Stressful life events and health-related quality of life in college students

Journal of College Student Development, Mar/Apr 1997 by Teresa M Damush, Ron D Hays, M Robin DiMatteo

Researchers examined the relationship between recent stressful life events in the past year and health-related quality of life (HRQOL) among 350 college students. Results indicate that stressful life events (i.e., autonomous, distressful, family or parental, and sexual life events) were related to poorer HRQOL. Furthermore, gender did not moderate the relationship between stressful events and HRQOL.

Various researchers have documented an association between the number of life change events experienced by an individual and his or her vulnerability to physical illness (Holmes & Rahe, 1967; Scaloubaca, Slade, & Creed, 1988). Attending college is a major life transition for late adolescents or young adults that includes a number of potentially stressful events such as relocation, separation from family members, and development of new peer relationships. These and other types of life event stress may detrimentally affect health-related quality of life (HRQOL)-that is, functioning and well-being in physical, mental, and social domains of life. In one study, for example, first year undergraduates who sought help in a student health center for psychological or physical symptoms tended to report experiencing adverse life events in the previous year such as a dissolution of a close relationship, or a death or serious illness in the family (Scaloubaca, Slade, & Creed, 1988). However, merely experiencing a life change or event does not necessarily result in a negative outcome. According to Lazarus and Folkman (1984), individuals tend to make subjective, cognitive appraisals of life events. An event that is negatively perceived has a greater potential for having an unfavorable impact on HRQOL (Siegel & Brown, 1988).

In addition, the influence of stressful life events on HRQOL may differ by gender. Previous research has suggested that females and males tend to differ in their perceptions of many life events (Burke & Weir, 1978; Tolan, Miller, & Thomas, 1988). In one study, 16- to 18-yearold females rated events as more stressful than did their male counterparts (Tolan et al., 1988). However, Tolan et al. did not find any gender differences in the prevalence of experiencing stressful life events. In contrast, other research has suggested an absence of gender differences in perceptions of stressors, but differences in the prevalence of experiencing stressful life events. For example, in one study female high school adolescents reported experiencing more stressors, especially regarding interaction with friends; but the researchers observed no gender differences in stress reactivity (Gore, Aseltine, & Colton,1992). In another study, females aged 12 to 14 reported experiencing more negative life events than did males, and males aged 12 to 14 reported more positive events than females (Compas, Davis, & Forsythe, 1985). In yet another study, adult women of all marital statuses except separated or divorced were significantly more likely to report negative health events (e.g., major illness, major injury, or hospitalization) than adult men (Thoits, 1987).

Researchers have also found gender differences in HRQOL. Previous studies have indicated that female adolescents and adults tend to report worse emotional well-being than males (Gore et al., 1992; Holmes & David, 1989; Nelson, Hays, Arnold, Kwoh, & Sherbourne, 1989; Nacoste & Wise, 1991; Siddique & D'Arcy, 1982; Thoits, 1987). Furthermore, research on college students has suggested that women tend to report more intense fear, joy, love, and sadness than do men (Grossman & Wood, 1993).

Although researchers have focused on different sources of stress for adolescents and the differential impact on gender among adolescents (Clarke,1995; Newcomb, Huba, & Bentler, 1981; Sherman & Walls, 1995; Siegel & Brown, 1988; Tolan, et al., 1988), few researchers have compared the impact of different kinds of undesirable life events on HRQOL in female and male college students (Scaloubaca et al., 1988; Tyrell, 1992). Ge, Lorenz, Conger, Elder, and Simons (1994) suggested the need for additional research to assess adolescent gender differences in reactivity to different types of stressors. Furthermore, Frazier and Schauben (1994) highlighted a need for specific information on the types of stressors college students are experiencing and the particular impact these stressors may have on adjustment, university counseling centers need such information to develop preventive and therapeutic programs. Moreover, Frazier and Schauben 1994 emphasized the need for researchers to examine areas of adjustment other than anxiety and depression that may be affected by stressors.

In this study the researchers examine the relationship between specific self-reported life events and HRQOL in a sample of male and female college students enrolled at a West Coast university. They evaluated the following hypotheses: (a) college students who reported experiencing negative life events would have worse HRQOL than students who did not report these events; and (b) the associations between stressful life events and HRQOL would vary by gender, with stronger negative associations for females than males.