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Stressful life events during adolescence and risk for externalizing and internalizing psychopathology: a meta-analysis

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Abstract

The main objective of the present research was to analyze the relations between stressful life events and the externalizing and internalizing spectra of psychopathology using meta-analytical procedures. After removing the duplicates, a total of 373 papers were found in a literature search using several bibliographic databases, such as the PsycINFO, Medline, Scopus, and Web of Science. Twenty-seven studies were selected for the meta-analytical analysis after applying different inclusion and exclusion criteria in different phases. The statistical procedure was performed using a random/mixed-effects model based on the correlations found in the studies. Significant positive correlations were found in cross-sectional and longitudinal studies. A transactional effect was then found in the present study. Stressful life events could be a cause, but also a consequence, of psychopathological spectra. The level of controllability of the life events did not affect the results. Special attention should be given to the usage of stressful life events in gene–environment interaction and correlation studies, and also for clinical purposes.

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References

  1. Dahl RE, Gunnar (2009) Heightened stress responsivity and emotional reactivity during pubertal maturation: implications for psychopathology. Dev Psychopathol 21:1–6

    Article  PubMed  Google Scholar 

  2. Serafini G, Muzio C, Piccinini G, Flouri E, Ferrigno G, Pompili M, Girardi P, Amore M (2015) Life adversities and suicidal behavior in young individuals: a systematic review. Eur Child Adolesc Psychiatry 24:1423–1446

    Article  PubMed  Google Scholar 

  3. Holder MK, Blaustein JD (2014) Puberty and adolescence as a time of vulnerability to stressors that alter neurobehavioral processes. Front Neuroendocrinol 35:89–110

    Article  PubMed  Google Scholar 

  4. Gee DG, Casey BJ (2015) The impact of developmental timing for stress and recovery. Neurobiol Stress 1:184–194

    Article  PubMed  PubMed Central  Google Scholar 

  5. Spear LP (2009) Heightened stress responsivity and emotional reactivity during pubertal maturation: implications for psychopathology. Dev Psychopathol 21:87–97

    Article  PubMed  PubMed Central  Google Scholar 

  6. Kessler RC, Avenevoli S, Costello J, Green JG, Gruber MJ, McLaughlin KA, Petukhova M, Sampson NA, Zaslavsky AM, Merikangas KR (2012) Severity of 12-month DSM-IV disorders in the national comorbidity survey replication adolescent supplement. Arch Gen Psychiatry 69:381–389

    Article  PubMed  PubMed Central  Google Scholar 

  7. Merikangas K, Jian-ping H, Burstein M, Swanson S, Avenevoli S, Lihong C, Benjet C, Georgiades K, Swendsen J (2011) Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Study-Adolescent Supplement. J Am Acad Child Adolesc Psychiatry 49:980–989

    Article  Google Scholar 

  8. Wittchen HU, Jacobi F, Rehm J et al (2011) The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol 21:655–679

    Article  CAS  PubMed  Google Scholar 

  9. Trotman HD, Holtzman CW, Ryan AT, Shapiro DI, MacDonald AN, Goulding SM, Brasfield JL, Walker EF (2013) The development of psychotic disorders in adolescence: a potential role for hormones. Horm Behav 64:411–419

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Yung ARAR, McGorry PD (1996) The prodromal phase of first-episode psychosis: past and current conceptualizations. Schizophr Bull 22:353–370

    Article  CAS  PubMed  Google Scholar 

  11. Caouette JD, Guyer AE (2014) Gaining insight into adolescent vulnerability for social anxiety from developmental cognitive neuroscience. Dev Cogn Neurosci 8:65–76

    Article  PubMed  Google Scholar 

  12. Pérez-Edgar KE, Guyer AE (2014) Behavioral Inhibition: temperament or prodrome? Curr Behav Neurosci Rep 1:182–190

    Article  PubMed  PubMed Central  Google Scholar 

  13. Lingford-Hughes AR, Welch S, Nutt DJ (2004) Evidence-based guidelines for the pharmacological management of substance misuse, addiction and comorbidity: recommendations from the British Association for Psychopharmacology. J Psychopharmacol 18:293–335

    Article  CAS  PubMed  Google Scholar 

  14. Kelly TM, Daley DC, Douaihy AB (2013) Treatment of substance abusing patients with comorbid psychiatric disorders. Addict Behav 37:11–24

    Article  Google Scholar 

  15. Valderas JM, Starfield B, Sibbald B, Salisbury C, Roland M (2009) Defining comorbidity: implications for understanding health and health services. Ann Fam Med 7:357–363

    Article  PubMed  PubMed Central  Google Scholar 

  16. Krueger RF, Markon KE (2006) Reinterpreting comorbidity: a model-based approach to understanding and classifying psychopathology. Annu Rev Clin Psychol 2:111–133

    Article  PubMed  PubMed Central  Google Scholar 

  17. Achenbach TM, Rescorla LA (2001) Manual for the ASEBA school-age forms & profiles. University of Vermont, Research Center for Children, Youth, & Families, Burlington, VT

  18. Lahey BB, Rathouz PJ, Van Hulle C, Urbano RC, Krueger RF, Applegate B, Garriock HA, Chapman DA, Waldman ID (2008) Testing structural models of DSM-IV symptoms of common forms of child and adolescent psychopathology. J Abnorm Child Psychol 36:187–206

    Article  PubMed  Google Scholar 

  19. Verona E, Javdani S, Sprague J (2011) Comparing factor structures of adolescent psychopathology. Psychol Assess 23:545–551

    Article  PubMed  Google Scholar 

  20. Beesdo-baum K, Höfler M, Gloster AT, Klotsche J, Lieb R, Beauducel A, Bühner M, Kessler RC, Hans-Ulrich W (2009) The structure of common mental disorders: a replication study in a community sample of adolescents and young adults. Int J Methods Psychiatr Res 18:204–220

    PubMed  Google Scholar 

  21. Cosgrove VE, Rhee SH, Gelhorn HL, Boeldt D, Corley RC, Ehringer M, Young SE, Hewitt JK (2011) Structure and etiology of co-occurring internalizing and externalizing disorders in adolescents. J Abnorm Child Psychol 39:109–123

    Article  PubMed  PubMed Central  Google Scholar 

  22. Witkiewitz K, King K, Mcmahon RJ, Va BC, Wu J (2013) Evidence for a multi-dimensional latent structural model of externalizing disorders. J Abnorm Child Psychol 41:223–237

    Article  PubMed  PubMed Central  Google Scholar 

  23. Fryers T, Brugha T (2013) Childhood determinants of adult psychiatric disorder. Clin Pract Epidemiol Ment Health 9:1–50

    Article  PubMed  PubMed Central  Google Scholar 

  24. Copeland WE, Shanahan L, Costello EJ, Angold A (2009) Which childhood and adolescent psychiatric disorders predict which young adult disorders? Arch Gen Psychiatry 66:764–772

    Article  PubMed  PubMed Central  Google Scholar 

  25. Low NC, Dugas E, O’Loughlin E, Rodriguez D, Contreras G, Chaiton M, O’Loughlin J (2012) Common stressful life events and difficulties are associated with mental health symptoms and substance use in young adolescents. BMC Psychiatry 12:116

    Article  PubMed  PubMed Central  Google Scholar 

  26. Stikkelbroek Y, Bodden DHM, Reitz E, Vollebergh WAM, van Baar AL (2016) Mental health of adolescents before and after the death of a parent or sibling. Eur Child Adolesc Psychiatry 25:49–59

    Article  PubMed  Google Scholar 

  27. Fröjd S, Kaltiala-Heino R, Pelkonen M, Von Der Pahlen B, Marttunen M (2009) Significance of family life events in middle adolescence: a survey on finnish community adolescents. Nord J Psychiatry 63:78–86

    Article  PubMed  Google Scholar 

  28. Swartz JR, Williamson DE, Hariri AR (2015) Developmental change in amygdala reactivity during adolescence: effects of family history of depression and stressful life events. Am J Psychiatry 172:276–283

    Article  PubMed  Google Scholar 

  29. Fernandez Castelao C, Kröner-Herwig B (2013) Different trajectories of depressive symptoms in children and adolescents: predictors and differences in girls and boys. J Youth Adolesc 42:1169–1182

    Article  PubMed  Google Scholar 

  30. Flouri E, Kallis C (2011) Adverse life events and mental health in middle adolescence. J Adolesc 34:371–377

    Article  PubMed  Google Scholar 

  31. Charles NE, Ryan SR, Acheson A, Mathias CW, Liang Y, Dougherty DM (2015) Childhood stress exposure among preadolescents with and without family histories of substance use disorders. Psychol Addict Behav 29:192–200

    Article  PubMed  Google Scholar 

  32. King KM, Chassin L (2008) Adolescent stressors, psychopathology, and young adult substance dependence: a prospective study. J Stud Alcohol Drugs 69:629–638

    Article  PubMed  PubMed Central  Google Scholar 

  33. Casement MD, Shaw DS, Sitnick SL, Musselman SC, Forbes EE (2013) Life stress in adolescence predicts early adult reward-related brain function and alcohol dependence. Soc Cogn Affect Neurosci 10:416–423

    Article  Google Scholar 

  34. Rutter M, Moffitt TE, Caspi A (2006) Gene–environment interplay and psychopathology: multiple varieties but real effects. J Child Psychol Psychiatry Allied Discip 47:226–261

    Article  Google Scholar 

  35. Plomin R, DeFries JC, Loehlin JC (1977) Genotype–environment interaction and correlation in the analysis of human behavior. Psychol Bull 84:309–322

    Article  CAS  PubMed  Google Scholar 

  36. Tsuang MT, Bar JL, Stone WS, Faraone SV (2004) Gene–environment interactions in mental disorders. World Psychiatry 3:73–83

    PubMed  PubMed Central  Google Scholar 

  37. Wichers M, Maes HH, Jacobs N, Derom C, Thiery E, Kendler KS (2012) Disentangling the causal inter-relationship between negative life events and depressive symptoms in women: a longitudinal twin study. Psychol Med 42:1801–1814

    Article  CAS  PubMed  Google Scholar 

  38. McAdams T, Gregory AM, Eley TC (2013) Genes of experience: explaining the heritability of putative environmental variables through their association with behavioural and emotional traits. Behav Genet 43:314–328

    Article  PubMed  PubMed Central  Google Scholar 

  39. Kendler KS, Baker JH (2007) Genetic influences on measures of the environment: a systematic review. Psychol Med 37:615–626

    Article  PubMed  Google Scholar 

  40. Johnson DP, Rhee SH, Whisman MA, Corley RP, Hewitt JK (2013) Genetic and environmental influences on negative life events from late childhood to adolescence. Child Dev 84:1823–1839

    Article  PubMed  PubMed Central  Google Scholar 

  41. Young-Wolff KC, Kendler KS, Prescott C (2012) Interactive effects of childhood maltreatment and recent stressful life events on alcohol consumption in adulthood. J Stud Alcohol Drugs 73:559–569

    Article  PubMed  PubMed Central  Google Scholar 

  42. Harkness KL, Bruce AE, Lumley MN (2006) The role of childhood abuse and neglect in the sensitization to stressful life events in adolescent depression. J Abnorm Psychol 115:730–741

    Article  PubMed  Google Scholar 

  43. Fandiño-Losada A, Bangdiwala SI, Lavebratt C, Forsell Y (2016) Path analysis of the chronicity of depression using the comprehensive developmental model framework. Nord J Psychiatry 9488:1–12

    Google Scholar 

  44. Goodyer IM, Park RJ, Herbert J (2001) Psychosocial and endocrine features of chronic first-episode major depression in 8–16 year olds. Biol Psychiatry 50:351–357

    Article  CAS  PubMed  Google Scholar 

  45. Stone LB, Liu RT, Yen S (2014) Adolescent inpatient girls׳ report of dependent life events predicts prospective suicide risk. Psychiatry Res 219:137–142

    Article  PubMed  PubMed Central  Google Scholar 

  46. Hammen C (1991) Generation of stress in the course of unipolar depression. J Abnorm Psychol 100:555–561

    Article  CAS  PubMed  Google Scholar 

  47. Liu RT, Alloy LB (2011) Stress generation in depression: a systematic review of the empirical literature and recommendations for future study. Clin Psychol Rev 30:582–593

    Article  Google Scholar 

  48. Bender RE, Alloy LB, Sylvia LG (2010) Generation of life events in bipolar spectrum disorders: a re-examination and extension of the stress generation theory. J Clin Psychol 66:907–926

    PubMed  PubMed Central  Google Scholar 

  49. Kercher AJ, Rapee RM, Schniering CA (2009) Neuroticism, life events and negative thoughts in the development of depression in adolescent girls. J Abnorm Child Psychol 37:903–915

    Article  PubMed  Google Scholar 

  50. Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB (2008) Meta-analysis of observational studies. JAMA 283:2008–2012

    Article  Google Scholar 

  51. World Health Organization (2014) Health for the world’s adolescents: a second chance in the second decade. http://www.who.int/adolescent/seconddecade. Accessed 02 Sept 2016

  52. Haller M, Chassin L (2012) A test of adolescent internalizing and externalizing symptoms as prospective predictors of type of trauma exposure and posttraumatic stress disorder. J Trauma Stress 25:691–699

    Article  PubMed  Google Scholar 

  53. Jenkins EJ, Wang E, Turner L (2009) Traumatic events involving friends and family members in a sample of African American early adolescents. Am J Orthopsychiatry 79:398–406

    Article  PubMed  Google Scholar 

  54. McMullen JD, O’Callaghan PS, Richards JA, Eakin JG, Rafferty H (2012) Screening for traumatic exposure and psychological distress among war-affected adolescents in post-conflict northern Uganda. Soc Psychiatry Psychiatr Epidemiol 47:1489–1498

    Article  PubMed  Google Scholar 

  55. Hammen C (2005) Stress and depression. Annu Rev Clin Psychol 1:293–319

    Article  PubMed  Google Scholar 

  56. Harkness KL, Hayden EP, Lopez-Duran NL (2015) Stress sensitivity and stress sensitization in psychopathology: an introduction to the special section. J Abnorm Psychol 124:1–3

    Article  PubMed  Google Scholar 

  57. Rudolph KD, Constance H, Burge D, Lindberg N, Herzberg D, Daley SE (2000) Toward an interpersonal life-stress model of depression: the developmental context of stress generation. Dev Psychopathol 12:215–234

    Article  CAS  PubMed  Google Scholar 

  58. Hankin BL, Abela (2005) Depression from childhood through adolescence and adulthood: a developmental vulnerability stress perspective. In: Hankin BL, Abela JRZ (eds) Dev. Psychopathol. a vulnerability Stress Perspect. Sage Publications, Thousand Oaks, pp 245–288

    Chapter  Google Scholar 

  59. Cohen JR, Hankin BL, Gibb BE, Hammen C, Hazel NA, Ma D, Yao S, Zhu XZ, Abela JRZ (2013) Negative attachment cognitions and emotional distress in mainland Chinese adolescents: a prospective multiwave test of vulnerability-stress and stress generation models. J Clin child Adolesc Psychol 42:531–544

    Article  PubMed  Google Scholar 

  60. Hedges LV, Vevea JL (1998) Fixed- and random-effects models in meta-analysis. Psychol Methods 3:486–504

    Article  Google Scholar 

  61. Viechtbauer W (2015) Package “metafor”. https://cran.r-project.org/web/packages/metafor/index.html. Accessed 11 Feb 2016

  62. Williams EJ (1959) The comparison of regression variables. J R Stat Soc Ser B 21:396–399

    Google Scholar 

  63. Hemphill JF (2003) Interpreting the magnitudes of correlation coefficients. Am Psychol 58:78–79

    Article  PubMed  Google Scholar 

  64. Kim KJ, Conger RD, Elder GH, Lorenz FO (2003) Reciprocal influences between stressful life events and adolescent internalizing and externalizing problems. Child Dev 74:127–143

    Article  PubMed  Google Scholar 

  65. Shapero B, Hankin BL, Barrocas AL (2013) Stress generation and exposure in a multi-wave study of adolescents: Transactional processes and sex differences. J Soc 32:1–17

    Google Scholar 

  66. Kendler KS, Hettema JM, Butera F, Gardner CO, Prescott CA (2003) Life event dimensions of loss, humiliation, entrapment, and danger in the prediction of onsets of major depression and generalized anxiety. Arch Gen Psychiatry 60:789–796

    Article  PubMed  Google Scholar 

  67. Hankin BL, Abramson LY (2002) Measuring cognitive vulnerability to depression in adolescence: reliability, validity, and gender differences. J Clin Child Adolesc Psychol 31:491–504

    Article  PubMed  Google Scholar 

  68. Johnson J, McCutcheon S (1980) Assessing life stress in children and adolescents: preliminary findings with the life events checklist. Stress Anxiety (Vol 7) 7:111–126

    Google Scholar 

  69. Karg K, Burmeister M, Shedden K, Sen S (2011) The serotonin transporter promoter variant (5-HTTLPR), stress, and depression meta-analysis revisited: evidence of genetic moderation. Arch Gen Psychiatry 68:444–454

    Article  PubMed  PubMed Central  Google Scholar 

  70. Amone-P’Olak K, Ormel J, Huisman M, Verhulst FC, Oldehinkel AJ, Burger H (2009) Life stressors as mediators of the relation between socioeconomic position and mental health problems in early adolescence: the TRAILS study. J Am Acad Child Adolesc Psychiatry 48:1031–1038

    Article  PubMed  Google Scholar 

  71. Bakker MP, Ormel J, Verhulst FC, Oldehinkel AJ (2010) Peer stressors and gender differences in adolescents’ mental health: the TRAILS study. J Adolesc Health 46:444–450

    Article  PubMed  Google Scholar 

  72. Barrera M, Li SA, Chassin L (1995) Effects of parental alcoholism and life stress on hispanic and non-hispanic caucasian adolescents: a prospective study. Am J Community Psychol 23:479–507

    Article  PubMed  Google Scholar 

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Acknowledgements

Thanks to the Comissionat per a Universitats i Recerca del DIUE, Generalitat de Catalunya (2014SGR1636); the Centre for Biomedical Research in the Mental Health Network (CIBERSAM) Intramural Project (SAM15PI12); the Spanish Ministry of Economy and Competitivity (ES-EUEpiBrain project, Grant SAF2015-71526-REDT); the Spanish Ministry of Economy and Competitivity, Instituto de Salud Carlos III (PI15/00097)—Ayuda cofinanciada por el Fondo Europeo de Desarrollo Regional (FEDER). “Una manera de hacer Europa”. Thanks to the Secretaria d’Universitats i Recerca del Departament d’Empresa i Coneixement de la Generalitat de Catalunya (expedient 2017FI-B00258).

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March-Llanes, J., Marqués-Feixa, L., Mezquita, L. et al. Stressful life events during adolescence and risk for externalizing and internalizing psychopathology: a meta-analysis. Eur Child Adolesc Psychiatry 26, 1409–1422 (2017). https://doi.org/10.1007/s00787-017-0996-9

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