not just depression involved …

1. not just depression involved … • serious life events & difficulties may trigger many different types of physical & psychological problem • commonly triggered psychological problems include depression, anxiety, alcoholism, ptsd, & traumatic grief • pre-existing life experiences and personal vulnerabilities affect how distress manifests after serious life events • traumatic grief involves a cluster of symptoms such as numbness, disbelief, thought intrusions, avoidance, etc • traumatic grief appears associated with worse longer term outcomes than post-loss depression or anxiety Silverman G K, Jacobs SC et al. Quality of life impairments associated with diagnostic criteria for traumatic grief. Psychol Med 2000;30: 857-62 Silverman GK, Johnson JG, et al. Preliminary explorations of the effects of prior trauma and loss on risk for psychiatric disorders in recently widowed people. Isr J Psychiatry Relat Sci 2001;38: 202-15. Butzlaff: effect sizes for ee & relapse in mood & eating disorders greater than for schizophrenia Paykel: increase in arguments with spouse the most commonly reported life event preceding depression onset Whisman [4796]: single question asked to 904 non-depressed community sample – “in general how do you feel you & your spouse have got along in the past 2 weeks?” after allowing for previous depression history, the 25% answering not well or fairly well were 2.4 x more likely to develop MDE over the next year than 75% answering very well Hickie (IBM), Staner (SAS), and Hooley/Teasdale (criticism) are all handouts they have as too are PBI, and DAS info

2. coping resources early life experiences life events & difficulties assessment can be helped by using the life events questionnaire, ibm, das (& qu.31), criticism scale, grief inventory, etc assessment can be helped by using the adverse childhood experiences (ace) scale, and parental bond inventory (pbi), etc genetic factors vulnerability to persisting distress coping resources include healthy – or unhealthy - personal habits, attitudes, and skills such as problem-solving, hardiness, diet, exercise, calming skills, therapeutic writing, social support, finances, use of alcohol, tobacco & other drugs, etc