Examining Psychosocial Constructs Related to Stress, Adversity, and Trauma

Abstract

Background: Adversity and stressful life events (SLE) are associated with worse psychosocial health due to potential impediments to normative development, disruption of social rhythms, threat to sense of identity, and/or significant financial strain. Psychosocial health refers to an individual’s overall well-being and ability to appropriately engage with the social environment. Empathy, insomnia disorder, and major depressive disorder (MDD) are important aspects of psychosocial health which may have a strong relationship to SLE. Objectives: This doctoral dissertation aims to contribute to the literature on SLE and psychosocial health. Over a series of three studies, the relationships between different forms of SLE and three aspects of psychosocial health - empathy, insomnia disorder, and recovery from MDD - were examined. Methods: Study 1 provides a systematic, narrative synthesis of current knowledge on the association between childhood adversity (CA) and empathy in adulthood. Study 2 utilized a cross-lagged panel analysis of longitudinal data to test whether insomnia disorder is associated with increased number of SLE in a sample of adults who have recently experienced involuntary job loss. Finally, Study 3 used fuzzy-set Qualitative Comparative Analysis (fsQCA) to examine set-theoretical relationships between individual and contextual conditions for recovery from MDD following involuntary job loss. Data for the latter two studies were drawn from the Assessing Daily Activity Patterns through Occupational Transitions (ADAPT) study. The ADAPT study longitudinally examined associations between involuntary job loss, sleep, social rhythms, weight, physical activity, and mental health in 191 adults who applied for unemployment insurance between 2015 and 2018. Results: Findings from Study 1 provide some evidence of impaired cognitive empathy and empathic concern, as well as increased personal distress, in individuals reporting CA. Synthesis of findings was limited by inconsistency of construct definitions and measurement across articles. Study 2 found that insomnia disorder at baseline predicted increased number of SLE at three-month follow-up. Finally, in Study 3, participants who screened positive for MDD at baseline that were reemployed at follow-up, had no history of CA, and did not use psychotropic medications were consistently recovered from MDD by three-month follow-up. Necessity analysis found that either 1) no psychotropic medication use or 2) no heavy intoxicant use was necessary for recovery from MDD in this sample. Conclusions: Results from these three studies provide further evidence for a strong relationship between SLE and psychosocial health. These findings point to the importance of public health interventions that not only consider effects of SLE on health, but also address potential psychosocial causes of SLE. Public health interventions are needed to foster resilience to and recovery from adverse psychosocial effects of SLE in populations vulnerable to high burdens of stress.