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Understanding the Effects of Life and Social Threats on Mental Health — A Cross-Sectional Study of 8,783 Women in Iceland

Johann Hardarson, Lovísa Hlynsdóttir, Andri Björnsson and Arna Hauksdóttir

Introduction: This research investigated how threat appraisal, in the context of women’s most distressing experiences, relates to post-traumatic stress disorder (PTSD) and overall mental health. It posits two primary threat types: life threats and social threats, including rejection and humiliation.
Methods: In an epidemiological study of Icelandic women (N=30,403), 8,783 participants met criteria for examining the association between threat appraisal and psychopathology. Women selected their worst stressor from the Life Events Checklist for DSM-5 (LEC-5) and rated life and social threats on a four-point severity scale. ANOVAs assessed mean differences in psychopathology scores, and Poisson log-linear models with robust error variance assessed prevalence ratios (PRs) for PTSD and other psychopathologies, adjusting for multiple covariates.
Results: 81.3% of women identified high social threat in their worst stressor, while 18.0% reported high life threat. High life threat without concurrent high social threat was rare (2.1%), with most identifying primarily social threat (65.4%). Compared to those with neither threat, experiencing both life and social threats resulted in higher psychopathology scores and prevalence rates. PTSD was nearly five times more prevalent (aPR = 4.74) and attempted suicide seven times higher (aPR = 7.07) in this group.
Conclusion: The findings highlight the pervasive role of social threat in women’s traumatic experiences and its significance in PTSD and other mental health issues. Women facing both threats exhibit a higher prevalence of psychological disorders, indicating a compounded impact on mental health. Social threat and its association with mental health outcomes could have diagnostic and clinical utility.

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