Psychological medicine · 2026
'What doesn't kill you doesn't always make you stronger': The impact of repeated exposure to adverse life events on mental health.
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Chye Alexander, Morris Richard W, Glozier Nick
Аннотация
BACKGROUND: Repeated exposure to adversity is universal to the human experience and may impact mental health negatively. However, competing hypotheses predict that repeated adversity leads to either sensitisation or habituation.
METHODS: Using a 22-year Australian population-based panel study, we examined changes in mental health following repeated exposure to seven common adverse life events in adulthood. Mixed-effects regression models estimated the relationship between repeated exposure to adverse life events of the same type and its impact on the Mental Health Inventory-5 score.
RESULTS: All seven adverse life events were associated with significant negative mental health impacts at each occurrence. Patterns of mental health response to repeated exposure varied by event type in the primary analysis. Sensitisation was observed for major worsening in finances and victimisation by property crime. Habituation was observed for separation/divorce and serious personal injury/illness. For physical violence, serious family injury/illness, and firing/redundancy, we found no clear associations. Sensitisation and habituation effects appeared to 'plateau' after the second adverse event rather than accumulating with exposure. Strength and direction of associations were robust to adjustments for pre-event mental health and a Mundlak correction.
CONCLUSIONS: In a population-based sample over two decades we found event-specific sensitisation and habituation in response to repeated adverse life events. Both effects appeared to 'plateau' after the second event. Our findings provide no consistent support for a single universal model of stress-response, indicating that how individuals respond psychologically to adversity is more nuanced and may depend on contextual factors such as individual meaning, resilience, or resources.
METHODS: Using a 22-year Australian population-based panel study, we examined changes in mental health following repeated exposure to seven common adverse life events in adulthood. Mixed-effects regression models estimated the relationship between repeated exposure to adverse life events of the same type and its impact on the Mental Health Inventory-5 score.
RESULTS: All seven adverse life events were associated with significant negative mental health impacts at each occurrence. Patterns of mental health response to repeated exposure varied by event type in the primary analysis. Sensitisation was observed for major worsening in finances and victimisation by property crime. Habituation was observed for separation/divorce and serious personal injury/illness. For physical violence, serious family injury/illness, and firing/redundancy, we found no clear associations. Sensitisation and habituation effects appeared to 'plateau' after the second adverse event rather than accumulating with exposure. Strength and direction of associations were robust to adjustments for pre-event mental health and a Mundlak correction.
CONCLUSIONS: In a population-based sample over two decades we found event-specific sensitisation and habituation in response to repeated adverse life events. Both effects appeared to 'plateau' after the second event. Our findings provide no consistent support for a single universal model of stress-response, indicating that how individuals respond psychologically to adversity is more nuanced and may depend on contextual factors such as individual meaning, resilience, or resources.