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Life events and psychiatric disorders Part 2: nature of causal link

Synopsis Methods are first described for testing for and measuring the proportion involved in the causal link between life-events and psychiatric disorders; the paper then deals with the nature of the causal effect itself. A method is described (and developed mathematically in an appendix) which enables a choice to be made between a triggering effect in which events are seen as precipitating an illness that would probably have occurred before long for other reasons, and a formative effect in which life-events either substantially advance onset in time, or bring it about altogether. The method is used to demonstrate the presence of a formative effect in depressive and a triggering effect in schizophrenic disorders.