Externe Monographien
Elisa Helms
2021,
In the context of the present thesis, an instrument for the assessment of subclinical stress symptoms was developed and investigated. For this purpose, the exposure to stress, other socio-economic risk factors, and childhood adversities were investigated on the basis of representative samples both of the general population as well as of forensic patient populations. Furthermore, subclinical stress symptoms were collected, differentiated according to relevance and factors, and their informative value in terms of past and present adversities as well as future subclinical and pathological developments regarding psychological well-being and aggression were analyzed. Stress is an important risk factor for both healthy and already mentally afflicted individuals and can have a variety of psychological and physiological consequences (DeVries & Wilkerson, 2003; Sapolsky, 2007; Thoits, 2013). Previous research results show that stress has negative effects on all areas and levels of psychological well-being, both on internalizing symptoms, such as depression and anxiety and on externalizing symptoms, such as aggression and crime (Rebok et al., 2019). However, between the quality and timing of the stressor and the specific psychopathology of the patients, specific useful correlations were found (Lupien, McEwen, Gunnar & Heim, 2009; Pietrek, Elbert, Weierstall, Müller & Rockstroh, 2013). In some areas of research (psychotic disorders, for example), significant early detection approaches already utilize subclinical symptoms to enable early mental disorder detection and intervention (McGlashan & Johannessen, 1996; McGorry, Hickie, Yung, Pantelis & Jackson, 2006). So far, there has been little systematic research on stress-related psychological disorders, and which factors in regards to psychopathological developments predict how a specific psychopathological syndrome evolves from an initially unspecific stress response, and the extent to which early stress symptom profiles allow prediction of future pathologies. This proposed model of stress symptoms as a mediator between risk factors and both secondary psychological disorders as well as other negative developments assumes that, for identification and prevention, it is no longer necessary to ask about early childhood and further life adversities, but that current symptoms can already provide information about possible risks and the necessary preventive measures. In the first paper, the relevance of risk factors was examined using a representative sample of the German general population (Socio-Economic Panel Germany; SOEP). Using data from 41,042 participants, it was shown that stress compared to other socio-economic risk factors is the strongest predictor of psychological well-being in the general population of a western country, even in the long run. For this purpose, the consequences of 1) stress, 2) unemployment, 3) relationship status, 4) equivalent income, 5) education and 6) the number of children onto psychological well-being (Short Form 12 Health Survey) were analyzed for men and women in the same year as well as two, four and six years later at an intra- and interindividual level. The results indicate that the factor stress requires more attention and should be considered in a more differentiated way for the healthy general population. Based on these insights, the subclinical stress symptom questionnaire SSQ25 was developed and validated in the second paper. In the course of this paper, items were collected and on the basis of three online studies selected, then subdivided into psychological and physiological factors, and finally distinguished from other clinical instruments. The result is a comprehensive, reliable and valid instrument for the assessment of subclinical stress symptoms, which allows researchers to investigate the aetiology and pathogenesis of disorders in subclinical populations, and thus makes an important contribution to the prevention of secondary psychological disorders. In the third study, the mediating role of subclinical stress symptoms was investigated using the recently developed questionnaire SSQ-25. For this reason, an online sample was taken in regards to the psychological well-being of an otherwise healthy population, and a forensic sample was taken in regards to aggression. It was found that subclinical stress symptoms in both cases mediate the relationship between childhood adversities and psychological well-being in adulthood on the one hand, as well as aggression in a forensic context on the other hand. In sum, this dissertation presents important findings on the risk factor stress, develops a new tool for assessing the respective subclinical symptoms, and provides a comprehensive, reliable and valid instrument. The present work expands the knowledge about the connections between early childhood adversities, subclinical stress symptoms, psychological well-being and aggression. Furthermore, this work emphasizes the relevance of subclinical stress symptoms for the identification and prevention of psychological secondary disorders.