The causal relationships between neuroticism (N), long-term difficulties (LTDs), life situation change (LSC), and psychological distress (PD) were examined using self-report and interview data from a 7-year, 3-wave study in a general population sample (N = 296). LTDs were classified as either endogenous (dependent) or exogenous (independent). We found that earlier neuroticism had a strong direct and a moderate indirect effect (through endogenous LTDs) on PD. The direct effect was strikingly stronger than those of LTDs and LSC. In addition, much correlation between endogenous LTDs, LSC, and PD could be attributed to the confounding effects of earlier neuroticism. High neuroticism tended to strengthen the effect of LSC on PD. These findings suggest that temperamental dispositions are more powerful than environmental factors in predicting PD.

The validity of the Impact of Events Scale (IES) and the Posttraumatic Stress Disorder (PTSD) Symptom Scale, Self-Report version (PSS-SR) was examined among crime victims. Both instruments performed well as screeners for PTSD. For the IES, sensitivity ranged between .93 and 1.00; for the PSS-SR, sensitivity ranged between .80 and .90. Specificity for the IES ranged between .78 and .84 and for the PSS-SR ranged between .84 and .88. Some individual items from the 2 scales performed just as well as the total scales. The authors conclude that either of these short self-report instruments or their individual items are suitable as screeners for PTSD, specifically in settings where mental health professionals are unavailable. Cross-validation of these results is necessary because of the small sample size in this study.

We found two peaks in the age at onset of bipolar disorder, one in early adulthood and one in later life, the former consisting mainly of bipolar I disorder subjects. The incidence of bipolar disorder is higher in deprived areas. The onset of bipolar disorder is not associated with gender, urbanization, or month or season of birth.