Stress Process Paradigm Research Articles

Untangling the role of social relationships in the association between caregiver burden and caregiver health: an observational study exploring three coping models of the stress process paradigm

BackgroundCaregivers health is often at risk due to the detrimental effects of caregiver burden. It is therefore vital to identify strategies and resources, which ensure the safeguarding of caregivers' health, whilst also enabling caregivers to continue providing high quality long-term care to care-receivers. The objective of this study is therefore to examine the moderating and mediating role of different social relationship constructs (social networks, social support, relationship quality, and loneliness) in the relationship between subjective caregiver burden and health, by exploring different coping models of the stress process paradigm, namely the stress buffering, social deterioration and counteractive models.MethodsLongitudinal survey data from 133 couples of caregiving romantic partners and persons with spinal cord injury, living in Switzerland were used. We employed multivariable regression analysis with the inclusion of interaction terms to explore moderation effects of social relationships (i.e. stress buffering model), and path analysis to explore mediation effects (i.e. social deterioration vs. counteractive model) of social relationships on the association between subjective caregiver burden and health. Health was operationalised using the following outcomes: mental health, vitality, bodily pain and general health.ResultsSocial support and relationship quality were found to buffer the negative effects of subjective caregiver burden on mental health. Mediating effects of social relationships were observed for mental health (indirect effect -0.25, -0.42- -0.08) and vitality (indirect effect -0.20, -0.37- -0.03), providing support for the deterioration model. Loneliness was found to be a particularly important construct on the pathway from caregiver burden to health.ConclusionOur study highlights the potential of social support and relationship quality to override the negative consequences of caregiver burden on mental health and vitality. Our evidence thus supports the advance of interventions that seek to improve qualitative aspects of social relationships, especially in caregivers experiencing a high subjective caregiver burden.

Clarifying the role of officer coping on turnover in corrections

ABSTRACT Correctional officers are at high risk of exposure to workplace violence, and many report experiencing severe mental health symptoms, including post-traumatic stress disorder, anxiety, and depression. Despite growing concern for these issues, however, we do not yet fully understand the coping mechanisms correctional officers employ to manage work-related stress, or how coping mechanisms affect workplace outcomes. To address these questions, we utilize original survey data about California correctional officers. We draw on the Stress Process Paradigm to model the relationship between exposure to violence and mental health, the impact of occupational stress on the development of coping mechanisms, and whether differential coping mechanism utilization impacts officers’ levels of cynicism and desire to leave corrections. Our findings suggest that emotion-focused coping (e.g. having someone to talk to) is associated with lower intention to leave correctional employment, while the opposite is true for avoidant coping (i.e. alcohol abuse). These insights shed light on the problem of officer turnover and retention, and provide potential direction to policymakers and practitioners seeking to create an effective, healthy workforce.

Hearing impairment, social support, and depressive symptoms among U.S. adults: A test of the stress process paradigm

Hearing impairment is a growing physical disability affecting older adults and is an important physical health stressor, but few studies have examined it in relation to mental health outcomes and even fewer have considered the role of social support in buffering this relationship. The current study builds on the stress process framework and uses longitudinal data from three waves of the Health and Retirement Study (2006, 2010, 2014) to examine the relationship between hearing impairment and depressive symptoms among U.S. adults aged 50 and older (n = 6075). The analysis uses fixed-effects models to assess this relationship and examine the extent to which social support mediates (buffers) or moderates (interaction) the association. The results found that worse self-rated hearing was associated with a significant increase in depressive symptoms, even after controlling for sociodemographic factors. Social support did not buffer this relationship. Instead, social support interacted with hearing impairment: low levels of social support were associated with more depressive symptoms but only among people with poor self-rated hearing. Among those with excellent self-rated hearing, low levels of social support did not increase depressive symptoms. Moreover, high levels of social support reduced depressive symptoms for those with poor hearing. These findings suggest that hearing impairment is a chronic stressor in individuals' lives, and that responses to this stressor vary by the availability of social resources.

Beyond Incarceration: Criminal Justice Contact and Mental Health

A growing literature documents deleterious consequences of incarceration for mental health. Although salient, incarceration is only one form of criminal justice contact and, accordingly, focusing on incarceration may mask the extent to which the criminal justice system influences mental health. Using insights from the stress process paradigm, along with nationally representative data from the National Longitudinal Survey of Youth 1997, we examine criminal justice contact—defined as arrest, conviction, and incarceration—and mental health. First, fixed-effects models, which adjust for stable unobserved and time-varying observed characteristics, show that arrest is deleteriously associated with mental health, and arrest accounts for nearly half of the association between incarceration and poor mental health, although certain types of incarceration appear more consequential than others. Second, the associations are similar across race and ethnicity; this, combined with racial/ethnic disparities in contact, indicates that criminal justice interactions exacerbate minority health inequalities. Third, the associations between criminal justice contact, especially arrest and incarceration, and mental health are particularly large among respondents residing in contextually disadvantaged areas during adolescence. Taken together, the results suggest that the consequences of criminal justice contact for mental health have a far greater reach than previously considered.

Does Social Support Buffer the Stress of Discrimination and Reduce Psychological Distress Among Asian Americans?

Using the stress process paradigm and data from the first national epidemiological survey of Asian Americans, we investigate whether social support from family and friends buffers the stress of discrimination to protect psychological well-being. Results suggest that perceived emotional support from family for a serious problem buffers the stress of high levels of everyday discrimination, controlling for sociodemographics, acculturation, and community factors. Contrary to our expectations, perceived emotional support from family about worries and received social support from regularly talking on the phone and getting together with family are not statistically significant stress buffers. Moreover, perceived and received social support from friends do not buffer the stress of any level of discrimination. Overall, our study has broader implications for research on the influence of social relationships on mental health and advances our knowledge of the social psychological process of coping with discrimination in the United States.

Maternal and paternal imprisonment in the stress process

Parental incarceration is now prevalent in community samples (e.g., with 11% of children reporting paternal imprisonment and 3% reporting maternal imprisonment in a national sample), pointing to a potentially important childhood trauma that should be included in work on contemporary childhood stressors in this era of mass incarceration. This paper investigates the influences of maternal and paternal imprisonment on changes in young adult mental health using a nationally representative sample. We assess four perspectives-gendered loss, same-sex role model, intergenerational stress, and maternal salience – on the joint influences of maternal and paternal incarceration within the broader stress process paradigm. The results generalize support for a gendered loss perspective developed in work on parental death and an early small study of parental incarceration. This pattern reveals maternal incarceration increases depressive symptoms while paternal incarceration increases substance role problems. Chronicity of parental imprisonment and its timing are also influential. Analyses further specify a vulnerability of male and minority young adults to high levels of mental health problems following maternal and paternal incarceration in adolescence.

The Mediating Roles of Stress and Maladaptive Behaviors on Self-Harm and Suicide Attempts Among Runaway and Homeless Youth

Runaway and homeless youth often have a constellation of background behavioral, emotional, and familial problems that contribute to stress and maladaptive behaviors, which, in turn, can lead to self-harming and suicidal behaviors. The current study examined the roles of stress and maladaptive behaviors as mediators between demographic and psychosocial background characteristics and self-injurious outcomes through the lens of the stress process paradigm. The model was tested in a sample of runaway and homeless youth from Los Angeles County (N=474, age 12-24, 41% female, 17% White, 32.5% African American, 21.5% Hispanic/Latino). Background variables (gender, age, sexual minority status, parental drug use history, and emotional distress) predicted hypothesized mediators of maladaptive behaviors and recent stress. In turn, it was hypothesized that the mediators would predict self-harming behaviors and suicide attempts in the last 3months. Females and LGBT (lesbian, gay, bisexual, transgender) youth were more likely to have self-harmed and attempted suicide; younger participants reported more self-harming. The mediating constructs were associated more highly with self-harming than suicide attempts bivariately, although differences were modest. Maladaptive behaviors and recent stress were significant predictors of self-harm, whereas only recent stress was a significant predictor of suicide attempts. All background factors were significant predictors of recent stress. Older age, a history of parental drug use, and greater emotional distress predicted problem drug use. Males, younger participants, and participants with emotional distress reported more delinquent behaviors. Significant indirect effects on self-harming behaviors were mediated through stress and maladaptive behaviors. The hypothesized paradigm was useful in explaining the associations among background factors and self-injurious outcomes and the influence of mediating factors on these associations.

Incarcerated Parents and Health: Investigating Role Inoccupancy Strains by Gender

This article elaborates research on parenthood, gender, and health by considering the context of incarceration using the stress process paradigm. The chronic strain of non-participation in a desired role, or “role inoccupancy,” in the form of non-resident parenthood on arrest is associated with psychological distress at time of lockup among women but not men, indicating a gendered strain. However, for both incarcerated men and women, anticipated resident parent role inoccupancy upon release (or expectations not to live with their minor children) is generically associated with current subjective mental health problems net of distress prior to lockup. Role inoccupancy strains are further associated with subjective physical health problems among women but not men, indicating more pervasive associations among the former.

Incorporating Children’s Lives into a Life Course Perspective on Stress and Mental Health

Emerging themes in demography, developmental medicine, and psychiatry suggest that a comprehensive understanding of mental health across the life course requires that we incorporate the lives of children into our research. If we can learn more about the ways in which the stress process unfolds for children, we will gain important insights into the factors that influence initial set points of trajectories of mental health over the life course. This will simultaneously extend the scope of the stress process paradigm and elaborate the life course perspective on mental health. Incorporating children's lives into the sociology of mental health will also extend the intellectual influence of the discipline on sociomedical and biomedical research on mental illness. I contend that sociology's greatest promise in understanding trajectories of mental health across the life course lies in a systematic analysis of the social and social-psychological conditions of children, the stressful experiences that arise out of these conditions, and the processes that mediate and moderate the stress process in childhood. In this regard, there are three major issues that sociologists could begin to address: (1) the identification of structural and institutional factors that pattern children's exposure to stress; (2) the construction of a stress universe for children; and (3) the identification of key elements of the life course perspective that may set or alter trajectories of mental health in childhood and adolescence.

Toward a Stress Process Model of Children’s Exposure to Physical Family and Community Violence

Theoretically informed models are required to further the comprehensive understanding of children's ETV. We draw on the stress process paradigm to forward an overall conceptual model of ETV (ETV) in childhood and adolescence. Around this conceptual model, we synthesize research in four dominant areas of the literature which are detailed but often disconnected including: (1) exposure to three forms of physical violence (e.g., child physical maltreatment, interparental violence, and community ETV); (2) the multilevel correlates and causes of ETV (e.g., neighborhood characteristics including concentrated disadvantage; family characteristics including socio-economic status and family stressors); (3) a range of consequences of ETV (e.g., internalizing and externalizing mental health problems, role transitions, and academic outcomes); and (4) multilevel and cross domain mediators and moderators of ETV influences (e.g., school and community factors, family social support, and individual coping resources). We highlight the range of interconnected processes through which violence exposures may influence children and suggest opportunities for prevention and intervention. We further identify needed future research on children's ETV including coping resources as well as research on cumulative contributions of violence exposure, violence exposure modifications, curvilinearity, and timing of exposure.

An Integrated Stress Process Theory: Viewing Intersections of Crime and Mental Illness

Conventional perspectives dichotomize mental illness and crime into distinct and largely unrelated categories. Both “being mad” and “being bad” (Mechanic, 1999) involve social deviance, yet each is ascribed with Criminal and mentally ill populations have traditionally been addressed by different systems and corrective philosophies. Recent studies, however, have identified high prevalence rates of depression and substance abuse disorders among inmates. Such comorbidity presents numerous conceptual challenges. Mental health theories are not designed to explain crime; criminology is not calibrated to explain depression. This article proposes paradigmatic modifications designed to help theory catch up with data. Criminological concepts of “criminal coping” and “deviant peers” are integrated into the Stress Process paradigm. A theory for explaining comorbidity and covariation of crime and mental illness is proposed. Social policy implications are raised. [Article copies available for a fee from The Transformative Studies Institute. E-mail address: journal@transformativestudies.org Website: http://www.transformativestudies.org ©2009 by The Transformative Studies Institute. All rights reserved.]

Growing up Fast: Stress Exposure and Subjective “Weathering” in Emerging Adulthood

We examine "subjective weathering" among females entering adulthood, using three waves of a national study. Subjective weathering is a social psychological component of aging that is associated with "physical weathering" previously observed in research on physical health. We examine the influence of stressors from childhood and adolescence on subjective weathering and depressive symptoms in emerging adulthood. Childhood abuse is associated with early menarche, as anticipated in research on physical weathering. Early menarche and child abuse are in turn associated with intimate partner violence exposure in adolescence. Both early menarche and intimate partner violence are associated with early parenthood and diminish the likelihood of high school graduation. These experiences culminate in subjective weathering associated with depressive symptoms in emerging adulthood. Our findings connect physical and subjective weathering within the stress process paradigm.

Understanding variations in exposure to social stress

Although exposure to stress is a central component of the stress process paradigm, little research has explicitly sought to identify antecedents of stress exposure. Based on a probability sample of 1393 adults aged 18-55 residing in Toronto, Canada, this research examines the effects of social status, past adversity, social and personal resources and history of mental disorder on recent exposure to stress. Consistent with earlier findings, results indicate that younger adults, divorced individuals and those with lower socioeconomic status, experience greater levels of social stress. Although respondent's history of major depressive disorder was related to all types of stress exposure, past cumulative adversity was the most powerful predictor of both total current stress (operant burden) and the subsequent onset of life events, independent of other antecedents. Findings suggest that the onset of chronic stress is more affected by personal characteristics, such as emotional reliance and disorder history, than is onset of life events. Implications of these findings are discussed.

Asian Immigrants and the Stress Process: A Study of Koreans in Canada

The stress process paradigm is one of the most widely held perspectives in the sociology of mental health. While this model has been applied to a large number of research problems, relatively little work has examined whether the paradigm can assist in understanding the link between socially induced stressors and their consequences for the mental health of immigrants. In this paper, we employ a stress process formulation to examine the interplay among stressors, psychological and social resources, and psychological distress among a large sample of Korean immigrants living in Toronto, Canada. Data from a longitudinal study of over 600 respondents indicate that the stress process paradigm provides a useful perspective for understanding how chronic stressors associated with the immigration experience manifest themselves in psychological distress. Our results suggest that social and psychological resources have important deterrent effects on the experience of stressors and their subsequent distressful consequences. Ethnic social support and mastery are especially important factors in this process.