Dohrenwend B S, Dohrenwend B P
J Nerv Ment Dis. 1978 Jan;166(1):7-15. doi: 10.1097/00005053-197801000-00003.
This paper is concerned with the kind of work that is needed in order to provide a more solid scientific foundation for the belief that life stress causes illness. Although indirect evidence from controlled laboratory studies and from extreme situations provides strong indications of the general relationship between stress and illness, the evidence concerning the effects of naturally occurring and more ordinary stressful life events is less clear. Although we have a body of research indicating that life events are associated with a wide range of disorders and distress, it does not provide a clear picture of the nature and strength of this relationship. In order to clarify our understanding of how stressful life events affect health and illness, we will need to deal with methodological issues that have emerged from research to date and to tackle a major substantive problem that has been largely neglected. The methodological issues are three: a) definition of the populations of life events to be studied; b) measurement of the magnitudes of the life events; and c) use of a research design appropriate to the question to be answered. The substantive issue concerns factors that mediate the impact of life events. Each of these issues is examined in turn in this paper.
本文关注的是为“生活压力导致疾病”这一信念提供更坚实科学基础所需开展的工作。尽管来自对照实验室研究和极端情况的间接证据有力地表明了压力与疾病之间的总体关系，但关于自然发生且更为常见的压力性生活事件的影响的证据却不那么明确。虽然我们有一系列研究表明生活事件与广泛的疾病和痛苦有关，但它并未清晰呈现这种关系的本质和强度。为了阐明我们对压力性生活事件如何影响健康和疾病的理解，我们需要处理迄今为止研究中出现的方法学问题，并解决一个在很大程度上被忽视的重大实质性问题。方法学问题有三个：a）要研究的生活事件人群的定义；b）生活事件严重程度的测量；c）使用适合待回答问题的研究设计。实质性问题涉及介导生活事件影响的因素。本文将依次探讨这些问题中的每一个。
