Vrshek-Schallhorn Suzanne, Stroud Catherine B, Mineka Susan, Hammen Constance, Zinbarg Richard E, Wolitzky-Taylor Kate, Craske Michelle G
Department of Psychology, Northwestern University.
Department of Psychology, Williams College.
J Abnorm Psychol. 2015 Nov;124(4):918-32. doi: 10.1037/abn0000088. Epub 2015 Aug 24.
Few studies comprehensively evaluate which types of life stress are most strongly associated with depressive episode onsets, over and above other forms of stress, and comparisons between acute and chronic stress are particularly lacking. Past research implicates major (moderate to severe) stressful life events (SLEs), and to a lesser extent, interpersonal forms of stress; research conflicts on whether dependent or independent SLEs are more potent, but theory favors dependent SLEs. The present study used 5 years of annual diagnostic and life stress interviews of chronic stress and SLEs from 2 separate samples (Sample 1 N = 432; Sample 2 N = 146) transitioning into emerging adulthood; 1 sample also collected early adversity interviews. Multivariate analyses simultaneously examined multiple forms of life stress to test hypotheses that all major SLEs, then particularly interpersonal forms of stress, and then dependent SLEs would contribute unique variance to major depressive episode (MDE) onsets. Person-month survival analysis consistently implicated chronic interpersonal stress and major interpersonal SLEs as statistically unique predictors of risk for MDE onset. In addition, follow-up analyses demonstrated temporal precedence for chronic stress; tested differences by gender; showed that recent chronic stress mediates the relationship between adolescent adversity and later MDE onsets; and revealed interactions of several forms of stress with socioeconomic status (SES). Specifically, as SES declined, there was an increasing role for noninterpersonal chronic stress and noninterpersonal major SLEs, coupled with a decreasing role for interpersonal chronic stress. Implications for future etiological research were discussed.
很少有研究全面评估哪种类型的生活压力与抑郁发作的关联最为紧密,相对于其他形式的压力而言,并且尤其缺乏对急性压力和慢性压力的比较。过去的研究表明,重大(中度至重度)应激性生活事件(SLEs)以及在较小程度上的人际压力形式与之相关;关于依赖性或独立性SLEs哪个影响更大,研究存在冲突,但理论上更倾向于依赖性SLEs。本研究使用了来自两个独立样本(样本1 N = 432;样本2 N = 146)的5年年度诊断和生活压力访谈数据,这些样本正步入成年初期;其中一个样本还收集了早期逆境访谈数据。多变量分析同时考察了多种生活压力形式,以检验以下假设:所有重大SLEs,尤其是人际压力形式,然后是依赖性SLEs,将对重度抑郁发作(MDE)的发生贡献独特的方差。人月生存分析始终表明,慢性人际压力和重大人际SLEs是MDE发病风险在统计学上的独特预测因素。此外,随访分析证明了慢性压力的时间先后顺序;按性别检验了差异;表明近期慢性压力介导了青少年逆境与后期MDE发作之间的关系;并揭示了几种压力形式与社会经济地位(SES)之间的相互作用。具体而言,随着SES下降,非人际慢性压力和非人际重大SLEs的作用增加,而人际慢性压力的作用减少。文中讨论了对未来病因学研究的启示。