Association between stressful life events during pregnancy and adverse pregnancy outcomes: a review / 预防医学

@#Improving the quality of newborns is a health development strategy, which has attracted global attention. Adverse pregnancy outcomes, including preterm birth, low birth weight and small for gestational age, are major causes of perinatal mortality and disability. Based on review of international and national publications pertaining to associations between stressful life events during pregnancy and adverse pregnancy outcomes from 2007 to 2023, this review summarizes the correlation between stressful life events during pregnancy and adverse pregnancy outcomes, including preterm birth, low birth weight and small for gestational age, and describes the underlying biological mechanisms. Previous studies have demonstrated the associations between maternal stressful life events during pregnancy and adverse pregnancy outcomes, and the underlying mechanisms mainly include neuroendocrine regulation, inflammation and microbiota pathways; however, the exact mechanisms remain unclear until now. Further studies to identify the critical window period for the association between stressful life events and adverse pregnancy outcomes, and unravel the pathogenesis of adverse pregnancy outcomes are warranted, so as to provide insights into reduction of adverse pregnancy outcomes.

Influencia del historial de victimización en mujeres nicaragüenses en la transmisión intergeneracional de la violencia / Influence of the victimization history in Nicaraguan women in the intergenerational transmission of violence

Resumen La exposición a la violencia y las experiencias de abuso infantil son factores de riesgo para su reproducción en la siguiente generación. Muchos estudios han analizado la transmisión intergeneracional de la violencia, aunque en menor medida se ha investigado este fenómeno en Nicaragua. El objetivo del presente trabajo es analizar la relación entre el historial de maltrato en madres nicaragüenses en situación de pobreza y la violencia en la siguiente generación. En el estudio de corte transversal participaron 124 mujeres que han sufrido diversas formas de polivictimización a lo largo de su vida. Los resultados indican que la presencia de violencia en los y las menores se relaciona con el historial de victimización de la madre, circunstancia que predice la violencia ejercida y padecida en la siguiente generación. Visibilizar el maltrato en la infancia constituye un objetivo prioritario, ya que crecer en contextos en los que se normaliza la violencia deriva en su reproducción.

Abstract Exposure to violence in childhood and experiences of child abuse are risk factors for a consequent repetition of them in the next generation. Many studies have analyzed the intergenerational transmission of violence, although this phenomenon has been investigated to a lesser extent in Nicaragua. The objective of this paper is to analyze the relationship between the history of abuse in Nicaraguan mothers in poverty and the violence in the next generation. The cross-sectional study involved 124 women who have undergone various forms of poly-victimization throughout their lives. The results indicate that the presence of violence in children is related to the mother's victimization history, circumstance that predicts the violence suffered in the next generation. Highlighting and identifying child abuse constitutes a priority objective, since growing up in contexts where violence is normalized leads to its reproduction.

Psychiatric Morbidity and Stressful Life Events in Elderly -A Hospital Based Cross-Sectional Study.

BACKGROUND There has been increasing prevalence of mental health problems in the elderly, with stressful life events being a precipitating factor and hence impairing the quality of life.METHODS263 patients of age 60 years and above attending psychiatry outpatient department and admitted in medical wards were included in the study. Patients with MMSE score ≥24 were included in the study. MINI PLUS was used to assess the psychiatric morbidity. Life events were assessed by PSLES. Statistical analysis was done using SPSS. Descriptive statistics and chi-square test were used for analysis.RESULTSOut of 263 patients, 207 (78.7%) were in the age group 60-69 yrs. The common psychiatric morbidity was found to be depression (43%), substance use disorders (16.7%) and anxiety spectrum disorders (15.5%). The most common precipitating stressful life events were family conflict (9.5%), son or daughter leaving home (8.7%), death of spouse (6.5%) and financial loss (6.5%). The common psychiatric morbidity precipitated by stressful life events were depression (44.4%) and substance use (18.2%) followed by anxiety and stress related disorders (22.2%).CONCLUSIONSThe above study emphasizes that psychiatric morbidity is common in the geriatric population, of which depression is the most common mental health problem. Stressful life events can lead to mental health problems. These factors impair the quality of life of the elderly. Hence it necessitates psychiatrists and physicians to recognize mental health problems at the earliest and provide the necessary support to improve the quality of life.

Relationship between stressful life events and emotional intelligence in Mexican adolescents: Male vs. female comparative study / Relación entre sucesos estresantes de la vida e inteligencia emocional percibida en adolescentes mexicanos: Estudio comparativo entre hombres y mujeres

Abstract Introduction Adolescents can present high levels of stress when faced with various biopsychosocial changes, affecting their daily activities and influencing the initiation and development of risk behaviours and/or a mental disorder. Therefore, it is important to identify protective factors against stress, such as emotional intelligence, for adolescents. Objective Determine the effect of stressful life events (SLE) and perceived emotional intelligence (PEI) on the stress level in adolescent high school students and identify differences by sex. Method Cross-sectional study, 1 417 adolescents (57% women and 43% men), with an average age of 15.90 (SD = .91), who were evaluated in levels of PEI, SLE, and stress perceived. Results The results show high rates of stressful events experienced. Attention to emotions increases the perception of stress in both sexes, while clarity and emotional repair have a stress-reducing effect on women. Discussion and conclusions The results suggest that the PEI is determinant in the emotional self-control and the adaptive capacity of the adolescent to face stressful situations.

Resumen Introducción Los adolescentes pueden presentar altos niveles de estrés cuando se enfrentan a diversos cambios biopsicosociales, que afectan sus actividades diarias e influyen en el inicio y el desarrollo de conductas de riesgo y/o trastornos mentales. Por lo tanto, es importante identificar en los adolescentes los factores de protección contra el estrés, como el caso de la inteligencia emocional. Objetivo Determinar el efecto de los sucesos vitales estresantes (SVE) y de la inteligencia emocional percibida (IEP) sobre el nivel de estrés en los adolescentes estudiantes de bachillerato e identificar las diferencias por sexo. Método Estudio transversal, con una muestra de 1 417 adolescentes (57% mujeres y 43% hombres), con una edad media de 15.90 (SD = .91), a los que se evaluó en niveles de IEP, los SVE y el estrés percibido de dichos SVE experimentados. Resultados Los resultados muestran altos índices de eventos estresantes experimentados. La atención a las emociones incrementa la percepción de estrés en ambos sexos, mientras que la claridad y la reparación emocional tienen un efecto amortiguador del estrés en mujeres. Discusión y conclusión Estos resultados sugieren que la IEP resulta determinante en el autocontrol emocional y la capacidad adaptativa del adolescente para afrontar situaciones estresantes.

Validación de una prueba para medir eventos vitales estresantes en adultos gay, lesbianas y bisexuales colombianos / Validation test in order to measure stressful life events in Colombian gays, lesbians and bisexual adults

Resumen Objetivo: Evaluar las características psicométricas de una prueba para valorar eventos vitales estresantes (PEVE), así como comparar el constructo según sexo, edad y orientaciones sexuales no heterosexuales residentes en tres ciudades de Colombia, Barranquilla, Bogotá y Tunja. Método: Se implementó un muestreo no probabilístico tipo bola de nieve mediante el cual 208 participantes con edades entre 18 y 67 años (ME= 26,16; DE=8,56) diligenciaron la PEVE, que medía diversos eventos estresantes (EE). Resultados: La consistencia interna obtenida a través de alfa de Cronbach fue 0,79 y el Omega de McDonald fue de 0,89. El 34,62% no experimentó EE durante el pasado año, el 56,25% experimentó bajos niveles y solo un 9,13% tuvo EE en alto grado. Análisis Paralelo y Test MAP sugieren un único factor que explicó el 54% de la varianza. Los EE en mujeres se asocian con mayor proporción de discusiones con la familia debido a su homosexualidad (p<0,05), mientras que EE en hombres se asocian con problemas con la policía y ser agredidos físicamente (p<0,05). Con relación a orientación sexual, EE se asocian con mayor proporción de homosexuales que reportan problemas con familiares en comparación de la proporción de bisexuales (p<.05). Con respecto a la edad, adultos jóvenes tienden a experimentar mayores niveles promedio de EE que adultos (p<.05). Conclusión: En población LGB colombiana, PEVE muestra adecuada validez de constructo y consistencia interna. La mayoría de participantes perciben un nivel bajo de EE y estos niveles cambian teniendo en cuenta variables como el sexo, orientación sexual y edad. Se requieren más investigaciones en contextos latinoamericanos.

Abstract Objective: This paper aims to evaluate psychometric properties of the test stressful life events (SLE) and also to compare the construct according to sex, age and non-heterosexual sexual orientations in individuals who live in three different cities in Colombia, Barranquilla, Bogotá y Tunja. Method: A non-probabilistic or snowball sampling was implemented. 208 participants between 18 and 67 years old (ME = 26.16, SD = 8.56) who completed the SLE test, being measured various stressful events (SE). 34.62% did not face SE during last year, 56.25% have experienced low levels of SE and only 9.13% faced a high degree of SE. Parallel Analysis and MAP Test suggested a single factor that showed 54% of the variance. In women, SE are associated with discussions with their family because of their homosexuality (p <.05), but in men SE are associated with problems with the police and being physically assaulted (p <.05). In relation with sexual orientation, SE are associated with homosexuals who report problems with relatives, comparing with bisexuals (p <.05). According to age, results show that young adults tend to experience higher levels of SE than adults (p <.05). Conclusion: In Colombian LGB population, PEVE shows adequate construct validity and internal consistency. Most participants faced low level of SE and these levels change taking into account variables such as sex, sexual orientation and age. More researches are required in Latin American contexts.

Extrinsic Factors Influencing Relapse in Alcohol Dependence

Introduction: Relapse is a common problem faced whenalcohol dependence is treated. The present study was doneto find the influence of extrinsic factors such as stressful lifeevents, peer pressure and perceived social support on relapsein alcohol dependence, which will be useful to developeffective interventions to prevent it.Material and methods: This cross sectional study conductedin tertiary care teaching hospital in Kottayam, included 60subjects who were grouped into 30 Late Relapsers (whorelapsed drinking after 3 months of abstinence) and 30Early Relapsers-(who relapsed drinking within 3 months ofabstinence). Mini-Mental Status Examination, DiagnosticCriteria for Research for ICD-10 (DCR-10) and the StressfulLife Inventory were used for each patient to collect theirdetails.Results: The mean age of onset of alcohol use of EarlyRelapsers was lower than that of the Late Relapsers. Alsothe number of stressful life events related to work, marriage,family and finance were more in the Early Relapsers comparedto the other and the difference was statistically significant forthe above mentioned factors.Conclusions: Early age of onset of alcohol use and occurrenceof stressful life events in 6 months preceding the relapse areassociated with relapse in alcohol dependence. Communitybased studies with larger sample size are needed to substantiatethe results of this study

Influencia de los hábitos en la depresión del estudiante de medicina peruano: estudio en siete departamentos / Influence of Habits on Depression in the Peruvian Medical Student: Study in Seven Administrative Regions

RESUMEN Objetivo: Determinar la influencia de los hábitos en la depresión del estudiante de medicina de 7 departamentos de Perú. Métodos: Estudio transversal analítico de un análisis secundario de datos. El diagnóstico de depresión se obtuvo según el resultado del test de Zung, considerado positivo ante cualquier grado de esta condición. Además, se comparó esto con otras variables socioeducativas importantes según publicaciones previas. Resultados: De los 1.922 encuestados, el 54,5% (n = 1.047) eran mujeres; la mediana de edad era de 20 [intervalo intercuartílico, 18-22] arios. El 13,5% (n = 259) tenía algún grado de depresión según la escala de Zung. En el análisis multivariable, incrementaron la frecuencia de depresión la mayor cantidad de horas de estudio por día (razón de prevalencias ajustada [RPa] = 1,03; intervalo de confianza del 95% [IC95%], 1,01-1,04; p < 0,001) y que el estudiante trabaje (RPa = 1,98; IC95%, 1,21-3,23; p = 0,006); en cambio, disminuyeron la frecuencia de depresión tener horarios similares para comer (RPa = 0,59; IC95%, 0,38-0,93; p = 0,022) y un lugar fijo donde conseguir sus alimentos (RPa = 0,66; IC95%, 0,46-0,96; p = 0,030), ajustado por el año de ingreso a la universidad. Conclusiones: Se encontró que algunos factores estresantes predisponen a la depresión (trabajar y estudiar más horas por día); en cambio, tener un orden en su rutina diaria disminuye esta condición (tener un lugar y horarios fijos para comer.

ABSTRACT Objective: To determine the influence of habits on depression in medical students from 7 Peruvian Regions. Methods: Analytical cross-sectional study of a secondary data analysis. The diagnosis of depression was obtained according to the Zung test result, with any level of this condition being considered positive. This was also compared with other social and educational variables that were important according to previous literature. Results: Of the 1922 respondents, 54.5% (1047) were female. The median age was 20 [interquartile range, 18-22] years, and 13.5% (259) had some degree of depression according to the Zung scale. In the multivariate analysis, the frequency of depression increased with the hours of study per day (RPA= 1.03; 95%CI; 1.01-1.04; P<.001) and the student work (RPA = 1.98; 95%CI; 1.21-3.23; P=.006). On the other hand, decreased the frequency of depression decreased on having similar meal schedules (RPA = 0.59; 95%CI; 0.38-0.93; P=.022), and having a fixed place in which to get food (RPA = 0.66; 95%CI; 0.46-0.96; P=.030), adjusted for the year of college entrance. Conclusions: Some stressors predisposed to depression were found (the work and studying more hours a day). On the other hand, to have order in their daily routine decreased this condition (having a set place and times for meals).

Stressful Events and Executive Functioning in Adolescents with and without History of Grade Repetition / Eventos estresores y funcionamiento ejecutivo en adolescentes con y sin historia de repetición escolar

Abstract A number of studies have investigated the association between psychiatric disorders and alterations in cognitive development, academic performance, and learning ability. However, few studies have explored the relationship between stressful events and grade repetition. Therefore, the main goal of the present study was to compare the frequency of exposure to stressful events, academic performance, executive functioning, and performance on working memory tasks between adolescents with and without a history of grade repetition. This was a cross-sectional study. The sample was composed of 83 adolescents divided into two groups: (1) individuals with a history of grade repetition (n = 39) and (2) participants who had never repeated a grade (n = 44). Participants were administered tests to assess executive functions, intelligence, exposure to stressful events, and academic performance. Results showed that individuals with a history of grade repetition reported to experiencing a higher number of stressful events in adolescence, had worse academic performance, and obtained lower scores on executive functioning and working memory tasks than non-repeaters.

Resumen Varios estudios han investigado la asociación entre trastornos psiquiátricos y alteraciones en el desarrollo cognitivo, el rendimiento académico y la capacidad de aprendizaje. Sin embargo, pocos estudios han explorado la relación entre los eventos estresantes y la repetición escolar. Por lo tanto, el objetivo principal de este estudio fue comparar la frecuencia de exposición a eventos estresantes, el rendimiento académico, el funcionamiento ejecutivo y el desempeño en tareas de memoria de trabajo en los adolescentes con y sin antecedentes de repetición escolar. Se trata de un estudio transversal. La muestra estuvo constituida por 83 adolescentes, divididos en dos grupos: (1) los individuos con antecedentes de repetición escolar (n = 39) y (2) los participantes que nunca repitieron un año escolar (n = 44). Los participantes fueron sometidos a pruebas para evaluar las funciones ejecutivas, la inteligencia, la exposición a eventos estresantes y el rendimiento académico. Los resultados mostraron que los individuos con historia de repetición escolar relataron la ocurrencia de un mayor número de eventos estresantes durante la adolescencia, tuvieron un peor rendimiento académico y obtuvieron puntuaciones más bajas en las tareas de funcionamiento ejecutivo y memoria de trabajo que los que no repitieron.

Gender differences in stressful life events and depression in Chinese adults aged 30-79 years / 中华流行病学杂志

Objective To investigate gender specific differences in the association between stressful life events (SLEs) and depression in Chinese adults aged 30-79 years. Methods In the baseline survey during 2004-2008, the China Kadoorie Biobank (CKB) recruited 512891 men and women aged 30-79 years from 10 areas of China. Detailed information on SLEs, including demographic and socio-economic status, smoking, alcohol drinking and history of chronic disease, as well as depression symptoms and major depressive episodes (MDEs) in preceding 12 months, was collected by using standardized questionnaire. Multinomial logistic regression model was employed to estimate the relative risk ratio (RRR) and 95%CI of SLEs (3 categories, 10 items) on depression and the dose-response relationship between the number of SLEs experienced and depression. The interactions between gender and SLEs on depression were examined with likelihood ratio test. Results Among the 512891 participants, 35085 (6.8%) reported family-related events, 5972 (1.2%) reported finance-related events, and 4453 (0.9%) reported other stressful life events. Females had a higher occurrence of family-related events, while males had a higher occurrence of finance-related and other events (all P-value <0.001). After adjusted for potential confounders, SLEs were significantly associated with MDEs (RRR=11.99, 95%CI: 10.49-13.71 for males; RRR=14.15, 95%CI: 12.97-15.43 for females), and with depressive symptoms (RRR=7.43, 95%CI:6.94-7.95 for males;RRR=8.30, 95%CI: 7.91-8.72 for females). And the associations were stronger in females than in males (P for interaction=0.049). In the three categories of SLEs, family-related events showed stronger association in female (P for interaction<0.001), while no gender specific differences were observed for the other two categories (all P-value>0.05). Furthermore, the effect of the number of SLEs experienced increased in a dose-response manner on depressive symptoms and MDEs for both genders, but no gender specific differences were found. Conclusions The gender modifies the association between stressful life events and depression in Chinese adults, and women experienced family-related events have a greater risk of depression. The more the stressful events experienced, the more likely to have depression.

Gender differences in stressful life events and depression in Chinese adults aged 30-79 years / 中华流行病学杂志

Objective To investigate gender specific differences in the association between stressful life events (SLEs) and depression in Chinese adults aged 30-79 years. Methods In the baseline survey during 2004-2008, the China Kadoorie Biobank (CKB) recruited 512891 men and women aged 30-79 years from 10 areas of China. Detailed information on SLEs, including demographic and socio-economic status, smoking, alcohol drinking and history of chronic disease, as well as depression symptoms and major depressive episodes (MDEs) in preceding 12 months, was collected by using standardized questionnaire. Multinomial logistic regression model was employed to estimate the relative risk ratio (RRR) and 95%CI of SLEs (3 categories, 10 items) on depression and the dose-response relationship between the number of SLEs experienced and depression. The interactions between gender and SLEs on depression were examined with likelihood ratio test. Results Among the 512891 participants, 35085 (6.8%) reported family-related events, 5972 (1.2%) reported finance-related events, and 4453 (0.9%) reported other stressful life events. Females had a higher occurrence of family-related events, while males had a higher occurrence of finance-related and other events (all P-value <0.001). After adjusted for potential confounders, SLEs were significantly associated with MDEs (RRR=11.99, 95%CI: 10.49-13.71 for males; RRR=14.15, 95%CI: 12.97-15.43 for females), and with depressive symptoms (RRR=7.43, 95%CI:6.94-7.95 for males;RRR=8.30, 95%CI: 7.91-8.72 for females). And the associations were stronger in females than in males (P for interaction=0.049). In the three categories of SLEs, family-related events showed stronger association in female (P for interaction<0.001), while no gender specific differences were observed for the other two categories (all P-value>0.05). Furthermore, the effect of the number of SLEs experienced increased in a dose-response manner on depressive symptoms and MDEs for both genders, but no gender specific differences were found. Conclusions The gender modifies the association between stressful life events and depression in Chinese adults, and women experienced family-related events have a greater risk of depression. The more the stressful events experienced, the more likely to have depression.

Qualidade de vida em pacientes da atenção primária do Rio de Janeiro e São Paulo, Brasil: associações com eventos de vida produtores de estresse e saúde mental / Quality of life of primary care patients in Rio de Janeiro and SãoPaulo, Brasil: associations with stressful life events and mental health

Resumo A qualidade de vida (QV) é um constructo subjetivo, que pode ser associado negativamente a fatores como os transtornos mentais e os eventos de vida produtores de estresse (EVPE). O objetivo deste artigo é identificar a associação entre variáveis demográficas, socioeconômicas, transtorno mental comum, sintomas sugestivos de ansiedade e depressão, EVPE com QV na Atenção Primária (AP). Estudo transversal realizado com 1.466 pacientes atendido na AP, nos munícipios de São Paulo e Rio de Janeiro, em 2009 e 2010. Realizou-se análise bivariada por meio do Teste-t e regressão linear múltipla para cada domínio de QV. Os escores de QV para os domínios físico, psicológico, relações sociais e meio ambiente foram, respectivamente de, 64,7, 64,2, 68,5 e 49,1. Pela análise multivariada foram encontradas associações do domínio físico com os problemas de saúde e discriminação, do psicológico com discriminação, das relações sociais com problemas financeiros/estruturais, causas externas e problemas de saúde, e do meio ambiente com problemas financeiros/estruturais, causas externas e discriminação. As variáveis de saúde mental, os problemas de saúde e os problemas/financeiros estruturais foram os que se associaram negativamente à QV.

Abstract Quality of life (QoL) is a subjective construct, which can be negatively associated with factors such as mental disorders and stressful life events (SLEs). This article seeks to identify the association between socioeconomic and demographic variables, common mental disorders, symptoms suggestive of depression and anxiety, SLEs with QoL in patients attended in Primary Care (PC). It is a transversal study, conducted with 1,466 patients attended in PC centers in the cities of São Paulo and Rio de Janeiro in 2009 and 2010. Bivariate analysis was performed using the T-test and four multiple linear regressions for each QoL domain. The scores for the physical, psychological, social relations and environment domains were, respectively, 64.7; 64.2; 68.5 and 49.1. By means of multivariate analysis, associations of the physical domain were found with health problems and discrimination; of the psychological domain with discrimination; of social relations with financial/structural problems; of external causes and health problems; and of the environment with financial/structural problems, external causes and discrimination. Mental health variables, health problems and financial/structural problems were the factors negatively associated with QoL.

Age of Onset in Schizophrenia Spectrum Disorders: Complex Interactions between Genetic and Environmental Factors

In this study we evaluated the role of a candidate gene for major psychosis, Sialyltransferase (ST8SIA2), in the risk to develop a schizophrenia spectrum disorders, taking into account exposure to stressful life events (SLEs). Eight polymorphisms (SNPs) were tested in 94 Schizophreniainpatients and 176 healthy controls. Schizophrenia patients were also evaluated for SLEs in different life periods. None of the SNPs showed association with schizophrenia. Nevertheless, when crossing genetic variants with childhood SLEs, we could observe trends of interaction with age of onset. Though several limitations, our results support a protective role of ST8SIA2 in individuals exposed to moderate childhood stress.

Comparative study of clinical profile and presumptive stressful life events in patients of psychogenic non epileptic seizure and epileptic seizure: a cross sectional study.

Background: Psychogenic Non Epileptic Seizure (PNES) is one of the most common conditions to be mistaken for epilepsy. No clinical feature is pathognomic of PNES, but some help in distinguishing it from epileptic seizure. Role of psychologically stressful events has been considered central to the pathogenesis of PNES and used in differentiating it from epileptic seizure. The purpose of present study was to compare the clinical profile and number of stressful life events in the two patient groups in Indian population. Methods: 50 new patients of epileptic seizure and PNES each, aged 16 to 60 visiting the psychiatric and neurology OPD were selected. Detailed history and physical examination was carried out to exclude any medical illness. Diagnosis was made based on clinical history given by an eye witness and EEG recording. Brain imaging (CT/MRI) was conducted, to rule out any secondary causes of seizure. General health questionnaire 12, and presumptive stressful life event scale was applied on all patients. SPSS 19 was used for data analysis. Chi square was used for categorical data and Man Whitney U test for continuous data. Results: There were significantly more females in the PNES group (P = 0.001) and significantly more illiterate (P = 0.004) .There were no significant difference with regard to the age of onset, marital status. Also there was no statistically significant difference between the two group with regard to number of stressful life event (P = 0.330). Conclusion: Stressful life event should not bias a clinician towards making a diagnosis of PNES.

The influence of pre-injury stressful life events on the life quality and mood symptoms following cerebral concussion / 中华行为医学与脑科学杂志

Objective To test the reliability and validity of Chinese version of Stressful Life Events Questionnaire and the influence of preinjury stressful life events on the life quality and mood symptoms of the patents following cerebral concussion.Methods 285 patients with cerebral concussion were assessed by Stressful Life Events Questionnaire(SLESQ),PTSD Checklist civilian version(PCL-C),Thirty-Six-Item Short-Form Health Survey (SF-36),Hamilton Depression Rating Scale(HDRS),Hamilton Anxiety Scale(HAMA) at baseline.The patients had been reassessed with the HDRS,HAMA,SF-36 at 3 months after cerebral concussion.The hierarchical regression analyses were used to determine the influence of Stressful Life Events for the life quality and mood symptoms of the patient with cerebral concussion.Results The incidence of stressful life events was 42.8％.The multiple regression analysis showed the experience of stressful life events were the influence factor of scores on the SF-36,HDRS,HAMA after adjusted by the age,gender,education,income,social support,the scores of anxiety and depression before injury and the R 2 value of SLESQ to SF-36 physical health factor,mental health factor,HDRS,HAMA was 0.064,0.111,0.145,0.028,respectively.Conclusion The history of stressful events is the influence factor of the patient with cerebral concussion to have poor life quality and mood disorder.

The mediator effect of coping strategy between stressful life events and negative emotions in young military men / 中华行为医学与脑科学杂志

Objective To investigate mediate role of coping strategy between stressful life events and negative emotions which anxiety and depression are included.Methods Questionnaires of psychosocial stress survey for groups (PSSG),Simple Coping Style Questionnarire(SCSQ),Selfrating Anxiety Scale (SAS) and Selfrating Depression Scale(SDS) were used to examine 1 764 young servicemen.Results Correlation analysis showed that there existed negative correlations between positive coping and stressful life events,passive coping,anxiety,depression(r=-0.080～-0.304,P＜0.05).And correlation analysis also showed there existed positive correlations among the other variables(r=0.230 ～ 0.756,P＜0.05).There existed partly mediating effect of positive coping,passive coping between stressful life events and negative emotions.The standardized total effect of life events to anxiety was 0.302.Mediating effects of positive coping and passive coping were 0.033,0.044.The standardized total effect of life events to depression was 0.230,mediating effects of positive coping and passive coping were 0.051,0.029.Conclusion Coping strategy is an important mediator between stress and negative emotions such as anxiety and depression.

Factors Influencing Empathy in Nursing Students in Korea / 한국간호교육학회지

PURPOSE: The purpose of the study was to explore the levels of self-awareness, assertiveness, life stress, and empathy in nursing students and identify influential factors on empathy. METHODS: A predictive correlational design was used. The data was collected by questionnaires from a convenience sample of 319 nursing students in 2014 in Korea. The data was analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and stepwise multiple regression. RESULTS: The mean items scores of self-awareness, assertiveness, life stress, and empathy were 3.49, 3.02, 2.20 and 3.58, respectively, of a possible score ranging from 1 to 5. Empathy significantly differed by gender, grade, satisfaction with nursing as a major, and clinical practice experience. Empathy was correlated with self-awareness and interpersonal relationship stress. As a result of multiple regression analysis, empathy accounted for 20.1% of the variance by self-awareness, gender, clinical practice experience and interpersonal relationship stress. The most important factor was self-awareness, which explained 11.6% of the variation. CONCLUSION: The results of the study reveal that strengthening self-awareness and relieving interpersonal relationship stress ought to be integrated in developing effective educational intervention for enhancing empathy in nursing students.

Eventos de vida estressores e episódios de humor: uma amostra comunitária / Stressful life events and mood disorders: a community sample

Transtornos de humor são consequentes de uma interação entre fatores biológicos e ambientais. O objetivo deste estudo foi identificar associações entre eventos vitais estressores e transtornos de humor em uma amostra comunitária de jovens do Sul do Brasil. Trata-se de estudo transversal de base populacional com jovens de 18 a 24 anos. A seleção da amostra foi realizada por conglomerados. Os episódios de alteração do humor foram avaliados através da Mini International Neuropsychiatric Interview , enquanto os eventos vitais estressores foram mensurados através da escala de reajustamento social de Holmes e Rahe. A amostra foi de 1172 jovens. A proporção de eventos vitais estressores no último ano, em cada categoria, no total da amostra, foi de: 53,8% trabalho, 42,4% perda de suporte social, 63,8% família, 50,9% mudanças ambientais, 61,1% dificuldades pessoais e 38,7% finanças. Houve associação significativa entre eventos vitais estressores e episódios de alteração de humor. Foi verificada maior ocorrência de eventos vitais estressores entre os jovens em episódio misto, quando comparados aos jovens em episódio depressivo, (hipo) maníaco e controles. Esses achados sugerem uma interação psicossocial entre eventos vitais estressores e os episódios de alteração de humor.

Mood disorders are a consequence of the interaction between environmental and biological factors. The objective of this study was to identify associations between stressful life events (LEs) and mood disorders in a community sample of young people in southern Brazil. It is a cross-sectional population-based study on young people between 18 and 24 years of age. The selection of the sample was conducted via conglomerates. Mini International Neuropsychiatric Interviews were used to evaluate mood disorders, and the Social Readjustment Rating Scale to assess stressful life events. The sample included 1172 young people. Of the total sample, the proportion of stressful life events in the last year in each category was: 53.8% work, 42.4% loss of social support, 63.8% family, 50.9% environmental changes, 61.1% personal difficulties, and 38.7% finances. A significant relationship was found between categories of stressful life events and mood disorder episodes. A higher incidence of stressful life events was found among young people in a mixed episode compared to young people in a depressive, (hypo)maniac episode with controls. This finding suggests a psychosocial interaction between stressful life events and the occurrence of mood disorders.

Valoración subjetiva de los sucesos de vida estresantes en dos grupos de adolescentes de zonas marginadas / Subjective assessment of stressful life events in two groups of adolescents from low-income neighborhoods

Resilience implies adaptation to significant stressful situations. The low-income or economic hardship is considered as a risk factor associated with stressful life events. A life event is any experience capable of producing stress and can therefore become a stressor depending of individual subjective assessment. The purpose of this study was to analyze the subjective assessment of stressful life events in adolescents from the eastern neighboring area of Mexico City, which is deemed as a socioeconomically vulnerable area because of its high poverty and low development rates. Participants were 638 male and female adolescents aged 13 to 18 from two non-probabilistic samples from public education and mental health institutions. A socio-demographic file and the Life Event Questionnaire were applied. T values show statistical differences between school and clinical samples in all socio-demographic variables and also in all areas of life events. The family, behavior problems, personal and school areas are the ones where a greater number of stressful life events are perceived in both samples, even though school sample scores are within the normal range, whereas the clinical sample scores are marginal and out of the normal range. The MANOVA showed significantly effects by sex but not by age on the perception of life events, and there was only an interaction of sex and age in health. In the clinical sample, the older adolescent showed higher scores in stressful life events. The findings are consistent with previous reports that point to a greater number of stressful life events in clinical groups and economic hardship. No significant differences were found in the perception of stressful events concerning age. These results may be useful in designing intervention models with adolescents aimed at changing perceptions and the way they cope with adverse life events, in order to strengthen resilience in low-income and psycho-social risk contexts.

La resiliencia implica adaptación ante situaciones de riesgo o estrés significativo. Las presiones económicas se consideran un riesgo por su asociación con sucesos de vida estresantes. Un suceso de vida es un acontecimiento que tiene el potencial de producir estrés, por lo que su valoración es un factor básico en los procesos adaptativos. El propósito de este estudio fue analizar la valoración subjetiva de los sucesos de vida estresantes de adolescentes de la zona oriente y conurbada de la Ciudad de México, caracterizada por vulnerabilidad económica. Participaron 638 hombres y mujeres adolescentes, de entre 13 y 18 años de edad, de dos muestras intencionales de instituciones públicas educativas y de salud mental. Se aplicaron una ficha socio-demográfica y el Cuestionario de Sucesos de Vida. Los valores de t de Student indican diferencias significativas entre la muestra escolar y la clínica en las variables sociodemográficas y en la percepción de los sucesos vitales. Las áreas familiar, problemas de conducta, personal y escolar exhiben las puntuaciones más altas en ambas muestras. La escolar con puntuaciones dentro del rango de normalidad y la clínica con valores marginales y fuera de la norma. Los análisis con MANOVA no muestran efectos significativos por la edad, pero sí por sexo, e interacción sexo-edad. Los hombres mayores de la muestra clínica perciben más sucesos estresantes en todas las áreas, en particular en salud. Los datos son consistentes con la bibliografía que indica mayor número de sucesos estresantes en grupos clínicos y adversidad económica, aunque no apoyan otros que señalan diferencias de edad. Esto sugiere que, independientemente de la edad, todos los adolescentes perciben de manera similar su entorno. Los resultados podrían orientar el diseño de programas con adolescentes que contribuyan a modificar sus percepciones y la forma de enfrentar los sucesos de vida adversos a fin de fortalecer la resiliencia.

Depresión en adolescentes: El papel de los sucesos vitales estresantes / Depression in adolescents: The role of stressful life events

Introduction Stressful life events have been seen to influence the onset and development of depressive symptoms in adolescents. These are originated by family, personal and economic situations altering the individuals' normal activities. Objective and method The objective of this study was to identify the relationship with and the effect of stressful life events on symptoms of depression in adolescent high-school students, as well as to determine if there are differences between males and females. 2 292 adolescents, aged 15 to 19 years, were included (54% females and 46% males). Both the CES-D-R revised version of the Center of Epidemiological Studies Depression Scale and the Sandín SV Life Events Questionnaire were used. Statistical Analysis. In order to assess the depressive symptoms and the life events degree of stress variables, we performed descriptive analyses, Student t-tests, Pearson correlations and stepwise multiple regression analyses. Results The results indicate that 15.6% of the adolescents had depressive symptoms (CES-D-R) and 80.4% had suffered some family stressful life event. There were statistically significant differences in the scores for the life events degree of stress when it was analyzed by sex, with a higher mean being found in females. A significant relationship was found between depressive symptoms and the degree of stress of life events related with the social area (r = 0.34; p<0.001). Additionally, the degree of stress of the life events dimensions was found to predict the presence of depressive symptoms in adolescents by 21%. Conclusions The degree of stress of life events is related with the presence of depressive symptoms in adolescents. Furthermore, the fact of being a female and having experienced any stressful life event is associated with a higher depressive symptoms score.

Introducción En los adolescentes se ha observado que los sucesos de vida estresantes pueden tener una influencia en el inicio y desarrollo de los síntomas de depresión; éstos se originan de situaciones familiares, personales y económicas que alteran las actividades normales de los individuos. Objetivo y método Identificar la relación y el efecto de los sucesos vitales estresantes sobre los síntomas de depresión en adolescentes estudiantes de bachillerato, así como determinar si existen diferencias entre hombres y mujeres. Participaron 2292 adolescentes de 15 a 19 años de edad (54% mujeres y 46% hombres). Se utilizó la versión revisada en español de la Escala de Depresión del Centro de Estudios Epidemiológicos (CES-D-R) y el Cuestionario de Sucesos Vitales de Sandín SV Análisis Estadístico. Para evaluar las variables síntomas de depresión y grado de estrés de los sucesos vitales se realizaron análisis descriptivos, t de Student, correlación de Pearson y regresión múltiple por pasos. Resultados Los resultados indican que 15.6% de los adolescentes presentaron síntomas de depresión (CES-D-R) y que 80.4% había sufrido algún suceso vital estresante familiar. Existen diferencias estadísticamente significativas en los puntajes de grados de estrés de los sucesos vitales cuando se analizó por sexo, encontrando una media más alta en mujeres. Se encontró una relación significativa entre síntomas de depresión y el grado de estrés de los sucesos vitales del área social (r = 0.34; p<0.001). Además se encontró que el grado de estrés de las dimensiones de los sucesos vitales predice en 21% la presencia de síntomas de depresión en los adolescentes. Conclusiones El grado de estrés de los sucesos vitales se relaciona con la presencia de síntomas de depresión en los adolescentes. Además, el hecho de ser mujer y haber vivido algún suceso vital estresante se asocia a un mayor puntaje de síntomas de depresión.

The Effects of Triallelic Serotonin Transporter Gene Polymorphism and Stressful Life Event on Depression in Patients with Alcohol Dependence

OBJECTIVES: The purpose of this study is to investigate the relationship between the triallelic serotonin transporter gene and stressful life events to determine their effect on depression with alcohol dependence. METHODS: Ninety-five hospitalized patients with alcohol dependence (73 male, 22 female) were enrolled in this study. Thirty-two (33.7%) of the total patients were diagnosed with major depressive disorder and dysthymic disorder by Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV. The characteristics of stress were evaluated using the stressful life events scale, and depressive symptoms were assessed using the depression scale (Beck Depression Inventory, BDI). Alcoholism with depression (n = 32) and alcoholism without depression (n = 63) were genotyped for the triallelic serotonin transporter gene (LA : higher expressing allele, LG/S : lower expressing allele). RESULTS: There was no significant difference in the allele frequency between the depression group and the non-depression group (chi2 = 0.345, p = 0.619). LG/S alleles had more comorbid depression in the higher score of stressful life events scale [Mental-Haenszel (MH)-chi2 = 4.477, p = 0.034]. But there was no significant difference in the comorbidity according to the scores from the stressful life event scale in the LA alleles (MH-chi2 = 0.741, p = 0.399). In the results, alcohol-dependent individuals with LG/S alleles had more comorbid depression than those with LA alleles when they had experienced severe stressful life events (MH-odds ratio = 2.699, p = 0.028). CONCLUSIONS: These results suggest that there is no direct relationship between triallelic serotonin transporter gene and depression in the alcohol dependent patients. But alcohol dependent individuals with the lower expressing alleles of the serotonin transporter gene were more susceptible to depression than those with the higher expressing alleles in response to stressful life events.