RAHE, MAHAN + ARTHUR OVERVIEW

AIMS-

aimed to conduct a prospective study using a normal population to investigate if there is a relationship between life events/changes and illness

CONTEXT-

hans selye's general adaptation syndrome suggests stress leads too illness, Dr Holmes supported this (hawkins et al 1957) found TB patients had 'disturbing occurences' in the two years prior to admission- more than control group of non tb patients.

1960, dr homes worked with dr rahe, to develop a standard measurements tool that could assess stress related life changes. - the schedule of recent experiences (SRE) analysing 5000 patients producing a list of 43 life events, then asked 400 people to score each event in terms of how much readjustment would be required. -produced life change units (LCU)

compared LCUs of peorple who are ill with people who hadnt = good ethics

PARTICIPANTS

• invovled 2664 naval men aboard 3 navy cruisers
• mean age accross the cruisers was 22.3 years
• range of backgrounds
• double blind - neither participants or medical team knew

MEASURING LIFE CHANGES

• asked to fill in military version of SRE prior to their tour
• self questionnare covvered: personal, family, community, social, religious, economic, occupational, residential and health experiences.
• completed an SRE every six weeks over a period of 2 years

MEASURING ILLNESS

• a research physician reviewd sailors health records
• each ship had a medical facility with all health records - even minor issues

FINDINGS

• no significant correlation between the two year period prior to cruise and the cruise period illness
• there was a signifcant postive correlation of .118 between the 6 months prior to the cruise and cruise peiod illness - this was significant at a probability level of less than 1%

relationship was strongest for cruisers 1 and 3

• crew members were split into 10 decile groups according to TLCU's
  • decile 1 contained 10% of ship's crew with lowest TLCUs during 6months prior
  • decile 2 contained next 10% with next lowest TLCU's        ..etc
  • low ilness-deciles 1-2 = mean ilness rate 1.405
  • high illness-deciles 9-10= mean illness rate 2.066
• regrouped into ranges 0-99 100-199 200-299 etc final four divisions were grouped into one as fewer than 3% fell into this group

• implications; result of the prospective study support the notion of a linear relationship between illness and stress

• support; consistant results from other prospective and retrospective studies

• correlation; small but findings are impressive because the illness were minor in degree and their pre-crusie life changes were often few and of low significance. these factors made it more difficult to detect relationships between TLCUs and illness.

• interaction; cruiser 2 experienced the most ardous cruise of the 3, explaining why the relationships were not as strong because in stressful environments life changes have less effect on illness as environmental factors are overwhelmed.

• age of participants; futher analysis of data suggests life change information predicted illness better in older participants and in married enlisted men than in the group of young single sailors.

design- collected with questionniers, analysed using correlation, correlational research includes intervening variables, eg; Brown(1974) suggests people with high levels of anxiety would be more likely to report negative life events and would be more prone to illness so anxiety levels act as iv

ethics- lacks fully informed consent, confidentiality, right to withdraw and final debreifing should be considered.

reliability- stress was measured using SRE which lacks reliability because the categories aren't clear, (what determines what counts as a change in social activitiy) test-retest

validity- problems with sre as a method of assessing stress levels
it doesnt distinguish between desirable and undesirable stresors
doesnt take into account the social/psychological help they have
some may not expereince any of the listed events with being so young

sampling- Rahe et als sample contained 2664 males from us navy with 22.3 years mean age
oppurtunity sample- limited to just men so can't be generalised
people in navy can be resilient and less affected by stress

Rubin et al (1972)  conducted further study using the SRE with naval aviators during a 6 month depoyment to Vietnam - found there was a predictive relationship between SRE scores and illness

Cohen et al- Given social readjustment rating scale, one group given nasal drops with common cold virus another given non- infectious nasal drops, Both groups quarentined and monitored. The higher the stree scores the higher chance of infection. This supports Rahe et al that levels of stress are related to chances of illness.

Delongis et al- Studied stress in 75 married couples and found no correlations with stress and health. Contradicts Rahe et al because no relationship was found between stress and health

Gupta and Gupta- Found life events were related to skin disorders such a scalp itching. This supports rahe et al, identifies specific illnesses and conditions relating to stress.

Some research suggested that daily hassles have a more serious effect on health, the immediate stress can cause pressure and lead to changes in life.

STRENGTHS

• shows relationship/link - valid
• can lead to other studies
• replicable
• prospective not retrospective = more powerful and valid
• restricted environment enables control
• double blind reduces demand characteristics
• medical record were systematic and comprehensive =  reliable

WEANESSES

• lacks ecological validity
• individual differences
• sample
• uninformed consent
• confounding factor was combat stress that obscured other stresses (cruiser 2)