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Partners in adversity V: Support, personality and coping behaviour at the time of crisis

  • P. McC Miller
  • P. G. Surtees
Original Paper

Abstract

This paper presents further results from a study of married women in Edinburgh who had just suffered an adverse experience: either their husband's non-fatal myocardial infartion, their husband's death or their own arrival in a Women's Aid refuge for battered women. Interviews were carried out 4–6 weeks following the adverse experience and, where possible, again approximately 3 months later. Symptoms were assessed using the 30-item General Health Questionnaire and criterion-based measures of depression and anxiety derived from it. The extent and nature of crisis support from household members and from groups of people outside the household, and also of failures in expected support, was measured at first interview. A modified version of Tyrer and Alexander's (1979) personality schedule was administered at the follow-up interview, and the resulting personality data were then reduced to six factors using principal components analysis. An interviewer assessment of how well the subject was coping was made at both interviews. The vast majority of the sample received extensive practical and emotional support from family and friends, and perhaps because such positive support was so prevalent, variations in it seemed to have little effect on symptoms. However, subjects who were unexpectedly ‘let down’ or criticised by friends or family tended to show higher symptom levels, although, surprisingly, this was less true for the bereaved wives than for the others. The six personality factors that emerged were labellednervousness (similar to neuroticism)impulsivity, social withdrawal, helplessness, inferiority andaggressiveness. There was evidence that subjects high on nervousness remained symptomatic longer following the adverse experience. The aggressiveness factor showed a curvilinear trend with high and low aggressives showing higher symptom levels than middle aggressives. However, for the coronary wives the trend was linear with low aggressives having high symptoms. Subjects low on impulsivity were more affected by being ‘let down’ by friends and family. The interviewer-assessed coping measure was linearly related to nervousness and showed a curvilinear relationship with aggressiveness.

Key words

Life event Support Personality Coping Symptoms 

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References

  1. American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders (DMS-III-R), 3rd edn, revised. American Psychiatric Press, Washington, DCGoogle Scholar
  2. Bedford A, Foulds G (1978) Personality deviance scale manual. National Foundation for Educational Research, WindsorGoogle Scholar
  3. Bornstein PE, Clayton PJ, Halikas JA, Maurice WL, Robins E (1973) The depression of widowhood after thirteen months. Br J Psychiatry 122:561–566PubMedGoogle Scholar
  4. Brown GW (1991) Etiological research in the stress area. Some lessons from the past. In: Seva A (ed) European handbook of psychiatry and mental health. Anthropos, BarcelonaGoogle Scholar
  5. Brown GW, Andrews B, Harris T, Adler Z, Bridge L (1986a) Social support, self-esteem and depression. Psychol Med 16:813–831PubMedGoogle Scholar
  6. Brown GW, Bifulco A, Harris T, Bridge L (1986b) Life stress, chronic subclinical symptoms and vulnerability to clinical depression. J Affect Disord 11:1–19CrossRefPubMedGoogle Scholar
  7. Brown GW, Andrews B, Bifulco A, Veiel H (1990a) Self-esteem and depression I. Measurement issues and prediction of onset. Soc Psychiatry Psychiat Epidemiol 25:200–209Google Scholar
  8. Brown GW, Bifulco A, Andrews B (1990b) Self-esteem and depression III. Aetiological issues. Soc Psychiatry Psychiat Epidemiol 25:235–243CrossRefGoogle Scholar
  9. Brown GW, Bifulco A, Andrews B (1990c) Self-esteem and depression IV. Effect on course and recovery. Soc Psychiatry Psychiat Epidemiol 25:244–249CrossRefGoogle Scholar
  10. Clayton PJ (1995) The model of stress: the bereavement reaction. Chapter in adversity, stress and psychopathology. American Psychiatric Press, Washington, DCGoogle Scholar
  11. Eysenck HJ, Eysenck SBG (1964) Manual of the Eysenck personality inventory. Hodder and Stoughton, SevenoaksGoogle Scholar
  12. Folkman S, Lazarus RS, Dunkel-Schetter C, DeLongis A, Rand JG (1986) Dynamics of a stressful encounter: cognitive appraisal, coping and encounter outcomes. J Pers Soc Psychol 50:992–1003CrossRefPubMedGoogle Scholar
  13. Goldberg D (1978) Manual fo the general health questionnaire. National Foundation for Educational Research, WindsorGoogle Scholar
  14. Golberg D, Williams P (1988) A User's Guide to the General Health Questionnaire. National Foundation for Educational Research, WindsorGoogle Scholar
  15. Hall CS, Lindzey G (1970) Theories of personality, 2nd edn. Wiley, New YorkGoogle Scholar
  16. Hays JC, Kasl S, Jacobs S (1994) Past personal history of dysphoria, social support, and psychological distress following conjugal bereavement. J Am Geriatr Soc 42:712–718PubMedGoogle Scholar
  17. Ingham JG (1966) Changes in MPI scores in neurotic patients: a three-year follow-up. Br J Psychiatry 112:931–939PubMedGoogle Scholar
  18. Ingham JG, Kreitman NB, Miller PMcC, Sashidharan SP, Surtees PG (1987) Self-appraisal, anxiety and depression in women — a prospective enquiry. Br J Psychiatry 151:643–651PubMedGoogle Scholar
  19. Kitamura T, Shima S, Sugawara M, Toda MA (1993) Psychological and social correlates of the onset of affective disorders among pregnant women. Psychol Med 23:967–975PubMedGoogle Scholar
  20. London H, Exner JE (1978) Dimensions of personality. Wiley, New YorkGoogle Scholar
  21. Miller PMcC (1995) The importance of context I: who needs and who does not need social support among college students? In Brugha TS (ed) Social support and psychiatric disorder: research findings and guidelines for clinical practice. Cambridge University Press, Cambridge (in press)Google Scholar
  22. Miller PMcC, LLoyd C (1991) Social support and its interaction with personality and childhood background as predictors of psychiatric symptoms in Scottish and American medical students. Soc Psychiatry Psychiat Epidemiol 26:171–177Google Scholar
  23. Miller PMcC, Surtees PG (1993) Parthers in adversity: II. Measurement and description of stressful event sequences (‘complexes’). Eur Arch Psychiatry Clin Neurosci 242:233–239CrossRefPubMedGoogle Scholar
  24. Miller PMcC, Kreitman NB, Ingham JG, sashidharan SP (1989) Selfesteem. life stress and psychiatric disorder. J Affect Disord 17:65–75CrossRefPubMedGoogle Scholar
  25. Nuss WS, Zubenko GS (1992) Correlates of persistent depressive symptoms in widows. Am J Psychiatry 149:346–351PubMedGoogle Scholar
  26. Stroebe W, Stroebe MS (1987) Bereavement and health: the psychological and physical consequences of partner loss. Cambridge University Press, CambridgeGoogle Scholar
  27. Surtees PG (1995) In the shadow of adversity: the evolution and resolution of anxiety and depressive disorder. Br J Psychiatry 166 (in press)Google Scholar
  28. Surtees PG, Miller PMcC (1993) Partners in adversity: I: Study design and context. Eur Arch Psychiatry Clin Neurosci 243:224–232CrossRefGoogle Scholar
  29. Surtees PG, Miller PMcC (1994a) Partners in adversity: III. Mood status after the event. Eur Arch Psychiatry Clin Neurosci 243:311–318PubMedGoogle Scholar
  30. Surtees PG, Miller PMcC (1994b) Partners in adversity: IV. Coping and outcome. Eur Arch Psychiatry Clin Neurosci 243:319–327PubMedGoogle Scholar
  31. Tyrer P, Alexander J (1979) Classification of personality disorder. Br J Psychiatry 135:163–167PubMedGoogle Scholar
  32. Tyrer P, Alexander J (1985) Resived classification of personality using the Personality Assessment Schedule. Mapperley Hospital, Nottingham, UKGoogle Scholar
  33. Vachon MLS, Sheldon AR, Lancee WJ, Lyall WAL, Rogers J, Freeman SJJ (1982) Correlates of enduring distress patterns following bereavement: social network, life situation and personality. Psychol Med 12:783–788PubMedGoogle Scholar
  34. Zisook S, Shuchter SR, Sledge PA, Paulus M, Judd LL (1994) The spectrum of depressive phenomena after spousal bereavement, J Clin Psychiatry 55 (Suppl):29–36Google Scholar

Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • P. McC Miller
    • 1
  • P. G. Surtees
    • 2
  1. 1.Alcohol Research GroupRoyal Edinburgh HospitalGB-Edinburgh
  2. 2.MRC Biostatistics Unit, Institute of Public HealthUniversity Forvie SiteGB-Cambridge

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