Stressful Life Events and Major Depression: Risk Period, Long-Term Contextual Threat, and Diagnostic Specificity
Abstract
Although stressful life events (SLEs) play a major role in many etiologic theories of major depression (MD), important questions remain about the nature of their association with the onset of depressive episodes. We assessed over the last year, in female twins ascertained from a population based registry, the occurrence of 15 classes of SLEs and the onset of DSM-III-R MD and 2-week generalized anxiety disorder (GAD). The sample contained 24,648 person-months, 316 onsets of MD, and 239 onsets of GAD. SLEs were rated on long-term contextual threat and dependence. Discrete time-survival analyses were employed. The association between SLEs and depressive onsets was usually strongest in the month of occurrence but extended for "difficulty-like" events for up to 6 months. The depressogenic effect of SLEs was strongly predicted by contextual threat level, although some low threat events significantly increased risk for MD. The risk for a depressive onset given the number of reported SLEs within one month was: no event, 0.9%; one, 3.4%; two, 6.8%; and three, 23.8%. Although a few events were relatively specifically depressogenic or anxiogenic, most SLEs increased risk for both MD and GAD. The risk period produced by SLEs range from short-lived to relatively prolonged. High threat events encompass most but not all of the depressogenic effects of SLEs. Multiple SLEs in the same month substantially increase the risk for a depressive onset. The specificity of most SLEs for depressive ver…
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The Swedish registry data used did not permit assessment of all relevant environmental stressors for MD, so the ERS covers a more restricted range of adversities than interview or questionnaire-based assessments.
“official Swedish registry data did not permit the assessment of all relevant environmental stressors for MD”
From The development of an environmental risk score using Swedish National Registers and its impact on subsequent episodes of major depression (2025) · cites this paper as Kendler et al., 1998
Stressful life events increase the risk for subsequent major depression episodes.
“Stressful life events (SLEs) increase the risk for subsequent major depression (MD) episodes.”
From The development of an environmental risk score using Swedish National Registers and its impact on subsequent episodes of major depression (2025) · cites this paper as Kendler, Karkowski, & Prescott, 1998
Previous studies have shown that high long-term contextual threat increases MDE onset following SLE occurrence substantially.
“Additionally, previous studies have shown that high long-term contextual threat increases MDE onset following SLE occurrence substantially (Kendler et al., 1998), but we did not assess long-term contextual threat in the current study.”
From Stressful life events increase the risk of major depressive episodes: A population-based twin study (2023) · cites this paper as Kendler et al., 1998
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“…from Swedish registry information and showed that, consistent with a range of prior studies based on interview-assess SLEs (Brown et al., 1995; Kendler et al., 1998), the death of a close relatives (parents, siblings, spouse, and children) was associated with a substantial and sustained…”
InfluentialSelf-citation
- Authors
- KENDLER, K. S., KARKOWSKI, L. M., & PRESCOTT, C. A.
- Affiliations
- Virginia Commonwealth University (US)
- Venue
- The Journal of Nervous & Mental Disease
- Published
- 1998-11
- Volume
- 186
- Issue
- 11
- Pages
- 661-669
- ISSN
- 0022-3018 (ISSN-L)
- OpenAlex
- W2023288605
- Cited by
- 380
- References
- 2
- Citations by year
- 2026: 11 · 2025: 10 · 2024: 11 · 2023: 17 · 2022: 17 · 2021: 23 · 2020: 14 · 2019: 14 · 2018: 16 · 2017: 15 · 2016: 18 · 2015: 18 · 2014: 25 · 2013: 19 · 2012: 20
- FWCI
- 9.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Nervous and Mental Disease (publishedVersion)
- PubMed (publishedVersion)
- 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
- life events, major depressive disorder, generalized anxiety disorder, risk periods, diagnostic specificity, female twins, twin registry, etiology of depression, anxiogenic effects
- MeSH terms
- Adult, Anxiety Disorders, Depressive Disorder, Diseases in Twins, Female, Humans, Life Change Events, Longitudinal Studies, Retrospective Studies, Risk Factors, Logistic Models, Odds Ratio, Survival Analysis
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