Do Multiple Health Events Reduce Resilience When Compared With Single Events?

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Abstract

Objective: The impact of multiple major life stressors is hypothesized to reduce the probability of resilience and increase rates of mortality. However, this hypothesis lacks strong empirical support because of the lack of prospective evidence. This study investigated whether experiencing multiple major health events diminishes rates of resilience and increases rates of mortality using a large population-based prospective cohort. Method: There were n = 1,395 individuals sampled from the Health and Retirement Study (HRS) and examined prospectively from 2 years before 4 years after either single or multiple health events (lung disease, heart disease, stroke, or cancer). Distinct depression and resilience trajectories were identified using latent growth mixture modeling (LGMM). These trajectories were compared on rates of mortality 4 years after the health events. Results: Findings indicated that 4 trajectories best fit the data including resilience, emergent postevent depression, chronic pre-to-post depression, and depressed prior followed by improvement. Analyses demonstrate that multiple health events do not decrease rates of resilience but do increase the severity of symptoms among those on the emergent depression trajectory. Emergent depression increased mortality compared with all others but among those in this class, rates were not different in response to single versus multiple health events. Conclusions: Multiple major stressors do not reduce rates of resilience. The emergence of depression after health events does significantly increase risk for mortality regardless of the number of events.

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