Stress and Coping

Both clinical experience and the results of research demonstrate that older adults vary considerably in the impact that stress has upon well-being. Stress-process models have identified a number of factors that may decrease the negative impacts of stressors, including appraisals, internal and external resources, and coping responses. These may be thought of as factors that can protect a person from the negative consequences of stress. From the perspective of a stress-process model, the experience of stress may be seen as a ‘‘balancing act’’ between stressors and resources. High levels of stressors, with few resources, will place individuals at high risk, while individuals with substantial psychological or social resources may be less vulnerable.

Depending on the mechanism through which variables affect the relationship between stressors and well-being, these responses and resources may have direct effects, or they may serve as either mediators or moderators of the relationship between stressors and well-being. In a direct effect, people with a high level of a resource (such as income) may be found to have higher well-being regardless of whether highly stressful circumstances occur. A moderator variable, on the other hand, may confer either risk or protection only on individuals facing a high level of stress. For example, research on the stress-buffering hypothesis suggests that under circumstances of high stress, individuals with strong social support may be at lower risk for depression than individuals with weaker social support, but that social support may matter little under conditions of low stress. In other words, the moderator model tests the significance of interactions among independent variables in predicting outcome. A mediator functions as an intermediate factor between stress and well-being; for example, research may find that a life event only affects depression if is subsequently appraised as a threat to well-being. Identification of these mechanisms of vulnerability and resistance to stress may be very useful in targeting interventions that may be helpful when a life event occurs.

Early writers who addressed coping in older persons tended to view older adults as unable to cope with stress, and they suggested that coping in late life was characterized by rigidity in coping mechanisms, and even regression. Contrary to these early speculations, older adults are often found to cope with stress as well as, if not more successfully than, younger individuals, due in part to the benefits of life experience. Older persons often face stressors that are expected, and they have either coped successfully with such stresses themselves or seen their peers cope with common late-life stressors.

Appraisals of stress. Appraisal is a subjective judgment about the nature of a stressor. It reflects individual variations in how people perceive and interpret their events or circumstances. One widely studied type of appraisal is primary appraisal, which is the perception of the degree of threat, harm, or challenge represented by potentially stressful life events. Research on family caregivers of patients with Alzheimer’s disease has shown that, even after controlling for the objective stressors of caregiving, subjective primary appraisals are important factors predicting care-giver depression.

In addition to primary appraisals, appraisals of self-efficacy, or one’s ability manage a stressor, can be important factors in successful coping. Other appraisals that have been studied include perceptions of the predictability or controllability of a stressor. A relatively recent innovation in stress-process research is the study of positive appraisals. Contrary to earlier research that focused only on the negative impacts of stress, it has been increasingly found that individuals undergoing stress may report benefits and positive experiences. For example, people may find meaning in adversity, or stress may provide a way to strengthen relationships or develop spiritual growth. The ability to appraise stress as being a challenge or growth experience, and to identify positive aspects of stress, may be a major asset in coping.

The consideration of appraisal as a variable has led researchers to go beyond the assumption that stressors can be quantified regarding their relative stressfulness, and to study individual differences in appraisal of stress. For example, the death of a spouse after a long and painful illness may be experienced quite differently than a sudden, unexpected death. A financial stress may be appraised as less threatening by an individual with substantial financial resources. Thus, assessment of the occurrence of life events may be less informative than the personal appraisal of such events in evaluating the potential impact on depression or life satisfaction. Despite important theoretical distinctions between occurrence and appraisals of life events, subjective appraisals of the impact of life events in older adults have received much less attention than studies viewing stressors as objective experiences.

In terms of age differences in the appraisal process, older adults are more likely to perceive their situations as unchangeable, but they are also more likely to face situations that are objectively difficult to change. As discussed below, an appraisal of the changeability of a stressor is an important predictor of the type of coping response utilized.

Internal resources. Individuals’ psychological resources constitute an important domain of individual differences in the stress process. Psychological resources include the personality characteristics that people draw upon to respond to stress. Research has demonstrated that psychological resources have great effects on how individuals perceive stressors and how stressors manifest themselves. Some positive personality traits such as optimism, self-esteem, internal locus of control, and mastery—and more negative traits such as neuroticism—have been shown to affect appraisal and choice of coping responses. For example, neurotic individuals are likely to focus on negative aspects of stressors, while optimists are more likely to view stress as a challenge and to cope positively.

As of 2002, there has been increasing interest in the role of spiritual beliefs and religious participation as factors promoting successful coping, although few studies of this topic have been completed. Results suggest that religious or spiritual beliefs and religious participation may improve coping with a variety of stressors. Possible mechanisms for such effects include aiding people in finding meaning in the face of adversity, and allowing access to a social support network including clergy and others in the faith.

External resources. Besides internal sources of coping, such external factors as economic resources or social resources may be valuable aids in dealing with stress. Higher socioeconomic status and income are often found to be protective factors in studies of stress, because financial resources can be used to provide concrete assistance such as transportation, medical care, and optimal housing arrangements. Other important external resources include social networks and social supports. Social networks are comprised of individuals with whom an older person can interact, and they represent potential sources of assistance. Social support refers to the actual receipt of some emotional, tangible, or informational help from others, and the subjective perceptions of support. Numerous studies have confirmed that social resources play important roles in improving life satisfaction and well-being Studies indicate that individuals with strong social networks and social support are often in better physical and mental health.