The pathogenic quality of life event stress in neurotic impairment.

• A life events inventory with matched scalings for distress and life change has been used in a study of life events and neurotic illness. The use of this inventory and scalings permits three measures of cumulative life event stress to be isolated for each subject: a cumulative distress score, a cumulative life change score, and the cumulative number of events experienced in any given time period. All three life stress scores demonstrated a significant relationship to the later onset of neurotic impairment in a community sample of adults. However, all three measures were intercorrelated, and when the association between each score and neurotic impairment was examined after eliminating the influence of each of the other two scores, it was shown that neither the number of events experienced nor the life change score exhibited a relationship with neurotic impairment independent of the distress score. The association of the distress score, however, was independent of each of the other two life event scores and was not confounded with the index of neurosis. This indicates that it is indeed the distressing quality of lite events, and not merely the life change they cause, that is associated with later onset of neurotic impairment.

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