The Moderating Role of Psychological Well‐Being in the Relation Between Stressful Life Events and Common Mental Disorders in the General Population

TL;DR

This study shows that psychological well-being can reduce the impact of stressful life events on mental health disorders in the general population.

Contribution

The study identifies psychological well-being as a significant moderator in the relationship between stressful life events and mental disorders.

Findings

Experiencing two or more stressful life events increases the risk of common mental disorders.

Low psychological well-being significantly enhances the risk of mood and anxiety disorders when combined with stressful life events.

Promoting psychological well-being could help build resilience against mental health issues caused by stress.

Abstract

Stressful life events (SLEs) are known to be associated with an increased prevalence of common mental disorders (CMDs), but the potential moderating role of psychological well‐being has not been comprehensively studied. In total, 6194 adults aged 18–75 years were interviewed for the third Netherlands Mental Health Survey and Incidence Study (NEMESIS‐3). Assessments included the adapted Composite International Diagnostic Interview (CIDI v3.0) to determine DSM‐5 mood, anxiety and substance use disorders, Brugha's List of Threatening Experiences for SLEs, and Brief INSPIRE‐O for psychological well‐being. Logistic regressions tested associations between having experienced at least two SLEs and the different CMDs and additive interactions with psychological well‐being. Having experienced ≥ 2 SLEs in the last year was associated with a higher prevalence of all CMDs in the last year, with adjusted odds ratios ranging from 1.71 (95% CI: 1.39; 2.10) for substance use disorders to 3.43 (95% CI: 2.73; 4.30) for mood disorders. The interaction effect of ≥ 2 SLEs and low psychological well‐being was statistically significant for any CMD (RERI = 5.64, 95% CI: 3.18; 8.10), mood disorder (RERI = 23.09, 95% CI: 10.10; 36.10) and anxiety disorder (RERI = 3.45, 95% CI: 1.27; 5.63), but not for substance use disorder (RERI = 0.21, 95% CI: −1.38; 1.80). The joint presence of ≥ 2 SLEs and poor psychological well‐being was associated with a higher prevalence of mood and anxiety disorders than would be expected from the sum of their individual associations. Promoting psychological well‐being may be a fruitful public mental health strategy to increase resilience against SLEs.