Life Events and Difficulties (LEDS) measure

In the 1970s the LEDS interview, designed by George Brown and Tirril Harris provided a major development in the measurement of stress in relation to disorder. In contrast to the checklist self-report measures current at the time, they introduced a contextualised way of exploring life experience where respondents were encouraged to give full details of their recent experiences within a 12-month time-frame. Probing questions were used to establish details of what had happened, when and with what impact. In rating this information interviewers attended only to the factual elements of the events or more chronic difficulties. The emotional response to the event was kept as separate information for rating purposes. In accordance with a dictionary of precedent ratings, each event was rated according to classification (by domain eg marital or work and type of event eg starting new relationship or losing job) and its ‘threat or unpleasantness’ on a 4-point scale. Other attributes such as its focus (on the respondent or on someone close), its independence from disorder as well as a number of characteristics such as loss, danger, trauma, humiliation, entrapment were also rated. For difficulties the classification and severity alone were rated.

The model developed showed that provoking agents consisted of severe life events (those rated as ‘marked’ or ‘moderate’ severity at two weeks after the beginning of event, focused on the respondent or jointly with someone close and not illness-related) or major difficulties (those of two years duration and of high level of severity). Such events included deaths of close others, partner's infidelity, children's delinquency, unplanned pregnancy or material crises such as redundancy or eviction. The type of events most likely to provoke a depression proved to be those involving close relationships. Characteristics of severe events most related to onset were those likely to produce shame, such as humiliations, personal failures and stigmatising events. Although major difficulties are less potent as provoking agents, a severe event arising out of such a difficulty greatly increases risk of onset and a category of 'entrapping' event is one of these.

The LEDS has now been used extensively over the last twenty years by a number of teams studying both psychiatric and physical illness. Its inter-rater reliability is high with correlations of around 0.90 for assessing severity of life events.

 

Key references Brown GW & Harris T (1978) Social Origins of Depression. Tavistock, London, New York. Brown, G. W., Bifulco, A., & Harris, T. O. (1987). Life events, vulnerability and onset of depression: Some refinements. British Journal of Psychiatry. Brown, G. W., Harris, T. O., & Hepworth, C. (1995). Loss, humiliation and entrapment among women developing depression: A patient and non-patient comparison. Psychological Medicine, 25, 7-21