, and Mini International Neuropsychiatric Interview. The PROCESS macro (Hayes) was used to analyze the moderation models. Results: Stressful life events were positively correlated with the suicidal narrative and suicide crisis syndrome. The effects of stressful life events on suicidal narrative and suicide crisis syndrome were strongest when suicide risk was low and weakest when suicide risk was high. Conclusions: These findings suggest that including stressful life events as part of suicide risk assessment in general and clinical settings is critical to managing treatment for suicidal thoughts and developing adaptive coping. [ABSTRACT FROM AUTHOR]

The aim of the study was to analyze the differences in suffering stressful life events (SLE) among women experiencing homelessness who had or had not been in prostitution. Data were collected from a sample of 135 women experiencing homelessness in Madrid. A total of 81% of the women interviewed had never been in prostitution, while 19% had been in prostitution at some point in their lives. Participants were recruited from shelters, drop-in centers, and public spaces. The information was collected using a structured interview. The results showed that women experiencing homelessness who had been in prostitution suffered a greater number of SLE, both in childhood and adolescence and throughout life. The interviewed who had been in prostitution were between two and nine times more likely to have experienced during their childhood and adolescence violence in their family, as well as to have run away from home, experienced abuse, attempted suicide, and used drugs excessively. Furthermore, during their lifetime, the interviewed who had been in prostitution were between two and four times more likely to suffer from serious physical and mental health issues, excessive alcohol consumption, intimate partner violence, physical violence from others, suicide attempts, police reporting, and unwanted pregnancies. Additionally, they were four to six times more likely to have been sexually assaulted or convicted/imprisoned for a crime, seven times more likely to have been arrested, and a striking 32 times more likely to have used drugs excessively. [ABSTRACT FROM AUTHOR]

Strategies of prevention for psychiatric disorders need a deep understanding of the aetiological factors involved in the psychopathological processes. Our twin study aims at disentangling the contributions of genes and environment to schizotypal and hypomanic dimensions, considering the role of stressful life events (LEs) and the quality of family relationships. The Magical Ideation Scale (MIS) and Perceptual Aberration Scale (PAS) were used to assess positive schizotypy, while Hypomanic Personality Scale (HPS) and its sub-scales were used to investigate proneness to affective disorders. 268 twins (54.5 % female; aged 18.0 ± 6.68) were included. Participants filled out a questionnaire on LEs and their parents provided an evaluation of intra-family relationship (Relationship Quality Index, RQI). Classic univariate twin models for quantitative traits were fitted for scales, and the effects of covariates (LEs and RQI) were assessed. For MIS, HPS and its sub-scales, significant common and unique environmental effects were detected, with genetic factors affecting only HPS Social Vitality sub-scale. Unique environment was the only source of variance of PAS score. The number of recent LEs influenced MIS and PAS models, while RQI score affected MIS model. The main limitation of the study is the small sample size, which reduces statistical power and may potentially lead to an underestimation of heritability. Additionally, the cross-sectional design limits the possibility to draw causal considerations. Findings provide preliminary evidence for a significant environmental role in modulating states of vulnerability. Moreover, the expression of positive schizotypy resulted influenced by recent stressors and intra-family relationships. • Twin studies aid at inferring the role of gene and environment on phenotypes. • Findings showed a crucial role of environment in modulating states of vulnerability; • Genetic factors affected only Social Vitality; • Expression of positive schizotypy was influenced by recent stressors; • The intra-family relationship showed an important role for MIS. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic increased the mortality rate in the U.S. and exposed many to the unexpected death of someone close. No prior research has assessed whether the COVID-19 pandemic was followed by an increase in bereavement during pregnancy, and whether patterns varied by race and ethnicity. Using data from the Pregnancy Risk Assessment Monitoring System from 2017–2021 across 23 U.S. sites (N = 107,226), we assessed trends in the odds of experiencing the death of someone close before and after the onset of the COVID-19 pandemic. Findings revealed an increased percentage of women who reported having someone close to them die in the year prior to childbirth after the start of the COVID-19 pandemic (March 2020 or later) (aPR=1.121, 95 % CI (1.079 – 1.165). Analysis by mother's race and ethnicity showed death of someone close increased significantly after the COVID-19 pandemic for Hispanic (aPR = 1.192, 95 % CI = 1.062, 1.337), non-Hispanic Black (aPR = 1.115, 95 % CI = 1.015 – 1.225), and American Indian-Alaskan Native pregnant women (aPR = 1.391, 1.023 – 1.891) compared to White, Non-Hispanic pregnant women. Increased bereavement among pregnant women during the COVID-19 pandemic warrants routine grief screening and response training in prenatal care. [ABSTRACT FROM AUTHOR]

Suicide is a serious public health problem and is the fourth leading cause of death among adolescents. Suicide ideation is the most significant predictor of suicide. However, few empirical studies have examined the relationship between stressful life events, insomnia, depression symptoms, self‐esteem, and suicide ideation among college students. This study builds on O'Connor's The integrated motivational‐volitional model of suicidal behavior theory will verify the relationship between these five factors through a large data study among college students, and further reveal the mechanisms and interventions of suicide ideation among college students. A total of 2717 (mean age = 19.81 years, 22.49% male) college students from South China participated in this behavioral and health survey. Using self‐reported questionnaires which were Adolescent Self Rating Life Events Check‐list, MINI‐C, Insomnia Severity Index, PHQ‐9, and Self‐Esteem Scale to assess the subjects' demographic information, suicide ideation, stressful life events, insomnia, depressive symptoms, and self‐esteem levels as comprehensively as possible. A moderated chain mediation model was used to validate their relationship. The results showed that stressful life events significant positively predicted insomnia symptoms, depressive symptoms, and suicide ideation. The mediating effect of depression between stressful life events and suicide ideation was significant. The chain mediating effect of insomnia and depression between stressful life events and suicide ideation was significant. However, the mediating effect of insomnia between stressful life events and suicide ideation was not significant. Also, the positive prediction of stressful life events and depression on suicide ideation was weaker when the individual's self‐esteem level was higher, and the moderated chain mediating effect was significant. This study developed a moderated chain mediation model, and proposes a new integrated stress coping‐self‐perception model of suicide ideation to discover the important role of self‐esteem levels in adolescent suicide prevention. Practitioner Points: Examined the relationship between stressful life events, suicidal ideation, insomnia, depression, and self‐esteem.Data from 2717 (mean age = 19.81 years, 22.49% male) college students were included.Proposed a new integrated stress coping‐self‐perception model of suicide ideation. [ABSTRACT FROM AUTHOR]

Elevated inflammatory activity is one possible pathway through which exposure to childhood adversity engenders risk for physical and psychiatric illnesses. Limited research has investigated the compounding effects of childhood and adolescent stress exposure on changes in circulating levels of inflammatory biomarkers. This study assessed whether childhood adversity interacted with chronic or acute stress during adolescence to affect the temporal trajectories of five inflammatory biomarkers across at least three blood draws in a diverse sample of adolescents (N = 134; observations = 462). Using multilevel modeling, the interaction of childhood adversity, time, and within-person variance of acute stressors significantly predicted trajectories of higher interleukin-10 levels, controlling for demographics, medication use, and body mass index. Adolescents with high levels of childhood adversity who were exposed to a higher frequency of acute stressors compared to their own average rate of stress exposure consistently had higher levels of IL-10 as they got older, but those with average and below frequency of acute stressors had decreasing trajectories of log IL-10 as they matured. The results demonstrate how events early in life shape biological responses to the adolescent environment. This study also highlights the importance of developmental timing on the bodys enhanced reactivity to acute and sustained stressors following childhood adversity.

Exposure to stressful life events (SLE) around the time of pregnancy is associated with adverse health outcomes for mothers and children. Previous New Zealand research found Indigenous Māori women are more likely to be exposed to SLE than non-Māori, and are exposed to a higher number of SLE. The consequences of this for ethnic inequities in child health outcomes are unknown. This paper examines the relationship between patterns of maternal SLE exposure with child health and development outcomes at age 3 years, for Indigenous and non-Indigenous children. We found most children had a stressful early life environment at least sometimes, but more than a quarter of Māori children had a mother experiencing multiple SLE on all occasions measured. We found a clear association between maternal experiences of SLE and disordered child sleep and development concerns. While not able to fully assess the contribution of maternal SLE to ethnic inequities in child health outcomes, we did clearly demonstrate that more Māori children have mothers exposed to multiple SLE, and that these maternal SLE are associated with poorer child outcomes. The impacts of chronic SLE exposure need to be better understood, especially given the large ethnic disparity in chronic SLE exposure.

BackgroundsInsomnia is frequent in schizophrenia and is found to be negatively affected by stressful life events， psychotic symptoms and depressive disorder， while the relationship among the four remains understudied in community-dwelling patients with schizophrenia.ObjectiveTo analyze the effect of stressful life events on insomnia in community-dwelling patients with schizophrenia， and to explore the mediation effect of psychotic symptoms and depression， so as to provide references for the intervention of insomnia in community-dwelling patients with schizophrenia.MethodsFrom April to June 2023， a sample of 1 105 patients with schizophrenia attending 48 community health centers in Chengdu， Sichuan province and fulfilling the International Classification of Diseases， tenth edition （ICD-10） diagnostic criteria were included. All subjects were assessed using Stressful Life Event Scale （SLEs）， Athens Insomnia Scale （AIS）， Psychosis Screening Questionnaire （PSQ）， and Patient Health Questionnaire Depression Scale （PHQ-9）. Spearman correlation analysis was used to determine the correlation among the scales. Then the mediation model was constructed using Smart PLS 4.0， and tested with partial least squares algorithm and Bootstrap techniques.Results332 patients （30.05%） with community schizophrenia were found to have insomnia. AIS scores in patients with schizophrenia were positively correlated with the scores on SLEs， PSQ and PHQ-9 （r=0.165， 0.322， 0.554， P

Youths face significant mental health challenges exacerbated by stressful life events, particularly in the context of the COVID-19 pandemic. Immature coping strategies can worsen mental health outcomes. This study utilised a two-wave cross-sectional survey design with data collected from Chinese youth aged 14–25 years. Wave 1 (N = 3038) and Wave 2 (N = 539) datasets were used for model development and external validation, respectively. Twenty-five features, encompassing dimensions related to demographic information, stressful life events, social support, coping strategies, and emotional intelligence, were input into the model to predict the mental health status of youth, which was considered their coping outcome. Shapley additive explanation (SHAP) was used to determine the importance of each risk factor in the feature selection. The intersection of top 10 features identified by random forest and XGBoost were considered the most influential predictors of mental health during the feature selection process, and was then taken as the final set of features for model development. Machine learning models, including logistic regression, AdaBoost, and a backpropagation neural network (BPNN), were trained to predict the outcomes. The optimum model was selected according to the performance in both internal and external validation. This study identified six key features that were significantly associated with mental health outcomes: punishment, adaptation issues, self-regulation of emotions, learning pressure, use of social support, and recognition of others' emotions. The BPNN model, optimized through feature selection methods like SHAP, demonstrated superior performance in internal validation (C-index [95 % CI] = 0.9120 [0.9111, 0.9129], F-score [95 % CI] = 0.8861 [0.8853, 0.8869]). Additionally, external validation showed the model had strong discrimination (C-index = 0.9749, F-score = 0.8442) and calibration (Brier score = 0.029) capabilities. Although the clinical prediction model performed well, the study it still limited by self-reported data and representativeness of samples. Causal relationships need to be established to interpret the coping mechanism from multiple perspectives. Also, the limited data on minority groups may lead to algorithmic unfairness. Machine learning models effectively identified and predicted mental health outcomes among youths, with the SHAP+BPNN model showing promising clinical applicability. These findings emphasise the importance and effectiveness of targeted interventions with the help of clinical prediction model. • Developed a novel feature selection method in machine learning for a high-performance youth mental health prediction model. • Identified key factors associated with youth mental health using machine learning, informing future interventions. • Revealed youths' latent capacity to recover from stressful life events. [ABSTRACT FROM AUTHOR]

There is scarce data concerning the relationship between negative life events (NLEs)* and current and new depressive episodes by age. Cross-sectional (baseline) and prospective analyses (4-year/8-year follow-ups) were performed in 15,105 civil servants in 6 cities in Brazil classified according to age strata at baseline: 1st(35–44), 2nd(45–54), 3rd(55–64), and 4th(65–74) years. The independent variable was NLEs in the last year (robbery, hospitalization, death of a relative, financial hardship, and rupture of a love relationship) collected at baseline. The dependent variable was depressive episodes assessed at baseline (current), and 4-year/8-year follow-ups (new). We built logistic (Odds Ratio[OR];95 % Confidence Interval[CI]) in the cross-sectional analysis and Poisson regression models (Relative Risk[RR], [CI]) in the prospective analysis. Robbery, hospitalization, financial hardship, rupture of a relationship were associated with current depressive episodes concentrated in the 35–44 age range, while for new depressive episodes, the association of hospitalization, death of a relative, and financial hardship were concentrated in the 45–54 age stratum. Financial hardship was associated with current depressive episodes in all age-strata: 1st: OR, 2.77(CI, 1.83–4.19); 2nd: OR, 1.71(CI, 1.26–2.34); 3rd: OR, 1.68(CI,1.15–2.46); 4th, OR, 4.07(CI, 1.24–13.34), and new depressive episodes: 1st: RR, 1.45(CI, 1.09–1.93); 2nd RR, 1.46(CI: 1.15–1.84); 3rd: RR, 1.97(CI, 1.38–2.82). Rupture of a relationship was associated only with current depressive episode, while death of a relative only with new depressive episode. We cannot rule out the possibility of recall bias, since NLEs' information was self-reported. The association between NLEs with depressive episodes was concentrated in youngers. • The association between negative life events with prevalent and incident depression was concentrated in the youngers. • The association of negative life events with prevalent and incident depression decreases with ageing. • Financial hardship was the negative life event most associated do prevalent and incident depression. [ABSTRACT FROM AUTHOR]

Exposure to stressful life events (SLE) around the time of pregnancy is associated with adverse health outcomes for mothers and children. Previous New Zealand research found Indigenous Māori women are more likely to be exposed to SLE than non-Māori, and are exposed to a higher number of SLE. The consequences of this for ethnic inequities in child health outcomes are unknown. This paper examines the relationship between patterns of maternal SLE exposure with child health and development outcomes at age 3 years, for Indigenous and non-Indigenous children. We found most children had a stressful early life environment at least sometimes, but more than a quarter of Māori children had a mother experiencing multiple SLE on all occasions measured. We found a clear association between maternal experiences of SLE and disordered child sleep and development concerns. While not able to fully assess the contribution of maternal SLE to ethnic inequities in child health outcomes, we did clearly demonstrate that more Māori children have mothers exposed to multiple SLE, and that these maternal SLE are associated with poorer child outcomes. The impacts of chronic SLE exposure need to be better understood, especially given the large ethnic disparity in chronic SLE exposure. [ABSTRACT FROM AUTHOR]

Abstract Background Medical students frequently face challenges in academic adjustment, necessitating effective support and intervention. This study aimed to investigate the impact of stressful life events on medical students’ academic adjustment, focusing on the mediating roles of depression and anxiety. It also differentiated the impacts between at-risk students (those with academic failures) and their peers respectively. Methods This case-control study involved 320 at-risk medical students and 800 other students from a university in western China. Participants anonymously completed the scales of stressful life events, depression, anxiety, and academic adjustment. T-tests, ANOVA, Pearson correlation, and structural equation modeling were employed for statistical analysis. Results Depression and anxiety were significantly more prevalent in at-risk students (46.8% and 46.1%, respectively) than in controls (34.0% and 40.3%, respectively). Notably, at-risk students had poorer academic adjustment (t = 5.43, p

Objectives: This study investigated the prevalence of suicidal ideation (SI) among Chinese medical students and its associated risk factors. Methods: A total of 6643 medical students (2383 males/4260 females) were recruited from a medical college in Hebei Province, China. Demographic data were collected via a self-administered questionnaire. The Childhood Trauma Questionnaire Short Form (CTQ-SF) was used to evaluate childhood maltreatment (CM), and the Adolescent Self-Rating Life Events Checklist (ASLEC) was used to evaluate the stressful life events. Suicidal ideation was assessed using the Beck Scale for Suicide Ideation (BSSI). Univariate and multivariate logistic regression models were used to analyze the factors affecting SI. Results: The prevalence of SI in medical students was 11.5% (763/6643). Multivariate logistic regression analysis revealed that SI was significantly associated with younger age, a female sex, being lovelorn, being introverted, experiencing CM during childhood, and experiencing stressful life events within the past 12 months. Of the five subtypes of CM, emotional abuse may have the strongest effect on SI (OR=2.76, 95% CI: 1.72-4.42). The joint effects of CM and stressful life events were significantly associated with an increased risk of SI (OR=5.39, 95% CI: 4.15-6.98). Conclusion: The prevalence of SI among medical students is high, and medical students who have experienced CM and stressful life events have a higher tendency towards SI. Screening for both CM and stressful life events may be an effective way of identifying individuals at high risk of SI. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Stressful life events are events that do not fulfil the A criterion of PTSD in the DSM‐5(TR) but are perceived as negative by the person. There is an ongoing debate about the usefulness of the A criterion as a gate criterion for PTSD, and especially regarding which events qualify as traumatic or stressful life events. This debate is particularly important for individuals with intellectual disabilities (ID) or borderline intellectual functioning (BIF), as they seem to be more likely to experience traumatic and stressful life events than their peers without ID‐BIF and appear to be more susceptible to the disruptive effects of these events. As a result, people with ID‐BIF are more likely to develop mental health and behavioural problems. There is insufficient knowledge about how the relationship between stressful life events and PTSD symptoms should be interpreted, how traumatic and stressful life events are defined and distinguished in people with ID, and whether the A criterion should be broadened for individuals with ID‐BIF. The aim of this scoping review was to understand stressful life events and their relationship with PTSD symptoms, other mental health and/or behavioural problems in individuals with ID‐BIF.The scoping review was conducted in accordance with the JBI methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Extension for Scoping Reviews (PRISMA‐ScR).Thirty‐eight studies were included. Five studies focused on stressful life events and PTSD symptoms. The other studies examined associations between stressful life events and other mental health and/or behavioural problems. Most of the studies did not clearly differentiate between stressful and traumatic events according to the A criterion of PTSD in the DSM‐IV (TR) or DSM‐5(TR). Of the six studies in which stressful life events were specified and could be distinguished from traumatic events, one found a positive association between PTSD symptoms and stressful life events and five showed weak to strong positive associations with other mental health and/or behavioural problems.PTSD symptoms following stressful life events in individuals with ID‐BIF are underrepresented in the literature. The lack of a clear definition of stressful life events leads to a gap in the knowledge on whether and how stressful life events may lead to PTSD symptoms, other mental health and/or behavioural problems in individuals with ID‐BIF. Therefore, no general conclusions or recommendations can be made regarding the appropriateness of the PTSD A criterion for individuals with ID‐BIF. Further research is needed to establish the role of stressful life events in relation to PTSD symptoms and to inform the assessment and effective treatment in people with ID‐BIF, as expert clinical experience studies suggest that broadening the PTSD A criterion should be considered for people with ID‐BIF. [ABSTRACT FROM AUTHOR]

Resilience, or successful coping with the experience of stressful life events (SLEs), protects against depression, but its operational mechanisms are unclear. Views diverge whether resilience intervenes as a trait or as a process of dynamic interactions of protective factors, such as self-esteem, social support and family cohesion. We evaluated five theoretically-based models of how resilience, defined as either a trait or a process, interacts with recent SLEs, to explain depressive symptomatology in 2434 university students. The moderating effect of problematic, age-inappropriate parenting (i.e., helicopter parenting) was also assessed. SLEs moderated both the effects of trait and process resilience on depression, but models conceptualising resilience as a dynamic process of interacting components showed better explanatory power than models conceptualising resilience solely as a trait. Trait resilience was protective through self-esteem at all levels of SLEs exposure (low, mild, moderate or high), and significantly, but less so through hope or social support. Experiencing helicopter parenting weakened the protective influence of process resilience, through decreasing family cohesion in the presence of SLEs. The overall assessment of the five models supports a process conceptualisation of resilience to depression in the face of adversity. However, the results also suggest that not all protective factors are equally important, with self-esteem appearing a significant and strong mediator of resilience to depression in all models including it as a variable. Building process resilience is proposed as a key intervention target for depressive symptoms. Clinical assessments and interventions following SLEs should routinely consider both trait resilience and self-esteem, as the interaction of these two factors protects against depression even at the highest levels of adversity exposure. Depression prevention approaches should address the individual's experience of overparenting, given the deleterious influence of helicopter parenting on resilience. [ABSTRACT FROM AUTHOR]

Obsessive-compulsive disorder (OCD) is a prevalent condition with multifactorial etiology involving genetic and environmental factors. The present study aims to summarize the correlates of stressful life events (SLEs) in OCD by reviewing studies comparing OCD associated or not with SLEs before its onset. To do so, a systematic review was performed by searching PubMed, Web of Science, Scopus, and PsycINFO databases for studies published between the database's inception and November 27, 2023. Studies including individuals whose OCD was precipitated or not by SLEs (SLEs OCD and NSLEs OCD, respectively) were assessed. Effect sizes or odds ratios were then calculated to identify the strength of association between SLEs and clinical characteristics, such as gender, age of onset, family history of OCD, severity of OCD symptoms, depressive symptoms, and mood comorbidities among patients with OCD. Out of the 4083 records initially identified, 5 studies met the inclusion criteria and 3 were comparable through a meta-analysis. Notably, the analyses were limited by the small number of studies available in the literature. The meta-analysis demonstrated SLEs OCD to be associated with female gender, later OCD onset, and increased comorbidity rates with mood disorders. Despite the cross-sectional nature of the reviewed studies, women may be more vulnerable to develop a later onset of OCD following SLEs, which may also lead to mood disorders. Caution is needed to avoid prematurely classifying this presentation as a distinct subtype of OCD. [ABSTRACT FROM AUTHOR]

Several autism‐related characteristics, such as social difficulties, may contribute to high perceived stress and increased exposure to stressful life events in some autistic individuals. Repeated exposure to stress might lead to the dysfunction of the hypothalamic–pituitary‐adrenocortical‐axis and be a vulnerability factor for developing mental health difficulties. Previous studies show contradictory findings on salivary cortisol in autism. In the current study, we investigated diurnal cortisol profiles in autistic adolescents and young adults, as well as their associations with social difficulties, stress exposure, and mental health symptoms. Autistic (n = 48, Mage = 17.6) and nonautistic (n = 51, Mage = 18.4) participants collected salivary cortisol at home six times a day for 2 days. Social difficulties, exposure to stressful life events/bullying, and mental health symptoms were assessed with questionnaires and clinical interviews. Similar diurnal cortisol slopes (DCS) and cortisol awakening responses were observed between the groups, but autistic participants showed higher total cortisol output (AUCG, area under the curve with respect to ground) during the day (b = 19.09, p = 0.009). In the autistic group, more severe social difficulties were associated with flatter DCS (b = 0.01, p = 0.007). Finally, cortisol alterations were associated with self‐reported mental health symptoms, especially in autistic females in analyses uncorrected for multiple comparisons. In conclusion, our results do not indicate autism‐related group‐level alterations in most diurnal cortisol measures, but autistic youth showed higher total cortisol (AUCG) compared with nonautistic peers. More detailed investigation of interindividual variability in cortisol profiles within autistic people might give us important insights into vulnerability to developing stress‐related mental health difficulties. Lay Summary: Cortisol is a glucocorticoid hormone the levels of which fluctuate following the body's daily rhythm over a 24‐hour cycle (i.e. circadian rhythm). Cortisol levels can also be altered due to perceived stress or other factors. We investigated whether daily cortisol rhythms differ in autistic and nonautistic adolescents and young adults. Most daily cortisol measures did not differ between the groups, but autistic youth showed higher cortisol levels than nonautistic youth. Moreover, in autistic participants, more severe social difficulties were associated with greater fluctuation in cortisol throughout the day. More detailed investigation of the observed variability in cortisol rhythms might help us to understand the vulnerability to stress‐related mental health difficulties. [ABSTRACT FROM AUTHOR]

Researchers have proposed that culture significantly influences perceived stress (PS). To date, however, twin studies on PS have been conducted mostly in western, individualistic cultures, which demonstrate that PS due to controllable (personal) life events is more heritable than PS due to uncontrollable (network) life events. This study aimed to investigate genetic and environmental influences on PS in South Korean twins. South Korea practices a dominant collectivist culture. In total, 1372 twin individuals (mean age = 22.4 ± 2.5 years) completed an online survey on PS, which consisted of the scales, Friendship, Academic Stress, Future Career, Family Conflicts, and Family Financial Difficulties (FFD). Friendship, Academic Stress, and Future Career can be considered PS due to personal life events, and Family Conflict and FFD, PS due to network life events. The general sex-limitation model-fitting analysis revealed the absence of qualitative or quantitative sex differences in genetic and environmental influences. Specifically, additive genetic influences were predominant for Friendship (63%), Academic Stress (67%), and Future Career (57%) for both sexes, with the remaining variance attributable to nonshared environmental influences. In contrast, shared environmental influences were largest for Family Conflict (47% for both genders) and FFD (64% for males, 63% for females) with no significant genetic effects. Despite known cultural differences in the means and variances of PS, South Korean twins exhibited significant genetic effects in PS due to personal life events and large shared environmental effects in PS due to network life events, which is similar to western samples. [ABSTRACT FROM AUTHOR]

Numerous studies have pointed to the strong impact of stressful life events on subjective stress and indirectly on the adolescents' mental health. However, the results of many such studies contain bias caused by the choice of measurement method or an incomplete theoretical framework. To estimate the extent of possible bias when using self‐reports, we conducted research on a representative sample of 2201 Croatian adolescents aged 14–18 years. Using manipulation we examined the influence of measurement method and the number of constructs included in the model on the variance of subjective stress explained by stressful events. Structural equation modelling indicated that different measurement methods, occurrence‐based and severity‐based, provide a marked discrepancy in the impact size estimation. The occurrence‐based method provided estimates of a much smaller proportion of the explained variance (6%–25%) compared to the severity‐based approach, which estimated the explained variance in the range of 25%–55% depending on the model. The complexity of the tested models additionally contributed to the variation in the estimates. It is recommended that when using self‐reports to measure stressful life events, occurrence‐based and severity‐based methods are used simultaneously and that impact estimates are expressed within intervals. [ABSTRACT FROM AUTHOR]

Stressful life events (SLEs) and suicidal ideation (SI) are prevalent in persons with major depression disorder (MDD). Less is known about the underlying role of insomnia symptoms in the association between SLEs and SI. This three-wave prospective cohort study sought to investigate the longitudinal association among SLEs, insomnia symptoms, and SI in persons with MDD. The study population included 511 persons with MDD (mean [SD] age, 28.7 [6.7] years; 67.1% were females). Generalized estimated equations (GEEs) were utilized to explore prospective association among exposure of SLEs, insomnia symptoms, and SI. Additionally, a structural equation model (SEM) was employed to estimate the longitudinal mediating effect of insomnia symptoms in the relationship between SLEs and SI. Our study demonstrated that cumulative SLEs were determined to be longitudinally associated with SI in persons with MDD. We further observed that the association between SLEs and SI was significantly mediated by insomnia symptoms. Clinicians assessing persons with MDD, especially those with the history of SLE, could carefully evaluate and promptly treat insomnia symptoms as part of personalized assessment of their depressive illness, thereby achieving early prevention and intervention for suicidal behaviors in persons with MDD. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed at examining the concurrent associations between stressful life events and borderline personality disorder (BPD) features in a clinical sample of young people. The moderating role of parental support and self-esteem was investigated (i.e., stress buffering). In a subsample, short term changes in BPD features were examined at a 6-month follow-up. Method: The total sample consisted of 318 young people (ages 12-26). Regression analyses were conducted to examine the link between stressful events, parental support, self-esteem, and BPD features. Prospective regression analyses were conducted in a subsample (N = 138). Results: Results indicate that stressful life-events and (low) self-esteem were related to more BPD features at wave 1. However, these associations did not hold in the prospective analyses. Also, no support was found for a stress-buffering effect. Discussion: The discrepancy between the concurrent and the prospective findings suggest that stressful events and self-esteem may be intertwined with BPD features, rather than predictive of change in BPD features 6 months later. [ABSTRACT FROM AUTHOR]

Problem gambling poses serious harm to individuals and societies worldwide. This study aims to investigate the relationship between stressful life events and problem gambling, and further explore the mediating role of coping strategies and magical thinking. Currently, the research on problem gambling is widely conducted worldwide. However, due to the unique characteristics of China's gambling industry, research on problem gambling conducted in the Chinese mainland has always been an underrepresented area in international gambling research. This study recruited participants from a province in central China, and data from 483 of them were ultimately analyzed. The data analysis results indicate that task-oriented coping, emotion-oriented coping, avoidance-oriented coping, and magical thinking all serve as mediators in the relationship between stressful life events and problem gambling. Emotion-oriented coping and magical thinking, avoidance-oriented coping and magical thinking, all serve as serial mediators in the relationship between stressful life events and problem gambling. Task-oriented coping and magical thinking did not act as serial mediators in this relationship. This study demonstrates that helping problem gamblers develop effective coping strategies and reduce their level of magical thinking is crucial for treating their problem gambling. [ABSTRACT FROM AUTHOR]

The present paper aims to introduce a constructivist narrative intervention for Narrative Identity Reconstruction (NIR) in working with clients with a history of stressful life events (SLE). This intervention is based on a proposed conceptual framework explaining how SLE affects narrative identity. First, we provide a conceptual model to show the theoretical links between SLE and narrative identity through the three functions of making meaning, unity, and purpose. The present conceptualization proposes that concepts of meaning-making, self-concept clarity, and agency should improve for narrative identity reconstruction. For designing therapy steps, we were inspired by the procedure of the Life Design process for reconstructing narrative identity. We defined the following steps: (a) construct self-story through small stories, (b) deconstruct these stories, (c) reconstruct them into an identity narrative or life portrait, and (d) co-construct intentions that lead to the next action episode in the real world. We hope NIR can help clients construct a robust self-narrative in which the SLE is not a confusing and distressing experience leading to a broken narrative; instead, it can make sense and integrate into the bigger picture of self-narrative. It is suggested that future research empirically examine the NIR to explore the feasibility and effectiveness of the intervention in mental health settings. [ABSTRACT FROM AUTHOR]

BackgroundLatin American youth have a high prevalence of mental health disorders and face major socioeconomic and public safety problems. This study assesses the association between stressful life events (SLEs) and depression, anxiety, and quality of life among adolescents and young adults from deprived neighbourhoods of Latin America.MethodsThe sample consisted of 2,402 participants, between adolescents (15–16 years) and young adults (20–24 years), from Bogotá (Colombia), Buenos Aires (Argentina), and Lima (Peru), assessed in 2021–2022 and recruited in education and community settings and social media. We evaluated the most frequent recent and distant SLEs (occurred in the previous year and more than a year ago, respectively), the relationship between SLEs and severity of depression (PHQ-8), anxiety (GAD-7), and quality of life (MANSA), and we tested for differences by gender and age group.ResultsThe most common recent and distant SLEs were related to public safety issues and financial distress. Accidents and school suspensions were more frequent among men, and sexual harassment and bullying among women. Every additional reported recent SLE increased the odds of mild, moderate, and severe depression (18, 17, and 25%, respectively) and anxiety (10, 17, and 21%, respectively) symptoms. Similar trends were found with distant SLEs and depression (8, 9, and 11% for mild, moderate, and severe symptoms, respectively) and anxiety (9, 11, and 12%, respectively). Furthermore, a higher number of recent and distant SLEs were associated with lower quality of life (β = −0.05, p

Yan Jin,1 Yiju Wang,2 Shusen Liu,3 Sifang Niu,4 Hao Sun,1 Yan Liu,5 Ning Liu6 1School of Clinical Medicine, Jining Medical University, Jining, Shandong, 272002, People’s Republic of China; 2School of Mental Health, Jining Medical University, Jining, Shandong, 272002, People’s Republic of China; 3School of Pharmacy, Harbin University of Commerce, Harbin, Heilongjiang, 150076, People’s Republic of China; 4School of Public Health, Binzhou Medical University, Binzhou, Shandong, 264003, People’s Republic of China; 5School of Public Health, Jining Medical University, Jining, Shandong, 272002, People’s Republic of China; 6School of Basic Medicine, Jining Medical University, Jining, Shandong, 272067, People’s Republic of ChinaCorrespondence: Yan Liu; Ning Liu, Email hakunaly@163.com; 631864@qq.comAim: Stressful life events have a significant impact on the mental health of college students. Depression, as a prevalent psychological issue, has garnered attention in the field of college student mental health and is closely linked to it. Additionally, parenting style is identified as an important factor influencing the development of college students’ mental health. Therefore, this study aims to explore the relationship between these three factors.Methods: A total of 8079 first-year college students from two medical universities in Shandong Province, China were surveyed. The Beck Depression Inventory was utilized to evaluate depressive symptoms among the college students, while the Adolescent Self-rating Life Events Checklist and the Egna Minnen Beträfande Uppfostran were employed to gather data. Subsequently, the SPSS macro program PROCESS was utilized to analyze both the mediating and moderating effects. All statistical analyses were conducted using SPSS 26.0.Results: The study found a detection rate of 6.3% for depressive symptoms among college students. The correlation analysis of this study showed that the stressful life events of college students were significantly positively correlated with depressive symptoms (r=0.261, p< 0.01). Each dimension of parenting style was associated with depressive symptoms in different degrees and directions. At the same time, parenting styles of all sizes play a partial mediating role between stressful life events and depressive symptoms in college students, gender plays a crucial regulatory role in this mediation.Conclusion: Stressful life events experienced by college students have a significant impact on their mental health. Early intervention through positive parenting styles from parents may prove to be beneficial in promoting the development of good mental health among college students.Keywords: college students, stressful life events, depressive symptoms, parenting style, gender

Purpose Stressful life events have the capacity to disrupt an individual’s worldview and life goals, leading to existential questions and identity loss. The subjective perception of identity is intricately linked with quality of life (QoL), and how individuals derive meaning from these stressful life events significantly influences their well-being. This article explored the impact of stressful life events on individuals’ QoL, and examined the potential for enhancing QoL through meaning making and narrative reconstruction. Methods Qualitative interviews were conducted with 11 individuals reporting diminished QoL and analysed using thematic analysis. Results The study reveals that stressful life events confront interviewees with the vulnerability of their values in life and the limits of their control, leading them to question their own beliefs and purpose in life. Consequently, these events prompt individuals to reconstruction their narratives to adapt to new life circumstances. Conclusions The study suggests that “securing the base,” including strong social relations and security in economic and housing conditions, is a prerequisite for enhancing QoL. The insights on “the base” have profound implications for QoL. Recognizing their fundamental importance, policymakers, healthcare professionals, and social service providers can support mechanisms to enhance these foundations, improving overall well-being for individuals and communities.

ABSTRACTThis study explored the susceptibility of inner-city youth to stressful life events. It employed the Conservation of Resources (COR) theory to elucidate the impact of stressful events on their psychological distress. It tested the applicability of the Conservation of Resources Evaluation (COR-E) scale, previously used only on adults, on an inner-city youth sample comprising 309 Israeli adolescents from high-risk urban schools. Participants completed the Stressful Life Events Screening Questionnaire (SLESQ), an adapted version of the COR-E, and the Short Brief Symptom Inventory (BSI-18). Unique resource categories emerged, grounded in the youths’ immediate environment. Positive correlations were established between resource loss and stressful life events, and heightened resource loss was associated with increased psychological distress. The study underscores the utility of the COR framework in comprehending the intricate relationship between psychosocial resource loss and the psychological well-being of inner-city youth.

This multiwave longitudinal study examined the effects of stressful life events on anxiety symptoms and their dimensions among adolescents, as well as the impact of urban and rural residential backgrounds on their development. The participants were 1,027 adolescents from two independent samples in Hunan Province, China. During the initial assessment, adolescents from urban and rural areas completed standardized assessments of anxiety and its dimensions and stressful life events. They completed the same assessments monthly for 6 consecutive months following the initial assessment. Hierarchical linear model analysis was undertaken to examine the relationships between the variables. Results revealed that stressful life events were predictive of different anxiety symptoms in adolescents. Notably, the impact of stressful life events on separation/panic was significantly greater for rural-dwelling than for urban-dwelling adolescents (p <.001). The results of the present study provide partial support for the vulnerability–stress model in adolescents. More specifically, the results of the study partially support the hypothesis that urban–rural residential background is a vulnerability factor in the separation/panic dimensions but not in the physical symptoms, harm avoidance, or social anxiety dimensions of anxiety following negative stress in Chinese adolescents. [ABSTRACT FROM AUTHOR]

To examine the role of COVID-19-specific stressful life events (SLE) in predicting depression, anxiety, and life satisfaction, and if personality traits (extraversion and neuroticism), and coping styles (problem-focused coping and avoidance coping) moderated these relations. Data were collected from 371 college students (Mage = 20.59; SDage = 2.58) from one large university of the Mid-Atlantic region in the U.S. Participants completed an online survey measuring COVID-19 related stressful life events (adapted from a tool developed to measure stressful life events during the SARS pandemic; Costa et al., 2001; Main et al., 2011), personality (the Mini-Markers; Saucier, 1994), coping styles (by using a measure developed by Aldrige-Gerry et al., 2011), depression (PHQ-9; Kroenke et al., 2011), anxiety (GAD-7; Spitzer et al., 2006), and life satisfaction (Student's Life Satisfaction Scale, Huebner, 1996) between March 27th and April 27th, 2020. Path analysis results showed that extraversion and avoidance coping style moderated the effects of SLE on depression and anxiety symptoms; neuroticism and avoidance coping style moderated the relation between SLE and life satisfaction. The moderation results also differed by gender. These findings indicated that the COVID-19 pandemic had deleterious effects on college students' mental health, where extraversion emerged as a protective factor, while neuroticism and avoidance coping style were risk factors. These findings underscore the importance of paying special attention to college students' mental health needs and promoting appropriate coping strategies in the light of the current pandemic. [ABSTRACT FROM AUTHOR]

Objectives Disruptive life events, such as the coronavirus disease 2019 (COVID-19) pandemic, may trigger adjustment and revision of older adults' identities. This mixed-methods study explored how older adults perceived their identities changing as a result of the pandemic, and how such identity dynamics related to pandemic-related events and well-being. Methods Participants included 2,248 older adults who participated in the longitudinal COVID-19 Coping Study spanning from April/May 2020 to April/May 2021. Mean age was 67.8 years, 70% were women, and 93% were White. We used qualitative thematic analysis to identify the ways the pandemic affected participants' identities. We then investigated the association between identity themes and testing positive for COVID-19, having a friend or family member hospitalized or dying due to COVID-19, or being vaccinated. Finally, we tested whether identity disruption was associated with 12-month trajectories of well-being (including life satisfaction, loneliness, depressive symptoms, anxiety, and self-rated health) using latent growth curve models. Results Some participants reported positive identity themes, such as rethinking and revising priorities and realization of strength and resilience. Others indicated harmful effects, including identity disruption. Individuals reporting identity disruption had worse well-being at baseline and remained consistently worse over time. Discussion Findings highlight that identity remains malleable in later life and that stressful events like the COVID-19 pandemic may trigger positive adaptive identity processes, but can also cause identity disruption that is associated with persistently worse well-being over time. [ABSTRACT FROM AUTHOR]

The purpose of the study is to analyse the stressful life events (SLEs) suffered by 62 people living homeless (32 men; 30 women) in Nicaragua, and how the different SLEs are related to patterns and trajectories in homelessness. The sample was classified based on SLEs, and the relationship between the resulting subgroups and sociodemographic characteristics, homelessness trajectories, health, substances consumption, social support, and outlook for the future was examined. Results suggest that a three-cluster solution was theoretically and structurally meaningful: (a) Cluster A was mainly characterized by a higher prevalence of SLEs and problems in the family from an early age, consisting of young people consuming substances, primarily drinking alcohol and sniffing glue; (b) Cluster B was characterized by low levels of SLEs, but with alcohol problems; and (c) Cluster C was characterized by a high number of violent SLEs from an early age, made up of people an older age group, who have been living homeless for longer and in suffering from poor health. Increased knowledge about the different subgroups and trajectories of people living homeless in Nicaragua can help with the design of public policy, intervention programs and social care tools that are sensitive to these differences. [ABSTRACT FROM AUTHOR]

College students in the U.S. and China have faced significant challenges during COVID-19. Data were collected from 120 Amerian students (Mage = 19.48, SDage = 1.30) and 119 Chinese students (Mage = 18.61, SDage = 0.91) in November, 2019 and March, 2020 to examine risk and protective factors for mental health (depression, anxiety, life satisfaction) during the pandemic, and potential cultural and gender differences. Results indicated that the frequency and impact of COVID-19-related stressful life events predicted deterioration of mental health over time, while social connectedness before the pandemic buffered the negative impact of COVID-19 stressful life events on life satisfaction. Chinese students reported higher levels of social connectedness and larger impact of COVID-19-related stressful life events, but lower frequency of stressful life events than American students. Stressful life events and social connectedness predicted mental health outcomes similarly for Chinese and American students. Gender differences were identified. Females reported more stressful life events, higher levels of depression, anxiety and less life satisfaction during COVID-19 than males. In addition, the frequency of stressful life events had a stronger impact on depression and anxiety for females compared with males. It is important to implement prevention and intervention programs to promote social connections and wellbeing among college students, especially among female students. [ABSTRACT FROM AUTHOR]

The link between stressful life events (SLE) and cardiovascular diseases (CVD) remains underexplored. This study aimed to examine the association between SLE and the diagnosis of heart disease or stroke, among older adults. Data from 678 participants from the population‐based cohort EPIPorto, with ≥60 years and complete information regarding SLE and heart disease or stroke, were analysed. Stressful life events were measured through the 'Stressful Life Events Screening Questionnaire'. A previous diagnosis of heart disease or stroke was self‐reported. Adjusted odds ratios (OR) with the respective 95% confidence intervals were computed through logistic regression. Almost a fourth of the participants never experienced any SLE throughout life, 30.0% experienced at least one event, 17.5% experienced two and 27.7% had experienced three or more SLE. A dose‐effect association between SLE and the diagnosis of heart disease or stroke was observed, statistically significant for those who had at least 3 types of SLE, independently of confounders (≥3SLE vs. 0SLE: OR = 2.00; 95% CI: 1.12–3.57). This cross‐sectional study suggests that cumulative exposure to different types of SLE during the life course was associated with a higher likelihood of having a diagnosis of heart disease or a stroke at a later age. Future longitudinal studies should better deepen this association, particularly by evaluating which type of SLE is more related to a higher prevalence of heart disease and stroke, and how the timing of the SLE influence this relation. [ABSTRACT FROM AUTHOR]

Despite the growing evidence that stressful life events are associated with adolescent non-suicidal self-injury (NSSI), few studies have investigated the mediating and moderating mechanisms underlying this link. The current study examined whether sleep quality mediated the link between stressful life events and NSSI and whether this mediating process was moderated by adolescent sensation seeking. The participants were 1006 Chinese adolescents (48.21% boys; mean age = 13.16 years, SD = 0.67). They completed the Life Events Checklist, Pittsburgh Sleep Quality Index, UPPS-P Impulsive Behavior Scale, and NSSI Questionnaire. The PROCESS macro for SPSS was used to examine the hypothesized moderated mediation model. The results showed that sleep quality significantly mediated the positive association between stressful life events and adolescent NSSI. Moreover, this mediating pathway was moderated by sensation seeking. Specifically, the risk impact of stressful life events on NSSI through sleep quality was significant only among adolescents with high-level sensation seeking but not among those with low-level sensation seeking. These findings provide intervention insights to reduce the risk of adolescent NSSI. [ABSTRACT FROM AUTHOR]

Although genetic and environmental factors are involved in the aetiology of bipolar disorder [BD], studies focused on their interplay are lacking. The current investigation examines interactions and correlations between polygenic risk scores [PRS] for BD and major depressive disorder [MDD] with stressful life events [SLEs] in liability for BD. This study used data from 1715 participants (862 bipolar cases and 853 controls) taken from UK and Canadian samples. The List of Threatening Experiences Questionnaire recorded SLEs that occurred 6 months before interview for controls and 6 months prior to the first (Canadian sample) and worst (UK sample) depressive and manic episodes for bipolar cases. PRS-BD and PRS-MDD were calculated from the Psychiatric Genomics Consortium. For the worst depressive episode, the PRS-MDD was significantly correlated with total number of SLEs (β = 0.13, 95 % CI:0.04–0.22, p = 0.003) and dependent SLEs (β = 0.09, 95 % CI:0.02–0.16, p = 0.007). After correction for multiple testing nominally significant correlations were detected for PRS-BD with total number of SLEs (β = 0.11, 95 % CI:0.02–0.20, p = 0.015) and dependent SLEs (β = 0.08, 95 % CI:0.01–0.15, p = 0.019). Among bipolar cases, these associations were slightly stronger but were only of nominal significance for total number of SLEs (PRS-MDD: β = 0.19, 95 % CI:0.04–0.35, p = 0.015; PRS-BD: β = 0.16, 95 % CI:0.01–0.32, p = 0.042) and dependent SLEs (PRS-MDD: β = 0.14, 95 % CI:0.03–0.26, p = 0.015; PRS-BD: β = 0.12, 95 % CI:0.004–0.24, p = 0.043). No other significant gene-environment correlations or interactions were found. Use of a larger sample size would be beneficial. The relationship between SLEs and genetic risk for mood disorders may be best explained through correlations rather than interactions. • Bipolar studies focused on the gene-stressful life event interplay use candidate genes but bipolar disorder is polygenic. • This study examined the relationship between stressful life events and polygenic risk for mood disorders using 2 samples • The polygenic risk score for bipolar disorder (PRS-BD) and major depressive disorder (PRS-MDD) were used in this study • Stressful life events experienced before the worst depressive episodes were found to significantly correlate with PRS-MDD • No evidence for significant interactions between stressful life events and the PRS-BD or PRS-MDD were observed [ABSTRACT FROM AUTHOR]

Objectives Stressful life events, such as going through divorce, can have an important impact on human health. However, there are challenges in capturing these events in electronic health records (EHR). We conducted a scoping review aimed to answer 2 major questions: how stressful life events are documented in EHR and how they are utilized in research and clinical care. Materials and Methods Three online databases (EBSCOhost platform, PubMed, and Scopus) were searched to identify papers that included information on stressful life events in EHR; paper titles and abstracts were reviewed for relevance by 2 independent reviewers. Results Five hundred fifty-seven unique papers were retrieved, and of these 70 were eligible for data extraction. Most articles (n  = 36, 51.4%) were focused on the statistical association between one or several stressful life events and health outcomes, followed by clinical utility (n  = 15, 21.4%), extraction of events from free-text notes (n  = 12, 17.1%), discussing privacy and other issues of storing life events (n  = 5, 7.1%), and new EHR features related to life events (n  = 4, 5.7%). The most frequently mentioned stressful life events in the publications were child abuse/neglect, arrest/legal issues, and divorce/relationship breakup. Almost half of the papers (n  = 7, 46.7%) that analyzed clinical utility of stressful events were focused on decision support systems for child abuse, while others (n  = 7, 46.7%) were discussing interventions related to social determinants of health in general. Discussion and Conclusions Few citations are available on the prevalence and use of stressful life events in EHR reflecting challenges in screening and storing of stressful life events. [ABSTRACT FROM AUTHOR]

Stressful life events (SLEs) constitute key risk factors for depression. However, previous studies examining associations between SLEs and depression have been limited by focusing on single events, combining events into broad categories, and/or ignoring interrelationships between events in statistical analyses. Network analysis comprises a set of statistical methods well-suited for assessing relationships between multiple variables and can help surpass several limitations of previous studies. We applied network analysis using mixed graphical models combining two large-scale population-based samples and >34,600 randomly sampled adults to investigate the associations between SLEs and current depressive symptoms in the general population. Numerous SLEs were uniquely associated with specific symptoms. Strong pairwise links were observed between SLEs during the past year and individual symptoms, e.g., between having experienced illness or injury and sleeping problems, having been degraded or humiliated and feeling blue, and between financial problems and hopelessness and being worried and anxious. Several SLEs, such as financial problems, sexual abuse, and having been degraded or humiliated, were associated with symptoms across more than one timepoint. More recent SLEs were generally more strongly associated with depressive symptoms. Several life events were strongly interrelated, such as multiple forms of abuse, and financial problems, unemployment, divorce, and serious illness or injury. Limitations include a retrospective SLE measure, cross-sectional data, a brief self-report measure of depressive symptoms, and possible attrition bias in the sample. Our findings may have implications for public health efforts seeking to improve population mental health. • Stressful life events were associated with depressive symptoms in the general population using a network analysis approach. • Numerous stressful life events were uniquely associated with specific symptoms. • Several stressful life events were strongly interrelated. • More recent SLEs were more strongly associated with depressive symptoms. [ABSTRACT FROM AUTHOR]

Background and Aims: The high prevalence of internet addiction (IA) has become a worldwide problem that profoundly affects people's mental health and executive function. Empirical studies have suggested trait anxiety (TA) as one of the most robust predictors of addictive behaviors. The present study investigated the neural and socio-psychological mechanisms underlying the association between TA and IA. Methods: Firstly, we tested the correlation between TA and IA. Then we investigated the longitudinal influence of TA on IA using a linear mixed effect (LME) model. Secondly, connectome-based predictive modeling (CPM) was employed to explore neuromarkers of TA, and we tested whether the identified neuromarkers of TA can predict IA. Lastly, stressful life events and default mode network (DMN) were considered as mediating variables to explore the relationship between TA and IA. Findings: A significant positive correlation between TA and IA was found and the high TA group demonstrated higher IA across time. CPM results revealed that the functional connectivity of cognitive control and emotion-regulation circuits and DMN were significantly correlated with TA. Furthermore, a significant association was found between the neuromarkers of TA and IA. Notably, the CPM results were all validated in an independent sample. The results of mediation demonstrated that stressful life events and correlated functional connectivity mediated the association between TA and IA. Conclusions: Findings of the present study facilitate a deeper understanding of the neural and socio-psychological mechanisms linking TA and IA and provide new directions for developing neural and psychological interventions. [ABSTRACT FROM AUTHOR]

Emotional/behaviour problems and exposure to stressful life events are thought to contribute to new onset of urinary incontinence (UI) amongst children who have attained bladder control. However, very few prospective studies have examined these associations. We assessed whether mental health problems and stressful life events were associated with subsequent new onset in UI using multivariable logistic regression in a prospective UK cohort (n = 6408). Mothers provided information on their child's symptoms of common mental disorders (Development and Wellbeing Assessment, 7 years), stressful life events (7–8 years) and wetting (day and night, 9 years). There was strong evidence that separation anxiety symptoms were associated with new-onset UI in the fully adjusted model (OR (95% CI) = 2.08 (1.39, 3.13), p < 0.001). Social anxiety, attention-deficit hyperactivity disorder and oppositional defiant disorder symptoms were associated with new-onset UI, but these associations attenuated following adjustment for child developmental level and earlier emotional/behaviour problems. There was weak evidence for a sex interaction with stressful life events (p = 0.065), such that females experiencing more stressful life events were at higher risk of new-onset UI (fully adjusted model OR (95% CI) = 1.66 (1.05, 2.61), p = 0.029), but there was no association in males (fully adjusted model OR (95% CI) = 0.87 (0.52, 1.47), p = 0.608). These results suggest that separation anxiety and stressful life events in girls may lead to an increase in UI. [ABSTRACT FROM AUTHOR]

Background: A small number of studies are available to assess the role of stressful life events (SLEs) in obsessive-compulsive disorder (OCD). The previous studies have reported contradictory results and they have methodological limitations. Aims and Objectives: The objectives of our study are (i) to find out the frequency of life events in patients with OCD in comparison to their matched healthy controls and (ii) to find out the impact of life events on the severity of the disorder. Materials and Methods: Sixty patients fulfilling Diagnostic and Statistical Manual of Mental Disorder, 5th edition (DSM-V) criteria of OCD were rated with Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Hamilton Rating Scale for Anxiety (HAM-A), Hamilton Rating Scale for Depression (HAM-D), and Presumptive Stressful Life Events Scale (PSLES). A group of 60 normal controls were also rated on PSLES. Finally, both groups were compared in terms of life events. Results: The frequency of life events, past 1 year (t=5.307, P=0.006) and lifetime (t=11.527, P

Background: Psychological stress can cause various mental and physical health problems. The previous results on stress and oral health are inconsistent, possibly because of the narrow stress measurements. We aimed to examine the association between a broader range of stressful life events and oral health among workers. Methods: This cross-sectional study analyzed anonymous individual data from a national survey in Japan. Data on stressful life events, oral health problems which are one or more of tooth pain, gum swelling/bleeding, and difficulty chewing, and covariates were obtained using a self-reported questionnaire. Covariates used included gender, age group, and disease under treatment. Logistic regression analysis was used to estimate the association between stressful life events and oral health problems. We then estimated the causal treatment effects of stress using the augmented inverse-probability weighting (AIPW) method. Results: Among the 274,881 subjects, 152,850 men (55.6%) and 122,031 women (44.4%) with a mean age of 47.0 (standard deviation, 14.4) years, 4.0% reported oral health problems, with a prevalence of 2.1% among those without any stress. The prevalence increased with stress score, reaching 15.4% for those with the maximum stress score. The adjusted odds ratio of this group compared to those without any stress was 9.2 (95% confidence interval [CI], 8.2–10.3). The estimated prevalence of oral health problems by the AIPW analysis was 2.2% (95% CI, 2.1–2.3%) for those without any stress and 14.4% (95% CI, 12.1–16.7%) for those with the maximum stress scores. Conclusion: There was a clear dose-response association between stressful life events and oral health problems.

Abstract Background Myocardial infarction is likely to be experienced as a life-threatening and potentially traumatic event. Approximately one-third of patients with myocardial infarction experience clinically significant symptoms of anxiety/depression. However, it is unclear how many of these patients experience these symptoms because of post-traumatic stress disorder (PTSD). We conducted a clinical screening of individuals with a confirmed myocardial infarction diagnosis. Our goal was to examine the prevalence of PTSD in myocardial infarction patients and study how PTSD symptoms were associated with exposure to potentially traumatic events. Method This is epidemiological research with a cross-sectional design following up participants from the Tromsø Study with a confirmed diagnosis of myocardial infarction. We sent invitations to participants in the Tromsø Study with clinically significant self-reported anxiety or depression symptoms following myocardial infarction. A cross-sectional sample of N = 79 participants (61 men and 18 women) was collected. During an interview, participants completed the Stressful Life Events Screening Questionnaire and the PTSD checklist PCL-5. Results We found nine participants (11.6%) with probable PTSD. This was significantly higher than the postulated population prevalence in Norway (p

Accumulating evidence suggests that maternal exposure to objectively stressful events and subjective distress during pregnancy may have intergenerational impacts on children's mental health, yet evidence is limited. In a multisite longitudinal cohort (N = 454), we used multi-variable linear regression models to evaluate the predictive value of exposure to stressful events and perceived distress in pregnancy for children's internalizing problems, externalizing problems, and adaptive skills at age 4. We also explored two- and three-way interactions between stressful events, distress, and child sex. Both objective and subjective maternal stress independently predicted children's behavior, with more stressful events and higher distress predicting more internalizing and externalizing problems and worse adaptability; stress types did not significantly interact. There was some evidence that more stressful events predicted higher externalizing behaviors only for girls. Three-way interactions were not significant. The current findings highlight the importance of considering the type of stress measurement being used (e.g., counts of objective event exposure or subjective perceptions), suggest prenatal stress effects may be transdiagnostic, and meet calls for rigor and reproducibility by confirming these independent main effects in a relatively large group of families across multiple U.S. regions. Results point to adversity prevention having a two-generation impact and that pre- and postnatal family-focused intervention targets may help curb the rising rates of children's mental health problems.