Final comments

There are two ways of looking at the findings that have been reviewed. First, that the study of life events has been an effective way of opening up wider issues concerning the aetiology of depression—and, it can be added, other psychiatric conditions that have not been reviewed. k^83,84,8 and 86) This has been possible because, given the presence of a substantial causal link, a platform is provided for the study of a whole range of other experiences. As research has progressed it has pushed back in time to consider the aetiological role of early experiences of neglect and abuse which can have event-like characteristics. In more general terms the study of events has led to consideration of issues of vulnerability and protection, event production, chronicity and course of particular episodes, and also issues not covered in this account such as coping and social support.

So far this kind of extension of life-event research has remained largely within the psychosocial realm, but potential ramifications are broader (for an exception concerning biological research see Calloway and Dolan (87)). In diagnostic terms, for example, it has raised issues concerning the role of kindling in explaining the lessening of the importance of stress in terms of episode number in onsets of melancholic/psychotic depressive conditions.

It has also been possible to isolate a small group of 'endogenous' neurotic depressive episodes. Such findings call out for collaborative research and hint at the possible advantage of taking into account of the aetiological models that have been developed around the event-onset link. Further, while this review has largely restricted itself to work on depression, the approach has been successfully employed with a number of other psychiatric and physical conditions and may prove of relevance for a wider range of issues in medical research such as 'illness behaviour' and the doctor-patient relationship.

The second contribution concerns insight about the depression-event link itself. This is a complex issue because depressogenic life events correlate with a whole range of factors ranging from genetic/personality(88) to macrolevel/societal.(89> However, the findings concerning events involving humiliation and entrapment may need to be viewed from an evolutionary perspective, i.e. that in some way a response pattern which has developed in group-living animals, closely linked to issues surrounding defeat and exclusion, may often be involved.(90) It is possible that clinically relevant depressive conditions are often a complication of essentially non-pathological submission and appeasement responses to defeat in group-living mammals.(81 Therefore the high rates of clinically relevant depression that appear to be possible in some populations may well be a result of the more highly developed cognitive developments of Homo sapiens together with the event-creating potential of many societies experiencing periods of marked social change due to factors such as war, industrialization, technological development, urbanization, changing sexual mores.

Break Free From Passive Aggression

Break Free From Passive Aggression

This guide is meant to be of use for anyone who is keen on developing a better understanding of PAB, to help/support concerned people to discover various methods for helping others, also, to serve passive aggressive people as a tool for self-help.

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