ADVERSITY OVER THE LIFE-COURSE - ASSESSMENT AND QUANTIFICATION ISSUES

Psychosocial factors are now established as important contributors to understanding inequality and change in health. However, their complex nature creates both assessment and analytic challenges for elucidating their role in competition with more traditional risk factors (particu larly in population studies) and serves to limit their adoption. This article considers these issues as they relate to the measurement and q uantification of adversity exposure over the life course in the contex t of a component study to the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is designed primarily to determine t he extent to which diet diversity across Europe can explain marked var iation in cancer incidence through longitudinal surveys. This article illustrates the extent to which psychological adaptation to loss event experience takes place with increasing time since event occurrence an d the importance of distinguishing such proximal from distal experienc es for analysis. A conceptual framework, graphically represented in te rms of unknown adversity states progressing through time, is discussed for testing and evaluating the relative importance of different adver se experiences and of their impact under increasing complexity. (C) 19 98 John Wiley & Sons, Ltd.