Title: Psychosocial Stressors and Major Depression, Schizophrenia, and Schizophreniform Disorder
Description: This study explored the relationship between the severity and types of psychosocial stressors and three major mental disorders. The data were derived from the field trials of the third edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-III), in which over 12,000 patients from all over the country were evaluated by over 500 clinicians. Two hundred forty-seven patients with Major Depression and 247 with Schizophrenia were randomly selected for this study, along with all 112 patients given the diagnosis of Schizophreniform Disorder, a disorder similar to Schizophrenia except for its brief duration. The number of psychosocial stressors recorded by the evaluating clinician for each subject was examined, and each stressor was classified according to whether it represented an entrance into or exit from the social field of the subject, whether or not it was desirable, whether or not its occurrence had been under the control of the subject, the number of Life Change Units it entailed, and what area of the subject's life is affected.

These variables were then compared across diagnostic groups, for individuals with and without associated Personality Disorders. In addition, for each diagnostic group, the relationship between the subjects' highest mean level of adaptive functioning and the mean severity of their psychosocial stressors was examined, using the multiaxial system of DSM-III. Major findings that replicated those reported in the literature include that a greater proportion of individuals with Major Depression were reported to have experienced a greater number of stressors, undesirable events, entrances, and uncontrollable events, than individuals with Schizophrenia. Significant new findings include that, for Schizophrenia, the highest level of adaptive functioning in the past year and level of severity of stressors experienced prior to episode onset are positively correlated, while for Major Depression these variables are negatively correlated. The results for Schizophreniform Disorder are equivocal, with similar results to Major Depression for some stressor dimensions, and midway between the other groups on others.

The implications for social work practice of these findings and further study of life events are great, for primary, secondary, and tertiary prevention of mental illness.