{"id":"https://openalex.org/W1991022916","doi":"https://doi.org/10.1097/00006842-200211000-00009","title":"Stressful Life Events Precede Exacerbations of Multiple Sclerosis","display_name":"Stressful Life Events Precede Exacerbations of Multiple Sclerosis","publication_year":2002,"publication_date":"2002-11-01","ids":{"openalex":"https://openalex.org/W1991022916","doi":"https://doi.org/10.1097/00006842-200211000-00009","mag":"1991022916","pmid":"https://pubmed.ncbi.nlm.nih.gov/12461197"},"language":"en","primary_location":{"id":"doi:10.1097/00006842-200211000-00009","doi":"https://doi.org/10.1097/00006842-200211000-00009","is_oa":false,"landing_page_url":"https://doi.org/10.1097/00006842-200211000-00009","pdf_url":null,"source":{"id":"https://openalex.org/S78750095","display_name":"Psychosomatic Medicine","issn_l":"0033-3174","issn":["0033-3174","1534-7796","2998-8748","2998-8756"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","doyens","jufo-2","ki-jl-2","medline","norway-2","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Psychosomatic Medicine","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5110328956","display_name":"Kurt D. Ackerman","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I170201317","display_name":"University of Pittsburgh","ror":"https://ror.org/01an3r305","country_code":"US","type":"education","lineage":["https://openalex.org/I170201317"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Kurt D. Ackerman","raw_affiliation_strings":["Kurt D. Ackerman, MD, PhD, Western Psychiatric Institute and Clinic, 3811 O\u2019Hara St., Pittsburgh, PA 15213. Email: [email\u00a0protected]","the Departments of Psychiatry (K.D.A., B.P.A., P.R.H., E.F., A.B.), Neurology (R.H.), Pathology (B.S.R.), and Psychology (A.B.), University of Pittsburgh, Pittsburgh, Pennsylvania","Department of Psychiatry, University of Pittsburgh Pittsburgh Pennsylvania USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Kurt D. Ackerman, MD, PhD, Western Psychiatric Institute and Clinic, 3811 O\u2019Hara St., Pittsburgh, PA 15213. Email: [email\u00a0protected]","institution_ids":[]},{"raw_affiliation_string":"the Departments of Psychiatry (K.D.A., B.P.A., P.R.H., E.F., A.B.), Neurology (R.H.), Pathology (B.S.R.), and Psychology (A.B.), University of Pittsburgh, Pittsburgh, Pennsylvania","institution_ids":["https://openalex.org/I170201317"]},{"raw_affiliation_string":"Department of Psychiatry, University of Pittsburgh Pittsburgh Pennsylvania USA","institution_ids":["https://openalex.org/I170201317"]}]},{"author_position":"middle","author":{"id":null,"display_name":"Rock Heyman","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I170201317","display_name":"University of Pittsburgh","ror":"https://ror.org/01an3r305","country_code":"US","type":"education","lineage":["https://openalex.org/I170201317"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Rock Heyman","raw_affiliation_strings":["the Departments of Psychiatry (K.D.A., B.P.A., P.R.H., E.F., A.B.), Neurology (R.H.), Pathology (B.S.R.), and Psychology (A.B.), University of Pittsburgh, Pittsburgh, Pennsylvania"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"the Departments of Psychiatry (K.D.A., B.P.A., P.R.H., E.F., A.B.), Neurology (R.H.), Pathology (B.S.R.), and Psychology (A.B.), University of Pittsburgh, Pittsburgh, Pennsylvania","institution_ids":["https://openalex.org/I170201317"]}]},{"author_position":"middle","author":{"id":null,"display_name":"Bruce S. Rabin","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I170201317","display_name":"University of Pittsburgh","ror":"https://ror.org/01an3r305","country_code":"US","type":"education","lineage":["https://openalex.org/I170201317"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Bruce S. Rabin","raw_affiliation_strings":["the Departments of Psychiatry (K.D.A., B.P.A., P.R.H., E.F., A.B.), Neurology (R.H.), Pathology (B.S.R.), and Psychology (A.B.), University of Pittsburgh, Pittsburgh, Pennsylvania"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"the Departments of Psychiatry (K.D.A., B.P.A., P.R.H., E.F., A.B.), Neurology (R.H.), Pathology (B.S.R.), and Psychology (A.B.), University of Pittsburgh, Pittsburgh, Pennsylvania","institution_ids":["https://openalex.org/I170201317"]}]},{"author_position":"middle","author":{"id":null,"display_name":"Barbara P. Anderson","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I170201317","display_name":"University of Pittsburgh","ror":"https://ror.org/01an3r305","country_code":"US","type":"education","lineage":["https://openalex.org/I170201317"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Barbara P. Anderson","raw_affiliation_strings":["the Departments of Psychiatry (K.D.A., B.P.A., P.R.H., E.F., A.B.), Neurology (R.H.), Pathology (B.S.R.), and Psychology (A.B.), University of Pittsburgh, Pittsburgh, Pennsylvania"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"the Departments of Psychiatry (K.D.A., B.P.A., P.R.H., E.F., A.B.), Neurology (R.H.), Pathology (B.S.R.), and Psychology (A.B.), University of Pittsburgh, Pittsburgh, Pennsylvania","institution_ids":["https://openalex.org/I170201317"]}]},{"author_position":"middle","author":{"id":null,"display_name":"Patricia R. Houck","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I170201317","display_name":"University of Pittsburgh","ror":"https://ror.org/01an3r305","country_code":"US","type":"education","lineage":["https://openalex.org/I170201317"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Patricia R. Houck","raw_affiliation_strings":["the Departments of Psychiatry (K.D.A., B.P.A., P.R.H., E.F., A.B.), Neurology (R.H.), Pathology (B.S.R.), and Psychology (A.B.), University of Pittsburgh, Pittsburgh, Pennsylvania"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"the Departments of Psychiatry (K.D.A., B.P.A., P.R.H., E.F., A.B.), Neurology (R.H.), Pathology (B.S.R.), and Psychology (A.B.), University of Pittsburgh, Pittsburgh, Pennsylvania","institution_ids":["https://openalex.org/I170201317"]}]},{"author_position":"middle","author":{"id":null,"display_name":"Ellen Frank","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I170201317","display_name":"University of Pittsburgh","ror":"https://ror.org/01an3r305","country_code":"US","type":"education","lineage":["https://openalex.org/I170201317"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Ellen Frank","raw_affiliation_strings":["the Departments of Psychiatry (K.D.A., B.P.A., P.R.H., E.F., A.B.), Neurology (R.H.), Pathology (B.S.R.), and Psychology (A.B.), University of Pittsburgh, Pittsburgh, Pennsylvania"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"the Departments of Psychiatry (K.D.A., B.P.A., P.R.H., E.F., A.B.), Neurology (R.H.), Pathology (B.S.R.), and Psychology (A.B.), University of Pittsburgh, Pittsburgh, Pennsylvania","institution_ids":["https://openalex.org/I170201317"]}]},{"author_position":"last","author":{"id":null,"display_name":"Andrew Baum","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I170201317","display_name":"University of Pittsburgh","ror":"https://ror.org/01an3r305","country_code":"US","type":"education","lineage":["https://openalex.org/I170201317"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Andrew Baum","raw_affiliation_strings":["the Departments of Psychiatry (K.D.A., B.P.A., P.R.H., E.F., A.B.), Neurology (R.H.), Pathology (B.S.R.), and Psychology (A.B.), University of Pittsburgh, Pittsburgh, Pennsylvania"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"the Departments of Psychiatry (K.D.A., B.P.A., P.R.H., E.F., A.B.), Neurology (R.H.), Pathology (B.S.R.), and Psychology (A.B.), University of Pittsburgh, Pittsburgh, Pennsylvania","institution_ids":["https://openalex.org/I170201317"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5110328956"],"corresponding_institution_ids":["https://openalex.org/I170201317"],"apc_list":null,"apc_paid":null,"fwci":5.1035,"has_fulltext":false,"cited_by_count":132,"citation_normalized_percentile":{"value":0.95528557,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":88,"max":99},"biblio":{"volume":"64","issue":"6","first_page":"916","last_page":"920"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10137","display_name":"Multiple Sclerosis Research Studies","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2734","display_name":"Pathology and Forensic Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10137","display_name":"Multiple Sclerosis Research Studies","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2734","display_name":"Pathology and Forensic Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10529","display_name":"Stress Responses and Cortisol","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2802","display_name":"Behavioral Neuroscience"},"field":{"id":"https://openalex.org/fields/28","display_name":"Neuroscience"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T11334","display_name":"Psychosomatic Disorders and Their Treatments","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2738","display_name":"Psychiatry and Mental health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/multiple-sclerosis","display_name":"multiple sclerosis","score":0.9950000047683716},{"id":"https://openalex.org/keywords/relapsing-remitting-multiple-sclerosis","display_name":"relapsing-remitting multiple sclerosis","score":0.9049999713897705},{"id":"https://openalex.org/keywords/stressful-life-events","display_name":"life events","score":0.9309999942779541},{"id":"https://openalex.org/keywords/disease-exacerbation","display_name":"disease exacerbation","score":0.7919999957084656},{"id":"https://openalex.org/keywords/psychosocial-stress","display_name":"psychosocial stress","score":0.8130000233650208},{"id":"https://openalex.org/keywords/women-with-multiple-sclerosis","display_name":"women with multiple sclerosis","score":0.6930000185966492}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.782999575138092},{"id":"https://openalex.org/C2777014857","wikidata":"https://www.wikidata.org/wiki/Q1383410","display_name":"Exacerbation","level":2,"score":0.7595227956771851},{"id":"https://openalex.org/C2780640218","wikidata":"https://www.wikidata.org/wiki/Q8277","display_name":"Multiple sclerosis","level":2,"score":0.7466496825218201},{"id":"https://openalex.org/C125370674","wikidata":"https://www.wikidata.org/wiki/Q1527480","display_name":"Stressor","level":2,"score":0.5409167408943176},{"id":"https://openalex.org/C207103383","wikidata":"https://www.wikidata.org/wiki/Q3930246","display_name":"Hazard ratio","level":3,"score":0.5135705471038818},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.4618169069290161},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.4439728260040283},{"id":"https://openalex.org/C118552586","wikidata":"https://www.wikidata.org/wiki/Q7867","display_name":"Psychiatry","level":1,"score":0.27671515941619873},{"id":"https://openalex.org/C44249647","wikidata":"https://www.wikidata.org/wiki/Q208498","display_name":"Confidence interval","level":2,"score":0.11927792429924011}],"mesh":[{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008016","descriptor_name":"Life Change Events","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D008137","descriptor_name":"Longitudinal Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009103","descriptor_name":"Multiple Sclerosis","qualifier_ui":"Q000523","qualifier_name":"psychology","is_major_topic":true},{"descriptor_ui":"D011446","descriptor_name":"Prospective Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012720","descriptor_name":"Severity of Illness Index","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D013997","descriptor_name":"Time Factors","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D016019","descriptor_name":"Survival Analysis","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":4,"locations":[{"id":"doi:10.1097/00006842-200211000-00009","doi":"https://doi.org/10.1097/00006842-200211000-00009","is_oa":false,"landing_page_url":"https://doi.org/10.1097/00006842-200211000-00009","pdf_url":null,"source":{"id":"https://openalex.org/S78750095","display_name":"Psychosomatic Medicine","issn_l":"0033-3174","issn":["0033-3174","1534-7796","2998-8748","2998-8756"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","doyens","jufo-2","ki-jl-2","medline","norway-2","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Psychosomatic Medicine","raw_type":"journal-article"},{"id":"doi:10.1097/01.psy.0000038941.33335.40","doi":"https://doi.org/10.1097/01.psy.0000038941.33335.40","is_oa":false,"landing_page_url":"https://doi.org/10.1097/01.psy.0000038941.33335.40","pdf_url":null,"source":{"id":"https://openalex.org/S78750095","display_name":"Psychosomatic Medicine","issn_l":"0033-3174","issn":["0033-3174","1534-7796","2998-8748","2998-8756"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","doyens","jufo-2","ki-jl-2","medline","norway-2","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Psychosomatic Medicine","raw_type":"journal-article"},{"id":"pmid:12461197","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/12461197","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Psychosomatic medicine","raw_type":"Journal Article"},{"id":"pmh:oai:CiteSeerX.psu:10.1.1.585.9075","doi":null,"is_oa":false,"landing_page_url":"http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.585.9075","pdf_url":null,"source":null,"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"http://intl.psychosomaticmedicine.org/content/64/6/916.full.pdf","raw_type":"text"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","score":1.0,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[{"id":"https://openalex.org/G1646267944","display_name":null,"funder_award_id":"HL65112","funder_id":"https://openalex.org/F4320337338","funder_display_name":"National Heart, Lung, and Blood Institute"},{"id":"https://openalex.org/G3396019356","display_name":"General Clinical Research Center","funder_award_id":"M01RR000056","funder_id":"https://openalex.org/F4320337375","funder_display_name":"National Center for Research Resources"},{"id":"https://openalex.org/G4118072816","display_name":"UNDERSTANDING SHARED PSYCHOBIOLOGICAL PATHWAYS","funder_award_id":"P50HL065112","funder_id":"https://openalex.org/F4320337338","funder_display_name":"National Heart, Lung, and Blood Institute"},{"id":"https://openalex.org/G7425153955","display_name":"BIOBEHAVIORAL MODEL OF STRESS AND MULTIPLE SCLEROSIS","funder_award_id":"K01MH001468","funder_id":"https://openalex.org/F4320337346","funder_display_name":"National Institute of Mental Health"},{"id":"https://openalex.org/G96926792","display_name":null,"funder_award_id":"MH30915","funder_id":"https://openalex.org/F4320337346","funder_display_name":"National Institute of Mental Health"}],"funders":[{"id":"https://openalex.org/F4320337338","display_name":"National Heart, Lung, and Blood Institute","ror":"https://ror.org/012pb6c26"},{"id":"https://openalex.org/F4320337346","display_name":"National Institute of Mental Health","ror":"https://ror.org/04xeg9z08"},{"id":"https://openalex.org/F4320337375","display_name":"National Center for Research Resources","ror":"https://ror.org/04pw6fb54"}],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":15,"referenced_works":["https://openalex.org/W21284273","https://openalex.org/W1970038830","https://openalex.org/W1978484258","https://openalex.org/W2037898705","https://openalex.org/W2075436847","https://openalex.org/W2076790534","https://openalex.org/W2076907106","https://openalex.org/W2095880706","https://openalex.org/W2112165124","https://openalex.org/W2121495218","https://openalex.org/W2127894240","https://openalex.org/W2130355701","https://openalex.org/W2145097697","https://openalex.org/W2331919567","https://openalex.org/W2609375989"],"related_works":["https://openalex.org/W2119576973","https://openalex.org/W1998185625","https://openalex.org/W2105515889","https://openalex.org/W2613937807","https://openalex.org/W4233038555","https://openalex.org/W2127894240","https://openalex.org/W4249800181","https://openalex.org/W2600028307","https://openalex.org/W1977135600","https://openalex.org/W1795155207"],"abstract_inverted_index":{"OBJECTIVE:":[0],"We":[1],"longitudinally":[2],"monitored":[3,66],"life":[4,102,110,143],"events":[5,19,52,103,111,144],"and":[6,59,88],"health":[7],"changes":[8],"in":[9,104,140,177],"patients":[10,178],"with":[11,28,100,122,147,165,179],"multiple":[12],"sclerosis":[13],"(MS)":[14],"to":[15,85],"determine":[16],"whether":[17],"stressful":[18,51,101],"may":[20],"trigger":[21,173],"exacerbation":[22],"of":[23,90,95,115,142,150,174],"MS.":[24,181],"METHODS:":[25],"Twenty-three":[26],"women":[27],"MS":[29,75,96,119,151],"were":[30,64,77,98],"followed":[31],"for":[32],"1":[33],"year.":[34,73],"Each":[35],"subject":[36],"completed":[37],"the":[38,56,72,86,105,166],"Psychiatric":[39],"Epidemiologic":[40],"Research":[41],"Interview":[42],"on":[43,49,67],"a":[44,68,80,126,171],"weekly":[45,69],"basis.":[46],"Further":[47],"information":[48],"potentially":[50],"was":[53,83,145],"acquired":[54],"using":[55],"Life":[57],"Events":[58],"Difficulties":[60],"Schedule.":[61],"Neurologic":[62],"symptoms":[63],"also":[65],"basis":[70],"throughout":[71],"Potential":[74],"exacerbations":[76,97,152],"confirmed":[78,136],"by":[79],"neurologist":[81],"who":[82],"blind":[84],"presence":[87],"timing":[89],"stressors.":[91],"RESULTS:":[92],"Eighty-five":[93],"percent":[94],"associated":[99,146],"preceding":[106],"6":[107],"weeks.":[108],"Stressful":[109],"occurred":[112],"an":[113,138],"average":[114],"14":[116],"days":[117,124],"before":[118,125],"exacerbations,":[120],"compared":[121],"33":[123],"randomly":[127],"selected":[128],"control":[129],"date":[130],"(p":[131],"<":[132,158],".0001).":[133],"Survival":[134],"analysis":[135],"that":[137,168],"increase":[139],"frequency":[141],"greater":[148],"likelihood":[149],"(hazard":[153],"ratio":[154],"=":[155],"13.18,":[156],"p":[157],".05).":[159],"CONCLUSIONS:":[160],"These":[161],"results":[162],"are":[163],"consistent":[164],"hypothesis":[167],"stress":[169],"is":[170],"potential":[172],"disease":[175],"activity":[176],"relapsing-remitting":[180]},"counts_by_year":[{"year":2026,"cited_by_count":1},{"year":2025,"cited_by_count":1},{"year":2024,"cited_by_count":1},{"year":2023,"cited_by_count":4},{"year":2022,"cited_by_count":1},{"year":2021,"cited_by_count":2},{"year":2020,"cited_by_count":3},{"year":2019,"cited_by_count":5},{"year":2018,"cited_by_count":7},{"year":2017,"cited_by_count":1},{"year":2016,"cited_by_count":9},{"year":2015,"cited_by_count":7},{"year":2014,"cited_by_count":11},{"year":2013,"cited_by_count":3},{"year":2012,"cited_by_count":8}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2016-06-24T00:00:00"}