But wait, what if…? - Catastrophising and integration of stressful life experiences

What is catastrophising? 

Catastrophising is when someone predicts or imagines the worst is going to come from a situation. For example, if you get one bad grade on an assignment, you might imagine that you'll fail your degree and drop out of university - which in all likelihood, won't be the case. But if this sounds familiar, don't worry, many of us catastrophise in our daily life and it isn't necessarily a symptom of a mental health condition. 

So, why do we care about catastrophising and how does it link to mental health? 

Well, while catastrophising on its own isn't a sign of anything concerning, it is a symptom of many different mental health conditions like depression and anxiety. 

For example, imagine someone with panic disorder, let's call her Alice. Alice struggles with panic attacks. She feels really stressed and scared about the possibility of having future panic attacks. This means if Alice gets chest pains or her heart starts beating faster after some exercise, she catastrophises about this change in her body and thinks she's having a heart attack. Even if this is not the case, it's because Alice is catastrophising. 

Does catastrophising link with how people are dealing with stressful life experiences ?

Now while catastrophising can link to mental health conditions, it also seems that catastrophising symptoms on their own may link to how people are dealing with stressful life experiences. 

For example, think about people working in emergency services like firefighters or police officers, they experienced highly stressful life events on the daily. While this is challenging work, most individuals can deal with these stressful life conditions and do not necessarily develop any mental health conditions.  

However, a study measured how much trainee firefighters engaged in catastrophising before starting their active duty - this means before going on the field (meaning fighting actual fires). The trainee firefighters with higher catastrophising levels before active duty were more likely to struggle with the high intensity and stressful experiences, developing PTSD-like symptoms once in their firefighting role.

But, as most of us aren't firefighters we don't experience that high level of stressful life experiences on a daily basis. Therefore, does the connection between stressful life experiences and catastrophising still apply?

Well, a different study measured catastrophising levels in a group of teenagers. Unfortunately, this group of teenagers went on to witness a terrorist attack. Now, most teenagers do not really experience the same level of daily stress as firefighters. However, similarly to the firefighters, the teenagers who initially had higher levels of catastrophising struggled more to manage after witnessing the terrorist attack, developing PTSD-like symptoms.

You might be wondering then how we can figure out if catastrophising is actually directly involved in how people deal with stressful life events. One way we can start to do this is by thinking about how catastrophising may be impacting how people find meaning from stressful life events or the meaning making process. 

What is the meaning-making process? 

The meaning making process is what some psychologists think happens after we go through a stressful life experience. Imagine you've just gone through a stressful life event or situation, sadly you've just found out you failed one of your first exams at university. 

The meaning-making process is that you will now try to find a positive or clear interpretation of what happened. 

You'll have two types of meanings for this life event (these may be unconscious).  

1. Global meaning - this doesn't change and includes your personal beliefs and goals e.g. I want to do well at university.
2. Appraised meaning - this is your feelings about the event e.g. sad or angry at failing but also what you think is the purpose of the event. For instance, you're motivated to study more for the next exam.

In the meaning making process, the individual will be trying to join the global and appraised meaning for the stressful life event. In other words, anyone struggling with a stressful life event is aiming to 'integrate' this event into their wider understanding of life. While, in this example of failing an exam, it may not be too difficult to integrate but more stressful/traumatic events are likely to be much harder to 'integrate', like the loss of a loved one. 

Therefore, perhaps unsurprisingly, if we struggle with this meaning making process after a stressful or traumatic life experience, this leads to more distress for people with/without prior mental health conditions. 

Are catastrophising and integration of stressful life events linked? 

It might seem to make sense that catastrophising and integration of stressful life events are linked together but no research has ever investigated this directly. 

Therefore, in our study, my supervisor Dr Alex Pike and I, looked at the relationship between catastrophising levels and how well people can integrate general stressful life experiences that most of us may experience in daily life, like financial issues.

If you think about it, people's mental health doesn't happen in a neat box and there's so many other factors that could affect it. So, we also looked into one of these factors, what people perceive their socioeconomic status is.

What is perceived socioeconomic status and how can we measure it in research?

Perceived socioeconomic status is all about where you perceive yourself to be compared to the rest of society. Sounds complicated but how we measured it in this study basically starts by getting you to picture a ladder with 10 rungs. 

Think this [10-rung] ladder representing where people stand in the UK. At the top of the ladder are the people who are the best off e.g. most money, the most education, and most respected jobs. At the bottom are the people who are the worst off e.g. least money, least education, least respected jobs, or no job. Where would you place yourself on this ladder at this time in your life?*

*Paraphrased from MacArthur Scale of Subjective Social Status (Adler et al., 2000)

So, what did the study find?

As expected, high levels of catastrophising were associated with reduced integration of stressful life experiences and lower perceived socioeconomic status. Importantly, as you might have heard before 'correlation does not equal causation', so it's not clear whether there is a cause and effect. This means we can't say high levels of catastrophising leads to reduced integration of stressful life experiences.

Unexpectedly, a person's perceived socioeconomic status was not linked with the levels of integration, in other words, how well they dealt with stressful life experiences. This is strange because research suggests that those from lower socioeconomic backgrounds experience more stressful life events. 

This could be because those in this group become so used to managing all these stressful life experiences, they're desensitised. Thus, we can't fully measure how well they're integrating with them. But it could also be that there is just no effect of socioeconomic status on the integration with stressful life experiences. We need further research to confirm this. 

We also did some extra analysis of the data, using a hierarchical regression. This means we can think about whether one thing can predict something else and it's closer to the idea of causation. The study found that some of the factors that can predict people's catastrophising scores are perceived socioeconomic status, age and one's integration with stressful life experiences.

Right, and…. What does all of this actually mean?

Well, the study established that there might be a connection between how well people deal with daily stressful life experiences in their lives and catastrophising. This seems to be one of the factors impacting catastrophising. 

While lots more research is needed to verify these findings, integration of stressful life experiences seems to be one of the factors impacting catastrophising alongside age and perceived socioeconomic status. This means that in the future, we might be able to tackle and target integration of stressful life experience in mental health therapy.  

Further reading 

Park, C. L. (2010). 'Making sense of the meaning literature: An integrative review of meaning making and its effects on adjustment to stressful life events'. Psychological Bulletin, 136(2), 257–301.

Borkovec, T. D., Hazlett‐Stevens, H., & Diaz, M. L. (1999). 'The role of positive beliefs about worry in generalised anxiety disorder and its treatment'. Clinical Psychology & Psychotherapy: An International Journal of Theory & Practice, 6(2), 126-138.

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