[Stressors and mental health : a contextual analysis of poverty.]

The author argues that social etiology of mental health, which suggests a causal link between living conditions and the occurence of mental disorders, is valid only when one applies a contextual evaluation of psycho-social stress factors. In that case, when life-events are cut from their environmental consequences, they are insufficient in themselves when trying to explain why mental disorders occur. However, once they are evaluated in function of the person's living conditions, the psycho-social stress factors become triggers and key to the person's stability. George W. Brown suggests a psycho-social model for a precipitative agent and for vulnerability factors linked to the significance and the impact of a life-event, relating also to the factual context at its origin and to the client's biographical history. Poverty then becomes a determining background for the life-event's repercussions. The LEDS (Life-Event and Difficulty Schedule) method of contextual analysis is based on a complete and systematical gathering of factual information on the events and on the context, stripped of the client's bias and emotional reactions. Furthermore, the grid of analysis allows one to qualify and organize this information while maintaining an optimal level of precision and objectivity. The empirical demonstration of the contextual analysis' predictive power is convincing in the case of disorders both mental (depression, anxiety, schizophrenia) and physical (infarction, appendicitis, ulcers). In such a frame of analysis and because of the chronic hardships experienced by the underpriveledged, poverty emerges as a determining contextual factor in the social etiology of mental disorders.