Sense of Coherence and Physical Health. Testing Antonovsky's Theory

Trine Flensborg-Madsen,Søren Ventegodt,Joav Merrick

doi:10.1100/tsw.2006.351

Abstract

In a previous paper, we argued that the original 29-item sense of coherence (SOC) scale developed by Aaron Antonovsky (1923–1994) was insufficient according to its reflection of SOC. The purpose of this study was to create a new version of the original 29-item SOC scale in order to test his hypothesis of a causal link between SOC and physical health. This shorter version was built on the exact same idea, theory, and conceptualization used by Antonovsky, which resulted in a SOC scale containing only 9 abstract questions. These nine questions, in addition to two questions about physical and psychological health, made up a questionnaire answered by 100 people at the entrance hall of the University Medical Center (Rigshospitalet) in Copenhagen. According to Antonovsky’s famous hypothesis, a strong association should be found between SOC and physical health, but surprisingly, we found that the new scale was falsifying the hypothesis, with a correlation between SOC and physical health of only r = 0.044 (NS). However, a highly significant correlation was found with psychological health with r = 0.502 (p = <0.0005). The authors are in a predicament since we strongly believe in Antonovsky’s famous idea of the relationship between SOC and health. However, we believe that it is our emotional aspects that primarily determine our physical health, which we will demonstrate in a subsequent study, but the reason we did not find any significant correlation in this study was the fact that our nine-item SOC scale was very mental (mental in the sense of applying to conscious cognition and attitude). We consider the mental aspects to determine our psychological health and the emotional aspects to determine our physical health. Our conclusion is that the original 29-item SOC scale mixed a few emotional aspects into the otherwise mental construct, which is the reason for the relatively low correlations found until now, when using the original scale.

Highlights

In 1970, Aaron Antonovsky (1923–1994), from the Faculty of Health Science at the Ben Gurion University of the Negev in Beer-Sheva, started to investigate what he would later name the salutogenic paradigm
Health is defined as a continuum between the two poles of total wellness and total disease, and Antonovsky suggested that the individual degree of sense of coherence in life influenced his or her position on this continuum: “The central thesis of the salutogenic model is that a strong sense of coherence (SOC) is crucial to successful coping with the ubiquitous stressors of living and to health maintenance”[1]
Antonovsky was interested in factors that could describe the ability to manage the stressors that we are bombarded with every day, and he defined this as the “sense of coherence” (SOC): “The sense of coherence is a global orientation that expresses the extent to which one has a pervasive, enduring though dynamic feeling of confidence that (1) the stimuli deriving from one’s internal and external environments in the course of living are structured, predictable, and explicable [comprehensibility]; (2) the resources are available to one to meet the demands posed by these stimuli [manageability]; and (3) these demands are challenges, worthy of investment and engagement [meaningfulness]”[1]

Summary

Introduction

In 1970, Aaron Antonovsky (1923–1994), from the Faculty of Health Science at the Ben Gurion University of the Negev in Beer-Sheva, started to investigate what he would later name the salutogenic paradigm. His idea of salutogenesis was based on findings about the overall health of women who had been in a concentration camp during the Holocaust. Health is defined as a continuum between the two poles of total wellness and total disease, and Antonovsky suggested that the individual degree of sense of coherence in life influenced his or her position on this continuum:. We were surprised to find a lack of evidence when it came to providing an association between SOC and physical health[2], since most studies investigate the association with psychological health[3,4,5,6,7,8,9,10,11,12,13] or with health measures that incorporate psychological aspects[14,15,16,17]

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Discussion

Conclusion