the impact of daily stress on health and mood

8/14/2019 The Impact of Daily Stress on Health and Mood

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Journal of Personality andSocial Psychology1988.Vol.54.No.3.486-495

Copyright 1988bvtheAmerican Psychological Association,Inc.0022-35I4/88/J00.75

TheImpactofDailyStress on Health andMood:Psychological andSocial Resources asMediators

AnitaDeLongisUniversity of Il l inoisat Urbana-Champaign Susan FolkmanUni v er s i t yofCalifornia,SanFranciscoRichardS.LazarusUni v er s i t yofCalifornia,Berkeley

Thisstudyexamineddailystress processesamong 75 marriedcouplesacross20assessmentsduringa 6-monthperiod.Thesomaticand psychologicaleffectsof commoneveryday hassleswereinvesti-gated.Overall,therewas asignificant relationship betweendailystressand theoccurrenceof bothconcurrent andsubsequenthealthproblemssuchas flu, sore throat, headaches, and backaches. Therelationship ofdailystress tomooddisturbance was more complex. Thenegativeeffectsof stress onmoodwerelimitedto asingleday. withthefollowingday characterized bymoodscoresthatwerebetterthanusual.Furthermore,striking individual differenceswerefound in theextentto whichdailystresswasassociatedwithhealthandmoodacrosstime. Participantswiihunsupporlive socialrelationships and lowself-esteem weremorelikelytoexperiencean increaseinpsychologicalandsomaticproblemsboth on and followingstressful daysthanwereparticipantshigh in self-esteemandsocialsupport.Thesedatasuggestthatpersonswithlowpsychosocialresourcesarevulnerableto illnessandmooddisturbancewhentheirstresslevelsincrease,even ifthey generallyhave littlestressintheirlives.

Despite long-standingmisgivingsabout its usefulness, theconceptofstresscontinuestogenerate greatinterestbecauseoftheconviction thatit is acausal factorinillness. Thisconvictionhas motivated widespread use ofmeasuresofstressbasedonlifeevents andalsolies behind our own measure of stressbasedon dailyhassles.

Thereare methodological and theoretical grounds forques-tioningmuch of the research that has attempted to relate stress,whethermeasuredintermsoflifeeventsorhassles,tolong-termhealthstatus. One difficulty isthat stressitselfis not asimplevariablebut asystemof interdependentprocesses, includingappraisal andcoping,which mediatethe frequency, intensity,duration, andtypeofpsychologicalandsomaticresponse. Mostinvestigatorsof thestress-healthrelationship treat stressas aunitaryvariableand do nottake theseprocessesinto account.

Aseconddifficulty isthat muchof theresearch that attemptsto demonstrate the causal relationship between stress and

This article isbasedon adissertationsubmitted by the first authorto theUniversityofCalifornia,Berkeley.Richard S. Lazarusservedaschairmanofthedissertation committee.

Theauthorswould liketo thankothermembers of thecommittee:GeraldA. Mendelsohn and William M.Runyan.Thanksalsoto JimCoyne, Chris Dunkel-Schetler, Robert Felner, Ron Kessler, CathySchaefer, andCamille Wortmanforcommentson earlier drafts.

Thisresearch was supported by agrantawardedtoRichardS.Laza-rus and Susan Folkman, co-investigators, by the MacArthurFounda-tion.

CorrespondenceconcerningthisarticleshouldbeaddressedtoAnitaDeLongis, Department ofPsychology, Universityof Illinois, Cham-paign, Illinois.61820.

health iscross-sectional rather thanlongitudinal.Ofthelongitu-dinalstudies,fewhavebeen adequately designed to overcomethemany obstacles todrawingappropriatecausal inferences(cf.Kasl, 1983). For example,causalityisbestaddressed whenchange isshownin thedependent variable. However,instudiesof theeffectsofstresson health,health statusistypicallymea-sured intermsofstable,chronic symptomsandconditions.Ifthe dependent measure used in a given study is designed to as-sessthatwhichisstableorcharacteristicfor agivenperson, thentheverychange thatiscrucialforexaminingcausal processesis systematicallyeliminatedfromexamination.

Inthetypical prospective study,theproposition thatleveloflife stress measuredat Time 1 has an important impact onhealthmeasured at amuchlater Time 2assumesthat the mea-sureofstressatTime I berepresentativeof theperson'scontin-uingstress statusandpsychobiologicalstress response. Insucha case, thesustainedlevelof stress and the psychobiological re-sponsemightbeexpectedtoproduce healthproblemsatTime2 (see, e.g.. House, Strecher, Metzner, & Robbins, 1986). Inmostresearch onstressand health, thetime betweenthe initialmeasurement ofstress (based, say,on major lifeevents)andhealthstatusis notmonitored. Withtwowidelyspaced assess-ments it isdifficult andperhaps impossibletodisentangle whathasbeen going on not onlypsychobiologically,but environmen-tallyaswell, duringthe intervalpriorto themeasurementofhealthstatusatTime2.

The preceding discussion has several methodological im-plicationsfor stressresearchers. First, more may be learnedabout the stress-health relationshipif a strategy is adoptedwherebycovariations betweenthestressofdaily living(as op-posed tomajor events)and health-related symptoms(as op-

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DAILY HASSLES. HEALTH, AND MOOD 487

posedtogeneral health status)areexamined. Second,it may beuseful tofollowpatternsofstressandillness acrossarelativelyshort period using a within-subject,intraindividual mode ofanalysisrather thananacross-subject,interindividualmode.

Across-subjectand within-subject designs address somewhatdifferent questions. In theacross-subject modethequestioniswhetherthereis arelationship between stressandhealthwithinaparticular population.Asinglescoreforstressand asinglescoreforhealthareobtained foreachsubjectbasedon asingleobservation or onmultipleobservations aggregatedacrossocca-sions. These scoresarecorrelatedacrosssubjects.Theproblemwith thisapproachisthat whereasit can beusedtocharacterizearelationship between stressand health, itobscureswhat maybesystematic differences among persons.In thewithin-subjectmode,thequestionaddressedis themore conceptually impor-tantone of whetherfluctuationsindaily stress levels covarywithchangesin health andwell-being.Multiplemeasuresofstressand health are obtained over time and can be used to calculatea separate correlation foreach subject. Thesubjectserves ashisor her owncontrol,whicheliminatestheeffectsofbetween-subjects differences.

Psychophysiologists learned the importance of the within-subjectapproach a number of years agowhiletryingto assesstherelationship betweendifferent autonomic nervous systemindicators of arousal such as heartrateandskin conductance.The basic question was whether or notskinconductanceriseswhen anindividual'sheart raterises.ExtendingLacey's(1959,1967)work, Lazarus, Speisman,andMordkoff (1963) foundalowcorrelation between indicatorswhenthedatawereanalyzedusingan across-subjectapproach.However, the correlation wassubstantialwhenthedata wereanalyzedwitha within-subjectapproach.The across-subject approach introduced individualdifferencesthat maskedtherelationship between indicators:thewithin-subject approach controlled for thesedifferences (seealsoOpton & Lazarus, 1967).

Thisissueisalsoexemplified inRehm's(1978) work.In ag-gregatingboth mood and daily eventsacrosstime points, hefoundthat average eventlevelwas not significantly correlatedwithaveragemoodlevelacrossthe same period. However, usingdisaggregated data, within-subject correlations revealed ahighlysignificant association between increases ineventsanddeclines inmood.In otherwords,mood wasaffectednot by theindividual'saveragelevelofstress, but ratherbywhethertheindividualwas experiencing more or less stress than usual.

Fewstudies have usedwithin-subjectanalysestoexaminethecovariations between dailystressful experiencesandphysicalhealth.HolmesandHolmes(1970)foundthat subjects reportedapproximatelytwiceasmany lifeeventsonsymptomatic daysas on nonsymptomatic days. However, the most frequently re-ported eventsintheir study were changesinhealthbehaviorsforexample,achangeinamountofsleep. Changes suchastheseare often prodromal signsof illness,which makes interpre-tations of the findingsdifficult. Another study(Meyer&Hag-gerty, 1962) examinedtheroleoffamilycrisisinstreptococcalinfections. It wasfound that streptococcal acquisitionandill-ness, aswell as nonstreptococcal respiratoryinfections, wereaboutfourtimes aslikelyto beprecededas to befollowedby astressfulfamilyepisode.

Recently,a fewstudies have usedwithin-subjectanalysestoexamine the role ofdaily stress in subsequent mood distur-bance. These studies havefound that whereas minor stressfuleventswereassociated with same-day moodproblems, therewasnoeffect ofdailystressonsubsequent mood (Eckenrode,1984;Stone&Neale, 1984). Another study (Caspi, Bolger,&Eckenrode, 1987)did find thatdailystressincreased thelikeli-hood of mood disturbance for at least the dayfollowingthe oc-currenceof thestressor.

Lewinsohn and his colleagues (Lewinsohn & Amenson,1978)foundlargeindiv idual differencesinintraindividual cor-relations between daily events and same-daymood.Their find-ingssuggest that within-subject research mightbe profitablysupplemented by a consideration of person and situation factorsthatmight accountfordifferencesinsomaticandpsychologicalresponses todailystress. In the present study weconsideredtwopsychosocial resources, self-esteem and emotional support.Self-esteem is a psychological resource that influences stressand coping processes(Pearlin&Schooler, 1978). Presumably,peoplewho have positiveviewsof themselves shouldbe lesslikelyto feeloverwhelmedwhenconfronted withstressful de-mandsthan should people who do not have positiveviews,be-causetheformer wouldseethemselvesasabletocope withabroad arrayofproblems. In one study, forexample, personswithhighself-esteem reported less depressionin thefaceof jobloss than did those with lowself-esteem (Pearlin,Lieberman,Menaghan,&Mullan. 1981).

Withrespecttosocial support, thereisfairlyconsistent evi-dence that itsperceived availability moderates the effects ofstress on subsequent physical(Wallston, Alagna, DeVillis, &DeVillis,1984)andpsychological distress (Kessler&McLeod,1985). Althoughanumberof dimensions of social supporthavebeen examined, the perception of havingavailableemotionalsupportfromclose others appearstoaccountformuchof theeffect ofsocial support onstress (Coyne&DeLongis, 1986).One of thewaysthat social support may protect people fromthepotentially damagingeffectsofexposuretostressisthroughitseffectsonmediating appraisalandcopingprocesses(Lazarus&DeLongis, 1983; Lazarus&Folkman, 1984).Forpeoplewithsupport, fewer situationsshould tax orexceed their resourcesand. consequently, less stress should be experienced. Evenwhenpeople do experience stress, havingcloseothers to rely uponshould makeitlesslikelythattheywillcope ineffectively andthus have a negative psychological orhealthoutcome.

The present study examined relationships between dailystressand two aspects of well-being,physical symptoms andmood,across20 assessments. We hypothesized that when par-ticipants were studied across time, increases in daily stresswould be associated withincreases insomaticsymptoms andnegativemood.Weexpected theseeffects toremain evenaftertaking into account average levels ofstress, mood,and illnessacrossthestudy.Wefurtherhypothesized that there wouldbeconsiderable individualvariationin thesizeofthese relation-ships, andthat people low ineither self-esteem oremotionalsupport would be particularly susceptible to the potentiallynegativehealth consequences of day-to-daystressand thereforeshow the highest covariations among hassles, symptoms, andmood.


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DAILY HASSLES, HEALTH, AND MOOD 489

in hasslesscores ranged from 2.58 to 379.58 (M = 61.93,SD=61.80).

Thewithin-subject mean numberofsomatic symptomsre-portedper dayrangedfrom 0 to2.55(M=0.68,SD =0.54).Threeparticipantsdid notreport experiencinganyhealth prob-lems on any of the diary days. Becausesomevariance is essen-tialin computing correlation coefficients, these 3 participantswere excludedfrom intraindividualanalyses thatutilizedsymp-tomscores.Fortheremaining147 participants,within-subjectvariance in symptomsacrossoccasionsranged from 0.05 to3.99(M =0.71,SD =0.64).Consistentwithpast research (Por-ter, Leviton, Slack, & Graham. 1981; Verbrugge, 1983). hus-bands(M = 11.35,SD = 10.58) reportedsignificantly fewersymptoms thandidtheirwives(. /= 16.04,SD=10.72),/(74)=2.70,p


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490 A . D E L O N G I S , s. F O L K M A N , A N D R . L A Z A R U SImraindividual CorrelationsofDailyHasslesand Symptoms

Four sets of within-subject Pearson correlation coefficientswere computed for each of the150participants across 20assess-ment occasions. Hassles scores and the numberofsomaticsymptoms experiencedon thesamedaywere correlated.Intra-individualrsranged from -.42 to .85(M =.14, SD =.30).2Approximatelyonethird(39o)of theparticipantshadnegativecorrelations(refrom -.01to-.42)between hasslesandsymp-toms.For these participants,higherlevelsof stress were associ-ated with slightlybetter health. Anotherthird of the sample(3 2 O Tc) had lowpositive correlations between hasslesandsymp-toms(refrom0 to.30).Forthese participants, increases in ev-erydaystresson aparticulardaywere associatedwith slightin-creases in the number of health problems experienced that day.For the finalthirdof the sample(29%),there was a strongposi-tivecorrelation(rsfrom .31to.85) between hasslesandsymp-toms.Forthese participants, increasesindailystresslevelswereaccompanied by anincreaseinhealth problems.

Within-subject correlations were also examinedbetweenhas-slesandnext-day symptom levels.Thepatternofrelationshipsbetween hassles and symptoms on thefollowingday was similartothat between hasslesandsame-day symptoms.Theone-daylaggedrsranged from-.52to .87(M = .17,SD =.30).Aswiththe relationships between hasslesandsame-day symptoms,onethird(35%)of thesamplehad anegative relationship betweeneverydaystressandsubsequent health problems(refrom -.52to-.01).Another third (35%)had lowpositive correlations(rsfrom0 to.30),and the finalthird (30%)hadhighpositivecorre-lations(rsfrom .31to.87) betweentheamountofstress experi-enced on a given day and the number ofhealthproblems on thefollowingday.

ImraindividualCorrelationsofDailyHasslesandMoodDisturbance

Asexpected, participants tended toexperiencepoorermoodonstressful days thanonnonstressfuldays. Imraindividualcor-relations between hasslesandsame-daymoodweresimilar tothose between hassles and health, ranging from .44 to .70(meanr=-.27,SD =.30).Fifty-fourparticipants (42%)had ahighassociation between fluctuations in hassles and same-daymood(refrom -.30 to-.70).Fifty-sixparticipants (43%)hadlow to moderate negative associations between hassles andmood(rsfrom0 to-.30),experiencing somewhat poorer moodon stressful days. Finally, a group of 20 participants (15%)tended toreport slightly highermoodwhen they experiencedmore hassles(rsfrom0 to.44).

Itis interesting that a quitedifferentpattern ofwithin-subjectcorrelationswasobserved between hasslesandnext-day mood.Overall, participants reported relativelybettermoodon the dayfollowingastressfuldaythanonotherdays (meanr =.34,SD =.22) . Infact,94% of the sample(132participants) had positivewithin-subjectcorrelations (refrom .01 to .80) between hasslesand next-day mood,withhigher levels of hassles associated withbetter moodon the followingday. A few participants showed

Table1PearsonCorrelationCoefficients Among H ithin-SubjectCoefficientsWithin-subject coeff icients I

1. Hassleswithsame-dayhealthproblems2. Hassleswithnext-da>

healthproblems3. Hasslesw i thsame-day

mood4. Hassleswithnexi-day

mood

.59**-.36** -.22*-.28* -.24* .50**

*p


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DAILY HASSLES HEALTH AND MOOD 491

Table2PearsonCorrelationCoefficients Among \l~ithin-SubjeclCoefficients andHassles,Symptom, and MoodScores

Within-subject coefficients

Hassles.symptoms,andmood

MeanhasslesHasslesvarianceMeansymptomsSympiom

varianceMeanmoodMoodvariance

Hassleswithsame-daysymptoms

-.08.01.01.07.00.13

Hassleswithnext-day

symptoms.03.02.16*.03

-.11.15*

Hassleswithsame-day

mood.07

-.06-.04-.01

.01-.19*

Hassleswithnext-daymood.36**.10.05

-.03.17*

-.30**

timepoints usedin theanalysis(20time pointsforsame-daycorrelations,and 15fornext-day correlations) werenotassoci-ated with intraindividual correlations between hassles andsymptoms(rs=-.08 and.03;ps>10).Similarly,mean hasslesscoresacross timewerenot associatedwith intraindividualcor-relations between hasslesandsame-day mood r =.07,p > .10).However,mean hasslesscoresaccounted for asignificant 13%of thevariancein thewithin-subject correlations between has-sles andnext-daymood r =.36,p .10). Individual differences invarianceinsymp-toms over timedid notaccountfordifferencesinwithin-subjectcorrelationseither (rs .10).However,asmallbutsignificant2% of thevarianceinwithin-subject correlationsofhassleswith subsequent illnesswasaccounted for by thetotal

amountofillnessreported across thestudy r - .15, p


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492 A . D E L O N G J S s. F O L K M A N A N D R . L A Z A R U Sefficientthan withthehassles/same-day-symptoms coefficient,emotional supportwasmore stronglycorrelatedacrosssubjectswiththe hassles/next-day-symptomscoefficient (r= -.19, p

the impact of daily stress on health and mood

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