Carole K. Holahan

Stress Generation, Avoidance Coping, and Depressive Symptoms: A 10-Year Model.

This study examined (a) the role of avoidance coping in prospectively generating both chronic and acute life stressors and (b) the stress-generating role of avoidance coping as a prospective link to future depressive symptoms. Participants were 1,211 late-middle-aged individuals (500 women and 711 men) assessed 3 times over a 10-year period. As predicted, baseline avoidance coping was prospectively associated with both more chronic and more acute life stressors 4 years later. Furthermore, as predicted, these intervening life stressors linked baseline avoidance coping and depressive symptoms 10 years later, controlling for the influence of initial depressive symptoms. These findings broaden knowledge about the stress-generation process and elucidate a key mechanism through which avoidance coping is linked to depressive symptoms.

Social support, coping, and depressive symptoms in a late-middle-aged sample of patients reporting cardiac illness.

This study tests a 1-year predictive model of depressive symptoms in a late-middle-aged sample of patients reporting diagnoses of cardiac illness. Results based on 325 individuals (248 men and 77 women) diagnosed with chronic cardiac illness, 71 individuals (52 men and 19 women) diagnosed with acute cardiac illness, and 219 healthy controls (129 men and 90 women) strongly supported the hypotheses. Compared with healthy persons, individuals with chronic and those with acute cardiac illness reported more depressive symptoms at follow-up. Women overall showed more depressive symptoms than did men, and women with cardiac illness were particularly vulnerable to behavioral manifestations of depressive symptoms. Integrative time-lag and prospective structural equation models indicated that, for individuals with cardiac illness, social support and adaptive coping strategies predicted fewer depressive symptoms.

Social context, coping strategies, and depressive symptoms: an expanded model with cardiac patients.

This research broadened and refined a resources model of coping to encompass negative as well as positive aspects of social relationships and examined this expanded conceptualization in a 4-year prospective model with 183 cardiac patients (140 men and 43 women). Social support and social stressors in the family and extrafamily domains contributed significantly to a common social context latent construct. In addition, this conceptualization of social context was significantly related to depressive symptoms 4 years later. Especially important conceptually, coping strategies functioned as a mechanism through which both social support and social stressors related to subsequent depressive symptoms. Moreover, positive and negative aspects of social relationships made essentially unique contributions in predicting subsequent coping efforts.

The Relation of Social Support and Coping to Positive Adaptation to Breast Cancer

This study examined the relation of perceived social support and coping to positive adaptation to breast cancer. Participants were 56 women between the ages of 38 and 58 who had been diagnosed with Stage I or II breast cancer from 1 to 26 months earlier. Social support was measured with the Social Provisions Scale (Cutrona, C. and Russell, D. (1987). The provisions of social relationships and adaptation to stress. In: Jones, W.H. and Perlman, D. (Eds.), Advances in Personal Relationships , Vol. 1, pp. 37-67, JAI Press, Greenwich, CT) and coping was measured with the revised Ways of Coping Scales (Folkman, S., Lazarus, R.S., Dunkel-Schetter, C., DeLongis, A. and Gruen, R. (1986). The dynamics of a stressful encounter: cognitive appraisal, coping, and encounter outcomes. Journal of Personality and Social Psychology , 50 , 992-1003). Adjustment was measured with the Scales of Psychological Well-Being (Ryff, C.D. (1989). Happiness is everything, or is it? explorations on the meaning of psychological well being. Journal of Personality and Social Psychology , 57 , 1069-1081) and frequency of positive health behaviors. Results showed that perceived social support and approach coping strategies were associated with positive adjustment. Avoidance coping strategies were negatively related to psychological well-being but were unrelated to positive health behaviors. The results of an exploratory path analysis were consistent with a direct relation and an indirect relation through approach coping of social support with psychological well-being.

Resource loss, resource gain, and depressive symptoms: a 10-year model.

This study examined a broadened conceptualization of the stress and coping process that incorporated a more dynamic approach to understanding the role of psychosocial resources in 326 adults studied over a 10-year period. Resource loss across 10 years was significantly associated with an increase in depressive symptoms, whereas resource gain across 10 years was significantly associated with a decrease in depressive symptoms. In addition, change in the preponderance of negative over positive events across 10 years was inversely associated with change in resources during the period. Finally, in an integrative structural equation model, the association between change in life events and depressive symptoms at follow-up was completely mediated through resource change.

Adjustment in aging: the roles of life stress, hassles, and self-efficacy.

This study examines the relationship of life stress, daily hassles, and perceived self-efficacy to adjustment in a community sample of 32 men and 32 women between ages 65 and 75. In a structured interview, negative life change events, daily hassles, self-efficacy, depression, psychosomatic symptoms, and negative well being were assessed. Both negative life events and daily hassles were related to psychological distress and physical symptoms for men, and hassles were associated with psychological distress and physical symptoms for women. An inverse relationship between self-efficacy and maladjustment was also found. Hassles showed the most powerful relationship to distress.

Employee Involvement Management Practices, Work Stress, and Depression in Employees of a Human Services Residential Care Facility

This article tests a theoretically driven model of the relationship between work environment, specifically, management practices, and employee mental health, specifically depression. It draws on theoretical perspectives connecting work environment and stress, and on others linking stress and depression. It also examines sense of coherence as a possible mediator of the relationships among work environment, work stress, and depression. Results showed that perceived exposure to employee involvement management practices was related to perceived work stress, sense of coherence, and depression. A model was specified to assess potential causal relationships using LISREL. Results suggested that increased exposure to employee involvement practices was indirectly associated with lower levels of depression through both perceived work stress and sense of coherence. The implications of these findings for management practice are discussed.

Relation of life goals at age 70 to activity participation and health and psychological well-being among Terman's gifted men and women.

In this study I investigated the relation of life goals to activity participation and health and psychological well-being for men and women in Termans Study of the Gifted. The subjects were between the ages of 65 and 75 years (M = 70.2 years) when they responded to a mail-out survey in 1982. The study included three goals scales-Autonomy, Involvement, and Achievement Motivation-as well as measures of activity participation and health and psychological well-being. Multiple regression analyses in which the three goals scales were used to predict health and psychological well-being were both significant. Path analyses demonstrated both a direct and an indirect contribution, through activity participation, of life goals to health and well-being. In most cases, the indirect effect of life goals on health and well-being accounted for more than one half of the total effect. Implications of the results for life satisfaction in aging are discussed.

Late-Life Alcohol Consumption and 20-Year Mortality

BACKGROUND Growing epidemiological evidence indicates that moderate alcohol consumption is associated with reduced total mortality among middle-aged and older adults. However, the salutary effect of moderate drinking may be overestimated owing to confounding factors. Abstainers may include former problem drinkers with existing health problems and may be atypical compared to drinkers in terms of sociodemographic and social-behavioral factors. The purpose of this study was to examine the association between alcohol consumption and all-cause mortality over 20 years among 1,824 older adults, controlling for a wide range of potential confounding factors associated with abstention. METHODS The sample at baseline included 1,824 individuals between the ages of 55 and 65. The database at baseline included information on daily alcohol consumption, sociodemographic factors, former problem drinking status, health factors, and social-behavioral factors. Abstention was defined as abstaining from alcohol at baseline. Death across a 20-year follow-up period was confirmed primarily by death certificate. RESULTS Controlling only for age and gender, compared to moderate drinkers, abstainers had a more than 2 times increased mortality risk, heavy drinkers had 70% increased risk, and light drinkers had 23% increased risk. A model controlling for former problem drinking status, existing health problems, and key sociodemographic and social-behavioral factors, as well as for age and gender, substantially reduced the mortality effect for abstainers compared to moderate drinkers. However, even after adjusting for all covariates, abstainers and heavy drinkers continued to show increased mortality risks of 51 and 45%, respectively, compared to moderate drinkers. CONCLUSIONS Findings are consistent with an interpretation that the survival effect for moderate drinking compared to abstention among older adults reflects 2 processes. First, the effect of confounding factors associated with alcohol abstention is considerable. However, even after taking account of traditional and nontraditional covariates, moderate alcohol consumption continued to show a beneficial effect in predicting mortality risk.

Unipolar depression, life context vulnerabilities, and drinking to cope

This study followed baseline samples of 424 unipolar depressed patients and 424 community controls across 10 years to investigate the association between depression and alcohol-related coping and to examine how life context vulnerabilities underlie the risk for depressed individuals to rely on drinking to cope. Findings supported all hypotheses. Depressed patients engaged in more drinking to cope than did community controls. Within individuals, more negative life events and less family support were associated with more drinking to cope across the 4 observations. Depressed patients experienced more negative life events and less family support than did community controls. These underlying life context vulnerabilities explained the relationship between depressed patient status and drinking to cope.