Sense of coherence buffers relationships of chronic stress with fasting glucose levels

A systematic review of the psychobiological burden of informal caregiving for patients with dementia: Focus on cognitive and biological markers of chronic stress

As the physiological impact of chronic stress is difficult to study in humans, naturalistic stressors are invaluable sources of information in this area. This review systematically evaluates the research literature examining biomarkers of chronic stress, including neurocognition, in informal dementia caregivers. We identified 151 papers for inclusion in the final review, including papers examining differences between caregivers and controls as well as interventions aimed at counteracting the biological burden of chronic caregiving stress. Results indicate that cortisol was increased in caregivers in a majority of studies examining this biomarker. There was mixed evidence for differences in epinephrine, norepinephrine and other cardiovascular markers. There was a high level of heterogeneity in immune system measures. Caregivers performed more poorly on attention and executive functioning tests. There was mixed evidence for memory performance. Interventions to reduce stress improved cognition but had mixed effects on cortisol. Risk of bias was generally low to moderate. Given the rising need for family caregivers worldwide, the implications of these findings can no longer be neglected.

The Salient Stressor Impact Questionnaire (SSIQ)

High stress is known to affect health, but stress impact, determined by events and responses to them, has not been studied systematically. For the Salient Stressor Impact Questionnaire (SSIQ), the impact of events was assumed to depend on their salience and chronicity and the impact of responses on their chronicity and intensity with greater unfavorable appraisal associated with greater response. The SSIQ assessed a person’s two most salient stressors. Chronicity items discriminated between clinically stressed and nonclinical participants and measured the chronicity of stressful feelings (distress) and the event. The remaining items measured the degree of distress and unfavorable appraisal. The SSIQ showed good test-retest and internal consistency reliability, concurrent validity, and stability across diverse populations. Exploratory analyses grouped items into distress, chronicity, and appraisal elements, and confirmatory analysis revealed a good fit to the hypothesized model. Preliminary data suggest that the SSIQ will be useful for studying relationships between stress and health.

A salutogenic view on subjective well-being in active elderly persons

In this paper, subjective well-being as an indicator for successful aging is investigated from a salutogenic perspective that states that the sense of coherence plays a key role for psychological adaptation. It should be demonstrated that the sense of coherence mediates the relationship between generalized resistance resources and subjective well-being. One-hundred-and-seventy psychophysically active elderly persons (37 men) filled out a questionnaire assessing the sense of coherence, subjective well-being and resistance resources (such as age, education, physical health, activity level, social support and personality variables). It was found that resources co-varied with the sense of coherence and subjective well-being, accounting for 52 and 48% of the variance, respectively. The most important predictors were self-efficacy, self-esteem and education. After controlling for resources, the sense of coherence accounted for an additional 6% of the variance in well-being. The sense of coherence clearly mediated the relationship between resources and well-being. The findings corroborate the salutogenic idea that the sense of coherence creates, or maintains, a form of psychological integrity as represented by subjective well-being. The promotion of a strong sense of coherence should be a major aim of gerontological interventions.

Hostility and urine norepinephrine interact to predict insulin resistance: the VA Normative Aging Study

OBJECTIVE

Previous research has produced mixed results pertaining to the association between hostility and insulin resistance. These inconsistent findings may be the result of a lack of studies examining potential moderators of this relationship and inconsistent measures of insulin resistance and/or hostility. We hypothesized that hostility may interact with circulating norepinephrine (NEPI) levels, indexed by 24-hour urine concentrations, to affect insulin resistance.

METHODS

Six hundred forty-three men (mean age = 63.1 years) free of diabetic medications completed the Minnesota Multiphasic Personality Inventory and participated in a laboratory assessment. The Cook-Medley Hostility (Ho) and 24-hour urine NEPI were used to predict insulin resistance defined by the homeostatic model assessment (HOMA) index, 2-hour postchallenge glucose (PCGL), and insulin levels (PCIL) after controlling for nine common covariates.

RESULTS

Multiple regression showed that the two-way interaction between Ho and NEPI significantly predicted HOMA and PCIL, but not PCGL, after controlling for covariates. Simple regression slopes of Ho on HOMA and PCIL were explored and indicated that, at higher levels of NEPI, higher Ho was associated with higher HOMA (beta = 0.14, p < .05). Ho was not a significant predictor of HOMA at mean and lower levels of NEPI. Similar results were obtained for PCIL, but not PCGL. Cynicism, but not other subscales of Ho, was similarly related to insulin resistance and NEPI.

CONCLUSION

Individuals with high stress and high hostility were more likely to have insulin resistance. It is important to study moderators in the relationship between hostility and insulin resistance.

Mastery, sense of coherence, and mortality: evidence of independent associations from the EPIC-Norfolk Prospective Cohort Study

This study investigated the association between 2 distinct personal coping resources (mastery and sense of coherence) and all-cause, cardiovascular, and cancer mortality. During follow-up (up to 6 years), 994 deaths were recorded among 20,323 participants, ages 41 to 80 years, in the European Prospective Investigation into Cancer Study in the United Kingdom. A strong sense of mastery was associated with lower rates of mortality from all causes, cardiovascular disease, and cancer, after adjusting for age, sex, and prevalent chronic physical disease. The association with all-cause mortality was observed for both men and women and remained following further adjustment for cigarette smoking, social class, hostility, neuroticism, and extroversion. Analysis of the joint association between mastery and sense of coherence revealed both personal coping dispositions to be independently associated with lower rates of all-cause mortality. In addition, these data suggested that the association for mastery was specific to cardiovascular mortality, whereas the association for sense of coherence was specific to cancer mortality. These results may aid future study of coping resources as determinants of persistent well-being.

Validity of Antonovsky's sense of coherence scale: a systematic review

STUDY OBJECTIVE

The aim of this paper is to systematically review and analyse the validity and reliability of Antonovsky's life orientation questionnaire/sense of coherence scale (SOC).

DESIGN

The study is descriptive and analytical with a systematic integration of the contemporary knowledge base on the salutogenic research published 1992-2003. The review includes 458 scientific publications and 13 doctoral theses.

SETTING

Worldwide, based on postgraduate scientific publications in eight authorized databases, doctoral theses, and available books.

MAIN RESULTS

The SOC questionnaire has been used in at least 33 languages in 32 countries with at least 15 different versions of the questionnaire. In 124 studies using SOC-29 the Cronbach's alpha ranges from 0.70 to 0.95. The alpha values in 127 studies using SOC-13 range from 0.70 to 0.92, and in 60 studies using a modified SOC scale range from 0.35 to 0.91. Test-retest correlation show stability and range from 0.69 to 0.78 (1 year), 0.64 (3 years), 0.42 to 0.45 (4 years), 0.59 to 0.67 (5 years) to 0.54 (10 years). The means of SOC-29 range 100.50 (SD 28.50) to 164.50 (SD 17.10) points and SOC-13 from 35.39 (SD 0.10) to 77.60 (SD 13.80) points. After 10 years SOC seems to be comparatively stable, but not as stable as Antonovsky initially assumed. SOC tends to increase with age. The factorial structure of SOC seems rather to be multidimensional than unidimensional. SOC predicts a positive outcome in a long term perspective, although there are divergent findings reported. The SOC scale seems to be a reliable, valid, and cross culturally applicable instrument measuring how people manage stressful situations and stay well.

Stress, stress response, and health

Components of stress and the stress response differ between men and women. The tend-and-befriend response, mediated by oxytocin and endogenous opioids, may be more applicable to women than the fight-or-flight response, which was based largely on studies of men. Even within the flight-or-flight response pattern there are sex-based differences. The HPA axis interacts with reproductive function, such as menstruation. For immune function there are sex differences as well as differences within the menstrual phase. Inclusion of men and women in stress response studies is critical. Further study is needed to clarify the influence of ovarian hormones on the stress and immune responses during the reproductive stages in women's lives, including menarche. pregnancy, and perimenopause.