Association of Stressful Life Events with Psychological Problems: A Large-Scale Community-Based Study Using Grouped Outcomes Latent Factor Regression with Latent Predictors

Objective The current study is aimed at investigating the association between stressful life events and psychological problems in a large sample of Iranian adults. Method In a cross-sectional large-scale community-based study, 4763 Iranian adults, living in Isfahan, Iran, were investigated. Grouped outcomes latent factor regression on latent predictors was used for modeling the association of psychological problems (depression, anxiety, and psychological distress), measured by Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (GHQ-12), as the grouped outcomes, and stressful life events, measured by a self-administered stressful life events (SLEs) questionnaire, as the latent predictors. Results The results showed that the personal stressors domain has significant positive association with psychological distress (β = 0.19), anxiety (β = 0.25), depression (β = 0.15), and their collective profile score (β = 0.20), with greater associations in females (β = 0.28) than in males (β = 0.13) (all P < 0.001). In addition, in the adjusted models, the regression coefficients for the association of social stressors domain and psychological problems profile score were 0.37, 0.35, and 0.46 in total sample, males, and females, respectively (P < 0.001). Conclusion Results of our study indicated that different stressors, particularly those socioeconomic related, have an effective impact on psychological problems. It is important to consider the social and cultural background of a population for managing the stressors as an effective approach for preventing and reducing the destructive burden of psychological problems.

[1]  Nestor L. Lopez-Duran,et al.  Stressful life events in a clinical sample of depressed children in Hungary. , 2009, Journal of affective disorders.

[2]  Y. Şenol,et al.  Anxiety, depression and stressful life events among medical students: a prospective study in Antalya, Turkey , 2001, Medical Education.

[3]  N. H. Rod,et al.  Psychosocial risk factors for the metabolic syndrome: A prospective cohort study. , 2016, International journal of cardiology.

[4]  A. Merkouris,et al.  The association between stressful life events and depressive symptoms among Cypriot university students: a cross-sectional descriptive correlational study , 2013, BMC Public Health.

[5]  D. Ndetei,et al.  Prevalence, types and comorbidity of mental disorders in a Kenyan primary health centre , 2014, Social Psychiatry and Psychiatric Epidemiology.

[6]  Awat Feizi,et al.  Association of Perceived Stress with Stressful Life Events, Lifestyle and Sociodemographic Factors: A Large-Scale Community-Based Study Using Logistic Quantile Regression , 2012, Comput. Math. Methods Medicine.

[7]  I. Gotlib,et al.  Stressful Life Events, Chronic Difficulties, and the Symptoms of Clinical Depression , 2009, The Journal of nervous and mental disease.

[8]  M. Marmot,et al.  Work characteristics predict psychiatric disorder: prospective results from the Whitehall II Study. , 1999, Occupational and environmental medicine.

[9]  J. Francis,et al.  THE IMPACT OF STRESSFUL LIFE EVENTS ON RELAPSE OF GENERALIZED ANXIETY DISORDER , 2012, Depression and anxiety.

[10]  Mary S Dietrich,et al.  Stressful life events, worry, and rumination predict depressive and anxiety symptoms in young adolescents. , 2015, Journal of child and adolescent psychiatric nursing : official publication of the Association of Child and Adolescent Psychiatric Nurses, Inc.

[11]  Olga V. Demler,et al.  Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. , 2005, Archives of general psychiatry.

[12]  K. Fjermestad,et al.  Stressful life experiences and mental health problems among unaccompanied asylum-seeking children , 2013, Clinical child psychology and psychiatry.

[13]  E. Sadeghian,et al.  Stressors and Mental Health Status among Students of Hamadan University of Medical Sciences , 2009 .

[14]  T. Si,et al.  Stressful life events preceding the onset of depression in Asian patients with major depressive disorder , 2015, The International journal of social psychiatry.

[15]  Golda S. Ginsburg,et al.  Stressful Life Events and Child Anxiety: Examining Parent and Child Mediators , 2016, Child Psychiatry and Human Development.

[16]  L. Clark,et al.  Neighborhood context, personality, and stressful life events as predictors of depression among African American women. , 2005, Journal of abnormal psychology.

[17]  J. Warner,et al.  The relation between psychological factors and DNA-damage: A critical review , 2006, Biological Psychology.

[18]  C. Buhusi,et al.  MENTAL DISORDERS , 1969 .

[19]  K. Kendler,et al.  Dependent stressful life events and prior depressive episodes in the prediction of major depression: the problem of causal inference in psychiatric epidemiology. , 2010, Archives of general psychiatry.

[20]  David Ruppert,et al.  Bayesian Models for Multiple Outcomes Nested in Domains , 2009, Biometrics.

[21]  S A Stansfeld,et al.  Effects of chronic job insecurity and change in job security on self reported health, minor psychiatric morbidity, physiological measures, and health related behaviours in British civil servants: the Whitehall II study , 2002, Journal of epidemiology and community health.

[22]  Wei Han,et al.  Examining the relationship between lifetime stressful life events and the onset of major depression in Chinese women , 2011, Journal of affective disorders.

[23]  I. Nazareth,et al.  Prevalence of common mental disorders in general practice attendees across Europe , 2008, British Journal of Psychiatry.

[24]  A. Noorbala,et al.  Trends in change of mental health status in the population of Tehran between 1998 and 2007. , 2012, Archives of Iranian medicine.

[25]  G. Bernal,et al.  Depression symptoms and stressful life events among college students in Puerto Rico. , 2013, Journal of affective disorders.

[26]  S. Hosseini,et al.  Analyzing the Relationship Between Job Stress to Mental Health, Personality Type And Stressful Life Events of the Nurses Occupied in Tehran 115 Emergency , 2013, Iranian Red Crescent medical journal.

[27]  C. Hoven,et al.  Relationship Between Specific Adverse Life Events and Psychiatric Disorders , 2001, Journal of abnormal child psychology.

[28]  R. Kessler,et al.  The effects of stressful life events on depression. , 1997, Annual review of psychology.

[29]  F. Ghoreishi,et al.  Prevalence of psychiatric disorders in the general population of Kashan, Iran. , 2012, Archives of Iranian medicine.

[30]  A. Dobson,et al.  Traumatic events, other operational stressors and physical and mental health reported by Australian Defence Force personnel following peacekeeping and war-like deployments , 2012, BMC Psychiatry.

[31]  A. Abas,et al.  Association Between Mental Health and Educational Stressful Factors Among Students of Razi Nursing and Midwifery School in Kerman , 2011 .

[32]  Costas N. Stefanis,et al.  Neuroticism, social network, stressful life events: Association with mood disorders, depressive symptoms and suicidal ideation in a community sample of women , 2015, Psychiatry Research.

[33]  C. Greeno,et al.  Economic Stress, Social Support, and Maternal Depression: Is Social Support Deterioration Occurring. , 2010 .

[34]  Tanzy M. T. Love,et al.  Latent factor regression models for grouped outcomes , 2013, Biometrics.

[35]  J. Bonde Psychosocial factors at work and risk of depression: a systematic review of the epidemiological evidence , 2008, Occupational and Environmental Medicine.

[36]  F. Ghoreishi,et al.  Prevalence of psychiatric disorders in the general population of Kashan, Iran. , 2012, Archives of Iranian medicine.

[37]  S. Assari,et al.  Stressful Life Events and Risk of Depression 25 Years Later: Race and Gender Differences , 2016, Front. Public Health.

[38]  S. Burgard,et al.  The Impact of Sleep Disturbance on the Association Between Stressful Life Events and Depressive Symptoms. , 2016, The journals of gerontology. Series B, Psychological sciences and social sciences.

[39]  Gholamreza Garmaroudi,et al.  The 12-item General Health Questionnaire (GHQ-12): translation and validation study of the Iranian version , 2003, Health and quality of life outcomes.

[40]  N. H. Rod,et al.  Stressful life events and leucocyte telomere length: Do lifestyle factors, somatic and mental health, or low grade inflammation mediate this relationship? Results from a cohort of Danish men born in 1953 , 2016, Brain, behavior, and immunity.

[41]  K. Conner,et al.  Stressful Life Events and Depressive Symptoms: Influences of Gender, Event Severity, and Depression History , 2009, The Journal of nervous and mental disease.

[42]  Ali Montazeri,et al.  The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian version , 2003, Health and quality of life outcomes.

[43]  J. O'Loughlin,et al.  Common stressful life events and difficulties are associated with mental health symptoms and substance use in young adolescents , 2012, BMC Psychiatry.

[44]  Jie Chen,et al.  The influence of pubertal timing and stressful life events on depression and delinquency among Chinese adolescents. , 2015, PsyCh journal.

[45]  Hamidreza Roohafza,et al.  Development and validation of the stressful life event questionnaire , 2011, International Journal of Public Health.

[46]  M. Abou-Saleh,et al.  Prevalence, symptom patterns and comorbidity of anxiety and depressive disorders in primary care in Qatar , 2011, European Psychiatry.

[47]  R. Kumar,et al.  Resilience, stressful life events, and depressive symptomatology among older Chinese adults , 2015, Aging & mental health.

[48]  Y. Şenol,et al.  Anxiety, depression and stressful life events among medical students: a prospective study in Antalya, Turkey , 2001, Medical education.

[49]  N. Ali,et al.  Trends in Change of Mental Health Status in the Population of Tehran between 1998 and 2007 , 2012 .

[50]  Norzarina Mohd Zaharim,et al.  Religiousness and Mental Health: Systematic Review Study , 2016, Journal of Religion and Health.

[51]  N. Talley,et al.  The study on the epidemiology of psychological, alimentary health and nutrition (SEPAHAN): Overview of methodology , 2012 .

[52]  E. Karademas,et al.  Financial strain, dyadic coping, relationship satisfaction, and psychological distress: A dyadic mediation study in Greek couples , 2017, Stress and health : journal of the International Society for the Investigation of Stress.

[53]  K. Harkness,et al.  Stressful Life Events Prior to Depression Onset and the Cortisol Response to Stress in Youth with First Onset Versus Recurrent Depression , 2016, Journal of abnormal child psychology.

[54]  M. Roca,et al.  Prevalence and comorbidity of common mental disorders in primary care. , 2009, Journal of affective disorders.