Life adversity in depressed and non-depressed older adults: A cross-sectional comparison of the brief LTE-Q questionnaire and life events and difficulties interview as part of the CASPER study

Abstract

250wBackground: There is a paucity of research on the nature of life adversity in depressed and nondepressed older adults. Early life events work used in-depth interviews; however, larger epidemiological trials investigate life adversity using brief questionnaires. This study investigates the type of life adversity experienced in later life and its association with depression and compares adversity captured using a brief (LTE-Q) and in-depth (LEDS) measure.Methods: 960 participants over 65 years were recruited in UK primary care to complete the PHQ-9 and LTE-Q.A sub-sample (n=19) completed the LEDS and a question exploring the subjective experience of the LTE-Q and LEDS.Results: Important life adversity was reported on the LTE-Q in 48% of the sample. In the LTE-Q sample the prevalence of depression (PHQ-E the odds of depression. The LTE-Q only captured a proportion of adversity measured by the LEDS (42% vs 84%). Both measures showed health, bereavement and relationship events were most common.Limitations: The cross-sectional design limits the extent to which inferences can be drawn around the direction of causality between adversity and depression. Recall in older adults is questionable.Conclusions: UK older adults face adversity in areas of health, bereavement and relationships which are associated with depression. This has clinical relevance for psychological interventions for older adults to consider social context and social support. It helps identify the strengths and weaknesses of a brief adversity measure in large scale research. Further research is needed to explore the mechanisms of onset and direction of causality.

Stressful Life Events: Association with Physical and Mental Health Conditions among Older Adults in Bhutan

“…Individuals who experienced higher cumulative SLEs had higher odds of reporting specific health problems such as frequent back pain, diseases of lungs, joint, and gout; vidual and hearing impairment, fatigue, depression, insomnia, and memory decline by more than two folds. These findings were consistent with the previous studies where strong association was shown between severe stressful events with poor physical functioning, higher risk of disabilities, and poor mental health [6][7][8][9][10][11][12][13][14][15][16][17]. Likewise, as observed in the past study [18,19], a significant positive relationship was also found between cumulative SLEs and psychological distress in this study.…”

“…The incidence of various life events also varies within social groups and from population to population [5]. Exposure to chronic stressful events significantly increases the vulnerability to a wide variety of physical and mental health outcomes [6][7][8]. SLEs involving death, suicide, or illness of a significant people including children, parents, or sibling may increase the risk of depression or anxiety [9,10].…”

Web-Based Measure of Life Events Using Computerized Life Events and Assessment Record (CLEAR): Preliminary Cross-Sectional Study of Reliability, Validity, and Association With Depression (Preprint)

“…In the sample as a whole, the average rate of CLEAR LEs was 2.28 (range 0-8), with 42% (136) of the sample having at least one SLE (see Table 2). This is similar to previously reported rates in interviewed [10] and self-report [12] rates. For LTPs, the average was 1.27…”

“…It captures context, and utilises investigator-based ratings of severity according to precedents to reduce subjective bias [7]. The LEDS is better than self-report measures at capturing LEs [12] and its SLEs (those with high negativity after 10-14 days and focused on the self) show superior effect sizes for depression [13]. Those prior to depression onset are given particular attention as provoking agents [14,15].…”

Characteristics of severe life events, attachment style, and depression – Using a new online approach

“…Previous publications have noted the lower validity of checklists of life events and their lower prediction of depression (Bifulco et al ., ; Donoghue, Traviss‐Turner, House, Lewis, & Gilbody, ). More intensive measures allow for exploration of event features, mining each severe event for characteristics which can be damaging to individuals such as loss, threatened loss (danger), and humiliation.…”