Life Stress and Illness: The Question of Specificity

The hypothesis that specific disorders arise from specific psychosocial circumstances has received little attention in the last couple of decades. Recently developed measurements of stress, specifically the Life Events and Difficulties Schedule (LEDS), allow a more focused perspective on the differing psychosocial pathways to psychiatric and physical disorder. This is the result of the level of measurement employed by the LEDS, whereby specific qualities of distress, such as losses, dangers, frustrations, and so on, can be distinguished from each other within the overall category of distressing/unpleasant experience. Studies of depression, anxiety, schizophrenia, abdominal pain, appendectomy, menorrhagia, secondary amenorrhea, and myocardial infarction using the LEDS suggest that the specific qualities of the stressors involved in the onset of each condition may parallel similar predisposing vulnerabilities in the personalities of those becoming ill, and corresponding psychiatric conditions between stressor and somatic onset. An overall framework is outlined within which disorders are typified as more or less disengaged/overengaged, and suggestions are offered for future research.