Introduction

While the notion of stress-related disease dates back to classical times, it is only in the last two decades that research into the role of life events has been systematic enough to inform general medical practice. Alongside these improvements in the study of environmental stressors, there has been increasing sophistication in the understanding of the impact of psychosocial factors in general upon health and illness. In parallel, work in neuropsychopharmacology has thrown up wide-ranging hypotheses, which have allowed the elaboration of integrated biopsy chosocial models with compelling implications for preventive interventions.

In a brief chapter of this kind, it is clearly impossible to do justice to all these developments, and the focus of this contribution has had to be restricted accordingly. The theme selected highlights the personal meaning of adverse life events and ways in which this might be explored by a person's doctor and other health care professionals. This theme will be developed by describing in some detail the work of one particular research tradition.

Life events, difficulties and meaning

The studies to be discussed here were undertaken during the last 25 years in London, by the Royal Holloway and Bedford College Medical Research Council research team, both in general population and in psychiatric patient samples. Their original purpose was to investigate the psychosocial aetiology of mental disturbance, although the study of the course of illness and recovery also became possible later.