Arch Gen Psychiatry -- Life Event Dimensions of Loss, Humiliation, Entrapment, and Danger in the Prediction of Onsets of Major Depression and Generalized Anxiety, A…
1/27/07 10:12 AM
ALTHOUGH THE correlation between stressful life events (SLEs)
and the onset of
major depression (MD) has been replicated frequently
and is probably causal,
the attributes that render the events depressogenic are still uncertain.
The concept of loss as the central depressogenic experience can be traced
and was first operationalized in SLE research as "exit events."
Jump to Section
influenced by evolutionary theory and animal behavior research, is that reduction of
status—forcing the individual into a subordinate position—is the essential depressogenic attribute of
Another perspective, influenced
is that helpless entrapment is the key
Another central question in life event research is the diagnostic specificity of events, as SLEs also precede
episodes of anxiety disorders,
however, have examined whether SLEs are divisible into categories of depressogenic vs anxiogenic.
Building on previous methodological developments, Brown and colleagues
(G. W. Brown, PhD,
unpublished manual, Guidelines, Examples and LEDS-2 Notes on Rating for a New Classification Scheme
for Humiliation, Loss, and Danger, 1996) proposed a more refined system for rating 4 dimensions of
SLEs: loss, humiliation, entrapment, and danger (Table 1). To date, only 2 studies samples of women—have used this system.
both with small
View this table: [in this window] [in a new window]
Table 1. Brief Definitions of Stressful Life Event Categories*
Several previous studies have examined sex differences in sensitivity to the depressogenic effects of
have reported an increase in sensitivity among women that is either
global or restricted to certain events usually involving either interpersonal relations or family. However,
analysis of the Epidemiologic Catchment Area study data found greater male sensitivity to the
depressogenic effects of marital disruption, a stronger depressogenic effect of divorce or 29
and, examining standard separation in men.
In this study, we examine, in 7322 male and female twins from a population-based register, SLEs blindly rated using the 4-dimension system and the onsets in the past year of (1) pure MD episodes, (2) pure episodes of a brief generalized anxiety disorder (GAD) syndrome we call generalized anxiety syndrome (GAS), and (3) mixed MD-GAS episodes. We examine these 2 disorders in part because results of twin s t u d i e s s u g g e s t t h a t t h e g e n e t i c f a c t o r s t h a t i n f l u e n c e l i a b i l i t y t o M D a n d G A D a r e s o c l o s e l y r e l a t e d that it is environmental risk factors that determine whether a vulnerable individual develops one or the - 3 1 3 4
other or both of these syndromes.
Using these more refined event ratings, we seek to (1) define the features of SLEs that predispose to pure MD, pure GAS, and mixed MD-GAS episodes and (2) determine whether men and women differ in the depressogenic and anxiogenic effects of these event dimensions and categories.
Jump to Section
Page 2 of 13