The Relationship of Hardiness, Coping Strategies, and Perceived Stress to Symptoms of Illness

Transcription

1 Journal of Behavioral Medicine, Vol. 23, No. 3, 2000 The Relationship of Hardiness, Coping Strategies, and Perceived Stress to Symptoms of Illness Mike Soderstrom, 1 Christyn Dolbier, 1 Jenn Leiferman, 1 and Mary Steinhardt 1,2 Accepted for publication: January 12, 2000 We proposed a conceptual model based on research supporting the relationship between symptoms of illness and the determinants of hardiness, coping strategies, and perceived stress. In this model, hardiness, avoidance coping, and approach coping have paths to perceived stress, perceived stress has a path to symptoms of illness, and hardiness also has a path to symptoms of illness. We examined the goodness of fit of this model using path analysis and tested its stability, as well as the presence of gender effects, in corporate (N = 110) and university (N = 271) samples. The proposed model was a good fit for the data in the corporate sample, and no gender effects were found. The proposad model was not a good fit for the data in the university sample, therefore we added two paths that have received some support in the research: from approach coping to symptoms of illness and from avoidance coping to symptoms of illness. This model was a good fit for the data in the university sample, however, the path from approach coping to symptoms of illness had a critical ratio <2.0, thus we removed this path and ran the model again. The final model was a good fit for the data, and no gender effects were found. Implications for the relationship of hardiness, coping strategies, and perceived stress to health are discussed. KEY WORDS: hardiness; coping strategies; stress; illness. 1 The University of Texas at Austin. 2 To whom correspondence should be addressed at Department of Kinesiology and Health Education, Bellmont Hall 222, The University of Texas, Austin, Texas MarySteinhardt@mail.utexas.edu /00/ $18.00/0 C 2000 Plenum Publishing Corporation

2 312 Soderstrom, Dolbier, Leiferman, and Steinhardt INTRODUCTION It is well documented that psychological stress is associated with a variety of physical and mental health illnesses (Dohrenwend and Dohrenwend, 1974, 1981; Sapolsky, 1994). However, the magnitude of these correlations is moderate (Rabkin and Struening, 1976), suggesting that stress accounts for only a portion of the variance in illness. Such data have led researchers to conclude that stress does not inevitably lead to illness (Wiebe and McCallum, 1986). As a result, research has focused on identifying those factors that have direct, indirect or modifying effects on illness. Although there has been an abundance of research over the past two decades focused on hardiness, coping strategies, perceived stress, and illness, the nature of the relationships among these variables remains inconclusive. Much research indicates that a hardy personality (Kobasa et al., 1982a) and approach-oriented coping behaviors (Williams et al., 1992) moderate or buffer the effect of stress on health. However, other research indicates that a hardy personality is not a moderating variable in the relationship between stress and illness, but rather hardiness has a direct effect on illness independent of its effect on stress (Orr and Westman, 1990). Simultaneously, it has been proposed that coping strategies mediate the relationship between hardiness and health (Gentry and Kobasa, 1984; Williams et al., 1992). Research has yet to examine concurrently the direct, indirect, and modifying effects of hardiness, coping strategies, and perceived stress on symptoms of illness. Hardiness The hardiness concept was originally developed by Kobasa (1979). The concept emerged from an existential theory of personality (Kobasa and Maddi, 1977) and is defined as a personality characteristic describing an individual with three closely related tendencies: challenge, commitment, and control. The term challenge reflects an outlook on life that enables an individual to perceive change as an opportunity for growth rather than a threat to one s sense of security or survival. Change rather than stability is seen as the normative mode of life. Individuals strong in commitment believe in the truth and value of who they are and what they are doing. They have a sense of meaning and purpose in work and relationships and are deeply involved rather than alienated out of fear, uncertainty, or boredom. The term control reflects a belief that one can influence the course of life events within reasonable limits. Hardy individuals have an internal sense of personal mastery, confronting problems with confidence in their ability to implement effective solutions, rather than feeling powerless, lacking self-confidence and initiative, and manipulating others.

3 Hardiness, Coping, Stress, and Illness 313 It was originally hypothesized that a hardy personality improves health by buffering or moderating the effects of stress. Some studies support this original hypothesis (Kobasa et al., 1982a; Rhodewalt and Zone, 1989); however, other research has found hardiness to have a direct effect on health independent of stress (Banks and Gannon, 1988; Kobasa, 1979; Kobasa et al., 1981, 1982a, 1983, 1985; Kobasa and Puccetti, 1983; Nowack and Hanson, 1983; Pollock, 1986; Wiebe and McCallum, 1986). Comprehensive analyses of this research base have found that the buffering effect of hardiness on stress is weaker than its direct effects on health (see reviews by Funk, 1992; Gentry and Kobasa, 1984; Hull et al., 1987; and Orr and Westman, 1990). Still other studies revealed that hardiness has an indirect effect on health through improved health practices (Wiebe and McCallum, 1986) and approach-oriented coping strategies (Williams et al., 1992). High-hardy individuals engage in behaviors positively associated with health and greater approach or problem-focused coping strategies, whereas low-hardy individuals engage in behaviors negatively associated with health and greater avoidance or emotion-focused coping strategies. These studies suggest that health practices and coping strategies mediate the stress illness relationship differently for high-hardy and low-hardy individuals. Kobasa s initial finding that hardiness was predictive of health outcomes was based solely on male samples, raising the issue of generalizability of these findings to women. Studies examining gender differences are inconsistent. Some studies have found that the relationship between hardiness and health outcomes seen in male samples is generalizable to female samples (Ganellen and Blaney, 1984; Gentry and Kobasa, 1984; Rhodewalt and Agustsdottir, 1984; Rhodewalt and Zone, 1989). However, other studies have shown that the predictive nature of hardiness found in males is not generalizable to females (Schmied and Lawler, 1986; Shepperd and Kashani, 1991; Wiebe, 1991). It has been suggested that these gender differences in hardiness are due to differences in coping strategies (Wiebe, 1991; Williams et al., 1992). For instance, several studies have found that males and females employ different coping strategies in the face of stress (Billings and Moos, 1981; Kvam and Lyons, 1991; Pearlin and Schooler, 1978), suggesting that the mechanism by which coping influences the hardiness illness relationship is different for males and females. Coping Strategies Coping refers to the cognitive and behavioral efforts to manage situations appraised as taxing or exceeding personal resources. Researchers make a common conceptual distinction in the focus of coping strategies. There are those strategies that are approach-oriented and deal with confronting the

4 314 Soderstrom, Dolbier, Leiferman, and Steinhardt problem and those that are oriented to avoiding dealing directly with the problem (Roth and Cohen, 1986, Moos et al., 1990). While their focus is different, both approach and avoidance coping use cognitive and behavioral methods to address the stressful situation and have been likened to transformational and regressive coping, respectively (Gentry and Kobasa, 1984), as well as problem-focused and emotion-focused coping, respectively (Lazarus and Folkman, 1984). Approach coping strategies are aimed at problem solving or active attempts to resolve the stressor. Avoidance coping strategies are aimed at avoiding active confrontation of the stressor or reducing emotional tension associated with the stressor. Coping strategies that fall under the approach-oriented domain have been associated with less stress (Pearlin and Schooler, 1978) and illness (Blake and Vandiver, 1988; Olff et al., 1993), while those falling under the avoidance-oriented domain have been associated with more stress (Pearlin and Schooler, 1978) and illness (Blake and Vandiver, 1988; Holahan and Moos, 1985; Kobasa, 1982). It has been proposed that high-hardy individuals engage in approach coping styles for the purpose of transforming stressful events into situations that seem to be more manageable. In contrast, low-hardy individuals tend to engage in avoidance coping styles such as cognitive and behavioral disengagement and denial to deal with a stressful situation (Gentry and Kobasa, 1984). These coping styles neither transform the situation nor solve the problem thought to be the source of stress. Several studies show support for a relationship between hardiness and coping strategies, whereby high-hardy individuals use more approach- or problem-focused types of coping strategies and low-hardy individuals use more avoidance- or emotion-focused coping strategies (Florian et al., 1995; Williams et al., 1992). Although based on conceptualizations of traditional sex roles, it is commonly assumed that men tend to be more analytical and task-oriented in response to stressful situations, while women respond more emotionally. This assumption infers that men are more inclined to use approach-oriented coping strategies aimed at the problem, whereas women use avoidance-oriented coping strategies aimed at reducing emotional tension. In fact, a pattern of gender differences in coping strategies consistent with part of this assumption has been observed, showing that women appear somewhat more likely to report using avoidance- or emotion-focused coping strategies, including venting or expressing emotions, becoming depressed, and avoiding the situation (Billings and Moos, 1981; Fondacaro and Moos, 1989; Kvam and Lyons, 1991; Pearlin and Schooler, 1978; Ptacek et al., 1992). In terms of approach- or problem-focused coping, as of yet there is not a clear pattern of gender differences. Some studies show that men report using more approach- or problemfocused coping (Holahan et al., 1995; Kvam and Lyons, 1991; Ptacek et al., 1992, 1994). Additional research supports these findings, but only in certain

5 Hardiness, Coping, Stress, and Illness 315 situations (Folkman and Lazarus, 1980), and still other research has found the opposite, with more problem-focused coping in women (Vitaliano et al., 1985) or no differences between men and women (Holahan and Moos, 1985). Based on the above research, we proposed a conceptual model illustrating the relationships among hardiness, coping strategies, perceived stress, and symptoms of illness. We predicted that hardiness would have a negative relationship to symptoms of illness independent of perceived stress (Banks and Gannon, 1988; Kobasa, 1979; Kobasa et al., 1981, 1982a,b, 1983, 1985; Kobasa and Puccetti, 1983; Nowack and Hanson, 1983; Pollock, 1986; Wiebe and McCallum, 1986). On the basis of previous research, we also hypothesized that perceived stress would demonstrate a positive relationship with symptoms of illness (Dohrenwend and Dohrenwend, 1974, 1981; Sapolsky, 1994). In addition, on the basis of coping research, we predicted that approach coping would have a negative relationship to perceived stress and avoidance coping would have a positive relationship to perceived stress (Pearlin and Schooler, 1978). This set of predictions is shown graphically in Fig. 1 as a nonreciprocal path model. The purpose of this study was to examine the goodness of fit of the proposed model using path analysis and test its stability in two different samples. These were convenience samples of corporate employees and university students. Additionally, because some research indicates that gender may be a differentiating variable, we also examined whether or not the proposed model differed by gender. This study extends earlier research in that Fig. 1. Model 1 for the corporate sample.

6 316 Soderstrom, Dolbier, Leiferman, and Steinhardt it examines the constructs of hardiness, coping strategies, perceived stress, and symptoms of illness concurrently. METHODS Subjects Corporate Sample Data for the corporate sample were collected from full-time employees of 3M in Austin, Texas. The overall subject pool included a convenience sample of employees (N = 110) with a mean age of 42.4 ± 8.5 years who were members of 3M s employee wellness program. 3M has approximately 1900 employees located in Austin, 1200 of whom are members of the wellness program. All subjects were assured that their decision regarding whether or not to participate would have no effect on their relationship with 3M or the university. University Sample Data for the university sample were collected from students enrolled in undergraduate introductory psychology classes at The University of Texas at Austin. Two hundred seventy students with a mean age of 19.2 ± 3.0 years volunteered to participate. All subjects were assured that their decision regarding whether or not to participate would have no effect on their grade in the class or their relationship with the university. Procedures The study involved a cross-sectional research design using survey data. Both corporate and university subjects completed a questionnaire in small groups of approximately individuals in quiet classroom conditions. Study procedures were approved by The University of Texas Institutional Review Board, and data were collected and recorded so as to protect the anonymity of subjects. Instrumentation Hardiness Bartone et al. s (1989) 30-item dispositional resilience scale was selected as a measure of hardiness because it represents one of the best third

7 Hardiness, Coping, Stress, and Illness 317 generation measures of hardiness (Funk, 1992), assessing each of the closely related tendencies of challenge, commitment, and control. The internal consistency of the hardiness scale was α =.81 for the corporate sample and α =.78 for the university sample. For both samples, the internal consistency of the composite measure of hardiness was higher than for each of the three subscales, thus supporting the use of the composite measure. Coping Strategies Coping strategies were assessed using the dispositional version of the Coping Orientations to Problems Experienced (COPE) scale (Carver et al., 1989), which measures a broad range of cognitive and behavioral coping strategies that individuals typically use in stressful life situations. The total scale contains 53 items and measures 14 subscales of coping styles. For our purposes, 8 of the 14 subscales of the COPE were used to measure approach and avoidance coping strategies. Each subscale contained four items. Four subscales were combined to assess approach coping strategies: active coping, planning, positive reinterpretation and growth, and suppression of competing activities. Active coping measures behavioral attempts to take action to deal directly with the problem ( I take direct action to get around the problem ). Planning assesses cognitive attempts to come up with action strategies ( I think hard about what steps to take ). Positive reinterpretation and growth measures cognitive attempts to construe the problem in positive terms while accepting the reality of the situation ( I try to grow as a person as a result of the experience ). While some researchers regard this type of coping as emotion-focused (Lazarus and Folkman, 1984), others classify it as an approach-oriented coping strategy whose value exceeds merely reducing distress (Holahan et al., 1997; Moos et al., 1990; Carver et al., 1989). Suppression of competing activities assesses cognitive and behavioral attempts to avoid becoming distracted by other events in order to deal with the problem ( I keep myself from getting distracted by other thoughts or activities ). The internal consistency of approach coping was α =.89 for the corporate sample and α =.87 for the university sample. Four subscales were also combined to assess avoidance coping strategies: denial, behavioral disengagement, mental disengagement, and focus on and venting of emotions. Denial measures cognitive attempts to refuse to believe that the problem exists ( I pretend that it hasn t really happened ). Behavioral disengagement assesses behavioral attempts to reduce one s effort to deal with the problem ( I just give up trying to reach my goal ). Mental disengagement measures behavioral attempts to distract the person from thinking about the problem ( I turn to work or other substitute activities to

8 318 Soderstrom, Dolbier, Leiferman, and Steinhardt take my mind off things ). Focus on and venting of emotions assesses behavioral attempts to focus on the distress associated with the problem and to ventilate those feelings ( I get upset and let my emotions out ). The internal consistency of avoidance coping was α =.79 for the corporate sample and α =.80 for the university sample. Perceived Stress Perceived stress was defined as the degree to which situations in one s life during the past month were perceived as stressful, as measured by the 14-item Perceived Stress Scale (Cohen et al., 1983). The scale has shown to be a good predictor of stress in that it correlates highly with symptomatogical measures and life event scores (Cohen et al., 1983). The internal consistency of the perceived stress scale was α =.89 for the corporate sample and α =.86 for the university sample. Symptoms of Illness Psychosomatic symptoms of illness were measured by the Symptoms Checklist (Bartone et al., 1989), which includes 20 items measuring the extent to which subjects had experienced various physical and psychological symptoms over the past few weeks, such as the common cold or flu, headaches, upset stomach, and feeling nervous or tense. The internal consistency of the symptoms checklist was α =.89 for the corporate sample and α =.82 for the university sample. Data Analysis Descriptive statistics including means and standard deviations were calculated for men, women, and total sample on all variables for both the corporate and university subjects. Gender differences among variables were examined using Hotelling s multivariate tests of significance with follow-up univariate tests. One analysis was conducted on the variables hardiness, approach coping, avoidance coping, perceived stress, and symptoms of illness. A second analysis was conducted using the subscales of hardiness, approach coping, and avoidance coping. In addition, Pearson correlation coefficients were calculated to examine the relationships among all variables for each sample. To test the proposed conceptual model, path analysis was used in both the corporate and the university samples to examine the relationship between symptoms of illness and the set of determinants including perceived stress,

9 Hardiness, Coping, Stress, and Illness 319 hardiness, and approach and avoidance coping. Gender differences were examined by comparing a multiple-group or less restricted model, where the path coefficients for men and women were allowed to be different, to the more restricted single-group model, where the path coefficients for men and women were forced to be the same. Goodness-of-fit indices were examined using the chi-square test, the normed fit index (NFI), the comparative fit index (CFI), and the Tucker Lewis index (TLI). The chi-square statistic provides a test of the null hypothesis that the reproduced covariance matrix has the specified model structure (i.e., that the model fits the data). The NFI ranges from 0 to 1, where 0 represents the goodness of fit associated with a null model (one specifying that all the variables are uncorrelated) and 1 represents the goodness of fit associated with a saturated model (a model with 0 degrees of freedom that perfectly reproduces the original covariance matrix). The CFI and TLI are similar to the NFI. Values over.95 on the NFI, CFI, and TLI indicate a good fit between model and data (Schumacker and Lomax, 1996). RESULTS Mean scores and standard deviations for men, women, and total sample for all variables in the corporate and university subjects are shown in Tables I and II, respectively. Several mean differences between males and Table I. Means and Standard Deviations for Hardiness, Coping Strategies, Perceived Stress, and Symptoms of Illness in the Corporate Sample Women Men Total (N = 70) (N = 40) (N = 110) Hardiness 60.5 ± ± ± 8.8 Challenge 18.0 ± ± ± 3.2 Commitment 21.2 ± ± ± 4.3 Control 21.2 ± ± ± 3.6 Approach coping 48.7 ± ± ± 7.5 Active 12.4 ± ± ± 2.1 Planning 12.9 ± ± ± 2.4 Positive reinterpretation and growth 12.7 ± ± ± 2.5 Suppression of competing activities 10.7 ± ± ± 2.2 Avoidance coping 32.1 ± ± ± 6.8 Denial 6.0 ± ± ± 2.3 Behavioral disengagement 7.0 ± ± ± 2.3 Mental disengagement 8.6 ± ± ± 2.4 Focus on and venting of emotions 10.3 ± ± ± 2.9 Perceived stress 24.5 ± ± ± 8.5 Symptoms of illness 12.5 ± ± ± 8.4 p <.01, two-tailed.

10 320 Soderstrom, Dolbier, Leiferman, and Steinhardt Table II. Means and Standard Deviations for Hardiness, Coping Strategies, Perceived Stress, and Symptoms of Illness in the University Sample Women Men Total (N = 168) (N = 102) (N = 270) Hardiness 58.8 ± ± ± 8.7 Challenge 17.5 ± ± ± 4.0 Commitment 21.1 ± ± ± 4.1 Control 20.4 ± ± ± 3.4 Approach coping 47.2 ± ± ± 7.4 Active 11.6 ± ± ± 2.2 Planning 12.6 ± ± ± 2.6 Positive reinterpretation and growth 12.4 ± ± ± 2.5 Suppression of competing activities 10.6 ± ± ± 2.2 Avoidance coping 32.0 ± ± ± 6.8 Denial 5.7 ± ± ± 2.0 Behavioral disengagement 6.2 ± ± ± 2.4 Mental disengagement 9.2 ± ± ± 2.5 Focus on and venting of emotions 10.6 ± ± ± 3.3 Perceived stress 26.0 ± ± ± 8.0 Symptoms of illness 15.4 ± ± ± 7.4 p <.05, two-tailed. p <.01, two-tailed. females were found. Hotelling s multivariate overall test of significance for the variables hardiness, approach coping, avoidance coping, perceived stress, and symptoms of illness was significant for both the corporate [F(5,101) = 3.9, p <.01] and the university [F(5,239) = 5.8, p <.01] samples. The univariate tests indicated that females used greater avoidance coping strategies in both the corporate [F(1,105) = 11.8, p <.01] and the university [F (1,243) = 11.3, p <.01] samples. In addition, females reported more symptoms of illness in both the corporate [F(1,105) = 9.4, p <.01] and the university [F(1,243) = 13.6, p <.01] samples. Females in the corporate sample also reported greater perceived stress [F(1,105) = 12.6, p <.01]. Hotelling s multivariate overall test of significance for the subscales of hardiness, approach coping, and avoidance coping was also significant for both the corporate [F(11,95) = 2.4, p <.01] and the university [F(11,236) = 5.5, p <.01] samples. The univariate tests indicated that females in the university sample used greater positive reinterpretation and growth coping strategies [F(1,246) = 5.1, p <.05] than males. In addition, females in both the corporate [F (1,105) = 20.1, p <.01] and the university [F(1,246) = 47.1, p <.01] samples used greater focus on and venting of emotions coping strategies. Pearson product moment correlations among the variables are shown in Table III for the corporate and university samples. As expected, higher levels of hardiness are related to lower levels of perceived stress and fewer

11 Hardiness, Coping, Stress, and Illness 321 Table III. Correlations Among Variables in the Corporate and University Samples Approach Avoidance Perceived Hardiness Challenge Commitment Control coping coping stress Corporate sample Hardiness Challenge.64 Commitment Control Approach coping Avoidance coping Perceived stress Symptoms of illness University sample Hardiness Challenge.68 Commitment Control Approach coping Avoidance coping Perceived stress Symptoms of illness p <.05, two-tailed. p <.01, two-tailed. symptoms of illness for both the corporate and the university samples. Hardiness is also associated with more approach coping and less avoidance coping in both samples. Approach coping is related to less perceived stress and fewer symptoms of illness for the corporate and university samples, whereas avoidance coping is related to greater stress and more symptoms of illness for both samples. Finally, greater levels of perceived stress are related to more symptoms of illness for both samples. Corporate Sample Model There was a nonsignificant gender effect with respect to the relationship of hardiness, coping strategies, and perceived stress to symptoms of illness. The multiple-group model, where the path coefficients for men and women were allowed to be different, was not significantly different from the more restricted single-group model, where the path coefficients for men and women were forced to be the same [χ 2 (8, N = 110) = 8.77, p =.362]. Therefore, the path model for the corporate sample assessed men and women combined. Results of the path analysis supported the proposed model (Model 1), as presented in Fig. 1. Estimation of the model revealed a nonsignificant chi-square value [χ 2 (2, N = 110) = 2.52, p =.283] and accounted for a large

12 322 Soderstrom, Dolbier, Leiferman, and Steinhardt Table IV. Goodness-of-Fit Indices for the Final Corporate and University Models Model χ 2 df p NFI CFI TLI RFI Corporate Model University Model Model Model amount of the variance in both symptoms of illness (R 2 =.54) and perceived stress (R 2 =.62), indicating that the model fit the data well. All values of the descriptive goodness-of-fit tests exceeded.95, also indicating a very good fit between the model and the data (see Table IV). Path coefficients for the proposed model appear in Table V. University Sample Model There also was a nonsignificant gender effect with respect to the relationship of hardiness, coping strategies, and perceived stress to symptoms of illness for the university sample. The multiple-group model, where the path coefficients for men and women were allowed to be different, was not significantly different from the more restricted single-group model, where the Table V. Path Coefficients for the Final Corporate and University Models a Predicted Predicting Unstandarized Standarized variable variable estimate estimate SE CR Corporate model Stress Resilience Stress Approach coping Stress Avoidance coping Symptoms of illness Stress Symptoms of illness Resilience University model Stress Resilience Stress Approach coping Stress Avoidance coping Symptoms of illness Stress Symptoms of illness Resilience a All path coefficients exceeded the absolute critical ratio (unstandardized estimate/standard error) value of 2.0 and thus are significant beyond the.05 level.

13 Hardiness, Coping, Stress, and Illness 323 path coefficients for men and women were forced to be the same [χ 2 (8, N = 270) = 6.75, p =.564]. Therefore, the path model for the university sample assessed men and women combined. However, results of the path analysis for the university sample did not support Model 1. Estimation of the model revealed a significant chi-square value [χ 2 (2, N = 270) = 15.14, p =.001], indicating that the model did not fit the data well. The path coefficient from resilience to symptoms of illness was the only path with a CR value less than 2.0 (B =.05, β=.06, SE =.06, CR =.91), therefore, this path was removed. Given that Model 1 did not fit the data for the university sample, we added two paths, from approach coping to symptoms of illness and from avoidance coping to symptoms of illness. Adding these paths from coping strategies to symptoms of illness have some support in the literature. Approach coping has been associated with less illness (Blake and Vandiver, 1988; Olff et al., 1993) while avoidance coping has been associated with more illness (Blake and Vandiver, 1988; Holahan and Moos, 1985; Kobasa, 1982). For this model (Model 2), there was a nonsignificant gender effect with respect to the relationship of hardiness, coping strategies, and perceived stress to symptoms of illness. The multiple-group model, where the path coefficients for men and women were allowed to be different, was not significantly different from the more restricted single-group model, where the path coefficients for men and women were forced to be the same [χ 2 (9, N = 270) = 10.64, p =.301]. Therefore, Model 2 assessed men and women combined. Results of this analysis supported the proposed model. Estimation of the model revealed a nonsignificant chi-square value [χ 2 (1, N = 270) =.62, p =.430], indicating that the model fit the data well. However, the path from approach coping to symptoms of illness had a CR value of less than 2.0 (B=.06,β=.06, SE =.05, CR = 1.09), thus we removed this path and ran the model again. This model (Model 3) is shown in Fig. 2. There was a nonsignificant gender effect for Model 3 with respect to the relationship of hardiness, coping strategies, and perceived stress to symptoms of illness. The multiple-group model, where the path coefficients for men and women were allowed to be different, was not significantly different from the more restricted single-group model, where the path coefficients for men and women were forced to be the same [χ 2 (8, N = 270) = 10.88, p =.209]. Therefore, Model 3 assessed men and women combined. This model revealed a nonsignificant chi-square value [χ 2 (2, N = 270) = 1.79, p =.409] and accounted for a large amount of the variance in both symptoms of illness (R 2 =.40) and perceived stress (R 2 =.54), indicating that the model fit the data well. All values of the descriptive goodness-of-fit tests exceeded.95, also indicating a very good fit between the model and the data (see Table IV). Path coefficients for the university model appear in Table V, and all exceeded a value of 2.0.

14 324 Soderstrom, Dolbier, Leiferman, and Steinhardt Fig. 2. Model 3 for the university sample. DISCUSSION This study examined the relationships of hardiness, coping strategies, and perceived stress to symptoms of illness using corporate and university samples. A conceptual model of these relationships was proposed based on the research and examined using path analysis. We also examined gender differences among these relationships. Comparing the means of men and women in both samples, several gender differences among coping strategies were found. Consistent with other research (Billings and Moos, 1981; Fondacarao and Moos, 1989; Kvam and Lyons, 1991; Pearlin and Schooler, 1978; Ptacek et al., 1992), women in both samples reported more avoidance coping than men, and most distinctly the focus on and venting of emotion strategy. The finding that women from both samples did not have significantly lower approach coping strategies is inconsistent with some of the research that supports men use more approach coping strategies than women (Holahan et al., 1995; Kvam and Lyons, 1991; Ptacek et al., 1992, 1994). In fact, that university women reported significantly more of the positive reinterpretation and growth strategy is consistent with research in this area that supports the opposite stance, that women use more approach coping than men (Vitaliano et al., 1985). The correlational results for both samples in our study support the relationships depicted in the literature. The well-documented relationship between perceived stress and illness was supported (Dohrenwend and

15 Hardiness, Coping, Stress, and Illness 325 Dohrenwend, 1981; Sapolsky, 1994). Consistent with the research literature, hardiness and approach coping were inversely related to stress and symptoms of illness (Blake and Vandiver, 1988; Olff et al., 1993; Orr and Westman, 1990; Wiebe and McCallum, 1986), whereas avoidance coping was directly related to stress and symptoms of illness (Blake and Vandiver, 1988; Holahan and Moos, 1985; Kobasa, 1982; Pearlin and Schooler, 1978). The finding that hardiness was directly related to approach coping and inversely related to avoidance coping is also consistent with other research (Florian et al., 1995; Williams et al., 1992). The relationship between hardiness and symptoms of illness was also supported, thus supporting the preponderance of research in this area (Banks and Gannon, 1988; Kobasa, 1979; Kobasa et al., 1981, 1982a, b, 1983, 1985; Kobasa and Puccetti, 1983; Nowack and Hanson, 1983; Pollock, 1986; Wiebe and McCallum, 1986). Consistent with previous research, the path of hardiness to symptoms of illness was found in the corporate sample (Funk, 1992; Orr and Westman, 1990). This path was not, however, found in the university sample. This discrepancy may be attributed to the age difference between the corporate (mean age = 42.4) and the university (mean age = 19.2) samples. It seems logical to assume that the more life experiences one has, the hardier one becomes. Perhaps the more pronounced hardiness becomes, the more direct influence it has on health. For example, Schmied and Lawler (1986) found that hardiness was associated with being older. Thus, the relationship of hardiness to health outcomes may be influenced by age, with hardiness predicting health outcomes among older but not younger individuals. Another interesting finding was the addition of the path from avoidance coping to symptoms of illness in the university sample. This difference may also be attributed to the age differences between the two samples. According to the growth and maturity hypothesis, older individuals may have a more effective and mature repertoire of coping styles (Diehl et al., 1996; Labouvie- Vief et al., 1987; McCrae, 1982). Therefore, the subjects in the university sample, being of a young age, may not have developed the more effective coping styles characteristic of approach coping. Several applications for intervention are implied by these findings. Most importantly, the finding that the personality trait of hardiness and coping strategies impact the stress illness relationship suggests that these are necessary components of an effective intervention. Due to the negative impact of avoidance coping, particularly in the university sample with the additional path from avoidance coping to symptoms of illness, interventions targeted for college-aged populations should focus on increasing awareness and understanding of the influence these strategies have on health. Finally, interventions targeted at corporate employees should reflect the stronger role hardiness has in the stress illness relationship as illustrated by

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