Posttraumatic Embitterment Disorder

1.1 Reactions to Stress and Life Events (P. 3)

Early concepts of stress and psychological disorders

In attempting to understand the antecedents of psychopathology, theorists historically have sought explanations from two spheres. On the one hand, the belief has long been held that individuals who develop a psychiatric disorder differ premorbidly from those who do not. Such differences were thought to be constitutional in origin (e.g., Beard, 1881). On the other hand, the belief has also long been held that stress is an important factor in the development of psychological disturbances (e.g., Hawkes, 1857).

Stress reactions and coping with threatening events have been at the center of research since the early days of psychology (Reck, 2001, Linden, 2003). Examples of early terms for stressrelated illnesses were "railway spine," "psychogenic or reactive depression," "traumatic neurosis," or "abnormal psychological reaction" (Jaspers, 1973, Freud, 1999, Van der Kolk, Weisath &, Van der Hart, 2000). A better recognition of the nature and consequences of battle stress followed the experience of the two World Wars, and terms like "shellshock" or "combat neurosis" emerged (Maercker, 2003).

An understanding of the impact of negative life events which lie more in the realm of common experience on the development of mental illnesses was slower to develop (Paykel, 2001b). In the following, research on life events which addresses possible effects of stressful everyday experiences will be reviewed and presented.

Life event research

The subject of life event research are the effects of life events on behavior, experience, and mental or physical health of the individual(s) in question (Filipp, 1995). There is common consent that relevant changes in life are associated with certain demands, which request specifi c processing, adjustment, and orientation performances (Dittmann, 1991). Petermann (1995, p.53) defi nes relevant (or critical) life events as a grouping of favorable or unfavorable social circumstances that are psychologically relevant, and which may be verifi ed by their effects (stress, illness). A more general defi nition has been put forward by Filipp (1995, p. 23), who characterizes life events as changes in the (social) life situation that demand adaptation behavior of the individual concerned.

Filipp (1995) differentiates two major theoretical branches within the fi eld of life event research: The clinical psychological approach, which examines psychosocial causes of physical and mental illnesses, and the developmental psychological approach, which conceptualizes life events as a precondition for developmental change. The foundation for systematic experimental research on the pathological effects of stressful events was laid by Cannon (1929). His detailed observations of bodily changes caused by stressful conditions and strong emotions provided a necessary link in the argument that stressful events can prove harmful (Dohrenwend &, Dohrenwend, 1974a).

Thereafter, a vast body of research evolved based on the hypothesis that stressful life events play a role in the etiology of various somatic and psychiatric disorders. This line of research can best be described as clinical life event research.