ABSTRACT

Background

The stress-to-disease association has been well-accepted for some time. However, the understanding of how stress exposure contributes to psychological disease progression remains unclear.

Objective

To test the real-time impact of variable stress exposure on risk-related clinical phenomena and affective disease progression in a high-risk sample of active-duty firefighters.

Methods

Participants completed weekly diaries reporting stressful event exposure, affect, sleep, and risk-related and healthy behaviors over six-months and were evaluated for lifetime and current psychiatric disease using clinical interviews before and after the sampling period.

Results

Stress exposure impacted clinical phenomena in differing ways. Major personal events and day-to-day hassles predicted health-impairing shifts in sleep and behavior that were associated with increases in symptoms and psychological distress over the 6-month period. In contrast, highly aversive incidents predicted greater adaptive behaviors that were uniquely predictive of symptom decreases over the six-month period.

Conclusion

These findings shed new light on stress-to-disease processes, demonstrating how variable stress exposure influences critical shifts in behavior and sleep, contributing to psychological adjustment of firefighters over time. These data suggest practical ways to monitor risk in high-risk samples (e.g., monitoring sleep latency) and offer avenues for further explication of disease processes in real time.

中文翻译：

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微观与宏观过程：特定压力暴露如何影响睡眠、情感和高危成人疾病路径上的风险相关行为

摘要

背景

一段时间以来，压力与疾病的关联已被广泛接受。然而，对压力暴露如何促进心理疾病进展的理解仍不清楚。

客观的

在现役消防员的高风险样本中测试可变压力暴露对风险相关临床现象和情感疾病进展的实时影响。

方法

参与者完成每周日记，报告六个月内的压力事件暴露、情感、睡眠以及与风险相关的健康行为，并在采样期之前和之后使用临床访谈评估其终生和当前的精神疾病。

结果

压力暴露以不同方式影响临床现象。主要的个人事件和日常麻烦预示着睡眠和行为的健康变化与 6 个月内症状和心理困扰的增加有关。相比之下，高度厌恶的事件预测了更大的适应性行为，这些行为独特地预测了六个月期间症状的减少。

结论

这些发现为压力到疾病的过程提供了新的线索，展示了可变压力暴露如何影响行为和睡眠的关键转变，随着时间的推移有助于消防员的心理调整。这些数据提出了监测高风险样本风险的实用方法（例如监测睡眠潜伏期），并为进一步实时解释疾病过程提供了途径。