Negative life events and symptoms of depression and anxiety: stress causation and/or stress generation
Open accessAbstract
BACKGROUND AND OBJECTIVES: Stressful life events are known to contribute to development of depression; however, it is possible this link is bidirectional. The present study examined whether such stress generation effects are greater than the effects of stressful life events on depression, and whether stress generation is also evident with anxiety. DESIGN: Participants were two large age cohorts (N = 732 aged 44 years; N = 705 aged 63 years) from the West of Scotland Twenty-07 study. METHODS: Stressful life events, depression, and anxiety symptoms were measured twice five years apart. Cross-lagged panel analysis examined the mutual influences of stressful life events on depression and on anxiety over time. RESULTS: Life events predicted later depressive symptomatology (p = .01), but the depression predicting life events relationship was less strong (p = .06), whereas earlier anxiety predicted life events five years later (p = .001). There was evidence of sex differences in the extent to which life events predicted later anxiety. CONCLUSIONS: This study provides evidence of stress causation for depression and weaker evidence for stress generation. In contrast, there was strong evidence of stress generation for anxiety but weaker evidence for stress causation, and that differed for men and women.
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Stress is a risk factor for physical and mental disorders.
“Even though research indicates, in line with the assumptions of the procrastination-health model, that stress is a risk factor for physical and mental disorders [63–66]”
From Procrastination, depression and anxiety symptoms in university students: a three-wave longitudinal study on the mediating role of perceived stress (2024) · cites this paper as [64]
The Background and Objectives section states that stressful life events contribute to the development of depression, supporting the mental-health part of the claim. The paper does not establish that stress is a risk factor for physical disorders; the physical-health terms found in the Methods describe categories of life events, not outcomes of stress. (LLM, conf=0.88)
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“[11] Cortisol has been considered a biological marker of stress and anxiety, and cortisol levels have been studied in relation to psychological changes in patients.”
The Relationship of Acculturation, Traumatic Events and Depression in Female Refugees
Starck, A., Gutermann, J., Schouler‐Ocak, M., Jesuthasan, J., Bongard, S., & Stangier, U. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.00906 · Cited by 32 · see citing works
Philpott, L. F., Leahy‐Warren, P., Fitzgerald, S. M., & Savage, E. (2022) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2022.33 · Cited by 31 · see citing works
“The link between stressful life events and the origin and development of anxiety has been investigated in populations outside the perinatal period and provides evidence for supporting the association (Gold, 2015; Phillips et al., 2015; Zuo et al., 2020).”
ResultSandín, B., & Chorot, P. (2017) · Revista de Psicopatología y Psicología Clínica · doi:10.5944/rppc.vol.22.num.2.2017.19729 · Cited by 31 · see citing works
Negative affective stress reactivity: The dampening effect of snacking
Wouters, S., Jacobs, N., Duif, M., Lechner, L., & Thewissen, V. (2017) · Stress and Health · doi:10.1002/smi.2788 · Cited by 29 · see citing works
de Vries, L. P., Baselmans, B. M. L., Luykx, J. J., de Zeeuw, E. L., Minică, C. C., de Geus, E. J. C., Vinkers, C. H., & Bartels, M. (2021) · Neurobiology of Stress · doi:10.1016/j.ynstr.2021.100315 · Cited by 31 · see citing works
Xia, H., Han, X., Jing, C., Liu, D., Wu, Y., & Liu, Y. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.781274 · Cited by 29 · see citing works
“Negative life events can effectively predict the occurrence of depression (Phillips et al., 2015).”
BackgroundZhao, C., Ding, N., Yang, X., Xu, H., Lai, X., Tu, X., Lv, Y., Xu, D., & Zhang, G. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2021.752210 · Cited by 28 · see citing works
“Several studies have confirmed that there was a positive correlation between stressful life events and depression (34, 35), stressful life events is a risk factor for depression (36), and have a direct impact on individuals’ depressive symptoms (37, 38).”
BackgroundXu, C., Liu, X., Chen, Y., Mao, Y., Guo, R., Zhou, G., Tang, L., Lin, A., Sun, Y. H., & Ma, J. (2017) · Cancer Medicine · doi:10.1002/cam4.1232 · Cited by 25 · see citing works
“Firstly, it has been verified that negative life events can induce psychological stress with adverse influence on health [17, 18].”
BackgroundOwens, G. P., Held, P., Hamrick, L., & Keller, E. (2018) · Motivation and Emotion · doi:10.1007/s11031-018-9688-0 · Cited by 27 · see citing works
Burger, R., Posel, D. R., & von Fintel, M. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.04.031 · Cited by 27 · see citing works
“…life events and vulnerability to depression is well documented in developed countries (Brown and Harris, 1978; Kendler et al., 1999; Kessler, 1997; Phillips et al., 2015; Slopen et al., 2011), but less so in developing countries, where data limitations have led researchers to focus more on the…”
BackgroundLin, S., Wu, Y., & Fang, Y. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.764806 · Cited by 28 · see citing works
“The stress-depression theory (19) deems that stress may cause or induce depression.”
BackgroundMaes, M. H. J., & Almulla, A. F. (2023) · Brain Sciences · doi:10.3390/brainsci13050714 · Cited by 27 · see citing works
“Furthermore, there is evidence that stressful life events may lead to depression, rather than the other way around [48].”
BackgroundMediating effect of social support on the association between life events and depression
Liu, L., Liu, C., Ke, X., & Li, N. (2020) · Medicine · doi:10.1097/md.0000000000022627 · Cited by 28 · see citing works
McCullen, J. R., Counts, C. J., & John‐Henderson, N. A. (2022) · Emotion · doi:10.1037/emo0001106 · Cited by 26 · see citing works
Jochmann, A., Gusy, B., Lesener, T., & Wolter, C. (2024) · BMC Psychology · doi:10.1186/s40359-024-01761-2 · Cited by 24 · see citing works
Güngör, A., Young, M. E., & Sivo, S. A. (2021) · Journal of Pedagogical Research · doi:10.33902/jpr.2021472963 · Cited by 24 · see citing works
“Journal of Pedagogical Research, 5(4), 62-75. https://dx.doi.org/10.33902/JPR.2021472963 life events and several psychological issues, including depressive symptoms, anxiety, somatic symptoms, delinquency, insomnia, and social dysfunction (e.g., Phillips et al., 2015).”
BackgroundInfluentialBrown, S. L., Fisher, P., Hope‐Stone, L., Hussain, R. N., Heimann, H., Damato, B. E., & Cherry, M. G. (2020) · Psycho-Oncology · doi:10.1002/pon.5514 · Cited by 22 · see citing works
“Cross-lagged studies in the mental health literature show that recent events, such as life experiences, predict anxiety, and depression.(10) Survivor studies rarely examine whether events occurring after treatment predict later anxiety and depression symptoms.”
BackgroundLi, H., Ludin, A. F. M., Ahmad, M., Xie, M., & Lei, H. Z. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1358210 · Cited by 21 · see citing works
Diez‐Canseco, F., Carbonel, A., Bernabé‐Ortiz, A., Olivar, N., Gómez–Restrepo, C., Toyama, M., Uribe-Restrepo, J. M., Brusco, L. I., Hidalgo-Padilla, L., Ramirez-Meneses, D., et al. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1466378 · Cited by 24 · see citing works
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The Link Between Major Life Events and Quality of Life: The Role of Compassionate Abilities
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Pathways from anxiety to stressful events: An expansion of the stress generation hypothesis
Meyer, A. E., & Curry, J. F. (2017) · Clinical Psychology Review · doi:10.1016/j.cpr.2017.08.003 · Cited by 16 · see citing works
“The findings of four studies, which conceptualized anxiety in diverse ways, including diagnostically, supported anxiety-associated stress generation (Brantley et al., 1999; Phillips et al., 2015; Shapero, Hamilton, Liu, Abramson, & Alloy, 2013; Uliaszek et al., 2012).”
BackgroundLocus of control, negative live events and psychopathological symptoms in collectivist adolescents
Moreira, P., Vaz, J. M., Stevanović, D., Atilola, O., Dodig‐Ćurković, K., Franić, T., Đorić, A., Davidović, N., Avicenna, M., Noor, I. M., et al. (2019) · Personality and Individual Differences · doi:10.1016/j.paid.2019.109601 · Cited by 16 · see citing works
Cox, C. C., Adler‐Baeder, F. M., McGill, J. M., & Cooper, E. B. (2020) · Mindfulness · doi:10.1007/s12671-020-01404-8 · Cited by 16 · see citing works
“…in particular anxiety, have been studied extensively (Clausen and Yarrow 1955; Connolly et al. 2010; McLeod 1994; Pankiewicz et al. 2012; Phillips et al. 2015; Riskind et al. 2010; Whisman 1999; Whisman et al. 2000; Whisman 2007), but the psychological resource of mindfulness has only…”
BackgroundMoreira, M. D. F., Gamboa, O. L., & Oliveira, M. A. P. (2021) · Women & Health · doi:10.1080/03630242.2021.1993423 · Cited by 16 · see citing works
“Additionally, women diagnosed with anxiety and depression exhibited higher perceived stress and higher pain unpleasantness, corroborating the close link and possible reinforcement between these negative emotional states (Phillips, Carroll, and Der 2015).”
BackgroundBody compassion safeguards against the impact of major life events on binge eating
Barata-Santos, M., Marta‐Simões, J., & Ferreira, C. (2018) · Appetite · doi:10.1016/j.appet.2018.12.016 · Cited by 15 · see citing works
Ni, T., Zhang, Y., Xue, S., Xu, W., & Tang, W. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.1050260 · Cited by 15 · see citing works
“The greater the number of negative life events experienced in childhood and early adolescence, the greater the vulnerability to depression and PTSD (Phillips et al., 2015; Young and Dietrich, 2015; Pinto et al., 2017; Van Den Berg et al., 2017).”
BackgroundCuadrado, E., Arenas, A., Moyano, M., & Tabernero, C. (2021) · Family Process · doi:10.1111/famp.12698 · Cited by 15 · see citing works
“Others have explained how the anxiety level displayed by individuals (which may be due to stressful situation exposure) interferes with the capacity to cope effectively with stress, being then related to acute stress levels (Fawzy & Hamed, 2017; Gillott & Standen, 2007; Phillips et al., 2015).”
BackgroundResultLuque, B., Castillo‐Mayén, R., Cuadrado, E., Gutiérrez‐Domingo, T., Rubio, S. J., Arenas, A., Delgado‐Lista, J., Pérez‐Martínez, P., & Tabernero, C. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9103165 · Cited by 14 · see citing works
“Concerning the regulation of negative affect, and although research with clinical samples is scarce in this domain, research shows some sex differences in relation to depression and anxiety levels and the use of emotional regulation strategies [44].”
BackgroundIovoli, F., Hall, M., Nenadić, I., Straube, B., Alexander, N., Jamalabadi, H., Jansen, A., Stein, F., Brosch, K., Thomas‐Odenthal, F., et al. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.03.119 · Cited by 14 · see citing works
Prevalence of depression and anxiety among otolaryngology outpatients at Jordan University Hospital
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Anxiety Depression Stress Scale (ADSS): A Factor Analytic Study
Singh, M., & Bhatnagar, P. (2016) · International Journal of Indian Psychology · doi:10.25215/0302.007 · Cited by 12 · see citing works
Goldstein, B. L., Armeli, S., Adams, R. L., Florimon, M. A., Hammen, C. L., & Tennen, H. A. (2021) · Anxiety Stress & Coping · doi:10.1080/10615806.2021.1910677 · Cited by 12 · see citing works
“In some longitudinal research, anxiety symptoms have been found to predict stressful life events (Jeronimus et al., 2013; Uliaszek et al., 2012) and anxiety may be even more strongly related to stressful events than depressive symptoms (Phillips et al., 2015).”
BackgroundHarrison, T. J., Ginsburg, G. S., Smith, I. C., & Orlando, C. M. (2022) · Anxiety Stress & Coping · doi:10.1080/10615806.2022.2076083 · Cited by 12 · see citing works
“First, we used the Anxiety Disorders Interview Schedule, a gold standard measurement of anxiety disorders rather than relying only on self-report measures of anxiety which has been the standard (e.g., Judah et al., 2013; Phillips et al., 2015; Schnieder et al., 2021; Siegel et al., 2018) when examining stress generati…”
BackgroundMethodResultInfluentialYazıcı‐Kabadayı, S., & Öztemel, K. (2022) · Psychological Reports · doi:10.1177/00332941221119415 · Cited by 12 · see citing works
“…behavioral qualities (Davila et al., 1995) that play a role in the formation of stress experienced by people with SGS tendency cause problems (Connolly et al., 2010) such as depression (Flynn & Rudolph, 2011; Hammen, 2006; Hammen & Shih, 2008) and anxiety (Phillips et al., 2015) in these people.”
BackgroundSarubin, N., Goerigk, S. A., Padberg, F., Übleis, A., Jobst, A., Erfurt, L., Schumann, C., Nadjiri, A., Dewald‐Kaufmann, J., Falkai, P., et al. (2018) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12205 · Cited by 12 · see citing works
Hannaford, E., Moore, F. R., & Macleod, F. J. (2017) · Aging & Mental Health · doi:10.1080/13607863.2017.1387761 · Cited by 12 · see citing works
“This relationship may be bi-directional, with longitudinal, community-based studies of both working-age and older adults finding recent SLEs were both predictive of, and predicted by, symptoms of depression (Fiske et al., 2003; Phillips et al., 2015).”
BackgroundResultDiFonte, M. C., Schick, M. R., & Spillane, N. S. (2022) · Journal of American College Health · doi:10.1080/07448481.2021.2024211 · Cited by 14 · see citing works
“25,26,29,30,55 Finally, while the present study aimed to examine the role of anxiety symptomatology in particular, future work would benefit from examining other mental health concerns, such as externalizing problems, depression, trauma, self-esteem, and other mood disorders.”
BackgroundWang, X., Cao, C.-H., Liao, X.-L., Jiang, X.-Y., Griffiths, M. D., Chen, I., Lin, C., & Malas, O. (2025) · BMC Psychology · doi:10.1186/s40359-025-02728-7 · Cited by 11 · see citing works
“Prolonged high stress can trigger mental health issues such as obsessive-compulsive disorder and depression [15, 16], impairing work efficiency and quality of life [15], and reducing life satisfaction and personal well-being [16].”
Işık, O., Tengilimoğlu, D., Tosun, N., Zekioğlu, A., & Tengilimoğlu, O. (2021) · Evaluation & the Health Professions · doi:10.1177/01632787211062660 · Cited by 11 · see citing works
“Stress can trigger depression and anxiety (Phillips et al., 2015).”
Lazić, M., Gavrilov‐Jerković, V., & Jovanović, V. (2018) · Journal of Happiness Studies · doi:10.1007/s10902-018-0050-8 · Cited by 11 · see citing works
Terp, U., Bisholt, B. K. M., & Hjärthag, F. (2022) · BMC Nursing · doi:10.1186/s12912-021-00761-6 · Cited by 10 · see citing works
“There is also a link between stress and more severe mental health problems as anxiety and depression [9].”
BackgroundKingsbury, M. K., Alaie, I., Clayborne, Z. M., Reme, B., Nilsen, W., & Colman, I. (2024) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2024.08.011 · Cited by 10 · see citing works
“Adults living with chronic illness tend to be at greater risk of experiencing depressive symptoms [12], as do those who have experienced stressful life events [24].”
Handwriting and Drawing for Depression Detection: A Preliminary Study
Raimo, G., Buonanno, M., Conson, M., Cordasco, G., Faúndez-Zanuy, M., McConvey, G., Marrone, S., Marulli, F., Vinciarelli, A., & Esposito, A. A. (2022) · Communications in computer and information science · doi:10.1007/978-3-031-24801-6_23 · Cited by 10 · see citing works
“Experiencing adverse life events, like a pandemic situation or a social isolation lockdown, can increase the likelihood of developing depression, also after many years [15].”
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Prenatal Stress and Maternal Role in Neurodevelopment
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“This fact should be considered in further studies, given that research has revealed sex differences in anxiety levels (Phillips et al., 2015) and the use of emotion regulation strategies (Nolen-Hoeksema, 2012), with women using most of them more frequently.”
BackgroundStressful Life Events Are Related to More Negative Interpretations, but Not Under Acute Stress
Bélanger, K., & Blanchette, I. (2021) · Psychological Reports · doi:10.1177/00332941211014150 · Cited by 9 · see citing works
“Studies have shown correlations between the number of stressful life events experienced and deleterious effects such as depression, anxiety and physical diseases (Holmes & Rahe, 1967; Phillips et al., 2015; Sharpley et al., 2004).”
BackgroundIncivility and Counterproductive Work Behavior
Hameed, Z., Khan, I. U., Chudhery, M. A. Z., & Ding, D. (2017) · International Journal of Applied Behavioral Economics · doi:10.4018/ijabe.2017070101 · Cited by 9 · see citing works
Stressor-evoked heart rate, perceived physiological arousal, and anxiety symptoms in young adults
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Depression, anxiety, and stress among Indian urban affluent adults
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“This aligns well with the existing literature as previous researchers have suggested that emotional distress predicts later stress (Kim et al., 2003; Phillips et al., 2015).”
Social exclusion and critical transitions in later life: Trajectories, forms and mechanisms
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“…longitudinal evidence from a birth cohort indicates that early childhood adversity correlates with increased stressful life events into adulthood (Brennan et al., 2024), both of which are strongly correlated with internalizing mental-health problems (Phillips et al., 2015; Raposa et al., 2014).”
Kigar, S. L., Lynall, M.-E., DePuyt, A. E., Atkinson, R., Sun, V. H., Samuels, J. D., Eassa, N. E., Poffenberger, C. N., Lehmann, M. L., Listwak, S. J., et al. (2025) · Nature Communications · doi:10.1038/s41467-025-62840-5 · Cited by 10 · see citing works
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“Self-compassion influences one’s cognitions and behavioral responses to tough life events while those life events are often accompanied by high levels of perceived stress (Phillips et al., 2015).”
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“In the general population, a greater number of stressful life events is associated with deleterious effects on physical and mental health, such as mood and anxiety disorders as well as physical diseases (Holmes & Rahe, 1967; Phillips et al., 2015; Sharpley et al., 2004).”
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“…can lead to the imbalance of homeostasis and cause mental disorders such as depression, anxiety, addictive behavior, psychosis (Zhao et al., 2021; Phillips et al., 2015; Restrepo & Lemos, 2021; Abdel Wahed & Hassan, 2017; Magalhães et al., 2022; Colizzi et al., 2023; Mansueto & Faravelli, 2022),…”
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Linking Anticipated Stigma to Psychological Well-Being: Mediating Role of Anxiety & Depression
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- Authors
- Phillips, A. C., Carroll, D., & Der, G.
- Affiliations
- University of Birmingham (GB)
- MRC/CSO Social and Public Health Sciences Unit (GB)
- Corresponding author
- Phillips, Anna C.
- Venue
- Anxiety, Stress, & Coping
- Publisher
- Informa UK Limited
- Published
- 2015-02-05
- Volume
- 28
- Issue
- 4
- Pages
- 357-371
- ISSN
- 1061-5806 (ISSN-L)
- 1477-2205
- PMC
- PMC4772121
- OpenAlex
- W2059911397
- Cited by
- 166
- References
- 45
- Citations by year
- 2026: 12 · 2025: 16 · 2024: 27 · 2023: 12 · 2022: 17 · 2021: 18 · 2020: 17 · 2019: 10 · 2018: 10 · 2017: 14 · 2016: 6 · 2015: 6
- FWCI
- 18.13
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Anxiety Stress & Coping (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Stirling Online Research Repository (University of Stirling) (submittedVersion, public-domain)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- Funders
- The UK Medical Research Council (WBS U.1300.80.001.00001)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- negative life events, life events, depression, anxiety symptoms, stress generation, bidirectional effects, sex differences, middle-aged and older adults, West of Scotland Twenty-07 Study
- MeSH terms
- Adult, Anxiety, Depression, Female, Humans, Life Change Events, Male, Middle Aged, Psychiatric Status Rating Scales, Surveys and Questionnaires, Sex Factors, Stress, Psychological
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