Gender moderates the relationship between stressful life events and psychopathology: Findings from a national study

Abstract

Background: While data suggest a strong relationship between trauma exposure and psychopathology, less research has investigated relationships between psychopathology and stressful life events more broadly, and how these relationships may differ by gender.

Aim: To examine strengths of associations between stressful life events and psychiatric disorders (i.e., past-year Axis I and lifetime Axis II, per DSM-IV) and how they may differ by gender.

Methods: Data from Wave 1 of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC; n = 43,093) were analyzed using chi-square tests and multinomial logistic regression analyses. Participants were categorized according to occurrence of stressful life events (low, moderate, and high).

Results: Women as compared to men were more likely to report moderate (p < 0.0001) or high occurrence stressful life events (p < 0.0001). Increasing experiences of stressful life events were associated with increasing odds of most past-year Axis I and lifetime Axis II disorders in both gender groups, with the largest odds typically observed in association with more frequent stressful life events. Associations between stressful life events and multiple psychiatric disorders were stronger in women compared to men.

Conclusions: Stressful life events are associated with multiple Axis I and Axis II psychiatric disorders in both men and women. This relationship is moderated by gender. Screening female patients who endorse significant stressors for mood, anxiety, and substance-use problems might be particularly important. The stronger associations in women between stressful life events and personality disorders in particular warrant further investigation.

Keywords: Alcohol use disorder; NESARC; Personality disorders; Psychiatric conditions; Stressful life events.