Path analytic investigation of stress-symptom relationships: Physical and psychological symptom models

Theoretical models of the psychosocial stress process emphasize the importance of contextual and mediating process variables in the study of stress-symptom relationships. This study examined a model of stress-symptom relationships that included negative life-change events, ongoing, chronic role strains, acute daily stressors, cognitive appraisals of stress, different methods of coping, and physical and psychological symptoms. Seventy-five adult male inmates of a county correctional facility were studied using a prospective research design to explore the relationships among variables constituting a stress process and between stress variables and symptoms of physical and psychological dysfunction. This investigation also addressed methodological issues of assessment, measurement, and design that have hampered interpretation and limited the explanatory power of the results from previous research on stress-symptom relationships.The findings revealed that chronic interpersonal and occupational role strains, acute daily stressors, stress appraisals, and avoidance coping each had a significant direct effect on physical symptoms. Total (direct and indirect) effects revealed that negative life events, occupational and economic strain, daily stressors, stress appraisals, and avoidance coping were overall the most important determinants of physical symptoms. For psychological symptoms, occupational role strain, daily stressors, stress appraisals, and cognitive coping had significant direct effects. Total effect results showed that negative life events, occupational and economic role strains, acute daily stressors, stress appraisals, and cognitive coping were the most important determinants of psychological symptoms. Negative life events, interpersonal and economic role strain, and acute daily stressors each had a substantial indirect effect on physical and psychological symptoms that was mediated by other variables in the model. Direct effects of negative life events on stress appraisals, chronic role strains on daily stressors, chronic role strains on stress appraisals, and stress appraisals on methods of coping were not statistically significant. The findings are discussed in relation to current substantive and methodological issues and stress-outcome specificity in the study of stress-symptom relationships.U of I OnlyETDs are only available to UIUC Users without author permissio