Antonovsky's Sense Research Articles

Psychische Beschwerden, interpersonale Probleme, Lebensqualität und Kohärenzgefühl bei ehemaligen deutschen Kriegskindern

Recently there is a growing psychotraumatological interest in late life effects in former German warchildren. The following article focusses on kind and amount of trauma and psychopathology (Symptom Check List 90-R; SCL-90-R) in elderly people, who have grown up during World War II. By means of psychometric self-reports we assessed their current interpersonal problems (Inventory of Interpersonal Problems; IIP), the quality of life (SF-36 Health Survey) and their sense of coherence (Antonovsky's Sense of coherence-Scale; SOC). Compared to norms from the general population and from "healthy controls", respectively, former German warchildren showed a higher psychopathological distress. They showed an interpersonal pattern of lower expressive/dominant in favour of enlarged passive and caring behaviour. The psychosocial dimension of quality of life was reduced, in contrast to the somatic scales. The former warchildren showed an increased sense of coherence, especially in the dimension of "meaningfulness". We discuss our findings in the light of the current scientifical knowledge and highlight possible future prospects to develop the warchildhood debate from the clinical and scientifical point of view.

A Test of the Age-Based Measurement Invariance and Temporal Stability of Antonovsky's Sense of Coherence Scale

The purpose of this investigation was to test the age-related measurement invariance and temporal stability of the 13-item version of Antonovsky's Sense of Coherence Scale (SOC). Multigroup structural equation modeling of longitudinal data from the Canadian National Population Health Survey was used to examine the measurement invariance across 3 age groups (19 to 25 years, n = 1,257; 30 to 55 years, n = 5,326; and ≥60 years, n = 2,213) and to compare the stability of the SOC scores obtained in 1994 and 1998 in the same participants. The results support the age-related structural invariance of the scale. Differences in the latent means and stability coefficients obtained for the three age groups provide weak to moderate support for the stability of SOC scores over time in the general population of Canada.

Antonovsky Revisited – Implications for Mental Health Promotion Practice

The paper assesses the validity of Antonovsky's (1996) assertion that health promotion should use the salutogenic model of health to guide practice, by drawing on the results of an evaluation of a supported further education programme for people with long-term mental health needs. Three consecutive cohorts of further education (FE) students with a long-term mental health diagnosis were assessed before and after participation, using Antonovsky's (1987) short form Sense of Coherence questionnaire (SOC-13). Students with SOC13 scores 52 and above at entry showed no significant change. However, students with entry SOC13 scores below 52 made statistically significant positive gains in their exit scores. A causation model was developed from qualitative evidence from students’ accounts of participation in the programme. The results of short questionnaires provided numerical data for building a model of the relationships between the themes and SOC13 scores. The model suggests that peer support is an important fac...

Validación transcultural de la Escala de Sentido de Coherencia de Antonovsky (OLQ-13) en ancianos mayores de 70 años

Sense of Coherence (SOC) is a construct relating to coping strategies in the face of traumatic events. SOC is defined as a personal disposition towards perceiving life experiences as understandable, manageable and meaningful. The construct has shown itself to be a predictor of self-reported and objective health in a variety of contexts. Although the SOC construct has been studied, among the elderly in particular, the scale has never been validated in the Spanish aged population. This paper reports on the cross-cultural validation of Antonovsky's Sense of Coherence Scale (OLQ-13) in a sample of Spanish senior citizens. We studied a sample of population from 8 locations across Spain, totaling 419 subjects aged 70 years or over. The psychometric attributes of the scale were studied. These included acceptability, scale assumptions, internal consistency, factor structure, construct validity (convergent validity, differential analyses, inter-domains correlation), and precision. The internal consistency of the scale was adequate (Cronbach = 0.80). SOC showed moderate correlations with self-reported indices of physical health, quality of life and depression. The scale was found valid in differential analyses conducted for gender, age groups, levels of disability and functional impact of diseases. Principal components analysis yielded four factors accounting for 65.59% of the variance. The Meaningfulness domain acted as an independent factor. The OLQ-13 is a valid and reliable instrument for use on Spanish elderly populations, including those with low educational level.

Living with Multiple Endocrine Neoplasia Type 1: Decent Care‐Insufficient Medical and Genetic Information A Qualitative Study of MEN 1 Patients in a Swedish Hospital

This qualitative study explores how 29 Swedish patients with Multiple Endocrine Neoplasia type 1 (MEN1) experience living with the condition, appraisal of the clinical follow-up program, and surveys their future expectations. The aim of this study is to build knowledge about this patient group in order to provide optimal care. The participants describe physical, psychological, and social limitations in their daily activities and how these limitations influence quality of life. Our findings indicate that a majority of patients have adjusted to their situation, describing themselves as being healthy despite physical symptoms and treatment. The participants received decent care in the clinical follow-up program, - however, greater effort should be put into patient information. These patients might benefit from genetic counseling. Health professionals involved should recognize their potential impact and influence on a patient's ability to adjust to these circumstances. Antonovsky's Sense of Coherence theory is used to discuss these findings.

Structure analysis of Antonovsky's sense of coherence from an epidemiological mental health survey with a brief nine‐item sense of coherence scale

Antonovsky has proposed the sense of coherence (SOC) as a crucial factor that protects against symptoms of mental disease. A central issue in research on the SOC construct is whether this is most appropriately considered as one-dimensional or three-dimensional with comprehensibility (C), manageability (Ma) and meaningfulness (Me) as separate dimensions. In this paper we address this issue by means of confirmatory factor analysis of a shortened nine-item version of Antonovsky's original 29- and 13-items Sense of Coherence Scale (SOCS-29), using epidemiological data from a mental health survey of adults in local communities (N = 1,062). In addition to analysing the internal structure of the SOC items, we examine the association between estimated factor scores and variables expected to be statistically related to SOC. Goodness-of-fit indices were very good for the three-factor model but acceptable even for the one-factor model. In the three-factor model, however, the factors were found to be very highly or, with regard to Ma and C, even perfectly correlated. Moreover, the factor scores had very similar correlations with measures of psychological wellbeing, depression and anxiety and they are also very similarly related to age (and none of them are related to gender). We therefore conclude in favour of a one-factor model.

Sense of coherence and parenting stress in mothers and fathers of preschool children with developmental disability

Background Few previous studies have examined Antonovsky's (1979, 1987) sense of coherence (SOC) in parents of young children with developmental disability (DD). This study explored relationships between parental stress, SOC, social support, and health in parents of preschool children with and without DD. A secondary aim was to explore the relevance of the SOC construct to parental adjustment.Method Data were analysed from 59 families with preschool children with DD and 45 families of typically developing preschoolers (children without DD) who completed the study questionnaire.Results Mothers and fathers of children with DD reported high levels of parenting stress, with 84% of mothers' and 67% of fathers' scores falling within the clinical range. Parents of children with DD consistently reported higher levels of parenting stress, weaker SOC, and, for mothers and parents in 2‐parent families, poorer health than parents of children without DD. Within families, mothers of children with DD reported poorer health, higher levels of parenting stress, and weaker SOC than their partners. There were no significant differences in reported health, parenting stress, or SOC between parents of children without DD.Conclusions The results supported previous findings on high levels of parental stress in parents of preschool children with DD. The weaker SOC of parents of children with DD is likely to be an indication of the pervasive impact on parents of their child's DD. These findings also indicated possible gender differences in parental adjustment to their child's DD. Overall, the findings of this study support the usefulness of SOC theory in understanding adaptation in parents of children with DD.

Sense of Coherence and Health. The Construction of an Amendment to Antonovsky's Sense of Coherence Scale (SOC II)

In two previous papers, we concluded that (1) the sense of coherence (SOC) scale developed by Aaron Antonovsky (1923—1994) is unable to prove the association between SOC and the physical health empirically and (2) the SOC scale is unlikely to be a fair materialization of Antonovskys idea and, thus, unlikely to measure SOC correctly. In order to improve the scale, we developed some new questions that we suggest should be incorporated in a new questionnaire and scale (SOC II) derived directly from Antonovsky's idea and the three key explanatory concepts of SOC: comprehensibility, manageability, and meaningfulness. We hope that this new scale will demonstrate a stronger correlation between SOC and physical health.

Sense of Coherence and Physical Health. The Emotional Sense of Coherence (SOC-E) was Found to be the Best-Known Predictor of Physical Health

In this study, we created a measure for emotionality named the emotional sense of coherence (SOC-E). We found that SOC-E was significantly associated with physical health (r = 0.266; p < 0.05), while it was not significantly associated with psychological health (r = 0.006; NS). Based on a correlation matrix, we constructed a new scale, the SOC-E II, which was even better associated with physical health (r = 0.362) and also associated with psychological health (r = 0.259; p < 0.01). Our results showed that SOC-E and SOC-E II were better predictors of physical health than the SOC scales developed by Aaron Antonovsky (1923–1994) (SOC-29 and SOC-13). We conclude that emotional coherence is important for physical health, but it is not important in the same way for psychological health. In a previous study, we found that a mental operationalization of Antonovsky's sense of coherence was highly associated with psychological health and not associated with physical health. Based on these two studies, we conclude that physical health is primarily associated with emotions, while psychological health is primarily associated with mentality.

The structure of Antonovsky's sense of coherence in patients with schizophrenia and its relationship to psychopathology

The main aim of the study was to investigate whether the three hypothesized subscales of Antonovsky's sense of coherence (SOC) scale: comprehensibility, meaningfulness and manageability, can be found when measuring SOC in a sample of patients with schizophrenia living in the community. A further aim was to study the relationship between SOC and psychopathology. The concept of SOC has been proposed to explain successful coping with life stressors. A total of 120 patients completed the SOC scale and the Brief Psychiatric Rating Scale (BPRS) was used to assess the psychopathology of the patients. The SOC scale was analysed by means of a factor analysis with a varimax rotation and the Spearman rank correlation test was used to test for associations between subscales, factors and psychiatric symptoms. A four-factor model presented the best solution and explained 48% of the total variation in SOC. The first factor, which included 12-items of the SOC scale, turned out to be the most salient factor explaining 29% of the total variation. All factors displayed some overlapping between items. Affective symptoms were negatively related to all the three subscales and the four factors of SOC, while positive symptoms were similarly related to two of the subscales and two of the factors while negative symptoms were not associated with any of the factors or subscales. The findings in this study corroborate those in studies with other patient groups and indicate that the theoretical framework of SOC should not be adopted uncritically. Furthermore, the use of the three subscales in the SOC scale in studies of patients with a severe mental illness is questioned and a further investigation of the relationship between SOC and psychopathology is proposed.

Our housing, our selves: A longitudinal investigation of low-income women's participatory housing experiences

This study explored the relationship between low-income urban mothers and their residential environments. The participants were women who lived in inadequate housing sometimes located in treacherous, drug- and crime-plagued neighborhoods. Conceptual content cognitive mapping (“3CM”) [Kearney and Kaplan (1997). Environment and Behavior, 29(5), 579–617], a qualitative/quantitative hybrid methodology, was used to obtain the mothers’ perspectives on both the positive and negative aspects of their housing experience as well as their sense of well-being. The women were followed through the process of partnering with a nonprofit, self-help housing organization, constructing new housing for themselves, and relocating to these new homes. One year later, the same methodology was employed. Results indicate that while living in inadequate housing, many women worried a great deal about their children and felt significant dissatisfaction with their housing. Despite these circumstances, however, they maintained a strong sense of self confidence, optimism, and determination, not unlike Antonovsky's sense of coherence [Antonovsky (1979). Health, stress and coping. San Francisco: Jossey-Bass Publishers; Antonovsky (1987). Unraveling the mystery of health. San Francisco, CA: Jossey-Bass Inc., Publishers]. Following relocation, the women were extremely satisfied with their new housing and seem to have a greater sense of well-being. They expressed fewer worries, and seemed to have even stronger sense of coherence.

The Adjustment Process for Individuals With Spinal Cord Injury

This study investigated the relationship between perceived changes in sense of coherence from pre- to postinjury and adjustment for a group of individuals with spinal cord injury. It was hypothesized that after a spinal cord injury, an individual's belief that he or she had significantly reduced his or her sense of coherence would be associated with reduced adjustment. Forty-eight individuals with spinal cord injury completed Antonovsky's Sense of Coherence Scale and Livneh and Antonak's Reactions to Impairment and Disability Inventory. Results indicated a positive relationship between adjustment and strengthened sense of coherence. Rehabilitation counselor implications are discussed.

Why is Antonovsky's sense of coherence not correlated to physical health? Analysing Antonovsky's 29-item sense of coherence scale (SOC-29)

We have previously concluded that the use of the Antonovsky sense of coherence (SOC) scale was unable to document a predicted strong association between SOC and physical health. By way of statistical methods, numerous studies have investigated the validity, reliability and applicability of the SOC scale with positive results. However, this paper analyses whether the questions in the SOC scale actually represent the universe of factors necessary to describe the phenomenon of SOC, which we believe is an important supplement to the statistically means of investigating validity and reliability. In this paper we explore the idea, the concepts, the theory and the operationalisation behind the SOC Scale. The conclusions are: 1) it seems that Antonovsky's basic idea of coherence, for which he coined the term sense of coherence, as the basis for the highly popular salutogenic orientation is outstandingly good, in spite of the lack of statistical evidence; 2) the chosen key explanatory concepts of comprehensibility, manageability, and meaning, seems to be a fair, although mental, conceptualisation of this idea; 3) Antonovsky's theory was unfortunately much less clear, as Antonovsky assumed predictability to be very important for the sense of coherence, especially for comprehensibility and manageability. This notion of predictability leaves its footprints in his operationalization of SOC into the SOC Scale. Our analysis convinced us that the SOC scale is unlikely to be a fair materialization of the idea of coherence and thus unlikely to measure SOC correctly.

Patients' experiences with self-referral to in-patient rehabilitation: A qualitative interview study

Purpose. To describe objectives, experiences and satisfaction among subjects referring themselves to in-patient rehabilitation.Method. Persons suffering from stroke or multiple sclerosis were invited to refer themselves to a specialised rehabilitationdepartment. Ten patients referred themselves within the study period, of whom two were excluded. The remaining eightunderwent qualitative semi-structured in-depth interviews, focusing on the decision of self-referral, the personal goals for therehabilitation, and the satisfaction with the stay. The interviews were tape-recorded and subjected to content analysis. As anunderlying theoretical framework, we applied Antonovsky's Sense of Coherence model.Results. Half of the patients had not written the application themselves and did not know which grounds had been put forwardin the application. Nevertheless, all the patients were able to formulate their personal goals for the rehabilitation stay. These weredistributed in three main categories: those who recently had got a progressive disability wanted education and improvedknowledge on their disease; those who had had an acute, traumatic change of health status wanted training in order to improvemuscular strength or everyday skills; and those who had been disabled for several years wanted inspiration for further life.Conclusions. Patients may put forward other reasons to apply for rehabilitation than health personnel. Does the Sense ofCoherence Model seems applicable to describe these reasons.

Testing Antonovsky's sense of coherence (SOC) scale among Swedish physically active older people.

In Antonovsky's salutogenic theory, the major concept sense of coherence (SOC) is constituted of three core components called comprehensibility, manageability, and meaningfulness. Several scales that are intended to measure SOC are available and used by researchers in health and caring sciences all over the world. When using a scale, evidence of its quality in different study groups is needed in order to get reliable and valid data. The aim of this study was to test reliability and construct validity of the Swedish version of Antonovsky's original 29-item sense of coherence (SOC) scale in a group of physically active older people. The scale was tested with a convenience sample of 140 physically active older individuals, who took part in different fitness-training groups in eastern Sweden. Reliability was assessed as item to total correlations and with the Cronbach's alpha coefficient. Construct validity was assessed with the known groups technique, confirmatory factor analysis, and with logistic regression analysis. The results showed that in the studied group of older individuals, the instrument was a very reliable tool with a Cronbach's alpha coefficient of 0.92. Construct validity of the scale was supported by the fact that the global concept sense of coherence was found to be hierarchically organized in a model that consisted of the three core components of comprehensibility, manageability, and meaningfulness. Furthermore, perceived health could be explained to some degree by sense of coherence, but even more by comprehensibility, in both cases independently of chronological age. The results clearly corroborated Antonovsky's theory.

Augmenting treatment of obsessive-compulsive disorder with Antonovsky's sense of coherence theory.

The complex nature of obsessive-compulsive disorder (OCD) necessitates a multifaceted approach to treatment. To examine Antonovsky's sense of coherence theory as a framework for psychotherapy to optimize treatment for individuals with OCD. Selective literature review. Antonovsky's sense of coherence theory provides a theoretical framework for understanding the multiple pathways by which cognitive behavioral therapy can maintain and improve outcomes for people struggling with OCD.

Sense of coherence and adjustment to divorce among Muslim Arab citizens of Israel

This study examined the distinctiveness and causal relationships of Antonovsky's (1979) Sense of Coherence Scale and the Mental Health Index of Veit and Ware (1983) in a sample of 306 divorced Muslim Arab men and women in Israel. The findings, based on confirmatory factor analysis and latent‐variable structural modelling, suggest that in the present sample sense of coherence (SOC) and mental health are two independent but correlated constructs. They also suggest that, consistent with Antonovsky's theory, SOC may be better viewed as a mediator between stress and mental health than as a concurrent outcome of stress, although the latter possibility is not ruled out. Finally, the findings indicate that the SOC of the sample was relatively low in comparison with other groups. Copyright © 2003 John Wiley &amp; Sons, Ltd.

Suicidal Ideation, Substance Use, and Sense of Coherence in Greek Male Conscripts

This study aimed to estimate the comorbidity of suicidal behavior and substance use in young male conscripts and to analyze the association between personal coping resources and the severity of these behaviors. A total of 1,098 Greek male conscripts participated in this study, completing the Antonovsky's sense of coherence questionnaire and a standard questionnaire concerning their lifetime and current suicidal and substance-use behavior. A proportion of 11.7% and 24%, respectively, had lifetime and current feelings that life is not worth living. The differences between past and current death wishes (8.9% vs. 9.2%), suicidal thoughts (8.3% vs. 7.6%), and suicide attempts (2.4% vs. 2.9%) were not significant. All of the subgroups with suicidal ideation or behavior showed a significantly lower sense of coherence questionnaire score as compared with the whole sample. The comorbidity of past and current suicide thoughts and substance use ranged from 16.4% to 33.3% and 31.4% to 44.2%, respectively, depending on the kind of the substance. Finally, the subjects with past or current substance use had a significantly higher incidence of past or current, respectively, suicidal ideation or behavior, as compared with those without a history of substance use. We suggest the necessity of the early detection of these high-risk behaviors applying closer monitoring and integrated prevention programs.

Sense of coherence, well-being, coping and personality factors: further evaluation of the sense of coherence scale

This study explored the construct and incremental validity of the short 13 item version of Antonovsky's sense of coherence scale (SOC-13) using a community-based sample ( N=439). Partial correlation coefficients (controlling for socially desirable responding) were calculated with measures of (1) physical and psychological health (2) personality (self-esteem, optimism, perceived control) and (3) dispositional coping. Sex differences in the strength of these relationships was also explored. The results provide further support for the SOC-13, confirming early theory and research linking sense of coherence with physical and psychological well-being, the use of adaptive coping strategies, and with existing personality measures. Although there were no differences in SOC-13 scores for males and females, some sex differences in the strength of the relationship between SOC-13 and the measures included in this study were observed.

Spouses of first-ever stroke victims: sense of coherence in the first phase after stroke.

According to Antonovsky, the individual's sense of coherence is assumed to be crucial in coping with stressful life events. The purpose of this study was to investigate the associations between the sense of coherence of the spouses of stroke victims, the objective severity of the stroke and the spouses' perception of life satisfaction, psychological well-being and cognitive image of life in the future in the first phase after stroke. Eighty-three consecutively enrolled spouses to first-ever stroke victims < 75 years participated. Multiple correlations were done to study the association between Antonovsky's 29-item Sense of Coherence scale and the objective impairments of the stroke victim, the Life Satisfaction Checklist, the "view of the future" and the Psychological General Well-being Index. The sense of coherence was significantly associated with satisfaction with life as a whole before stroke (p < 0.001), partnership (p = 0.002), sexual life (p = 0.005), family life (p < 0.001) and financial situation (p = 0.001). The severity of the impairments of the stroke victims was not significantly associated with the spouses' sense of coherence. However, the sense of coherence was significantly associated with the perception of the future life situation (p = 0.006). The sense of coherence was also significantly associated with the perception of positive well-being (p = 0.007), self-control (p = 0.009), general health (p = 0.009) and vitality (p = 0.002) at the present, whereas the association with anxiety and depressed mood were not statistical significant. In the experience of a stressful life event such as stroke, satisfaction with general life, close relationships and the socio-economic situation were significantly associated with the spouse's sense of coherence. Spouses with a low sense of coherence were more likely to have low psychological well-being and a more pessimistic view of their life in the future.