A Multi-Perspective Examination of Stress in Later Life

The broad objectives of this study were to document the nature of stress in the lives of older adults and to examine how stress is related to clinical depression in later life. Although considerable research links stress and depression, the term stress has been used to refer to the presence of a life event (i.e., a stressor), a psychological appraisal (i.e., perceiving an experience as stressful), or a physiological response (e.g., activation of stress hormones, allostatic load). In order to understand the relationship between stress and depression, each of these different definitions was considered.

The extensive literature on stress can be grouped into three broad traditions: environmental, psychological, and biological. The environmental tradition focuses on the idea of stress as life events that affect the individual or important members of family or friends. The psychological tradition focuses on individuals' subjective appraisals of events and their own resources to cope with the stressor. The biological tradition defines stress as stimulus that activates specific physiological responses. Each of these theoretical perspectives conceptualizes links between stress and mental health differently, emphasizing the influence of their particular view of stress (i.e., occurrence of a severe life event, the individual's psychological appraisal, cumulative adaptational wear-and-tear on the body, respectively) on the outcome. At the conceptual level, investigators from each domain mention potential contributions from the other perspectives; however, environmental, psychological, and biological stress data are rarely collected in the same investigation. Using a multi-pronged approach to assessing stress and synthesizing this information to create stress profiles in persons with and without psychopathology is a necessary next step.

This descriptive study examined stress from environmental, psychological, and biological perspectives in a sample of 16 outpatients from a local community mental health center with a diagnosis of depression and 16 community-dwelling (matched for demographic characteristics) older adults. Quantitative and qualitative techniques were employed. First, life events, perceived stress, and allostatic load were used as predictors of current depression. Second, qualitative themes derived from individuals' stories of stress were developed and patterns across depressed and non-depressed explored. Exploratory, data-intensive studies such as this can guide future investigations of the complex processes between stress and illness.