Surviving adversity: event decay, vulnerability and the onset of anxiety and depressive disorder

Knowledge concerning the temporal relationship between adverse experiences and the onset of anxiety and depressive disorders remains sparse despite li fe stress forming a pivotal component to social, neurological and cognitive science models of their aetiology. In this study two groups of married wom en were selected through their shared adverse experiences; for one group, t he marital partner had recently died, and in the second group, the marital partner had recently experienced a myocardial infarction. These groups were assessed in close proximity to their event experiences and again approxima tely 3 months later Adaptations of both the Longitudinal Interval Follow-up Evaluation and the Life Event and Difficulty Schedule were used to provide a detailed clinical and event history both preceding and following their e xperiences. Analysis showed clear evidence for the progressive decay in the adverse effects of life events over time: an attribute thus far largely ne glected in work seeking to clarify event-illness relationships. Comparisons between fixed and time-varying effects, representative of precisely formul ated models of vulnerability/resilience, confirmed the role both of previou s psychiatric consultation history and of limited individual coping skills as risk factors for the onset of diagnosable disorder. Improvements in the specification of stress modelling procedures should facilitate the integrat ion of ideas from competing aetiological models of the onset and subsequent course of anxiety and depressive disorder.