Fear of COVID-19 and Life Satisfaction: The Role of the Health-Related Hardiness and Sense of Coherence

Introduction: The COVID-19 pandemic is contributing to increased fear and anxiety throughout society, which may affect life satisfaction. Health-related hardiness and sense of coherence (SOC) are personal resources that help people adapt to difficult circumstances. The purpose of this study was to investigate the relationship between fear of COVID-19, SOC, health-related hardiness, and life satisfaction. Methods: A total of 907 Polish people (522 women and 385 men) participated in this study. The Fear of COVID-19 Scale (FOC-6), the Health-Related Hardiness Scale, the Sense of Coherence Scale (SOC-29), and the Satisfaction with Life Scale were used. Results: Correlation showed that fear of COVID-19 was negatively related to health-related hardiness, SOC, and life satisfaction. Health-related hardiness and SOC were positively related to life satisfaction. Both SOC and hardiness were mediators between fear of COVID-19 and life satisfaction during the current pandemic. Conclusion: SOC and health-related hardiness are personal resources that are important for dealing with the effects of the COVID-19 pandemic. According to our study, SOC and hardiness can mediate between fear of COVID-19 and life satisfaction. Presented cross-sectional results have to be verified in future longitudinal studies in order to strengthen the conclusions presented in this manuscript. This study verified the role of only two personal resources, so more research is needed on the role of other personal resources during COVID-19 pandemic.

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

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

Hardiness and Support at Work as Predictors of Work Stress and Job Satisfaction

Purpose.

To test a theoretically and empirically based model linking potential protective resources (hardiness, coworker and supervisor support) to the outcomes of work stress and job satisfaction and replicating the relationship of work stress to job satisfaction while accounting for the potential influence of negative affectivity.

Design.

A cross-sectional research design using survey data collected from two convenience samples.

Setting.

Two worksites: (1) a high-tech company and (2) a government agency.

Subjects.

High-tech employees (N = 310; response rate, 73.8%) and government agency employees (N = 745; response rate, 49.7%).

Measures.

The Dispositional Resilience Scale measured hardiness and the Positive and Negative Affect Schedule measured negative affectivity. Coworker and supervisor support were measured using the Coworker Support Scale and the Supervisor Support Scale, respectively. The Perceived Work Stress Scale measured work stress, and a single item from the Job Satisfaction Scale assessed overall job satisfaction.

Results.

A multiple-group path analysis examined the proposed model. Similar patterns of association were found for both samples and suggested a more parsimonious model without the path from negative affectivity to job satisfaction. The model supports the protective nature of hardiness and support at work with regard to work stress and job satisfaction.

Conclusion.

Explanations of relationships depicted in the model, practical implications for reducing work stress and enhancing job satisfaction, limitations and future directions are discussed.

Hostility and quality of life among Hispanics/Latinos in the HCHS/SOL Sociocultural Ancillary Study

OBJECTIVE

The purpose of this study was to determine if hostility is associated with physical and mental health-related quality of life (QoL) in US. Hispanics/Latinos after accounting for depression and anxiety.

METHODS

Analyses included 5313 adults (62% women, 18-75 years) who completed the ancillary sociocultural assessment of the Hispanic Community Health Study/Study of Latinos. Participants completed the Center for Epidemiological Studies Depression Scale, Spielberger Trait Anxiety Scale, Spielberger Trait Anger Scale, Cook-Medley Hostility cynicism subscale and Short Form Health Survey. In a structural regression model, associations of hostility with mental and physical QoL were examined.

RESULTS

In a model adjusting for age, sex, disease burden, income, education and years in the US., hostility was related to worse mental QoL, and was marginally associated with worse physical QoL. However, when adjusting for the influence of depression and anxiety, greater hostility was associated with better mental QoL, and was not associated with physical QoL.

CONCLUSIONS

Results indicate observed associations between hostility and QoL are confounded by symptoms of anxiety and depression, and suggest hostility is independently associated with better mental QoL in this population. Findings also highlight the importance of differentiating shared and unique associations of specific emotions with health outcomes.

Home Leaving to Military Service

The home-leaving transition of male adolescents in Israel, where most 18-year-olds leave home to perform a 3-year mandatory military service, was examined. Transfer of attachment functions from parents to peers across the transition and adjustment to the basic-training period were investigated. Adolescents ( N = 143) filled out questionnaires 3 months before conscription and 6 months later, following their basic training. Before conscription, participants were in the midst of the process of transfer, and attachment insecurity was associated, as expected, with less transfer. Contrary to expectation, high fear of closeness was associated with increased transfer of proximity seeking from parents to peers across the transition. This contributed to better adjustment, offsetting the negative effect of low hardiness. Anxiety over abandonment was negatively associated with adjustment, with low hardiness mediating part of this effect. Results are discussed in light of developmental changes in relationships with primary caregivers during the home-leaving transition.

Leaving Home Transition in Israel: Changes in Parent-Adolescent Relationships and Adolescents’ Adaptation to Military Service

The transition from adolescence to adulthood includes, for most young adults, physical separation from their parents in order to live away from home (Moore, 1987). This physical separation was found to be associated with positive changes in the parent-adolescent relationship (Sullivan & Sullivan, 1980). The present study extended previous findings by examining the effects of physical separation from one’s parents in the Israeli culture, where the time of home-leaving is based on the youngster’s age (18) and is not chosen by the parents or the adolescent, and where the transition is into mandatory military service. A group of 143 young men participated in the study and filled out questionnaires regarding their relationships with their parents and their adjustment and coping at two points in time: three months before conscription and three months later, following their basic training period in the army. Relationships with mothers and fathers were reported to improve (more warmth, less confrontation, and more autonomy) between the two times of measurement. Baseline level (Time l) relationships with parents contributed significantly to reported coping and adjustment. In addition, changes in relationships with parents, in particular a decrease in confrontation with parents and an increase in autonomy granted by parents, all significantly contributed to an increase in feelings of control and adjustment. Results are discussed in the light of the importance of relationships with primary caregivers (i.e. parents) and developmental changes in these relationships in promoting adjustment in early adulthood during home leaving transition.

Development of salutogenetic factors in mental health - Antonovsky's sense of coherence and Bandura's self-efficacy related to Derogatis' symptom check list (SCL-90-R)

BACKGROUND

The paper analyses how resilience factors and mental health problems interrelate in a 3-year-longitudinal study with 16-19 year olds.

METHODS

Resilience was measured with a 13-item short version of the Life-Orientation-Scale by Antonovsky (sense-of-coherence, SOC) and a 10-item self-efficacy-scale (SWE) by Jerusalem and Schwarzer. Mental health problems were measured with Derogatis Symptom Check list (SCL-90-R). The data set included 155 participants and was analyzed using Structural Equation Modeling (SEM) designed to examine mutual influence in longitudinal data with Mplus software.

RESULTS

The descriptive data analysis indicates (1) negative correlations between SOC and SCL-90-R at both age 16 and 19 in all subscales but somatization and likewise (2) between self-efficacy and SCL-90-R. (3) SOC correlates positively with SWE at age 16 and 19. Results of SEM analysis were based on the assumption of two latent variables at two points in time: resilience as measured with mean SOC and mean self-efficacy scores and health problems measured with sub scale scores of SCL-90-R - both at ages 16 and 19. The first SEM model included all possible paths between the two latent variables across time. We found (4) that resilience influences mental health problems cross-sectionally at age 16 and at age 19 but not across time. (5) Both resilience and mental health problems influenced their own development over time. A respecified SEM model included only significant paths. (6) Resilience at age 16 significantly influences health problems at age 16 as well as resilience at age 19. Health problems at age 16 influence those at age 19 and resilience at age 19 influences health problems at age 19.

CONCLUSION

(a) SOC and self-efficacy instruments measure similar phenomena. (b) Since an influence of resilience on mental health problems and vice versa over time could not be shown there must be additional factors important to development. (c) SOC and self-efficacy are both very stable at 16 and 19 years. This refutes Antonovsky's assumption that SOC achieves stability first around the age of 30. SOC and self-efficacy are protective factors but they seem to form in (early) childhood.

Kohärenzerleben im Arbeitskontext

Das gesundheitspsychologische Konstrukt sense of coherence (Kohärenzerleben; SoC) liefert eine Erklärung dafür, warum Menschen–trotz widriger Umstände–gesund bleiben. In diesem Artikel wird erstmals untersucht, ob eine bereichsspezifische, auf den Arbeitsplatz bezogene Konzeptualisierung (Work-SoC) einen über das globale Kohärenzerleben hinausgehenden Erklärungswert hat und ob sich dieses Konstrukt im Sinne einer Meta-Ressource interpretieren lässt. Für die Studie wurden 93 Pfarrsekretärinnen befragt. Insgesamt weisen die Ergebnisse darauf hin, dass es sich bei dem Kohärenzerleben am Arbeitsplatz um ein für die ABO-Psychologie nützliches Konstrukt handelt: Das Work-SoC klärt zusätzliche Varianz arbeitsbedingter Beanspruchungen auf und erweist sich als stärkerer Prädiktor als das globale SoC. Das Konstrukt lässt sich darüber hinaus im Sinne einer Meta-Ressource interpretieren, die pathogene Einflüsse von Stressoren am Arbeitsplatz reduziert und eine integrative Erklärung dafür liefert, warum personale und externale Widerstandsressourcen am Arbeitsplatz arbeitsbedingte Beanspruchungen reduzieren.

Patterns of psychoactive substance use among Arab secondary school students in Israel

The current study examines patterns and trends in the use of psychoactive substances among Arab secondary school students throughout Israel. Data were collected in late 2004 using self-report questionnaires. The sample consisted of 2,944 students, Grades 7 through 12. Participants were sampled using a cluster method from schools throughout Israel. Results indicate higher use rates among males and among low-religiosity adolescents, as well as a strong link among attitudes, risk perception, behavioral intentions, and substance use. The study's implications and limitations, as well as possibilities for future research, are discussed. This study was funded by the Israel Anti-Drug Authority.

Sense of coherence and biomarkers of health in 43-year-old women

The aim of this cross-sectional study was to investigate how sense of coherence (SOC) relates to biomarkers of health in 43-year-old nonsmoking premenopausal women. Before taking part in a standardized medical health examination including assessment of blood pressure, blood lipids, and physical symptoms, participants completed a three-item measure of SOC. On the basis of their SOC scores, the 244 women with complete datasets were categorized into 1 of 3 groups with a weak, intermediate, or strong SOC. Results showed that women with a strong SOC had significantly lower levels of systolic blood pressure (p < .05) and total cholesterol (p < .05) than did women with a weak SOC. It is suggested that the lower levels of systolic blood pressure and total cholesterol found in women with a strong SOC may constitute a biological buffer against ill health and disease.

What helps middle-aged widows with their psychological and social adaptation several years after their loss?

This study examines the factors contributing to middle-aged widows' adaptation to their husbands' death due to physical illness, 1 to 5 years after the initial loss. Ninety-three widows and 93 married women, who served as controls, filled out questionnaires assessing their experience of stress and strain, their Sense of Coherence level, the social support they received, as well as measures of psychological and social adaptation. Results show that several years after their husbands' death, many widows still perceive life events and hassles as significantly more intense experiences than do their married counterparts. Moreover, they report a significantly lower Sense of Coherence, diminished social support and a lower level of mental health, as compared with married women. Multiple regression revealed that Sense of Coherence was the most significant contributor to adaptation variables, especially to mental health. Social support contributed significantly to the 2 social adaptation subscales. The discussion emphasizes the importance of Sense of Coherence to adaptation

Predicting blood pressure reactivity and heart rate variability from mood state following coronary artery bypass surgery

STUDY OBJECTIVES

Coronary Artery Bypass Graft (CABG) surgery is a common and successful procedure for revascularisation. However, the experience can induce emotional reactions prior to and following surgery. This study aimed to document changes in blood pressure (BP) reactivity and heart rate variability (HRV) following CABG surgery, and to determine the impact of mood state, particularly anxiety and depression upon cardiovascular functioning.

METHOD

Twenty-two patients preparing to receive elective, first time CABG surgery were recruited from The Cardiothoracic Centre, Liverpool, UK and psychologically assessed using the Hospital Anxiety and Depression Scale (HAD), Global Mood Scale (GMS) and the Dispositional Resilience Scale (DRI). BP and heart rate responses were also measured during four conditions: baseline response; laboratory session; ambulatory monitoring; and self-initialised recordings during the ambulatory period. In addition, HRV was measured for 12 h in conjunction with the ambulatory monitoring period. All measures were assessed 1 week prior to surgery and 2 months following surgery.

RESULTS

A significant decrease in negative mood and an increase in positive mood were reported following surgery. Forty percent of patients were clinically anxious and depressed prior to surgery although this was reduced to 27% after surgery. Depression was the strongest independent predictor of pre-operative BP and HRV whilst anxiety was most significantly related to follow-up BP reactivity. DBP was most strongly predicted by mood state.

CONCLUSIONS

These results suggest that patients with higher levels of anxiety and depression are at risk of reduced HRV and increased BP reactivity in response to mental stressors. The study also strongly suggests that current patient services should be expanded to acknowledge the role of psychological factors within clinical prognosis after CABG surgery.

Alexithymia and sense of coherence in patients with total spinal cord transection

OBJECTIVE

The study investigated the possibility that total spinal cord transection leading to tetraplegia would affect the ability to experience and identify emotions. It also examined whether the dispositional orientation of "sense of coherence" contributed to self-rated quality of life after spinal cord transection.

METHODS

Twenty patients with total spinal cord transection at the level of the sixth cervical vertebrae and 20 age- and sex-matched healthy control subjects completed measures of alexithymia, sense of coherence, and quality of life.

RESULTS

There were no differences between the two groups on alexithymia scores. However, spinal injury patients reported significantly decreased quality of life relative to matched healthy control subjects. A strong sense of coherence was associated with better self-reported quality of life. This relationship remained after controlling for current affective status.

CONCLUSIONS

We conclude that 1) loss of afferent feedback to the brain via the spinal cord does not have a significant effect on alexithymia scores, particularly factor 1 (difficulty in identifying feelings), and 2) sense of coherence may be an important factor in determining psychological adjustment after serious injury.

Long-term mental health of men after a first acute myocardial infarction

OBJECTIVE

To evaluate the differential and independent impact of sociodemographic, medical, and psychologic variables assessed at hospital discharge on patients' short- and long-term mental health.

DESIGN

Longitudinal study.

SETTING

Eight medical centers in central Israel.

PARTICIPANTS

Male Israeli patients (N = 209; age range: 30-65 y) with documented first acute myocardial infarction (AMI).

INTERVENTION

Subjects were interviewed 3 times, once (T1) before hospital discharge, a second time (T2) at 3 to 6 months after discharge, and a third time (T3) at 5 years post-AMI. Sociodemographic, medical, and psychologic data were elicited at the first interview and completed with medical information in the files. Psychologic well-being and psychologic distress were evaluated by the Mental Health Inventory at the second and third interviews. These 2 outcome variables were compared with normative community data on these aspects of mental health.

MAIN OUTCOME MEASURES

Hierarchical regression was used to examine the relation between the independent variables, sociodemographic, medical, and psychologic variables, and the dependent variables, psychologic well-being and psychologic distress, at T2 and T3.

RESULTS

Depression, perceived health, sense of coherence, social support, and educational level at discharge predicted aspects of mental health 3 to 6 months and 5 years post-AMI. However, only psychologic distress differentiated between the research participants and the normative community sample of men.

CONCLUSIONS

A first episode of AMI appears to increase psychologic distress more than it decreases psychologic well-being both 3 to 6 months and 5 years post-AMI. Educational level and sense of coherence may serve as protective factors, whereas depression may foster vulnerability to distress and impaired psychologic well-being.

Hardiness: an examination of its relationship with positive and negative long term changes following trauma

Two models positing direct versus moderating effects of hardiness were examined in relation to long term positive and negative changes following exposure to traumatic stress. Participating in the study were 164 Israeli POWs and a matched group of 184 veterans of the 1973 Yom Kippur War. Participants completed a battery of questionnaires that included the Personal Views Survey (hardiness); the Trait, Attitude, and Behavior Change questionnaire; and questions related to their captivity/war experiences. Findings were consistent with a model that posits moderating effects of hardiness on both long term negative and positive changes. The discussion addresses the possible role of hardiness in relation to negative and positive outcomes of traumatic events.

Burnout in Psychiatric Nurses: Contributions of the Work Environment and a Sense of Coherence

Burnout not only affects psychiatric nurses' ability to provide optimal patient care, but its consequences extend to the nurse's psychological and physical health. Couched in a cognitive-transactional model, the broad aim of the current study was to measure burnout levels for psychiatric nurses and to determine the respective roles of the environment and the individual on burnout levels. Burnout levels were measured using Maslach and Jackson's (1986) Burnout Inventory. Environmental variables measured included work load, collegial support, role conflict and role ambiguity. Finally, Antonovsky's (1987) sense of coherence (SOC) measured the characteristics of the individual. Although burnout levels were generally high, a low sense of personal accomplishment was particularly problematic. Emotional exhaustion and depersonalisation correlated significantly with all factors of the work environment and with the SOC. Personal accomplishment related only to role conflict. Multiple regression analyses showed the sense of coherence and work load to explain a large proportion of both emotional exhaustion and depersonalisation, and role conflict to explain a small but significant amount of the variance in personal accomplishment. Moderated multiple regression analyses added to a growing body of research pointing towards a possible direct effect of the SOC on burnout.

Sense of coherence and health: evidence from two cross-lagged longitudinal samples

We explored the stability of sense of coherence (SOC) and the relationship between SOC and health in two cross-lagged longitudinal samples by using structural equation modeling. In Study 1, comprising 577 municipal male and female employees, SOC was found to be stable in both sexes. In women, SOC significantly predicted sickness absences in the 4-year follow-up period. A low SOC, but not a high SOC, was associated with health prospects. Surprisingly, SOC did not influence sickness absences among men. Study 2 further tested the relationship between SOC and health in 320 male technical designers. Although SOC was cross-sectionally associated with psychological and somatic health complaints, it did not predict later health complaints in a 5-year follow-up. Thus, the present study supports the dispositional character of SOC in both sexes and its predictive validity among women. No support was found to the salutogenic status of SOC and an unexpected gender difference was revealed.

Conceptualization and measurement of the spiritual and psychological dimensions of wellness in a college population

Wellness is commonly conceptualized as having many dimensions, but little effort has been made to evaluate how spiritual and psychological dimensions are related to overall wellness. To explore the relationship between measures of spiritual and psychological wellness and perceived wellness in a college student population, the authors administered a series of survey instruments to 112 undergraduate students under quiet classroom conditions. They used the Life Attitude Profile to measure spiritual wellness, the Life Orientation Test and the Sense of Coherence Scale to measure psychological wellness, and the Perceived Wellness Survey to measure overall wellness. Path analysis performed with a proposed theoretical model revealed that the effect of life purpose on perceived wellness was mediated by optimism and sense of coherence, which had independent effects on perceived wellness beyond that of life purpose. The findings suggested that an optimistic outlook and sense of coherence must be present for life purpose to enhance a sense of overall well-being.

Psychosocial adjustment in patients after a first acute myocardial infarction: the contribution of salutogenic and pathogenic variables. Israel Study Group on First Acute Myocardial Infarction

OBJECTIVE

To ascertain the differential and independent impact of sociodemographic, medical, and psychologic variables assessed at patients' hospital discharge on these patients' psychosocial adjustment in several domains of life 3 to 6 months later.

DESIGN

Two-hundred ninety Israeli male patients, aged 30 to 65 years, with a documented first acute myocardial infarction (AMI) were interviewed once before discharge and again 3 to 6 months postinfarct. Sociodemographic, medical, and psychologic data were elicited at the first interview and completed from medical information in the hospital files. Psychosocial adjustment in seven significant life domains was evaluated by the Psychosocial Adjustment to Illness Scale-Self-Report Version (PAIS-SR) at the second interview. Hierarchical regression analysis was used to examine the relation between the sociodemographic, medical, and psychologic variables at discharge to psychosocial adjustment in the different life domains 3 to 6 months later.

RESULTS

Psychologic variables, such as depression, sense of coherence, and social support, and the sociodemographic variable of educational level at discharge predicted a relatively substantial amount of variance in psychosocial adjustment in most PAIS-SR-measured life domains. Low to moderate relations were found between such medical variables as Killip class, heart disease before AMI, other medical conditions, and perceived health before first AMI and psychosocial adjustment in specific life domains. The results also raised the possibility that part of the impact of the medical variables at discharge on psychosocial adjustment 3 to 6 months later may have been mediated by the psychologic variables. The centrality of the psychologic and domestic life domains to psychosocial adjustment in post-AMI patients was also suggested by the results.

CONCLUSIONS

Both external and internal pathogenic (depression) and health proneness variables (sense of coherence and social support) at discharge predict psychosocial adjustment in most life domains 3 to 6 months after AMI.

The sense of coherence, occupation and the risk of coronary heart disease in the Helsinki Heart Study

The risk of coronary heart disease (CHD) was studied in 4405 Finnish middle-aged working men in different occupations according to their sense of coherence (SOC). The study design was prospective and the follow-up time was eight years. Clinical findings such as total cholesterol, systolic blood pressure and body-mass index showed differences when comparing blue and white collar workers. Lifestyle factors such as smoking also differed, but leisure time physical activity depended on SOC. In the white collar work environment the low SOC tertile had a high CHD incidence of 20.1 per 1000 person-years; the incidences in the medium and high SOC tertiles were 10.9 and 12.3, respectively. A similar effect was not observed in the blue collar work environment. There, contrary to theoretical expectations, the low SOC tertile had the lowest incidence of CHD. The difference in the CHD incidence pattern depended on the blue and white collar dichotomy and not on the branch (state agencies vs. industry). The SOC had a salutogenic effect among white collar workers, but failed to have any consequent effect on the health of blue collar workers. Further study is needed to look at the psychosocial factors among blue collar workers.

Emotional distress before coronary bypass grafting limits the benefits of surgery

BACKGROUND

The inclusion of large, heterogeneous groups of patients for coronary bypass grafting (CABG) surgery has resulted in a more mixed treatment outcome. Thus it becomes important to identify patients who are less likely to benefit from surgery or who may require additional support to improve treatment outcome. The aim of the present study was to examine whether psychological status measured before CABG can contribute to prediction of short- and long-term outcomes of the surgery.

METHODS AND RESULTS

One hundred seventy-one consecutive patients from two large university hospitals in Stockholm completed a psychosocial questionnaire before being scheduled for surgery. One year after CABG, patients again completed the questionnaire. Follow-up of medical charts was conducted during the first 3 years after surgery. All major cardiac events (cardiac death, definite myocardial infarction, revascularization, and unstable angina verified by angiography or myocardial scintigraphy) were recorded. Although the overall effect of surgery was excellent in the majority of cases, the patients exhibiting a high degree of distress (anxiety, depression, and tiredness) before surgery assessed their status as being much worse both before the operation and at the 1-year follow-up. Equally important was the fact that patients considered distressed before surgery had significantly higher rates of cardiac events (16%) in the 3-year follow-up period compared with nondistressed patients (5%) (chi-square=5.11, degrees of freedom=1, p < 0.02).

CONCLUSIONS

Systematic evaluation and treatment of emotional distress in the candidates for coronary revascularization may be expected to result in more optimal subjective results and a reduction in the number of serious cardiac events after surgery.

ANTONOVSKY'S SENSE OF COHERENCE SCALE AND 16PF SECOND-ORDER FACTORS

The SOC scale (A. Antonovsky, 1987) purports to measure a disposition which engenders and enhances health but some empirical findings suggest that it is seriously contaminated with negative affectivity. In a criterion validation on 100 undergraduates at a predominantly Black university, SOC was correlated with S.E. Krug and E.F. Johns' (1986) 16PF second-order factor scores, as a broad spectrum of personality variables. The SOC-Anxiety correlation was -.52, in line with studies intimating negative affectivity; it could, however, also be interpreted in terms of its inverse, emotional stability. SOC correlated significantly with the other 4 second-order factors too. It thus measured a complex mixture of personality domains, rather than a single predominant trait.

Sense of coherence, negative affectivity, and general health in farm supervisors

Interview schedules were administered, 9 mo. apart, to 79 male first-line supervisors. The first included the 13-item Sense of Coherence scale (Antonovsky) and the PANAS, from which the Negative Affectivity scale was used; the second included two graphic rating scales for general health. Scores on Sense of Coherence and Negative Affectivity correlated -.30, indicating that the relationship is not always strong enough to assume that the former scale measures the inverse of the latter. Scores on Sense of Coherence and health ratings correlated .26, reducing to .25 with Negative Affectivity partialled out. This supports the validity of the Sense of Coherence scale as a measure of Antonovsky's "salutogenesis" construct.

Childhood conditions, sense of coherence, social class and adult ill health: exploring their theoretical and empirical relations

In order to expand our knowledge of how health inequalities are generated, a broader range of possible mechanisms has to be studied. Two mechanisms of potential importance here are childhood conditions and sense of coherence. Drawing on theoretical arguments and empirical findings in these two research fields, a conceptual model of the relationships between childhood conditions, sense of coherence, adult social class and adult health is presented. On the basis of this model, this paper sets out to analyse (1) the degree to which a low sense of coherence is based in childhood experiences, (2) the degree to which the impact of childhood conditions on adult health is mediated through sense of coherence, and (3) the importance of sense of coherence for class differences in ill health. The analyses are carried out on both cross-sectional data (n = 4390) and panel data (n = 3773) from the Swedish Level of Living Surveys in 1981 and 1991. The analyses indicate that childhood family size and the experience of a broken home are unrelated to sense of coherence later in life, while economic hardship has a small and indirect effect, mediated via class position in adulthood. Only dissension in the childhood family was found to have a direct, although fairly modest, effect on sense of coherence. Furthermore, it is demonstrated that sense of coherence does not mediate the effect of childhood factors on adult health. Rather, childhood conditions and adult sense of coherence appear to be complementary and additive risk factors for illness in adulthood. The results presented here also suggest that sense of coherence may be a factor involved in the shaping of class inequalities in health.