Stress Process Theory Research Articles

Identity Characteristics as Moderators of Discrepancy on Well-being

Research finds that discrepancies between individuals’ self-views and their perceptions of how others view them decrease psychological well-being. According to identity theory, certain characteristics of identities may exacerbate the impact of discrepancy on well-being, while stress process theory suggests they may have the opposite, weakening effect. Using telephone survey data from a national probability sample of adults, I investigate whether several identity characteristics—subjective importance of an identity (prominence), extensiveness (interactional commitment) and intensiveness of ties (affective commitment) to others that are based on an identity, and the potential costs of failing to fulfill the role obligations of an identity (role-based commitment)—moderate associations between discrepancy and well-being (depressive symptoms and self-esteem) in two types of identities (obligatory and voluntary). I find that identity commitment buffers the effects of discrepancy in obligatory identities and exacerbates the effects of discrepancy in voluntary identities. Implications of these findings are discussed.

SOCIAL RELATIONSHIPS AND DUAL FUNCTIONALITY IN LATER LIFE

Abstract Longer lives are often accompanied by greater risk of cognitive and physical impairments, but we investigate whether social relationships reduce the risk of those impairments. We examine dual functionality – the absence of both dementia and activities of daily living impairments – and draw upon stress process and social integration theories to examine the impact of positive and negative dimensions of relationship quality with friends and family to better understand how social factors may affect how long people maintain both their physical and cognitive functioning in later life. We use nationally representative panel data from the Health and Retirement Study (2006-2016, N=6,985) and Weibull accelerated failure-time models. Higher strain with family members and with friends was associated with a loss of dual functionality at earlier ages (Time Ratio = .97 [95% CI: .95, .99] and TR = .96 [CI: .94, .98], respectively). Greater social support from family members was beneficial, related to a longer time as dual functional (TR = 1.04, CI: 1.02, 1.06); however, more support from friends was related to loss of dual functionality at earlier ages (TR = .98, CI: .96, .99). Findings reveal the implications of social support and strain in different types of relationships for dual functionality.

“It’s a lonely journey”: Personal experiences and psychosocial distress among Chinese American dementia family caregivers

AbstractBackgroundChinese American dementia caregivers are a growing but understudied population. Prior survey studies suggest they experience high rates of depressive symptoms and adverse health outcomes, but data are limited on their caregiving experiences, distress processes, and related contextual factors. The current study aims to address the literature gap with a qualitative investigation.MethodIn‐depth interviews were conducted with 18 Chinese American dementia caregivers. An interview guide was developed priori based on literature on family dementia caregivers and stress process theories. All interviews were transcribed verbatim, thematic content analysis was conducted.ResultParticipants’ ages ranged from 39 to 85 with a median age of 60 years. 70% were female, and 64% had limited English proficiency. A conceptual framework of caregiving distress process was developed based on the interview guide and major themes emerged from the data. Caregiving stress stems from a complex interaction of care‐recipients’ and caregivers’ characteristics; stress leads high levels psychosocial distress, including poor sleep, depression and anxiety, and chronic conditions. The distress process is attenuated by caregivers’ help‐ seeking, social support, and use of formal services; it is also negatively influenced by caregivers’ poor self‐care, social isolation, and self‐perceived poor mastery of caregiving. The distress experienced by Chinese American dementia caregivers is a dynamic process in the caregiving context at multiple levels, including their social networks, available health and social services, immigration policies, and social norms. Participants described their caregiving experience as a “lonely journey”, reflecting their isolation and limited social support.ConclusionOur data suggest that Chinese American dementia caregivers, especially those with limited English proficiency, experience elevated psychosocial distress. They face daunting barriers to social support and health services due to their immigrant and minority status. Culturally appropriate targeted intervention is urgently needed for this underserved and vulnerable population.

Recent Economic Intimate Partner Violence and Posttraumatic Stress Symptoms Among a Racially and Ethnically Diverse Sample of U.S. Women Experiencing Intimate Partner Violence.

Posttraumatic stress disorder (PTSD) is a prevalent consequence of physical and sexual intimate partner violence (IPV); however, little is known about the unique contributions of economic IPV. Furthermore, women's economic self-sufficiency may explicate the potential relationship between economic IPV and PTSD symptoms. Guided by the Stress Process Theory and Intersectionality, this study examined associations between economic IPV and women's PTSD symptoms and assessed economic self-sufficiency as a mediator. Participants were 255 adult women experiencing IPV recruited from metropolitan Baltimore, MD, and the state of CT who participated in two different studies. Participants completed surveys on IPV, economic self-sufficiency, and PTSD. Path analyses were conducted to examine direct and indirect associations of economic IPV with economic self-sufficiency and PTSD. Economic IPV was uniquely associated with PTSD symptoms while controlling for other forms of IPV. Economic self-sufficiency significantly partially mediated the association between economic IPV and PTSD symptoms such that economic IPV was associated with PTSD symptoms through economic self-sufficiency. Economic IPV may limit women's ability to make autonomous decisions related to finances, which could be distressing. The mental health impact of economic IPV may be particularly debilitating for women with low economic self-sufficiency as their posttraumatic stress occurs within the context of feeling unable to meet their financial goals and also having a partner control their economic resources. Fostering economic empowerment and asset building may be a strengths-based approach to reduce the PTSD symptomatology among women experiencing IPV.

Supporting farmer wellbeing: exploring a potential role for farm advisory staff.

Farmers in Ireland experience poor health outcomes and are considered 'hard to reach'. Agricultural advisors ('advisors') are uniquely positioned to support and signpost farmers on health issues. This paper explores the acceptability and terms of reference of a potential health role for advisors, and offers key recommendations for developing a bespoke farmers' health training programme. Following ethical approval, eleven focus groups (n=26 female, n=35 male, age-range 20s-70s) were conducted with farmers (n=4), advisors (n=4), farming organisations (n=2) and farmers' 'significant others' (n=1). Utilizing Thematic Content Analysis, transcripts were coded iteratively and emerging themes were grouped into primary and subthemes. Our analysis identified three themes. 'Scope and acceptability of a potential health role for advisors' examines how participants envision and are receptive to such a role. 'Roles, responsibilities and boundaries' considers both a health promotion and 'health connector' advisory role - normalising health conversations and signposting farmers to services/supports. Finally, 'trouble-shooting potential obstacles to advisors assuming a health role' reflects on the barriers that may impede advisors capacity or potential to have a broader health role. Within the context of the stress process theory, findings provide unique insights into how advisory can mediate stress and contribute to farmers' health and wellbeing. Finally, findings have important implications for potentially extending the reach of training to other aspects of farming support services (eg agri-banking, agri-business, veterinary services etc.), as well as serving as a springboard for the development of similar initiatives in other jurisdictions.

SOCIAL RELATIONSHIPS AND COGNITIVE IMPAIRMENT IN LATER LIFE

Abstract With population aging and the growing population at-risk of cognitive impairment, Alzheimer’s disease, and related dementias, there is a need for a better understanding of how social factors may affect cognitive impairment. Drawing from stress process theory and social integration theory, we examine the impact of positive and negative dimensions of relationship quality with friends and family on cognitive impairment in later life. We analyze Cox proportional hazards models using nationally representative panel data from the Health and Retirement Study (2006-2016, N=10,626) to examine how the quality of family and friend relationships in adulthood may influence risk of cognitive impairment. Strain with family members and with friends was significantly related to higher risk of cognitive impairment (Hazard Ratio: 1.15 [95% CI: 1.08, 1.21] and 1.20 [95% CI: 1.13, 1.28], respectively). Support from family members was beneficial, related to lower risk of cognitive impairment (HR: 0.93, CI: .89, .99); however, support from friends was related to higher risk of cognitive impairment (HR: 1.10, CI: 1.05, 1.14). Findings reveal the implications of social support and strain in different types of relationships for cognitive health.

Revisiting the Black-White Mental Health Paradox During the Coronavirus Pandemic.

Black Americans have lower rates of depression and anxiety than Whites, despite greater exposure to stressors known to negatively impact mental health, characterized as the Black-White mental health paradox. This study revisited the paradox during the coronavirus pandemic. Drawing on stress process theory, minority stress theory, and the rejection-identification model of discrimination, in-group identity, and well-being, we analyzed original survey data from a quota sample of African American and White adults (N = 594). The survey included a range of stressors and coping resources, including those relevant to the pandemic (e.g., COVID-19 illness) and race (e.g., witnessing anti-Black police violence). Results indicate that despite African Americans' greater exposure and vulnerability to racial discrimination, the Black-White mental health paradox holds, owing in part to protective effects of African American's higher self-esteem. Directions for future exploration of the paradox are presented based on this study's findings.

Applying the Stress Process Theory to Assess Correlates of Suicide Ideation-to-Action Among Persons on Parole in the United States.

There is limited knowledge regarding precipitating factors associated with suicidality among persons on parole. Pairing the suicide ideation-to-action framework and stress process theory, the present study aimed to characterize sources of major stress (drug use, physical health, and mental health) and their associations to suicide ideation, planning, and attempt among a national sample of persons on parole. This study included a subsample of persons on parole (N = 1725) using pooled national data from the National Survey on Drug Use and Health (2015-2019). A series of logistic regression results indicate that various drug use, physical health, and mental health factors significantly influenced all three suicidality measures. Due to this population's unique experiences and numerous barriers following release from prison, it is essential to personalize interventions geared toward this population to meet their specific needs and address suicidality based on where they fall on this continuum.

Impact of older adults' oral health on caregiving stress of their family caregivers in the United States: The mediating effect of functional ability.

Extensive studies have explored the factors affecting caregiving stress, but how oral health of care recipients (CRs) associates with caregiving stress and the mechanism behind it are not well-known. Guided by Stress Process Theory, this study addressed such research gaps. Caregiver services dataset came from the 13th National Survey of Older Americans Act Participants in the United States (N=1289). Caregiving stress included physical, emotional, and financial stress. The oral health of CRs was self-rated by a single item. The functional ability of CRs was assessed by activities of daily living (ADLs) and instrumental activities of daily living (IADLs). PROCESS 3.4 for SPSS 26.0 was used to conduct the mediation analyses. Results from the study showed that caregivers reported slightly high levels of physical (M=3.06, SD=1.33, Range =1-5), emotional (M=3.43, SD=1.28, Range =1-5), and financial (M=2.83, SD=1.43, Range =1-5) stress. The results from hierarchical linear regression revealed that poor oral health of CRs was significantly associated with higher levels of physical (B=0.11, p < 0.001), emotional (B=0.09, p < 0.01), and financial (B=0.12, p < 0.001) stress, respectively. The functional ability of CRs mediated such relationships between the oral health of CRs and the caregiving stress of their family caregivers. Findings from this study enrich our theoretical and practical understanding of caregiving stress in aged care and offer programs and policy implications of oral and physical healthcare for community-dwelling older adults.

Perceived Discrimination as a Moderator between Living Difficulties and Psychological Distress among Asylum Seekers from Darfur

Abstract Migration inevitably involves difficulties. These difficulties are more pronounced for refugees and asylum seekers, who also often suffer discrimination. In this study, we examined the impact of living difficulties on the psychological wellbeing of Darfuri asylum seekers in Israel. Based on the stress process theory, we hypothesized that perceived discrimination mediates the relationship between living difficulties and psychological distress, post-traumatic stress disorder (PTSD), and psychological quality of life. The sample consisted of 300 Darfuri asylum seekers aged 19 or older. Measures included post-migration living difficulties, perceived discrimination, psychological distress, PTSD, psychological quality of life, and demographic factors. The results show that greater living difficulties were associated with lower psychological quality of life, higher PTSD symptoms, and increased psychological distress. As hypothesized, perceived discrimination fully mediated the relation between living difficulties and psychological quality of life and PTSD symptoms. Additionally, perceived discrimination partly mediated the relation between living difficulties and psychological distress. Our findings support the stress process theory and the role of society in stressful situations. It also indicates that by reducing perceived discrimination, psychological wellbeing can be improved.

Stress, coping, and positive aspects of caregiving among caregivers of children with rare disease

Objective Caregivers of children with rare diseases often consider caregiving to be a rewarding experience, despite high levels of burden. The present study examined associations between caregiver stress and positive aspects of caregiving (PAC); investigated associations between interpersonal coping strategies and PAC; and determined whether coping strategies moderated associations between stressors and PAC. Design Survey data came from a study on caregivers across different caregiving conditions, including caregivers of children diagnosed with inherited metabolic conditions (n = 167), undiagnosed diseases (n = 23), and caregivers of typically-developing children (n = 74). Main outcome measures Positive Aspects of Caregiving (PAC) scale. Results Results from generalized linear models indicated that perceived burden was not associated with PAC. Venting was negatively associated with PAC (b= −0.09, p=.03), whereas emotional support was associated with increased PAC for caregivers of children with undiagnosed conditions (b = 0.15, p=.02). Care needs were associated with greater PAC among caregivers engaged in high levels of emotional support coping (b = 0.10, p=.01) and venting (b = 0.09, p=.03). Conclusion These findings illuminate important differences in PAC based on the caregiving condition, and aspects of the caregiver stress process model that might be universal to caregivers. Results inform stress process theory and highlight the potential of support-based interventions for promoting PAC. Supplemental data for this article is available online at

COVID‐19–related stressors, family functioning and mental health in Canada: Test of indirect effects

AbstractObjectiveThe purpose of this study was to examine how family relationships relate to stress and mental health during the COVID‐19 pandemic response in Ontario, Canada.BackgroundGenerally, families are pillars of strength during times of stress and burden. However, enduring stressors, such as the COVID‐19 pandemic, may challenge the cohesion and caregiving functions of families. Researchers are just beginning to explore stressors associated with the COVID‐19 pandemic, family functioning, and mental health in the general population. Rooted in stress process theory, the current study disentangles the complex pathways through which COVID‐19‐pandemic–related stressors and family cohesion and family conflict are associated with the mental health of the general population in Ontario, Canada.MethodData were collected using an online survey from April 22, 2020, to May 22, 2020. Through convenience sampling, 933 individuals were recruited from the general population in Ontario, Canada.ResultsFindings suggest that COVID‐19‐pandemic–related stressors are associated with anxiety directly and indirectly through eroding family cohesion and exacerbating family conflicts.ConclusionBy looking into family cohesion and family conflicts simultaneously, this investigation has taken a nuanced approach to studying the influence of COVID‐19‐pandemic–related stressors on family functioning.ImplicationsThese findings suggest that efforts to assist families in bolstering cohesiveness may be helpful. Further, diminishing family conflicts, especially during community or global disasters, such as epidemics, pandemics, or natural disasters, should be a focus in both practice and future research.

Differences in subjective age by filial caregiving status among US adults in mid and later life

Subjective age is an important indicator of age identity and is associated with both psychological and physical well-being. Previous studies have revealed that older adults who feel younger than their chronological age show better health status, better life satisfaction, and less risk of mortality. Considerable evidence shows that stress contributes to feeling older than one’s chronological age. Given the fact that taking a caregiving role involves stress, it is expected that caregiving might accelerate subjective aging. This study examined the association between the stressor of caregiving and subjective age in mid and later life. Data were drawn from the Health and Retirement Study in 2014 and 2016. Participants aged 50 years and over (n=1,087) were identified according to adult-child caregiver status at across the two waves: those who provided care consecutively (long-term caregivers), those who became caregivers in 2016 (new caregivers), those who were no longer providing care in 2016 (recent caregivers), or those who did not report providing care in both 2014 and 2016 (non-caregivers). Linear regression analysis showed that new caregivers reported feeling older than their chronological age compared to non-caregivers. However, long-term or recent caregivers did not show significant differences in subjective age compared to non-caregivers. The finding is consistent with the stress process theory and adaptation hypothesis. Although the onset of caregiving stress may accelerate subjective aging, this deleterious effect may decrease over time due to family caregivers’ adaptability. Future research will examine the role of support, resilience and mastery in this pathway.

Differences in subjective age by filial caregiving status among US adults in mid and later life

COVID-19 has adversely impacted the well-being of informal caregivers (CG) due to infection risk, changes to the home environment, and changes to resource availability. CG of persons living with dementia (PLWD) may be especially vulnerable due to the intensity of care provided. We compared CG activities and well-being among CG who did and did not care for PLWD during COVID-19. We conducted an anonymous online survey from April 2020-present. Respondents self-identified as 18+ years and CG to a child or adult with mental health or medical conditions. CG answered questions regarding hours of care provision and caregiving activities, and completed measures of CG burden (Zarit Burden Inventory-4), loneliness (UCLA Loneliness Scale), depressive symptoms (Patient Health Questionnaire), and anxiety (Generalized Anxiety Disorder-2). Of the 258 respondents within the United States, 86 cared for PLWD (33%; 88% female; 56±12 years) while 172 did not (66%; 87% female; 49±14 years). Compared to non-dementia CGs, more CGs of PLWD provided 40+ hours of caregiving/week (36% vs. 49%, p<.05), performed more caregiving activities (8.5 vs. 10.5, p<.01), and assisted with more activities of daily living (55% vs. 73%, p<.01). Compared to non-dementia CG, more dementia CG reported CG burden (53% vs. 67%; p<.05) and loneliness (7.3 vs. 9.1, p<.05). No differences in depressive symptoms or anxiety were found. Results suggest that existing needs of CG of PLWD may be exacerbated by the stressors and concerns of the pandemic, necessitating higher levels of support.

Care-giver wellbeing: exploring gender, relationship-to-care-recipient and care-giving demands in the Canadian Longitudinal Study on Aging

AbstractThe three-way intersection of gender, relationship-to-care-recipient and care-giving demands has not, to our knowledge, been examined in relation to the wellbeing of family care-givers. We explore inequalities in depressive symptoms and life satisfaction, comparing wives, husbands, daughters and sons providing very-intensive care (36+ hours/week) with those providing less care and disparities between these groups in the factors related to disadvantage. Data from the Canadian Longitudinal Study on Aging (N = 5,994) support the existence of differences between the groups. Very-intensive care-giving wives report the most depressive symptoms and lowest life satisfaction; less-intensive care-giving sons report the fewest depressive symptoms, and less-intensive care-giving daughters report the highest life satisfaction. However, group differences in life satisfaction disappear among very-intensive care-givers. Drawing on Intersectionality and Stress Process theories, data from regression analyses reveal a non-significant gender–relationship–demand interaction term, but, health, socio-economic and social support resources play a strong mediating role between care demand and wellbeing. Analyses of the eight groups separately reveal diversity in the care-giving experience. Among less-intensive care-givers, the mediating role of resources remains strong even as differences are evident. Among very-intensive care-givers, the role of resources is less and differences in wellbeing between the groups are magnified. Policy implications emphasise the imperative to personalise services to meet the varied needs of care-givers.

Does Cognitive Status Moderate the Relationship between Environmental Factors and Self-Reported Health?

Using data from NHATS Round 9, the present study examines the relationships between environmental factors and self-reported health among older adults with dementia, mild cognitive impairment (MCI), and normal cognition. Based on neighborhood stress process theory, we investigate the following questions: 1) Are there associations between dwelling safety hazards and neighborhood environments and self-reported health? 2) Is cognitive status a moderator between the relationship? 3) How do these associations differ between older adults with varying cognitive status (i.e., dementia, MCI, and normal cognition)? A hierarchical linear regression analyses are conducted. Results indicate that better quality of sidewalk surface and neighborhood social cohesion are associated with better self-reported health, after taking into account sociodemographic, health, and social factors. Interaction terms are then used to examine the moderating effects of cognitive status on the associations; four interactions terms are found to be statistically significant. Lastly, separate linear regression analyses are implemented for the dementia, MCI, and normal cognition groups. Findings show that the predicting power of environmental factors vary by cognitive status of older adults. For individuals with dementia, tripping hazards, cluttered home, and community disconnectedness are associated with poor self-reported health. However, no significant relationship was found for older adults with MCI. For older adults with normal cognition, better quality of sidewalk surface and neighborhood social cohesion predict better self-rated health scores. Findings of this study illuminate the important role of a hazard-free home, community walkability, and socially cohesive neighborhood environments in predicting better health status of older adults.

Relationships Between Perceived Neighborhood Disorder and Depressive Symptomatology: The Stress Buffering Effects of Social Support Among Older Adults

ABSTRACT Existing research indicates neighborhood is an important determinant of depressive symptoms. However, this research has several limitations. These include a lack of investigation of older adults’ experiences and of social support as a possible moderator. The current study aims to fill these gaps by increasing knowledge about the relationships between perceived neighborhood disorder and depressive symptoms among older adults. Applying stress process theory, this study investigated the relationships between two subjective indicators of neighborhood stressors – physical and social perceived neighborhood disorder and depressive symptoms. This study also tested whether social support moderated the effects of the neighborhood stressors on depressive symptoms. This study was based on secondary data analysis from the Health and Retirement Study 2016 (N = 3,684; age 50+). This study applied a negative binomial regression in that the outcome was a count variable. The results showed the stress buffering effects of social support were not significant for both perceived neighborhood social disorder and physical disorder. Not as a moderator but as the main effect, lower social support was significantly related to higher depressive symptoms. Having a depression history, lower self-rated health, female, and lower education were also related to higher depressive symptoms. This study contributes to social work practice by addressing older adults’ depressive symptomatology. Findings identified vulnerable older adults to target for interventions based on individual characteristics. Focusing on social support should be a vital component of interventions. Social workers can help older adults maintain and strengthen their social support, with beneficial effects on their depressive symptomatology.

The Role of Personal, Social and Religious Resources in Caregiving Stress

This study puts personal, social, and religious resources as a stress buffer for caregivers. The limitation of personal, social, religious resources have a detrimental effect on the mental health of caregivers of a family member with schizophrenia (hereinafter referred to as People with Schizophrenia, or PwS). Following the caregiving stress process theory, this study aims to clarify not only the role of personal and social resources but also the religious ones. For this purpose, in-depth interviews with a life history method were done to twenty (20) caregivers of PwS. The result shows that personal resources like coping mechanism management (for example, by doing a positive comparison with others and reducing the expectations on the PwS) would help to perceive the role of a caregiver more positively. Meanwhile, social resources like social support were received by the caregivers from their significant others (family members) and similar others (support group). Social support was received in the form of emotional support, caregiving help, and instrumental aid. Religious resources in the form of religious coping were also used as a buffer for the stress that came from caregiving. This was done by positive religious coping, such as asking for help from God during difficult times, involving God in everything they do, and surrendering themselves to God to get the strength to face life problems. These three resources (personal, social, religious) were needed by the caregivers so they can preserve their mental health.

The Role of Religious Coping in Caregiving Stress

Studies explaining how stressors and religious coping affect caregivers’ depression have been rarely conducted in the Indonesian context. Therefore, this study discusses stress process theory by examining the role of religious coping as a moderating variable between relational deprivation and loss of self on depression. In a quantitative study of 50 caregivers of persons with schizophrenia in Indonesia, this study analyzed the moderating variables using multiple regression. The results showed that higher relational deprivation will lead to increased depression, but religious coping mechanisms can reduce the effect of relational deprivation on depression (buffering effect). Religious coping can also minimize the effect of loss of self to depression. Subjective stressors and religious coping offer new theoretical insights and must be considered when studying caregiving stress. In this regard, mental health services aiming to enhance caregivers’ welfare need to be provided by the state and community.

Mercurial Hearts: A Dyadic Perspective on the Role of Affect Spin in Work‐Family Conflict and Marital Satisfaction

Affect spin, or the dispositional maladaptive tendency to experience qualitatively shifting affective states over time, has attracted growing interest in organizational scholarship. We take a first step to extend affect spin research to the work‐family interface. Drawing on the theoretical framework of personality in the stress process and family systems theory, we examine affect spin as a novel predictor of marital satisfaction and as a boundary condition for the interpersonal crossover of work‐family conflict (WFC) to marital satisfaction. A sample of 201 dual‐earner couples (402 participants) provided 7,533 experience sampling responses of affective states at home over 7 days, based on which we compute affect spin. Results from dyadic multilevel modeling suggest that individuals’ own affect spin not only takes a toll on their marital satisfaction but also exacerbates the negative crossover of spouses’ WFC to individuals’ marital satisfaction. In contrast, spouses’ affect spin does not predict individuals’ marital satisfaction nor does it impact the crossover effect of spouses’ WFC, suggesting individuals’ own affect spin, compared to spouses’ affect spin, is more consequential for marital well‐being. These findings underscore the challenge that affect spin presents for employees to tackle work‐family stressors and secure marital well‐being.