Rahe, Mahan & Arthur (1970)

Rahe et al - Prediction of near future health change from subjects' preceding life changes:

- Context & Aims

- Procedures

- Findings & Conclusions

- Methodology

- Alternative

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  • Created by: anika
  • Created on: 06-02-13 20:14

Context

  • Selye (late 1930s-40s) - research led to psychosomatic research (link between psychological sate of stress & physical illness
  • Freidman (1958) - found link between stress & coronary heart disease, observed patients with heart conditions in waiting room & found unable to relax & not sit still (type A), however, stressful life events impact general wellbeing
  • Holmes & Hawkins (1949-61) - Tuberculosis (TB) more common with poor people, not poverty itself but stress that poverty causes
  • Hawkins (1957) - compared TB patients with non TB workers at TB hospital (sanatorium), 2 groups matched for age race & income - found increase in 'disturbing occurences' in 2 years prior to admission in TB patients more than TB patients in controls
  • Holmes & Rahe pointed out previous research measured stressful life events in different ways - difficult to draw concrete conclusions (old, lacked ecological validity & reliability)
  • Social Readjustment Rating Scale (1967) - 1960s - H&R analysed case histories of 5000+ patients poducing list of 43 critical life events, found stressfulness of each event - asked 400 people (diff types)
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Aims

  • Overcome methodological issues & conduct a prospective study (not looking back & recording stress & illness which has already happened but measuring stressfull life changes & correlating it with future illness)
  • Instead of using a sample including people who already ill, 'normal population' would be used (naval personnel as sample)
  • Investigate the relationship between stressful life events & future illness
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Procedures

  • Research method used - correlation
  • Research design - double-blind study (reduces researcher biased)
  • Co variable 1: Stress & 2: Illness
  • 2664 participants - 2463 Navy enlisted men, 125 Navy Officers, 96 Marine Enlisted personnel aboard on 3 US Navy Cruisers
  • Men were on 1 of 3 aircraft cruisers - 2 aircraft carriers involved in military operations off the coast of Vietnam & other aircraft carrier based in the Mediterranean
  • Mean age across 3 cruisers = 22.3 years & participants came from different backgrounds (education, rank & marine experience)
  • 10% inital sample lost due to transfer of men off the ships
  • Method: Participants required to fill in the Military version of the SSRS
  • Schedule of Recent Experience (SRE) - adapted version of SRRS - so specifically relevant to military experience.
  • Pen & paper self administered questionnaire recording significant changes in a person's life relating to various experiences in different areas (Personal, family, community, social, religious, economic, occupational, residential & health)
  • Each life change event on scale allocated life change unit (LCU) - reflects severity & adjustment needed for particular event, each sailor completed SRE every 6 months for 2 years prior to 6-8 month deployment
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Procedures Continued

  • LCU score calculated from established questionnaire (SSRS)
  • Followed by a tour of duty of 6-8 months
  • All illnesses recorded on ship's medical files 
  • Medical records then scrutinised & assessed independently of reseracher by medical staff & health score compiled using number, type & severity of illness
  • Any participants with previously known conditions were not used, nor were those who were reported to be faking or shirking work
  • LCU scores banded (1-10) & grouped - higher the LCU band, higher mean illness rating
  • LCU scores & health scores were correlated
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Findings

  • Relationship between pre-cruise TLCU & illness occuring during cruise was examined
  • Found no significant correlation between TLCUs for the 2 years before the cruise & level of illness that occurred while at sea
  • However, found a significant correlation between illness & TLCUs for the 6 months directly preceding the cruise
  • Correlation co-efficient = 0.118 (probability of this correlation less than 1%)
  • Relationship most apparent in cruiser 1&3 + in married enlisted men category compared to young single sailors
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Conclusions

  • Illnesses experienced by men were generally minor in degree & their pre-cruise life changes were often few & of low significance - difficult to detect relationships between TLCUs & illness. (In populations with greater variability, stronger relationship might be demonstrated
  • Significant relationship detected under such conditions - findings = impressive & supported by being consistent with other prospective/retrospective studies
  • Cruiser 2 experienced most arduous (difficult) & showed less of a relationship between TCLUs & illness - suggests in stressful environments, life changes have less effect on illness as their effects are overwhelmed by environmental factors
  • TLCUs predicted illness better in older pp's (over 21) & married men than the younger single men - suggests there may be other factors involved & previous life changes have greater effect on some men than others
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