Harkness K L, Monroe S M, Simons A D, Thase M
Department of Psychology, University of Oregon, USA.
Psychol Med. 1999 Jan;29(1):135-44. doi: 10.1017/s0033291798007752.
The stress generation hypothesis proposed by Hammen (1991) holds that depressed individuals generate stressful conditions for themselves, which lead to recurrence. The original test of this hypothesis compared dependent life events in women with recurrent depression to medical and normal controls. Two further research questions emerged from this work: (a) do individuals with a history of many depressive episodes generate more dependent life events than depressives with fewer episodes?; and (b) what is the aetiological relevance of any stress that may be generated?
The present research tested differences in dependent and independent events between depressed individuals who had experienced: (a) no previous major depressive episodes; (b) one previous episode; and (c) two or more previous episodes. We predicted that, based on the stress generation hypothesis, recurrent depressives would show more dependent events than people without a depression history, and that these generated stressors would be of aetiological importance for precipitating recurrence (i.e. severe events in the 3 months preceding recurrence).
Recurrent depressives experienced significantly more total dependent events than first-onset depressives in the 12 months, but not the 3 months, preceding their episode.
Although the findings supported the general premise of stress generation, the aetiological relevance of the generated stress for recurrence requires further study.
哈门（1991年）提出的压力产生假说认为，抑郁个体为自己制造压力情境，进而导致复发。对这一假说最初的检验是将复发性抑郁症女性中的依赖性生活事件与医学对照组和正常对照组进行比较。这项研究引出了另外两个研究问题：（a）有多次抑郁发作史的个体比发作次数较少的抑郁症患者产生更多的依赖性生活事件吗？（b）可能产生的任何压力的病因学相关性是什么？
本研究检验了有以下经历的抑郁症患者在依赖性生活事件和独立生活事件方面的差异：（a）既往无重度抑郁发作；（b）既往有一次发作；（c）既往有两次或更多次发作。基于压力产生假说，我们预测，复发性抑郁症患者比无抑郁病史的人会表现出更多的依赖性生活事件，并且这些产生的压力源对促发复发具有病因学重要性（即复发前3个月内的严重事件）。
在发作前12个月而非3个月内，复发性抑郁症患者经历的依赖性生活事件总数显著多于首次发作的抑郁症患者。
尽管研究结果支持压力产生的总体前提，但所产生的压力对复发的病因学相关性仍需进一步研究。
