Advertisement

Quality of Life Research

, Volume 21, Issue 7, pp 1149–1158 | Cite as

The association between cumulative adversity and mental health: considering dose and primary focus of adversity

  • Giora Keinan
  • Amit Shrira
  • Dov Shmotkin
Article

Abstract

Purpose

The study addressed the dose–response model in the association of cumulative adversity with mental health.

Method

Data of 1,725 participants aged 50+ were drawn from the Israeli component of the Survey of Health, Ageing, and Retirement in Europe. Measures included an inventory of potentially traumatic events, distress (lifetime depression, depressive symptoms), and well-being (quality of life, optimism/hope).

Results

The maximal effect of cumulative trauma emerged in the contrast between 0–2 and 3+ events, where the higher number of events related to higher distress but also to higher well-being. While self-oriented adversity revealed no, or negative, association with well-being, other-oriented adversity revealed a positive association.

Conclusions

The study suggests an experiential dose of cumulative adversity leading to a co-activation of distress and well-being. The source of this co-activation seems to be other-oriented adversity.

Keywords

Dose–response Cumulative adversity Self-oriented adversity Other-oriented adversity SHARE-Israel 

Notes

Acknowledgments

The Israeli component of the Survey of Health, Ageing, and Retirement in Europe was funded by the US National Institute on Aging (R21 AG2516901), by the German-Israeli Foundation for Scientific Research and Development (G.I.F.), and by the National Insurance Institute of Israel. We are grateful to Howard Litwin for facilitating our study with the data. We thank Rany Abend for his assistance.

References

  1. 1.
    Turner, R. J., & Lloyd, D. A. (1995). Lifetime traumas and mental health: The significance of cumulative adversity. Journal of Health and Social Behavior, 36, 360–376.PubMedCrossRefGoogle Scholar
  2. 2.
    Green, B. L., Goodman, L. A., Krupnick, J. L., et al. (2000). Outcomes of single versus multiple trauma exposure in a screening sample. Journal of Traumatic Stress, 13, 271–286.PubMedCrossRefGoogle Scholar
  3. 3.
    Schnurr, P. P., Spiro, A., Vielhauer, M. J., et al. (2002). Trauma in the lives of older men: Findings from the normative aging study. Journal of Clinical Geropsychology, 8, 175–187.CrossRefGoogle Scholar
  4. 4.
    Cloitre, M., Stolbach, B. C., Herman, J. L., et al. (2009). A developmental approach to complex PTSD: Childhood and adult cumulative trauma as predictors of symptom complexity. Journal of Traumatic Stress, 22, 399–408.PubMedCrossRefGoogle Scholar
  5. 5.
    Courtois, C. A. (2004). Complex trauma, complex reactions: Assessment and treatment. Psychotherapy: Theory, Research, Practice, Training, 41, 412–425.CrossRefGoogle Scholar
  6. 6.
    Dohrenwend, B. P., Turner, J. B., Turse, N. A., et al. (2006). The psychological risks of Vietnam for U. S. veterans: A revisit with new data and methods. Science, 313, 979–982.PubMedCrossRefGoogle Scholar
  7. 7.
    Mollica, R. F., Mcinnes, K., Pham, T., et al. (1998). The dose-effect relationships between torture and psychiatric symptoms in Vietnamese ex-political detainees and a comparison group. Journal of Nervous and Mental Disease, 186, 543–553.PubMedCrossRefGoogle Scholar
  8. 8.
    Chipman, K. J., Palmieri, P. A., Canetti, D., et al. (2011). Predictors of posttraumatic stress-related impairment in victims of terrorism and ongoing conflict in Israel. Anxiety, Stress, and Coping, 24, 255–271.PubMedCrossRefGoogle Scholar
  9. 9.
    Harvey, P. D., & Yehuda, R. (1999). Strategies to study risk for the development of PTSD. In R. Yehuda (Ed.), Risk factors for posttraumatic stress disorder (pp. 1–22). Washington, DC: American Psychiatric Press.Google Scholar
  10. 10.
    McNally, R. J. (2003). Progress and controversy in the study of posttraumatic stress disorder. Annual Review of Psychology, 54, 229–252.PubMedCrossRefGoogle Scholar
  11. 11.
    Rosen, G. M., & Lilienfeld, S. O. (2008). Posttraumatic stress disorder: An empirical evaluation of core assumptions. Clinical Psychology Review, 28, 837–868.PubMedCrossRefGoogle Scholar
  12. 12.
    Shevlin, M., Houston, J. E., Dorahy, M. J., et al. (2008). Cumulative traumas and psychosis: An analysis of the national comorbidity survey and the British psychiatric morbidity survey. Schizophrenia Bulletin, 34, 193–199.PubMedCrossRefGoogle Scholar
  13. 13.
    Chapman, D. P., Whitfield, C. L., Felitti, V. J., et al. (2004). Adverse childhood experiences and the risk of depressive disorders in adulthood. Journal of Affective Disorders, 82, 217–225.PubMedCrossRefGoogle Scholar
  14. 14.
    Breslau, N., Chilcoat, H. D., Kessler, R. C., et al. (1999). Previous exposure to trauma and PTSD effects of subsequent trauma: Results from the detroit area survey of trauma. American Journal of Psychiatry, 156, 902–907.PubMedGoogle Scholar
  15. 15.
    American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
  16. 16.
    Breslau, N., Kessler, R. C., Chilicoat, H. D., et al. (1998). Trauma and posttraumatic stress disorder in the community: The 1996 detroit area survey of trauma. Archives of General Psychiatry, 55, 626–632.PubMedCrossRefGoogle Scholar
  17. 17.
    Shmotkin, D., & Litwin, H. (2009). Cumulative adversity and depressive symptoms among older adults in Israel: The differential roles of self-oriented versus other-oriented events of potential trauma. Social Psychiatry and Psychiatric Epidemiology, 44, 989–997.PubMedCrossRefGoogle Scholar
  18. 18.
    Kira, I., Lewandowski, L., Somers, C. L., et al. (in press). The effects of trauma types, cumulative trauma, and PTSD on IQ in two highly traumatized adolescent groups. Psychological Trauma: Theory, Research, Practice, and Policy.Google Scholar
  19. 19.
    Keyes, C. L. M. (2007). Promoting and protecting mental health as flourishing: A complementary strategy for improving national mental health. American Psychologist, 62, 95–108.PubMedCrossRefGoogle Scholar
  20. 20.
    Kessler, R. C. (1997). The effects of stressful life events on depression. Annual Review of Psychology, 48, 191–214.PubMedCrossRefGoogle Scholar
  21. 21.
    Krause, N. (2004). Lifetime trauma, emotional support, and life satisfaction among older adults. The Gerontologist, 44, 615–623.PubMedCrossRefGoogle Scholar
  22. 22.
    Krause, N. (2005). Traumatic events and meaning in life: Exploring variations in three age cohorts. Aging and Society, 25, 501–524.CrossRefGoogle Scholar
  23. 23.
    Royse, D., Rompf, E. L., & Dhooper, S. S. (1993). Childhood trauma and adult life satisfaction. Journal of Applied Social Sciences, 17, 179–189.Google Scholar
  24. 24.
    Litwin, H., & Sapir, E. V. (2008). Israel: Diversity among population groups. In A. Börsch-Supan, A. Brugiavini, H. Jürges, et al. (Eds.), First results from the survey of health, ageing and retirement in Europe (2004–2007): Starting the longitudinal dimension (pp. 93–98). Mannheim: Mannheim Research Institute for the Economics of Aging.Google Scholar
  25. 25.
    American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th edn. text revision). Washington, DC: American Psychiatric Association.CrossRefGoogle Scholar
  26. 26.
    Lloyd, D. A., & Turner, R. J. (2003). Cumulative adversity and posttraumatic stress disorder: Evidence from a diverse community sample of young adults. American Journal of Orthopsychiatry, 73, 381–391.PubMedCrossRefGoogle Scholar
  27. 27.
    Robinson, J. S., & Larson, C. (2010). Are traumatic events necessary to elicit symptoms of posttraumatic stress? Psychological Trauma: Theory, Research, Practice and Policy, 2, 71–76.CrossRefGoogle Scholar
  28. 28.
    Prince, M. J., Reischies, F., Beekman, A. T. F., et al. (1999). Development of the Euro-D scale—A European Union initiative to compare symptoms of depression in 14 European centres. British Journal of Psychiatry, 174, 330–338.PubMedCrossRefGoogle Scholar
  29. 29.
    Hyde, M., Wiggins, R. D., & Blane, D. B. (2003). A measure of quality of life in early old age: The theory, development and properties of a needs satisfaction model (CASP-19). Aging and Mental Health, 7, 186–194.PubMedCrossRefGoogle Scholar
  30. 30.
    Von Dem Knesebeck, O., Wahrendorf, M., Hyde, M., et al. (2007). Socio-economic position and quality of life among older people in 10 European countries: Results of the SHARE study. Aging and Society, 27, 269–284.CrossRefGoogle Scholar
  31. 31.
    Scheier, M. F., Carver, C. S., & Bridges, M. W. (1994). Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A reevaluation of the life orientation test. Journal of Personality and Social Psychology, 67, 1063–1078.PubMedCrossRefGoogle Scholar
  32. 32.
    Snyder, C. R., Harris, C., Anderson, J. R., et al. (1991). The will and the ways: Development and validation of an individual-differences measure of hope. Journal of Personality and Social Psychology, 60, 570–585.PubMedCrossRefGoogle Scholar
  33. 33.
    Amit, K., & Litwin, H. (2010). The subjective well-being of immigrants aged 50 and older in Israel. Social Indicators Research, 98, 89–104.CrossRefGoogle Scholar
  34. 34.
    United Nations Educational Cultural Scientific Organisation (UNESCO). (1997). International standard classification of education 1997. Geneva: UNESCO.Google Scholar
  35. 35.
    Brickman, P., & Coates, D. (1987). Commitment and mental health. In C. B. Wortman & R. Sorrentino (Eds.), Commitment, conflict, and caring (pp. 222–276). Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  36. 36.
    Staub, E., & Vollhardt, J. (2008). Altruism born of suffering: The roots of caring and helping after victimization and other trauma. American Journal of Orthopsychiatry, 78, 267–280.PubMedCrossRefGoogle Scholar
  37. 37.
    Brown, S. L., Smith, D. M., Schulz, R., et al. (2009). Caregiving behavior is associated with decreased mortality risk. Psychological Science, 20, 488–494.PubMedCrossRefGoogle Scholar
  38. 38.
    Roth, D. L., Perkins, M., Wadley, V. G., et al. (2009). Family caregiving and emotional strain: Associations with quality of life in a large national sample of middle-aged and older adults. Quality of Life Research, 18, 679–688.PubMedCrossRefGoogle Scholar
  39. 39.
    Bonanno, G. A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59, 20–28.PubMedCrossRefGoogle Scholar
  40. 40.
    Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15, 1–18.CrossRefGoogle Scholar
  41. 41.
    Updegraff, J. A., & Taylor, S. E. (2000). From vulnerability to growth: Positive and negative effects of stressful life events. In J. Harvey & E. Miller (Eds.), Loss and trauma: General and close relationship perspectives (pp. 3–28). Philadelphia, PA: Brunner-Routledge.Google Scholar
  42. 42.
    Folkman, S., & Moskowitz, J. T. (2000). Positive affect and the other side of coping. American Psychologist, 55, 647–654.PubMedCrossRefGoogle Scholar
  43. 43.
    Larsen, J. T., Hemenover, S. H., Norris, C. J., et al. (2003). Turning adversity to advantage: On the virtues of the coactivation of positive and negative emotions. In L. G. Aspinwall & U. M. Staudinger (Eds.), A psychology of human strengths: Fundamental questions and future directions for a positive psychology (pp. 211–225). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  44. 44.
    Cacioppo, J. T., Gardner, W. L., & Berntson, G. G. (1999). The affect system has parallel and integrative processing components: Form follows function. Journal of Personality and Social Psychology, 76, 839–855.CrossRefGoogle Scholar
  45. 45.
    Ryff, C. D., Singer, B., Love, G. D., et al. (1998). Resilience in adulthood and later life: Defining features and dynamic processes. In J. Lomranz (Ed.), Handbook of aging and mental health: An integrative approach (pp. 69–99). New York: Plenum.Google Scholar
  46. 46.
    Shmotkin, D. (2005). Happiness in face of adversity: Reformulating the dynamic and modular bases of subjective well-being. Review of General Psychology, 9, 291–325.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  1. 1.Department of PsychologyTel Aviv UniversityTel AvivIsrael
  2. 2.The Herczeg Institute on AgingTel Aviv UniversityTel AvivIsrael

Personalised recommendations