The role of adversity and stress in psychopathology: Some evidence and its implications for theory and research
The role of adversity and stress in psychopathology: Some evidence and its implications for theory and research
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DOI：
10.2307/2676357
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发表时间：
2000-03-01
影响因子：
5
通讯作者：
Dohrenwend, BP
中科院分区：
文献类型：
--
作者：
Dohrenwend, BP
三条研究路线-极端情况的研究，社会经济地位（SES）和精神疾病之间关系的流行病学调查，以及流行病学调查结果提出的社会原因-社会选择问题的准实验测试-提供了强有力的证据，表明环境逆境不仅在创伤后应激障碍（PTSD）的发生中很重要，而且在其他类型的精神病理学中也很重要，包括重度抑郁症、酗酒、物质滥用障碍、反社会人格？紊乱和非特异性的痛苦。从这三方面的研究线索发展成为一个关于逆境和压力作用的本质的基本命题。这一命题的核心是，上述类型的障碍发作的可能性随着两个因素的增加而增加：（1）在重大负面事件之后发生不可控制的负面变化的个人日常活动的比例;以及（2）不可控制的变化对个人的重要目标和价值观有多重要。在我们自己和其他现代城市社会中，环境逆境在带来这些无法控制的变化方面的作用因性别、民族/种族地位和社会经济地位而异。精神病理学的类型，发展和他们的课程随着两种类型的逆境而变化（例如，是否涉及生命威胁）以及经历逆境和压力的个体的个人倾向（例如，特定类型的精神病理学家族史）。
Three lines of research-studies of extreme situations, epidemiological investigations of relations between socioeconomic status (SES) and psychiatric disorders, and a quasi-experimental test of the social causation-social selection issue raised by the epidemiological findings-provide strong evidence that environmental adversity is important in the occurrence not only of post-traumatic stress disorder (PTSD) but also of other types of psychopathology, including major depression, alcoholism, substance use disorders, antisocial personality? disorder and nonspecific distress. Leads from this triad of studies are developed into a basic proposition about the nature of the role of adversity and stress. The core of this proposition is that the likelihood of onset of the above types of disorder increases with two factors: (I) the proportion of the individual's usual activities in which uncontrollable negative changes take place following a major negative event; and (2) how central the uncontrollable changes are to the individual's important goals and values. The role of environmental adversity in bringing about these uncontrollable changes varies with gender; ethnic/racial status, and SES in our own and other modern, urban societies. The types of psychopathology, that develop and their course vary with both the types of adversity (e.g., whether life threat is involved) and with the personal predispositions of the individuals who experience the adversity and stress (e.g., family history of particular types of psychopathology).