title: How multiple types of stressors impact on health.
abstract: OBJECTIVE
  Although many studies have focused on the relationship between stress and health, few have examined the impact of multiple types of stressors. The current study investigated the health impact of four stressors: sexual and physical abuse history, lifetime losses and traumas, turmoil in childhood family, and recent stressful life events.
  
  
  METHODS
  The sample included 239 female patients from a referral-based gastroenterology clinic.
  
  
  RESULTS
  We found that the four stressors (abuse history, lifetime traumas, turmoil in childhood family, and recent stressful life events) were related to poor health status (eg, more pain, symptoms, bed disability days, physician visits, functional disability, and psychological distress); together, these stressors accounted for 32% of the variance in overall current health. Furthermore, women who scored high on one type of stressor also tended to have experienced other types. Unlike many previous studies, we did not find that social support buffered the effects of stress.
  
  
  CONCLUSIONS
  This study provides evidence that many different types of stressors independently contribute to poor health outcome. Such findings suggest that health practitioners and researchers should question patients about histories of traumatic events, in addition to the examination of the biological aspects of illness, inasmuch as both may have notable effects on health status.
authors.affiliation: Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill 27599-7160, USA.
authors.forename: J
authors.initials: J
authors.lastname: Leserman
authors.forename: Z
authors.initials: Z
authors.lastname: Li
authors.forename: Y J
authors.initials: YJ
authors.lastname: Hu
authors.forename: D A
authors.initials: DA
authors.lastname: Drossman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005192:Family Health; D005260:Female; D006304:Health Status; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D012044:Regression Analysis; D013315:Stress, Psychological / Q000453:epidemiology*