Hostname: page-component-cd4964975-4wks4 Total loading time: 0 Render date: 2023-04-01T21:35:37.289Z Has data issue: true Feature Flags: { "useRatesEcommerce": false } hasContentIssue true

Adverse events over the life course and later-life wellbeing and depressive symptoms in older people

Published online by Cambridge University Press:  14 October 2020

Sol Richardson*
Research Department of Epidemiology and Public Health, International Centre for Life Course Studies in Society and Health, University College London, London, UK
Ewan Carr
Research Department of Epidemiology and Public Health, International Centre for Life Course Studies in Society and Health, University College London, London, UK Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
Gopalakrishnan Netuveli
Research Department of Epidemiology and Public Health, International Centre for Life Course Studies in Society and Health, University College London, London, UK Institute for Connected Communities, University of East London, London, UK
Amanda Sacker
Research Department of Epidemiology and Public Health, International Centre for Life Course Studies in Society and Health, University College London, London, UK
Correspondence should be addressed to: Sol Richardson, Research Department of Epidemiology and Public Health, International Centre for Life Course Studies in Society and Health, University College London, 1-19 Torrington Place, LondonWC1E 6BT, UK. Phone: +44 (0)20 35596440. Email:



Exposures to adverse events are associated with impaired later-life psychological health. While these associations depend on the type of event, the manner in which associations for different event types depend on when they occur within the life course has received less attention. We investigated associations between counts of adverse events over the life course, and wellbeing and mental health outcomes in older people, according to their timing (age of occurrence), orientation (self or other) and, both their timing and orientation.


Linear and logistic random-effects models for repeated observations.


England, 2002–2015.


A total of 4,208 respondents aged >50 years with 22,146 observations across Waves 1–7 of the English Longitudinal Study of Ageing.


Cumulative adversity was measured by counts of 16 types of events occurring within four age ranges over the life course using retrospective life history data. These were categorized into other- (experienced through harms to others) and self-oriented events. Outcomes included CASP-12 (control, autonomy, self-realization, and pleasure), the eight-item Centre of Epidemiological Studies Depression Scale, and self-appraised subjective life satisfaction.


Additional adverse events were associated with lower CASP-12 and life satisfaction scores, and higher odds of probable depressive caseness. In childhood, other-oriented events had a larger negative association with later-life wellbeing than self-oriented events; the converse was found for events occurring in adulthood.


Events occurring at all life course stages were independently associated with both later-life wellbeing and depression in a cumulative fashion. Certain age ranges may represent sensitive periods for specific event types.

Original Research Article
© International Psychogeriatric Association 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Aldwin, C. M. (1990). The Elders Life Stress Inventory: Egocentric and nonegocentric stress. In: Stephens, M. A. P., Crowther, J. H., Hobfoll, S. E. and Tennenbaum, D. L. (Eds.), Stress and coping in later-life families (pp. 4969). Washington, DC: Hemisphere.Google Scholar
Alwin, D. F. (2012). Integrating varieties of life course concepts. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 61, 206220. doi: 10.1093/geronb/gbr146.CrossRefGoogle Scholar
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, 4th Edition (p. 427). Washington, DC: American Psychiatric Association.Google Scholar
Australian Psychological Society. (2019). Understanding and managing psychological trauma. Retrieved from:; last accessed Mar 3 2020.Google Scholar
Baird, K. and Kracen, A. C. (2006). Vicarious traumatization and secondary trauma stress: a research synthesis. Counselling Psychology Quarterly, 9, 181188. doi: 10.1080/09515070600811899.CrossRefGoogle Scholar
Bebbington, P. et al. (1993). Life events and psychosis: initial results from the Camberwell Collaborative Psychosis Study. British Journal of Psychiatry, 162, 7279. doi: 10.1192/bjp.162.1.72.CrossRefGoogle ScholarPubMed
Ben-Shlomo, Y. and Kuh, D. (2002). A life course approach to chronic disease epidemiology: conceptual models, empirical challenges and interdisciplinary perspectives. International Journal of Epidemiology, 31, 285293. doi: 10.1093/ije/31.2.285.CrossRefGoogle ScholarPubMed
Blane, D. (1996). Collecting retrospective data: Development of a reliable method and a pilot study of its use. Social Science and Medicine, 42, 751757. doi: 10.1016/0277-9536(95)00340-1.CrossRefGoogle Scholar
Breslau, N., Chilcoat, H. D., Kessler, R. C. and Davis, G. C. (1999). Previous exposure to trauma and PTSD effects of subsequent trauma: results from the Detroit Area Survey of Trauma. American Journal of Psychiatry, 156, 902907. doi: 10.1176/ajp.156.6.902.CrossRefGoogle ScholarPubMed
Breslau, N., Kessler, R. C., Chilcoat, H. D., Schultz, L. R., Davis, G. C. and Andreski, P. (1998). Trauma and posttraumatic stress disorder in the community: the 1996 Detroit Area Survey of Trauma. Archives of General Psychiatry, 55, 626632. doi: 10.1001/archpsyc.55.7.626.CrossRefGoogle ScholarPubMed
Brown, G. W., Bifulco, A. and Harris, T. O. (1987). Life events, vulnerability and onset of depression: some refinements. British Journal of Psychiatry, 150, 3042. doi: 10.1192/bjp.150.1.30.CrossRefGoogle ScholarPubMed
Brown, G. W. and Harris, T. O. (1978). Social origins of depression: a study of psychiatric disorder in women (pp. 63149). London: Tavistock.Google Scholar
Brown, L. L., Mitchell, U. A. and Ailshire, J. (2018). Disentangling the stress process: race/ethnic differences in the exposure and appraisal of chronic stressors among older adults. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 75, 650660. doi: 10.1093/geronb/gby072.CrossRefGoogle Scholar
Brown, G. W., Sklair, F., Harris, T. and Birley, J. L. T. (1973). Life-events and psychiatric disorders Part 1: some methodological issues. Psychological Medicine, 3, 7487. doi: 10.1017/S0033291700046365.CrossRefGoogle Scholar
Cohen, S., Janicki-Deverts, D., Chen, E. and Matthews, K. A. (2010). Childhood socioeconomic status and adult health. Annals of the New York Academy of Sciences, 1186, 3755. doi: 10.1111/j.1749-6632.2009.05334.x.CrossRefGoogle ScholarPubMed
Courtin, E., Knapp, M., Grundy, E. and Avendano-Pabon, M. (2015). Are different measures of depressive symptoms in old age comparable? An analysis of the CES-D and Euro-D scales in 13 countries. International Journal of Methods in Psychiatric Research, 24, 287304. doi: 10.1002/mpr.1489.CrossRefGoogle ScholarPubMed
Elder, G. H. (1998). The life course as developmental theory. Child Development, 69, 112. doi: 10.2307/1132065.CrossRefGoogle ScholarPubMed
Felitti, V. J. et al. (1998). Relationship of childhood abuse and household dysfunction to many leading causes of death in adulthood. American Journal of Preventative Medicine, 14, 245258. doi: 10.1016/S0749-3797(98)00017-8.CrossRefGoogle Scholar
Galobardes, B., Lynch, J. and Smith, G. D. (2007) Measuring socioeconomic position in health research. British Medical Bulletin, 81, 2137. doi: 10.1093/bmb/ldm001.CrossRefGoogle ScholarPubMed
Galobardes, B., Shaw, M., Lawlor, D. A., Lynch, J. W. and Davey Smith, G. (2006) Indicators of socioeconomic position (part 1). Journal of Epidemiology and Community Health, 60, 712. doi: 10.1136/jech.2004.023531.CrossRefGoogle Scholar
Green, J. G. et al. (2010). Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication I: associations with first onset of DSM-IV disorders. Archives of General Psychiatry, 67, 113123. doi: 10.1001/archgenpsychiatry.2009.186.CrossRefGoogle ScholarPubMed
Hardt, J. and Rutter, M. (2004). Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. Journal of Child Psychology and Psychiatry, 45, 260273. doi: 10.1111/j.1469-7610.2004.00218.x.CrossRefGoogle Scholar
Hepp, U. et al. (2006). Inconsistency in reporting potentially traumatic events. British Journal of Psychiatry, 188, 278283. doi: 10.1192/bjp.bp.104.008102.CrossRefGoogle ScholarPubMed
Holmes, T. H. and Rahe, R. H. (1967). The social readjustment rating scale. Journal of Psychosomatic Research, 11, 213218. doi: 10.1016/0022-3999(67)90010-4.CrossRefGoogle ScholarPubMed
Hyde, M., Wiggins, R. D., Higgs, P. and Blane, D. B. (2003). A measure of quality of life in early old age: the theory, development and properties of a needs satisfaction model (CASP-19). Aging & Mental Health, 7, 186194. doi: 10.1080/1360786031000101157.CrossRefGoogle Scholar
Kamiya, Y., Timonen, V. and Kenny, R. A. (2016). The impact of childhood sexual abuse on the mental and physical health, and healthcare utilization of older adults. International Psychogeriatrics, 28, 415422. doi: 10.1017/S1041610215001672.CrossRefGoogle ScholarPubMed
Kessler, R. C. and Magee, W. J. (1993). Childhood adversities and adult depression: basic patterns of association in a US national survey. Psychological Medicine, 23, 679690. doi: 10.1017/S0033291700025460.CrossRefGoogle Scholar
Kessler, R. C. et al. (2010). Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys. British Journal of Psychiatry, 197, 378385. doi: 10.1192/bjp.bp.110.080499.CrossRefGoogle ScholarPubMed
Krause, N. (2004). Lifetime trauma, emotional support, and life satisfaction among older adults. The Gerontologist, 44, 615623. doi: 10.1093/geront/44.5.615.CrossRefGoogle ScholarPubMed
Krause, N., Shaw, B. A. and Cairney, J. (2004). A descriptive epidemiology of lifetime trauma and the physical health status of older adults. Psychology and Aging, 19, 637648. doi: 10.1037/0882-7974.19.4.637.CrossRefGoogle ScholarPubMed
Kuh, D., Ben-Shlomo, Y., Lynch, J., Hallqvist, J. and Power, C. (2003). Life course epidemiology. Journal of Epidemiology and Community Health, 57, 778783. doi: 10.1136/jech.57.10.778.CrossRefGoogle ScholarPubMed
Lacey, R. E., Bartley, M., Pikhart, H., Stafford, M., Cable, N. and Coleman, L. (2012). Parental separation and adult psychological distress: evidence for the ‘reduced effect’ hypothesis. Longitudinal and Life Course Studies, 3, 359368. doi: 10.14301/llcs.v3i3.195.Google Scholar
Loftus, E. F. (1993). The reality of repressed memories. American Psychologist, 48, 518537. doi: 10.1037/0003-066X.48.5.518.CrossRefGoogle ScholarPubMed
Magruder, K. M., Kassam-Adams, N., Thoresen, S. and Olff, M. (2016). Prevention and public health approaches to trauma and traumatic stress: a rationale and a call to action. European Journal of Psychotraumatology, 7, 29715. doi: 10.3402/ejpt.v7.29715.CrossRefGoogle Scholar
Office for National Statistics. (2000). Standard Occupational Classification 2000, Volume 1. London: Her Majesty’s Stationery Office.Google Scholar
Office for National Statistics. (2016). Small area income estimates: model-based estimates of the mean household weekly income for middle layer super output areas (2013/14 Technical Report). London: Her Majesty’s Stationery Office.Google Scholar
Ogle, C. M., Rubin, D. C. and Siegler, I. C. (2014). Cumulative exposure to traumatic events in older adults. Aging & Mental Health, 3, 316325. doi: 10.1080/13607863.2013.832730.CrossRefGoogle Scholar
Organisation for Economic Co-operation and Development. (2019). OECD.Stat. Retrieved from; last accessed Mar 8 2020.Google Scholar
Palgi, Y., Shrira, A., Ben-Ezra, M., Shiovitz-Ezra, S. and Ayalon, L. (2012). Self- and other-oriented potential lifetime traumatic events as predictors of loneliness in the second half of life. Aging & Mental Health, 16, 423430. doi: 10.1080/13607863.2011.638903.CrossRefGoogle ScholarPubMed
Paykel, E. S. (1978). Contribution of life events to causation of psychiatric illness. Psychological Medicine, 8, 245–53. doi: 10.1017/S003329170001429X.CrossRefGoogle ScholarPubMed
Pine, C. J., Padilla, A. M. and Maldonado, M. (1985). Ethnicity and life event cognitive appraisals and experiences. Journal of Clinical Psychology, 41, 460465. doi: 10.1023/A:1022800118777.3.0.CO;2-N>CrossRefGoogle ScholarPubMed
Phillips, A. C., Carroll, D. and Der, G. (2015). Negative life events and symptoms of depression and anxiety: stress causation and/or stress generation. Anxiety, Stress and Coping, 28, 357371. doi: 10.1080/10615806.2015.1005078.CrossRefGoogle ScholarPubMed
Qi, W., Gevonden, M. and Shalev, A. (2016). Prevention of post-traumatic stress disorder after trauma: current evidence and future directions. Current Psychiatry Reports, 18, 20. doi: 10.1007/s11920-015-0655-0.CrossRefGoogle ScholarPubMed
Radloff, L. S. (1977). The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385401. doi: 10.1080/10615806.2015.1005078.CrossRefGoogle Scholar
Richardson, S., Carr, E., Netuveli, G. and Sacker, A. (2018). Country-level welfare-state measures and change in wellbeing following work exit in early old age: evidence from 16 European countries. International Journal of Epidemiology, 48, 389401. doi: 10.1093/ije/dyy205.CrossRefGoogle Scholar
Riley, J. C. (1989). Sickness, recovery and death: a history and forecast of ill-health (p. 47). Basingstoke: Macmillan.CrossRefGoogle Scholar
Ross, M. (1989). Relation of implicit theories to the construction of personal histories. Psychological Review, 96, 341357. doi: 10.1037/0033-295X.96.2.341.CrossRefGoogle Scholar
Rutter, M. (1996). Transitions and turning points in developmental psychopathology: as applied to the age span between childhood and mid-adulthood. International Journal of Behavioral Development, 19, 603626. doi: 10.1177/016502549601900309.CrossRefGoogle Scholar
Searle, S. D., Mitnitski, A., Gahbauer, E. A., Gill, T. M. and Rockwood, K. (2008). A standard procedure for creating a frailty index. BMC Geriatrics, 8, 24. doi: 10.1186/1471-2318-8-24.CrossRefGoogle ScholarPubMed
Shmotkin, D. (2003). Vulnerability and resilience intertwined: a review of research on Holocaust survivors. In: Jacoby, R., and Keinan, G. (Eds.), Between stress and hope: from a disease-centered to a health-centered perspective (pp. 213233). Westport, CT: Praeger.Google Scholar
Shmotkin, D. and Litwin, H. (2009). Cumulative adversity and depressive symptoms among older adults in Israel: the differential roles of self-oriented versus other-oriented events of potential trauma. Social Psychiatry and Psychiatric Epidemiology, 44, 989997. doi: 10.1007/s00127-009-0020-x.CrossRefGoogle ScholarPubMed
Shrira, A., Shmotkin, D. and Litwin, H. (2012). Potentially traumatic events at different points in the life span and mental health: findings from SHARE-Israel. American Journal of Orthopsychiatry, 82, 251259. doi: 10.1111/j.1939-0025.2012.01149.x.CrossRefGoogle ScholarPubMed
StataCorp. (2015). Stata Statistical Software: Release 14 [Computer software]. College Station, TX: StataCorp LP.Google Scholar
Steptoe, A., Breeze, E., Banks, J. and Nazroo, J. (2013). Cohort profile: the English Longitudinal Study of Ageing. International Journal of Epidemiology, 42, 16401648. doi: 10.1093/ije/dys168.CrossRefGoogle ScholarPubMed
Suh, E., Diener, E. and Fujita, F. (1996). Events and subjective well-being: only recent events matter. Journal of Personality and Social Psychology, 70, 10911102. doi: 10.1037/0022-3514.70.5.1091.CrossRefGoogle ScholarPubMed
Turner, H. A. and Schieman, S. (2008). Stress processes across the life course: introduction and overview. Advances in Life Course Research, 13, 115. doi: 10.1016/S1040-2608(08)00001-4.CrossRefGoogle Scholar
Turner, R. J. and Lloyd, D. A. (1995). Lifetime traumas and mental health: the significance of cumulative adversity. Journal of Health and Social Behavior, 36, 360376. doi: 10.2307/2137325.CrossRefGoogle ScholarPubMed
Turvey, C. L., Wallace, R. B. and Herzog, R. (1999). A revised CES-D measure of depressive symptoms and a DSM-based measure of major depressive episodes in the elderly. International Psychogeriatrics, 11, 139148. doi: 10.1017/S1041610299005694.CrossRefGoogle Scholar
Vanhoutte, B. (2014). The multidimensional structure of subjective wellbeing in later life. Journal of Population Ageing, 7, 120. doi: 10.1007/s12062-014-9092-9.CrossRefGoogle Scholar
Weiss, T. (2004). Correlates of posttraumatic growth in husbands of breast cancer survivors. Psycho-oncology, 13, 260268. doi: 10.1002/pon.735.CrossRefGoogle ScholarPubMed
Wheaton, B. (1994). Sampling the stress universe. In: Avison, W. R., and Gotlib, I. H. (Eds.), Stress and mental health: contemporary issues and prospects for the future (pp. 77114). New York: Plenum Press.CrossRefGoogle Scholar
White, J. et al. (2016). Duration of depressive symptoms and mortality risk: the English Longitudinal Study of Ageing (ELSA). British Journal of Psychiatry, 208, 337-342. doi: 10.1192/bjp.bp.114.155333.CrossRefGoogle Scholar
World Health Organization. (2013). Mental Health Action Plan 2013–2020 (p. 17). Geneva: World Health Organization.Google Scholar
Supplementary material: Image

Richardson et al. supplementary material

Richardson et al. supplementary material 1

Download Richardson et al. supplementary material(Image)
Image 489 KB
Supplementary material: Image

Richardson et al. supplementary material

Richardson et al. supplementary material 2

Download Richardson et al. supplementary material(Image)
Image 103 KB
Supplementary material: File

Richardson et al. supplementary material

Richardson et al. supplementary material 3

Download Richardson et al. supplementary material(File)
File 104 KB