Changes In Sense Of Coherence Research Articles

Change in sense of coherence mediates the association between economic recession and mortality among middle-aged men: A population-based cohort study from Eastern Finland

A financial recession has been associated with a decrease in all-cause mortality, but little is known about how psychosocial fluctuations in stress tolerance or orientation to life affect this association. Sense of Coherence (SOC) is a core construct in the Salutogenic Model of Health and is determined by generalized resistance resources and measures one's orientation to life by comprehensibility, manageability, and meaningfulness. We followed the mortality of a cohort of middle-aged Finnish men (n = 854) from the 1980s to the end of 2019. The cohort baseline was stratified into four age groups at baseline: 42, 48, 54, and 60. SOC was measured twice, at the baseline and at the 11-year follow-up visit. Between these SOC measurements, Finland confronted a deep financial recession, the effects of which were examined at the follow-up visit by questionnaires related to economic hardship (sum of nine items) and experience of the recession (one item). Using age group, marital status, employment status, and education as covariates, the change in SOC mediated both the economic hardship and the experience of recession relations to mortality: the indirect effects -19.57 (95% CI -43.23 to -0.92), and -26.82 (95% CI -59.52 to -0.61), respectively. Every one-point increase in economic hardship predicted about 2 and a half weeks shorter life expectancy, and those who experienced very strong disadvantages of economic recession had about 3 and a half months lower life expectancy by the end of 2019 than those who fully avoided the disadvantages. Furthermore, the younger age groups, 42 and 48, experienced the recession more severely than the older groups, 54 and 60. We conclude that following how orientation to life changes among middle-aged might be an informative approach after a recession.

Long-term changes in sense of coherence and mortality among middle-aged men: A population -based follow-up study

Sense of coherence (SOC) scale measures one's orientation to life. SOC is the core construct in Antonovsky's salutogenic model of health. It has been shown that weak SOC correlates with poor perceived health, low quality of life, and increased mortality. Some studies have indicated that SOC is not stable across life, but there are no previous studies on how a change of SOC is reflected in mortality. However, there is some evidence that a change in perceived quality of life is associated with mortality. The study explores the association between the change in SOC and mortality using longitudinal data from a cohort of middle-aged Finnish men recruited between 1986 and 1989. Approximately 11 years after the baseline examinations, between 1998 and 2001, 854 men returned the SOC questionnaire a second time. The baseline SOC was adjusted for the regression to the mean phenomenon between the two measurements. The hazard ratios of the SOC difference scores were adjusted for initial SOC age and 12 somatic risk factors of mortality (alcohol consumption, blood pressure, body mass index, cholesterol concentration, physical activity, education, smoking, marital status, employment status, history of cancer, history of cardiovascular disease and diabetes). SOC was not stable among middle-aged Finnish men and a decline in SOC was associated with an increased hazard of all-cause mortality. In the fully adjusted model, a decrease of one standard deviation (SD) of the SOC mean difference increased the mortality hazard by about 35 %, two SDs decrease about 70 %, and 2.5 SDs about 100 %. Strengthening SOC showed a limited association with decreasing mortality hazards in the age-adjusted model. Policies, strategies, or plans, supporting SOC in the middle-age may help to decrease mortality and increase quality of life in later years.

The long-term buffering effect of sense of coherence on psychopathological symptoms during the first year of the COVID-19 pandemic: A prospective observational study

The COVID-19 pandemic is a major chronic stressor affecting all societies and almost all individuals. Consequently, research demonstrated a negative impact of COVID-19 on mental health in parts of the general population. However, not all people are affected equally thus making the identification of resilience factors modulating the pandemic's impact on mental health an important research agenda. One of these factors is sense of coherence (SOC), the key component of the salutogenesis framework. The current study aimed at investigating the long-term relationship between SOC and psychopathological symptoms, and the impact of COVID-19-related rumination as its moderator. The prospective observational study assessed psychopathological symptoms and SOC before the COVID-19 outbreak in Germany (February 2020) and at six critical time points during the pandemic in an online panel (n = 1,479). Bivariate latent change score models and latent growth mixture modeling were used to analyze changes in psychopathological symptoms and SOC along with their interaction and to differentiate trajectories of COVID-19-related rumination. A model allowing for unidirectional coupling from SOC to psychopathological symptoms demonstrated best fit. In the total sample, psychopathological symptoms increased significantly over time. Previous SOC predicted later changes in psychopathological symptoms, whereby a stronger SOC was associated with a decrease in symptoms over time. The same pattern of results was evident in the high-rumination (17.2%) but not in the low-rumination group (82.8%). Our findings demonstrate that SOC is an important predictor and modulator of psychopathological symptoms during the COVID-19 pandemic, particularly in those respondents that ruminate about the pandemic.

Changes in Japanese Junior High School Students' Sense of Coherence Before and After the Onset of the COVID-19 Pandemic: A Longitudinal Study of Children and Mothers.

We conducted a longitudinal study to clarify the changes in the sense of coherence (SOC); that is, the ability to cope with stress successfully, of 166 Japanese junior high school students and their mothers before and after the onset of the COVID-19 pandemic. First, we analyzed changes in SOC at three time points for all students and divided them into two groups: Group 1 included students with SOC scores that increased or maintained before and after the onset of the pandemic and Group 2 included students with decreased SOC scores after the onset of the pandemic. Second, we conducted a comparative analysis between the two groups. Overall, results indicated that student's SOC scores increased. Additionally, interpersonal stress scores were lower after the onset of the pandemic than before. There were almost no differences in family relationships, financial conditions, or personality tendencies between the two groups. However, Group 2 did not regain their sense of belonging to school. In this group, the frequency of stress experiences in club activities after the onset of the pandemic, troubles with the opposite gender, and inability to catch up with the contents of the subject lecture were high. The accumulation of small stressors may have hindered the maintenance of a sense of school affiliation. Mothers of students in Group 2 either were full-time employees at baseline or had started a new job after the onset of the pandemic. Their children may have been affected by the household's damaged financial budget and changes in mother's working styles. As COVID-19 reduced the number of days students went to school, students' SOC could have reduced had they not felt a sense of presence or belonging due to the lack of participation in club activities, school events, etc. Teachers and mothers should communicate carefully with their students and children, respectively, to develop a sense of belonging.

Sense of coherence and changes over six years among older adults aging with long-term spinal cord injury.

Cross-sectional and longitudinal. To (i) describe sense of coherence (SOC) and changes over six years in older adults aging with long-term spinal cord injury (SCI) and (ii) investigate how changes in SOC are associated with injury characteristics and changes in sociodemographics and secondary health conditions (SHCs; bowel-related and bladder-related problems, pain and spasticity). Community in Southern Sweden. From the initial 123 participants in the Swedish Aging with Spinal Cord Injury Study (SASCIS), 76 individuals (33% women, median age 66 years, median time since injury 30 years, AIS A-D, 30% complete) responded to the 13-item SOC scale (range 13-91) twice with a 6-year interval. Data were analyzed with multivariable hierarchical regression. The participants rated a strong SOC at both assessments (median 73 and 76.5, respectively) which significantly increased over time. Overall, their marital status and vocational situation remained stable whereas SHCs increased. A change from not having a partner to having one was the only significant explanatory factor for a positive change in SOC. The present study describes, for the first time, changes in SOC over time and associated factors in older adults aging with long-term SCI. They generally maintain a strong ability to understand, handle, and being motivated when dealing with stressful events arising in their lives as a result of their SCI. The associations emphasize the importance of the social context for successful adaptation to living with SCI along the aging process.

Strengthening sense of coherence: Evidence from a physical activity intervention targeting vulnerable adults

Sense of coherence (SOC), a concept that refers to individuals’ abilities to manage, comprehend, and find meaning in their lives and the world around them, has been shown to be an important predictor of health outcomes. While SOC was initially hypothesized to be static after early-adulthood, there is growing evidence that health interventions can strengthen SOC. In this study, we accordingly examined whether SOC could be strengthened among adults in the context of a physical activity intervention.This intervention, Communities on the Move, was conducted in the Netherlands, and was primarily targeted at older adults from socially vulnerable backgrounds. Four cohorts were followed for 18 months each, between 2012 and 2016. The SOC-3 questionnaire was used to collect data on SOC at baseline (T0) and after eighteen months (T3), with information on 117 participants in both of these waves. To assess the change in SOC between T0 and T3, ordered logistic regressions were performed, as well as mixed ordered logistic regressions with random intercepts for group and program location.This study found evidence that SOC significantly changed from T0 to T3. Participants with weak SOC at baseline reported a median one-point stronger SOC at T3 (on a 6-point scale), while those with moderate or strong SOC at baseline reported a median change of zero points between T0 and T3. Further, based on the results of the regression analyses, those with weaker SOC scores were most likely to have stronger SOC at T3: having a weak SOC at baseline was associated with a 76% probability of stronger SOC, and a 4% probability of weaker SOC at T3. These results indicated that SOC may be strengthened in vulnerable older adults, particularly when their SOC is initially low.

Parental-couple separation during the transition to parenthood.

AimTo evaluate factors associated with parental separation during the parenthood transition.DesignProspective, longitudinal and explorative.MethodsThis is a quantitative longitudinal study of N784 subjects throughout the pregnancy journey with multivariate regression analysis of survey data derived from three validated measurement scales; the Sense of Coherence scale, the Multidimensional Scale of Perceived Social Support and the Perceived Quality of the Dyadic Relationship scale conducted 2014–2016.ResultsN17 participants separated at 2 years. Parental separation was significantly greater for those women and partners with low or changing sense of coherence, perceived social support and perceived quality of the parental‐couple relationship indexes. Partners with a change in sense of coherence (p: .003) and perceived quality of the parental‐couple relationship (p: .020) between 1 week and 2 years were at greater risk for separation. Attending professional preparatory support with a partner for women (p: .013) and attending the “Inspirational Lecture” for partners (p: .046) were, to a lesser extent, associated with a risk of parental separation.

Related Changes in Personal Recovery, Benefit Finding, and Sense of Coherence among People with Chronic Mental Illness: A Two-Wave Study

Personal recovery is a process of developing new meaning and purpose in life beyond the catastrophic effects of mental illness. Benefit finding (BF) is conceptualized as finding positive changes or benefits through experiences in adversity. Sense of coherence (SOC) focuses on how people can stay healthy and maintain well-being, even in adversity. This study aimed to examine the relationships among the initial levels and longitudinal changes in personal recovery, BF, and SOC among people with chronic mental illness in Japan. In this longitudinal study, a two-wave self-report questionnaire survey was conducted for service users aged 20 or older with mental illness using convenience sampling method in 2014 and 2015. We applied the Latent Change Score approach. Model fit was evaluated according to the CFI and RMSEA. Among 373 eligible participants at baseline, valid responses in both T1 and T2 from 195 respondents were included in the study (valid response rate = 52.3%). Among them, 65.6% were male, with average age of 45.6. The model of the three constructs at the two time points had good to reasonable fit to the data. The initial levels and changes in personal recovery, BF, and SOC were significantly and positively related to each other.

Associations between APOE-, COMT Val108/158Met- and BDNF Val66Met polymorphisms and variations in depressive and anxiety symptoms, sense of coherence and vital exhaustion in the real-life setting of mandatory basic military training.

Apolipoprotein E (APOE) ε, catechol-O-methytranferase (COMT) Val108/158Met and brain-derived neurotrophic factor (BDNF) Val66Met single nucleotide polymorphisms (SNPs) were shown to affect stress perception and response. The present study explored possible associations between these SNPs and changes in subclinical anxiety- and depressive symptoms, sense of coherence (SOC) and vital exhaustion (VE) during compulsory basic military training. The study encompassed 179 conscripts of a training base in Greece. The neuropsychiatric assessment was based on the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Antonovsky SOC scale and the Maastricht Questionnaire. It was conducted at three time points of the 19-day basic military training: on day one (baseline), day six (follow-up I) and day 13 (follow-up II). Statistical analyses included Mann-Whitney test, Chi-square test and cross-sectional time series regression models based on the Skillings-Mack statistic. APOE ε4 non-carriers encountered significant changes in anxiety- and depressive symptoms and SOC (in all cases P < 0.001) over the observation period, whilst ε4 carriers did not. The changes in anxiety, depressive symptoms and SOC attained statistical significance in both BDNF Met66 carriers (in all cases P < 0.001) and non-carriers (P = 0.036; < 0.001; < 0.001, respectively) as well as in COMT Met108/158 carriers (P = 0.004; < 0.001; < 0.001, respectively) and non-carriers (P = 0.02; 0.01; 0.021, respectively. Changes over time in VE were not significant (P > 0.05). The observed resistance of APOE ε4 carriers vs non-carriers to changes in anxiety- and depressive symptoms and SOC when exposed to a stressful environment may point to superior coping capacities of healthy young men carrying the ε4 allele.

Impact of COVID-19 on Public Mental Health and the Buffering Effect of a Sense of Coherence

Introduction: It is claimed that the coronavirus disease 2019 (COVID-19) pandemic has had a negative impact on mental health. However, to date, prospective studies are lacking. Moreover, it is important to identify which factors modulate the stress response to the pandemic. Previously, sense of coherence (SOC) has emerged as a particularly important resistance factor. Objective: This prospective study aimed to assess the impact of the COVID-19 outbreak on mental health and to investigate the ability of pre-outbreak SOC levels to predict changes in psychopathological symptoms. Methods: This study assessed psychopathological symptoms and SOC before and after the COVID-19 outbreak as well as post-outbreak COVID-19-related traumatic distress in a German-speaking sample (n =1,591). Bivariate latent change score (BLCS) modeling was used to analyze pre- to post-outbreak changes in psychopathological symptoms and the ability of SOC to predict symptom changes. Results: Overall, there was no change in psychopathological symptoms. However, on an individual-respondent level, 10% experienced a clinically significant increase in psychopathological symptoms and 15% met cut-off criteria for COVID-19-related traumatic distress. Using BLCS modeling, we identified a high-stress group experiencing an increase in psychopathological symptoms and a decrease in SOC and a low-stress group showing the reversed pattern. Changes in SOC and psychopathological symptoms were predicted by pre-outbreak SOC and psychopathological symptom levels. Conclusions: Although mental health was stable in most respondents, a small group of respondents characterized by low levels of SOC experienced increased psychopathological symptoms from pre- to post-outbreak. Thus, SOC training might be a promising approach to enhance the resistance to stressors.

The relationship between quality of life and sense of coherence in patients presenting for care in a chiropractic practice-based research network

IntroductionAntonovsky’s sense of coherence (SOC) has been shown to positively correlate with quality of life (QoL). We examined the relationship between socio-demographic data and clinical covariates along with various QoL domains to SOC in patients presenting for care within a chiropractic practice-based research network. MethodsIn addition to providing socio-demographic information and clinical covariates, patients attending care within a PBRN completed the PROMIS-29 and PROMIS global health to measure of QoL and SOC-29 to measure SOC at baseline. In addition to descriptive statistics, we utilized a random forest analysis to assess the predictively ability of covariates to SOC. ResultsOur dataset was comprised of a convenience sample of 1980 responders (average age = 40.72 years; 1494 females and 486 males). The mean T scores (T1/T2) for the various QoL domains physical functioning (50.97), anxiety (52.03), depression (47.47), fatigue (51.15), ability to participate in social roles and activities (54.44), sleep disturbance (59.85), pain interference (51.27), global physical health (GPH) (49.34) and global mental health (GMH) (50.69). Mean pain intensity rating was 4.23. The mean SOC-29 was 148.34. The most important covariates to changes in SOC were: GPH, depression, anxiety age, fatigue and sleep disturbance. Partial dependence plots revealed that increasing GPH, GMH and age of patient predict increasing SOC. A high SOC was predicted in the presence of low GPH given a high GMH scoring. ConclusionsThe mental health QoL domains had a stronger predictability for SOC than physical health domains.

Change in sense of coherence and health-related quality of life after injury – a prospective cohort study

Purpose To investigate how accidents leading to fracture affect sense of coherence and health-related quality of life 6 months later and the association between the two phenomena. Materials and methods A cohort study including 201 patients admitted to hospital with fractures was conducted. Data were based on structured interviewing a few days after admission and 6 months later. Sense of coherence was evaluated with a nine-item scale and health-related quality of life was examined with the subscales of Short Form-36 (SF-36). Results Follow-up comprised 164 patients (81.6%), mean age 47 years. Sense of coherence changed to be either stronger (43%) or weaker (41%) and was stable for 15.9% of the participants. Health-related quality of life changed positively after 6 months but did not reach normative values. Strong sense of coherence was significantly associated with the SF-36 subscales emotional role functioning, social functioning, vitality, and mental health. Conclusions Accidents leading to fracture can be stressful life events that could influence an individual’s sense of coherence to be stronger or weaker. The association between sense of coherence and health-related quality of life emphasises the importance of therapists supporting the patients’ personal resources and promote a salutogenic focus. IMPLICATIONS FOR REHABILITATION An injury may change an individual’s sense of coherence to be stronger or weaker. For patients who sustain fracture, sense of coherence should be included in therapists’ analysis of personal resources and support a salutogenic perspective. Health-related quality of life is especially for younger individuals affected by an accident and its consequences and need a guided and meticulous rehabilitation course.

The Significance of Tailored, Web-Based Information on Experiences Regarding Perceived Self-Management in Ovarian Cancer Patients in the Diagnostic Phase-An Experimental Study

Cancer patients can experience a low self-management, which is associated with burn out and negatively associated with health-related quality of life. Patient-provider time at hospitals is often short and patients can lack knowledge, communication and support. We aimed to evaluate the influence of a healthcare-professional developed website, available to both patients and relatives, on patients’ experienced self-management before surgery for ovarian cancer. In an experimental study, Danish women with ovarian cancer were consecutively included if they would participate and had a relative, willing to offer attention to the cancer situation. The control group had standard care, the intervention group plus their relatives had additional access to a website with cancer-specific physical, psychical, and practical information. The validated questionnaires Cancer Behavior Inventory and Sense of Coherence provided data for statistical analysis. Patients’ difference in change in Sense of Coherence over time was statistically significant in favor of those who had used the website (mean difference 4.42, p<0.001).Patients’ and relatives’ access to our website prevented a decrease in self-management of Danish women in the diagnostic phase of ovarian cancer. Such support might be helpful to all patients approaching critical illness and who have a helpful relative, but this needs further investigation.

Sense of coherence and women׳s birthing outcomes: A longitudinal survey

Backgroundin Western countries, caesarean section rates are increasing at an alarming rate. This trend has implications for women׳s health and calls into question the use of pathogenesis to frame maternity services. The theory of salutogenesis offers an alternative as it focuses on health rather than illness. Sense of coherence (SOC), the cornerstone of salutogenesis, is a predictive indicator of health. This study aimed to explore associations between pregnant women׳s SOC, their birthing outcomes and factors associated with SOC changes. Methodsa longitudinal survey was conducted where women completed a questionnaire in the antenatal and postnatal period. Questionnaire one provided information on SOC scores, Edinburgh Postnatal Depression Scale (EPDS) scores, Support Behaviour Inventory (SBI) scores, pregnancy choices and demographics. Questionnaire two provided information on SOC scores, EPDS scores and birthing outcomes. Findings1074 women completed questionnaire one and 753 women completed questionnaire two. Compared to women with low antenatal SOC, women with high antenatal SOC were less likely to experience caesarean section (OR 0.437 95% CI 0.209–0.915) and more likely to experience assisted vaginal birth (AVB) (OR 3.108 95% CI 1.557–6.203). Higher birth satisfaction, higher antenatal EPDS scores and lower antenatal SOC were associated with an increase in SOC. Epidural, AVB and decreased birth satisfaction were associated with a decrease in SOC. Conclusionhigh sense of coherence in pregnant women is associated with half the likelihood of caesarean section compared to women with low sense of coherence. Women׳s sense of coherence is raised and lowered by degree of satisfaction with their births and lowered by some labour interventions.

Empirical relations between sense of coherence and self-efficacy, National Danish Survey.

Salutogenic orientation is a health promotion paradigm focusing on the resources of the individual. This study analyzed the relationship between sense of coherence (SOC) and self-efficacy (SE) based on population data. By conducting an empirical analysis of the two models, we wanted to see whether we could make a valid judgement as to whether both SOC and SE could be utilized in health promotion practice, or whether one is preferable to the other. The study population was randomly selected from the Danish Central Population Register and consisted of five birth-year cohorts (1920, 1930, 1940, 1965 and 1975). The study used the 13-item SOC scale and the general SE scale. The main findings were that SOC score increased by age cohort (p = 0.0004), and there is a positive and graded correlation between SOC and SE (r = 0.39; p < 0.0001) and adjusted OR = 10.3 (CI = 6.7-15.4). We found the strongest association at the lowest level of SOC. For health promotion practice, this finding signifies the importance of focusing on improving SOC in people with a low SOC score, as they are most in need and most likely to increase their SOC level. The finding of higher SOC scores in the older age cohorts indicates that SOC changes over lifetime. Public health work focusing on lifestyle change by increasing SOC can be effective throughout life, however early intervention is important. The finding of a positive correlation between SOC and SE indicates that health promotion altering one of the constructs is paralleled in the other.

Sense of coherence changes with aging over the second half of life.

Sense of coherence (SOC), a concept reflecting meaningfulness, comprehensibility, and manageability of life, has been demonstrated to have strong connections to positive outcomes such as good health. However, less is known about how SOC changes over the second half of life as age-related deficits accumulate. We used longitudinal samples of mature adults that included the oldest-old to track change in SOC from age 55 to 101. Growth curves using an accelerated longitudinal design were estimated for 1809 individuals who contributed 4072 observations from five national Swedish surveys between 1991 and 2010/11. Results indicated that deficits in health and social resources were largely responsible for the precipitous decline in SOC after age 70. When controlling for these deficits, SOC increased continuously into advanced old age. We conclude that the capacity to comprehend, manage, and find meaning in life--the component elements of SOC--strengthens over the last years of life, suggesting a positive ontogenic development that runs parallel but opposite to the negative impact of health and social decline.

Sense of Coherence Mediates the Effects of Low Work Ability on Mental Distress During Unemployment

Previous research has found that work ability (as measured with the Work Ability Index) is related to mental health in employee samples and in the general population. This study extends this research to unemployed people. In addition, it tests whether the effect of impaired work ability on mental health can be explained by changes in sense of coherence. A longitudinal design with two measurement points was used with a sample (N = 98) of jobless individuals in Finland participating in labor market interventions. Consistent with expectations, impaired work ability predicted lower sense of coherence and more psychological distress, and the association between impaired work ability and distress was mediated by sense of coherence. The important role of impaired work ability for jobless individuals' sense of coherence and, consequently, mental health during unemployment is discussed.

Social and psychological functioning of opiate dependent patients in methadone maintenance treatment – longitudinal research report

IntroductionSubstitution treatment is recommended by the WHO as an effective form of curbing and abstaining from opiate use and improvement of psychosocial functioning of drug addicted persons. It was positively demonstrated that this treatment leads to abstinence from illegal drugs and reduction of harm of use. However, despite the long-term application of this form of treatment, and despite various studies on changes occurring under its influence, still little is known about what changes occur in patients participating in substitution treatment. For this reason, the aim of the present research analysis was to determine what changes appeared in cognitive emotion regulation strategies, sense of coherence, intensity of psychopathological symptoms and level of developmental task completion in the patient group. MethodThe longitudinal study procedure was applied. Opiate addicts were studied twice – first when on starting therapy and second after six months of participation. The research was conducted at five substitution treatment centres in Poland. The first research stage included 37 subjects addicted to opiates, and the second 22 persons after 6 months of substitution treatment. ResultsAfter six months of methadone treatment, patients displayed a statistically significant change in sense of coherence. The respondents believed life to be more understandable, predictable and meaningful. A significant increase in the realisation of all developmental tasks was also observed, but not of specific tasks. There were no significant changes in cognitive emotional regulation strategies and intensity of psychopathological symptoms.

Sense of coherence among cognitively intact nursing home residents – a five-year longitudinal study

Aim and objectives: To examine how stable the sense of coherence (SOC) is over a five-year period among residents of nursing homes (NH) who are not cognitively impaired and whether components of social support influence SOC.Background: Many studies have investigated the stability of SOC, and the findings have been inconsistent. Social support is a crucial resource in developing SOC. Few researchers have studied the stability of SOC and how various social support dimensions influence changes in SOC among older NH residents who are cognitively intact.Design: The study was prospective and included baseline assessment and five-year follow-up.Methods: The sample comprised 52 cognitively intact NH residents (Clinical Dementia Rating score ≤0.5). We obtained data through direct interviews using the Social Provisions Scale and Sense of Coherence Scale.Results: SOC increased statistically significantly from baseline to follow-up. The social support subdimension reassurance of worth predicted change in SOC after adjustment for sociodemographic factors. When controlled for baseline SOC, attachment was associated with change in SOC, but reassurance of worth was not.Conclusions: The study indicates that the change in SOC over time during the 5 years of follow-up and the social support dimension attachment appear to be important components of change in SOC. Nursing personnel should be aware of the residents’ individual needs for attachment and the importance of emotional support for personal strength and ability to cope.

Sense of coherence and substance use: Examining mutual influences

Sense of coherence (SOC) is conceptualized as a mutable orientation to life, but has often been found a stable attribute of individual differences. While several studies have documented the relationship between SOC and substance use, nothing is known about mutual influences between both variables over time in adolescence. The present study examines whether changes in SOC predict changes in substance use, or whether changes in substance use predict changes in SOC. A longitudinal cross-lagged panel design was used to inspect SOC and self-reported frequency of substance use of tobacco, alcohol, and cannabis over the course of ten years. Participants were 318 German adolescents aged 14–15 at the beginning of the study. Structural equation modeling indicated a single significant negative path from SOC to later cannabis use as well as one significant positive path from cannabis use to SOC. Despite a general association – high SOC corresponds to less substance use – SOC overall develops independently from substance use.