The effects of stressful life events and disasters: research and theoretical issues.

The study of the relationship between adversity and physical and psychiatric illness can be researched by examining either the effect of multiple random events or the impact of a single event, such as a disaster. There has, however, been little cross-fertilisation of theory or methodology between these two areas of investigation. Disaster research has much to learn from the methodological rigour of life events research. Equally the study of disaster victims can help define the similarities and differences between distress and illness, an issue central to the validity of the concept of 'caseness' in the study of nonpatient samples. In the past, the failure to separate these phenomena may have led to exaggerated estimates of the prevalence of morbidity among disaster victims. It is also important to examine the intervening role played by distress generated by an event in causing physical and psychiatric disorder.