Lifetime stressors and recurrent depression: preliminary findings of the Adult Life Phase Interview (ALPHI)

Background: The well-established association between stress and depression is explored in a lifespan context in relation to adverse childhood experien ce. A new retrospective interview instrument, the Adult Life Phase intervie w (ALPHI) examined the number of chronic stressors (or 'adversities') exper ienced over the adult life course in relation to chronic or recurrent clini cal depression. The role of such lifetime adversity in mediating the relati onship between childhood neglect/abuse and adult disorder was examined. Met hod: The ALPHI uses an investigator-based, contextual approach suited to re trospective and time-linked enquiries. Reliability of the instrument was fo und to be satisfactory. Its association with both lifetime clinical depress ion and childhood neglect or abuse was examined in a community series of 19 8 women, consisting of 99 sister pairs, where one-half of the series was se lected for having had adverse childhood experience and the other for compar ison. Results: Adult adversity, both at settled/fixed times and at times of major life change, was significantly higher among those with prior childho od neglect or abuse. Both a high adult adversity score and childhood neglec t or abuse were related to chronic or recurrent episodes of clinical depres sion, with logistic regression indicating both indices contributed independ ently to disorder. The same results held when controls were made for sister status, given possible familial bias in experience, and for age, since wom en under age 25 had fewer adult phases and less adversity. Conclusions: Cha racteristics of adult life phases and change-points are described and the r elevance of the measure for intensive survey work seeking to investigate re lationships between lifespan experience and depression is discussed.