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The external environment
Published in Tony Cassidy, Stress, Cognition and Health, 2023
A great deal of research on the effects of major life events was based on the initiative by Holmes and Rahe (1967), who developed measures of life events. For Holmes and Rahe, major life events were “life change events”, i.e. any event which forced the person to face substantial change in their daily life and required some readjustment or behavioural adaptation. This definition included positive and negative events, something which has been substantiated in later research. Holmes and Rahe listed forty-three events, including death of spouse, divorce, vacation, Christmas and minor violations of the law. Measures could be attained in one of two ways. Individuals could be asked to indicate which of these events they had experienced during a specified time period (Schedule of Recent Experiences—SRE). The alternative form (Social Readjustment Rating Scale—SRRS) had predetermined weightings attached to each event, thus allowing the calculation of a severity score. More recent scales to measure major life events include the Life Events Inventory (LES; Sarason, Johnson & Siegel, 1978) and the Psychiatric Epidemiology Research Interview (PERI; Dohrenwend, Krasnoff, Askenasy & Dohrenwend, 1978). The semi-structured interview technique (Life Events and Difficulties Schedule—LEDS) used by Brown and Harris (1978, 1989) will be discussed separately later.
Understanding mental health and mental illness
Published in April Russello, Severe Mental Illness in Primary Care, 2018
Although an association between life events and illness does not automatically indicate causality, periods of life changes (Rahe et al, 1970) for both good and bad are associated with illness. ‘Exit events’ or events involving loss or departure of an individual from the immediate social field of the client or patient, are loosely associated with depression (Paykel et al, 1969). Creed (1992), writing about ‘life events’, looked at two studies on life events in depression and schizophrenia using the ‘Life-Events and Difficulties Schedule’ (LEDS). In the study on schizophrenia, following a relapse, there was a clear increase in subjects experiencing life events prior to relapse when compared with a control group, even if the life events were relatively minor and non-threatening. In the study on depression conducted with women participants, only events with a severe threat were common among the depressed group and not mild or non-threatening events. This seems to suggest that individuals with schizophrenia may perceive life events, however minor or non-threatening, as disruptive, severe and threatening.
MRCPsych Paper A1 Mock Examination 5: Questions
Published in Melvyn WB Zhang, Cyrus SH Ho, Roger Ho, Ian H Treasaden, Basant K Puri, Get Through, 2016
Melvyn WB Zhang, Cyrus SH Ho, Roger CM Ho, Ian H Treasaden, Basant K Puri
A widely used toolkit for further research into life events and associated psychiatric disorder would be the Life Events and Difficulties Schedule (LEDS) proposed by Brown and Harries (1978). All of the following statements regarding LEDS are true, with the exception of It is based on a semi-structured interview.Forty areas are being probed during the interview.Detailed narratives are obtained regarding events, including their circumstances.It has a high level of reliability.It has a high level of validity.
Predictors of poor 6-week outcome in a cohort of major depressive disorder patients treated with antidepressant medication: the role of entrapment
Published in Nordic Journal of Psychiatry, 2021
Serafim Carvalho, Filipa Caetano, José Pinto-Gouveia, Jorge Mota-Pereira, Dulce Maia, Paulo Pimentel, Cátia Priscila, Paul Gilbert
The Life Events and Difficulties Schedule (LEDS) is a semi-structured interview schedule that facilitates an in-depth investigation of life adversity over a set reporting period [45,46]. The reporting period in this study was the previous 12 months before the index episode. In the LEDS interview, stressful life events and difficulties (LEDs) can be categorized into four dimensions: loss, danger, humiliation and entrapment. They can also be divided into ten key categories of adversity, including health, reproduction, marital and other relationships, work, education, housing, money, crime/legal issues, bereavement and entrapment [47,48]. This measure distinguishes between discrete events and ongoing difficulties (for > 4 weeks). Events are rated on ‘reported’ and ‘contextual’ severity, as well as short- and long-term threat (10–14 days after the event). Threat is rated on a 4-point scale ranging from 1 (marked) to 4 (little or none). Severe events are those rated 1 or 2 on severity. Difficulties are rated on a 7-point scale ranging from 1 (high marked severity) to 7 (no longer a difficulty); fresh starts can also be recorded. The interviews were carried out by three trained LEDS interviewers (SC, PP and DM), who completed the LEDS Course at St. Thomas’s Hospital – King’s College, in London, with the authors of the interview, George Brown and Tirrill Harris. Their training involved practice ratings, pilot interviews and supervision to become competent administrators of the measure. The interviews were recorded and rated using rating dictionaries with contextualized examples to standardize the process.
Stress measurement using speech: Recent advancements, validation issues, and ethical and privacy considerations
Published in Stress, 2019
George M. Slavich, Sara Taylor, Rosalind W. Picard
Given these effects of stress on health, numerous approaches have been developed for assessing individuals’ stress levels. The current gold-standard method involves conducting life stress interviews using instruments such as the Life Events and Difficulties Schedule, UCLA Life Stress Interview, and Stress and Adversity Inventory (Monroe & Slavich, in press; Slavich, 2019). In turn, the most commonly used approach involves administering brief self-report questionnaires such as the Perceived Stress Scale (Monroe, 2008). Interview-based measures can be time-consuming and costly, though, and self-report questionnaires often lack item specificity and validity (Cohen, Kessler, Underwood, & Gordon, 1997; Dohrenwend, 2006; Shields & Slavich, 2017). Moreover, both methods are retrospective in nature and subject to (often unmeasured) degrees of cognitive bias and social desirability that can influence the veracity, reliability, and validity of the resulting scores (Monroe, 2008; Monroe & Slavich, 2016).