A systematic review and Bayesian meta-analysis of 30 years of stress generation research: Clinical, psychological, and sociodemographic risk and protective factors for prospective negative life events.

Abstract

Stress generation posits that (a) individuals at-risk for psychopathology may inadvertently experience higher rates of prospective dependent stress (i.e., stressors that are in part influenced by their thoughts and behaviors) but not independent stress (i.e., stressors occurring outside their influence), and (b) this elevated dependent stress, in some measure, is what places these individuals at-risk for future psychopathology. In recognition of 30 years of stress generation research, we conducted a systematic review and meta-analysis using frequentist and Bayesian approaches (102 articles with 104 eligible studies, N = 31,541). Generally strong support was found for psychopathology predicting dependent stress (e.g., ds Overall psychopathology = 0.36-0.52, BF 10 = 946.00 to 4.65 × 10 18 ). Moderator analyses for dependent stress revealed larger effects for briefer assessments periods, shorter follow-ups, and self-report measures than for interviews. Among risk factors, depressogenic cognitive styles (ds = .26-.50, BF 10 = 47.50 to 1.00 × 10 5 ) and general interpersonal vulnerability (ds = .26-.44, BF 10 = 2.72 to 2708.00) received the strongest support as stress generation mechanisms, and current evidence is modest for protective factors predicting dependent stress. Overall, larger effects were generally found for prospective prediction of dependent stress than independent stress. Evaluations of mediation in the research literature were relatively few, limiting the current review to qualitative analysis of the mediation component of stress generation. General support was found, however, for dependent stress as a mediator for psychopathology and associated risk factors in relation to subsequent psychopathology. The current review ends with recommendations for future research and integration of stress generation within minority stress frameworks. Public Significance StatementStress generation is the process by which individuals' characteristics, behaviors, and psychopathology inadvertently generate stress in their lives. This systematic review and meta-analysis of 102 studies provides a comprehensive evaluation on the prospective association between (a) psychopathology, (b) biopsychosocial risk factors, (c) protective factors, and (d) sociodemographic characteristics in relation to dependent and independent stress. We found robust effects for associations between overall dependent stress and (a) overall psychopathology, particularly depression, and (b) cognitive and interpersonal vulnerabilities. Some supportive evidence was found, however, for small associations with independent stress. In short, there is robust evidence that psychopathology predicts future dependent stressors and that these stressors may in turn lead to further psychopathology. Prevention and intervention efforts aimed at addressing and preventing dependent stressors may be critical to reduce psychopathology. Findings further our understanding of stress generation in the development, maintenance, and recurrence of mental health problems across d...