Skip to main content
Log in

Sense of Coherence Buffers Relationships of Chronic Stress with Fasting Glucose Levels

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Sense of coherence (SOC) was examined as a buffer of the relationship of chronic stress with fasting glucose and insulin levels. Spouse caregivers of persons with diagnoses of Alzheimer's disease (AD) (n = 73) were compared to controls [spouses of nondemented persons (n = 69)], group-matched on age/gender. After controlling for anger and coronary heart disease (CHD), interactions of SOC and gender explained variance in glucose (but not insulin) at study entry (T1) and 15–18 months later (T2). However, this occurred only in caregivers. At both times SOC and glucose were negatively related in men caregivers but not in women caregivers or in controls. In caregivers (but not controls), SOC at T1 predicted glucose at T2, independent of gender, anger, and glucose at T1; and hassles at T1 appeared to mediate this relationship. Future research should examine SOC as a buffer of other chronic stressors and metabolic variables.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  • Allen, M. T., Stoney, C. M., Owens, J. F., and Matthews, K. A. (1993). Hemodynamic adjustments to laboratory stress: The influence of gender and personality. Psychosom. Med. 55: 505–517.

    Google Scholar 

  • Alvarez, M. A., Portilla, L., Gonzalez, R., and Ezcurra, E. (1989). Insulin response to a short stress period. Psychoneuroendocrinology 14: 241–244.

    Google Scholar 

  • American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders, 3rd ed., APA, Washington, DC.

    Google Scholar 

  • Antonovsky, A. (1987). Unraveling the Mystery of Health: How People Manage Stress and Stay Well, Jossey-Bass, San Francisco, CA.

    Google Scholar 

  • Antononvsky, A. (1993). The structure and properties of the sense of coherence scale. Soc. Sci. Med. 36: 725–733.

    Google Scholar 

  • Arnetz, B. B. (1984). The potential role of psychosocial stress on levels of hemoglobin A1c (HbA1c) and fasting plasma glucose in elderly people. J. Gerontol. 39: 424–429.

    Google Scholar 

  • Barefoot, J. C., Dodge, K. A., Peterson, B. L., Dahlstrom, W. G., and Williams, R. B. (1989). The Cook-Medley hostility scale: Item content and ability to predict survival. Psychosom. Med. 51: 46–57.

    Google Scholar 

  • Barglow, P., Hatcher, R., Edidin, D. V., and Sloan-Rossiter, D. (1984). Stress and metabolic control in diabetes: Psychosomatic evidence and evaluation of methods. Psychosom. Med. 46: 127–144.

    Google Scholar 

  • Blumenthal, J. A., Barefoot, J. C., Burg, M. M., and Williams R. B. (1987). Psychological correlates of hostility among patients undergoing coronary angiography. Br. J. Med. Psychol. 60: 349–355.

    Google Scholar 

  • Brown, L. L., Tomarken, A. J., Orth, D. N., Loosen, P. T., Kalin, N. H., and Davidson, R. (1996). Individual differences in repressive-defensiveness predict basal salivary cortisol levels. J. Pers. Soc. Psychol. 70: 362–371.

    Google Scholar 

  • Buchi, S., Sensky, T., Allard, S., Stoll, T., Schnyder, U., and Klaghofer, R. (1998). Sense of coherence-A protective factor for depression in rheumatoid arthritis. J. Rheumatol. 25: 869–875.

    Google Scholar 

  • Callahan, L. F., and Pincus, T. (1995). The sense of coherence scale in patients with rheumatoid arthritis. Arth. Care Res. 8: 28–33.

    Google Scholar 

  • Cesana, G., Panza, G., Ferrario, M., Zanettini, R., Arnoldi, M., and Grieco, A. (1985). Can glycosylated hemoglobin be a job stress parameter? J. Occup. Med. 27: 357–360.

    Google Scholar 

  • Clerc, D., Wick, H., and Keller, U. (1986). Acute cortisol excess results in unimpaired insulin action on lipolysis and branched chain amino acids, but not on glucose kinetics and C-peptide concentrations in man. Metabolism 35: 404–410.

    Google Scholar 

  • Cohen, C., Teresi, J., and Holmes, D. (1985). Social networks, stress, and physical health: A longitudinal study of an inner-city elderly population. J. Gerontol. 40: 478–486.

    Google Scholar 

  • Cohen, J., and Cohen, P. (1983). Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences, 2nd ed., Lawrence Erlbaum, Hillsdale, NJ.

    Google Scholar 

  • Cohen, S., Line, S., Manuck, S. B., Rabin, B. S., Heise, E. R., and Kaplan, J. R. (1997). Chronic social stress, social status, and susceptibility to upper respiratory infections in nonhuman primates. Psychosom. Med. 59: 213–221.

    Google Scholar 

  • Davies, H., Priddy, J. M., and Tinklenberg, J. R. (1986). Support groups for male caregivers of Alzheimer's patients. Clin. Gerontol. 5: 385–395.

    Google Scholar 

  • Dennis, B., Ernst, N., Hjortland, M., Tillotsen, J., and Grambsch, V. (1980). The NHLBI nutrition data system. J. Diet. Assoc. 77: 641–647.

    Google Scholar 

  • Dressler, W. W., Grell, G. A.C., Gallagher, P.N., and Viteri, F. E. (1992). Social factors mediating social class differences in blood pressure in a Jamaican community. Soc. Sci. Med. 35: 1233–1244.

    Google Scholar 

  • Dyck, D. G., Short, R., and Vitaliano, P. P. (1999). Predictors of burden and infectious illness in schizophrenia caregivers. Psychsom. Med. 61: 411–419.

    Google Scholar 

  • Edwards, C., and Yates A. J. (1985). The effects of cognitive task demands on subjective stress and blood glucose levels in diabetics and non-diabetics. J. Psychosom. Res. 29: 59–69.

    Google Scholar 

  • Efendic, S., Cerasi, E., and Luft, R. (1974). Trauma: Hormonal factors with special references to diabetes mellitus. Acta Anesthesiol. Scand. 55: 107–119.

    Google Scholar 

  • Flannery, R. B., and Flannery, G. J. (1990). Sense of coherence, life stress, and psychological distress: A prospective methodological inquiry. J. Clin. Psychol. 46: 415–421.

    Google Scholar 

  • Folstein, M. F., Folstein, E., and McHugh, P. R. (1975). Mini-Mental State: A practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res. 12: 189–198.

    Google Scholar 

  • Frankenhaeuser, M. (1991). The psychophysiology of sex differences as related to occupational status. In Frankenhaeuser, M., Lundberg, U., and Chesney, M. (eds.), Women, Work and Health: Stress and Opportunities, Plenum Press, New York, pp. 39–61.

    Google Scholar 

  • Frommberger, U., Stieglitz, R. D., Straub, S., Nyberg, E., Schlickewei, W., and Berger, M. (1999). The concept of "sense of coherence" and the development of posttraumatic stress disorder in traffic accident victims. J. Psychosom. Res. 46: 343–348.

    Google Scholar 

  • Gallagher, T. J., Wagenfeld, M. O., Baro, F., and Haepers, K. (1994). Sense of coherence, coping, and caregiver role overload. Soc. Sci. Med. 39: 1615–1622.

    Google Scholar 

  • Gallagher, D., Wrabetz, A., Lovett, S., Del Maestro, S., and Rose, J. (1989). Depression and other negative affects in family caregivers. In Light, E., and Lebowitz, B. (eds.), Alzheimer's Disease Treatment and Family Stress: Future Directions of Research, U.S. GPO, Washington, DC, pp. 218–244.

    Google Scholar 

  • Gillin, J. L., Mills, P. J., Nelesen, R. A., Dillon, E., Ziegler, M. G., and Dimsdale, J. E. (1996). Race and sex differences in cardiovascular recovery from acute stress. Int. J. Psychophysiol. 23: 83–90.

    Google Scholar 

  • Gordon, R. D., Bachmann, A. W., Ballantine, D. M., and Thompson, R. E. (1991). Potassium, glucose, insulin interrelationships during adrenali infusion in normotensive and hypertensive humans. Clin. Exp. Pharmacol. Physiol. 18: 291–294.

    Google Scholar 

  • Hall, J. B., and Brown, D. A. (1979). Plasma glucose and lactic acid alterations in response to a stressful exam. Biol. Psychol. 8: 179–188.

    Google Scholar 

  • Halter, J. B., Beard, J. C., and Porter, D. (1984). Islet function and stress hyperglycemia: Plasma glucose and epinephrine interaction. Am. J. Physiol. 247: 47–52.

    Google Scholar 

  • Hanken, M. A. (1989). A study of physician performance in a physician oriented in-patient clinical record system. Dissert. Abstr. Int. 50–12a: 3823.

    Google Scholar 

  • Hanson, C. L., Henggeler, S. W., and Burghen, G. A. (1987). Model of associations between psychosocial variables and health-outcome measures of adolescents with IDDM. Diabetes Care 10: 752–758.

    Google Scholar 

  • Hinrichsen, G. A., and Ramirez, M. (1992). Black and white dementia caregivers: A comparison of their adaptation, adjustment, and service utilization. Gerontologist 32: 375–381.

    Google Scholar 

  • Holm, G. (1983). Adrenergic regulation of insulin release. Acta Med. Scand. Suppl. 672: 21–25.

    Google Scholar 

  • Irwin, M., Hauger, R., Patterson, T. L., Semple, S., Ziegler, M., and Grant, I. (1997). Alzheimer caregiver stress: Basal natural killer cell activity, pituitary-adrenal cortical function, and sympathetic tone. Ann. Behav. Med. 19: 83–90.

    Google Scholar 

  • Ismail, A. H., and Young, R. J. (1977). Effect of chronic exercise on the multivariate relationships between selected biochemical and personality variables. J. Multivar Behav. Res. 12: 49–67.

    Google Scholar 

  • Kaiser, C. F., Sattler, D. N., Bellack, D. R., and Dersin, J. (1996). A conservation of resources approach to a natural disaster: Sense of coherence and psychological distress. J. Soc. Behav. Person. 11: 459–476.

    Google Scholar 

  • Kanner, A. D., Coyne, J. C., Schaefer, C., and Lazarus, R. S. (1981). Comparison of two modes of stress measurement: Daily hassles and uplifts versus major life events. J. Behav. Med. 4: 1–39.

    Google Scholar 

  • Kessler, R. C., and McLeod, J. D. (1985). Social support and mental health in community samples. In Cohen, S., and Syme, S. L. (eds.), Social Support and Health, Academic Press, New York, pp. 219–240.

    Google Scholar 

  • Kjeldsen, S. E., Moan, A., Petrin, J., Weder, A. B., and Julius, S. (1996). Effects of increased arterial epinepherine on insulin, glucose and phosphate. Blood Pressure 5: 27–31.

    Google Scholar 

  • Kumanyika, S. K. (1993). Special issues regarding obesity in minority populations. Ann. Intern. Med. 119: 650–654.

    Google Scholar 

  • Langius, A., Bjorvell, H., and Antonovsky, A. (1992). The sense of coherence concept and its relation to personality traits in Swedish samples. Scand. J. Caring Sci. 6: 165–171.

    Google Scholar 

  • Lazarus, R. S., and Folkman, S. (1984). Stress, Appraisal, and Coping, Springer, New York.

    Google Scholar 

  • Lutgendorf, S. K., Vitaliano, P. P., Reimer, T. T., Harvey, J. H., and Lubaroff, D. M. (1999). Sense of coherence moderates the relationship between life stress and natural killer cell activity in healthy older adults. Psychol. Aging 14: 552–563.

    Google Scholar 

  • Lutzky, S. M., and Knight, B. G. (1994). Explaining gender differences in caregiver distress: The roles of emotional attentiveness and coping styles. Psychol. Aging 9: 513–519.

    Google Scholar 

  • Markovic, N., Matthews, K. A., Huston, S. L., Egbagbe, E., Ukoli, F. A., and Bunker, C. H. (1995). Blood pressure reactivity to stress varies by hypertensive status and sex in Nigerians. Am. J. Epidemiol. 142: 1020–1028.

    Google Scholar 

  • McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA work group under the auspices of Department of Health and Human Services task force on Alzheimer's disease. Neurology 34: 939–944.

    Google Scholar 

  • McSherry, W. C., and Holm, J. E. (1994). Sense of coherence: Its effects on psychological and physiological processes prior to, during, and after a stressful situation. J. Clin. Psych. 50: 476–487.

    Google Scholar 

  • Mintzer, J. E., Rubert, M. P., Loewenstein, D., Gamez, E., Millor, B., Quinteros, R., Flores, L., Moberg, E., Kollind, M., Lins, P. E., and Adamson, U. (1994). Acute mental stress impairs insulin sensitivity in IDDM patients. Diabetologia 37: 247–251.

    Google Scholar 

  • Motzer, S. U., and Stewart, B. J. (1996). Sense of coherence as a predictor of quality of life in persons with coronary heart disease surviving cardiac arrest. Res. Nurs. Health 19: 287–298.

    Google Scholar 

  • Mullen, P. M., Smith, R. M., and Hill, E. W. (1993). Sense of coherence as a mediator of stress for cancer patients and spouse. J. Psychosocial Oncol. 11: 23–46.

    Google Scholar 

  • Natelson, B. H., Krasnegor, N., and Holaday, J. W. (1976). Relations between behavioral arousal and plasma cortisol levels in monkeys performing repeated free-operant avoidance sessions. J. Comp. Physiol. Psychol. 90: 958–969.

    Google Scholar 

  • Nathanson, C. A. (1990). The gender-mortality differential in developed countries: Demographic and sociocultural dimensions. In Ory, M. G., and Warner, J. R. (eds.), Gender, Health, and Longevity: Multidisciplinary Perspectives, Springer, New York, pp. 3–24.

    Google Scholar 

  • Netter, P., and Neuhauser-Metternich, S. (1991). Types of aggressiveness and catecholamine response in essential hypertensives and healthy controls. J. Psychsom. Res. 35: 409–419.

    Google Scholar 

  • Peyrot, M. F., and McMurry, J. F. (1985). Psychosocial factors in diabetes control: Adjustment of insulin-treated adults. Psychosom. Med. 47: 542–557.

    Google Scholar 

  • Puckett, C. D. (1993). The Educational Annotation of ICD-9-CM, 4th ed., Channel, Reno, NV.

    Google Scholar 

  • Rand, C. S. W., and Kuldau, J. M. (1989). The epidemiology of obesity and self-defined weight problem in the general population: Gender, race, age, and social class. Int. J. Eating Disord. 9: 329–343.

    Google Scholar 

  • Rosencranz, H. A., and Pihlblad, C. T. (1970). Measuring the health of the elderly. J. Gerontol. 25: 129–133.

    Google Scholar 

  • Rowe, J. W., and Kahn, R. L. (1997). Successful aging. Gerontologist 37: 433–444.

    Google Scholar 

  • Sagy, S., Antonovsky, A., and Adler, I. (1995). Explaining life satisfaction in later life: The sense of coherence model and activity theory. Behav. Health Aging 1: 11–25.

    Google Scholar 

  • Scanlan, J. M., Vitaliano, P. P., Ochs, H. D., Savage, M. V., and Borson, S. (1998). CD4 and CD8 counts are associated with interactions of gender and psychosocial stress. Psychosom. Med. 60: 644–653.

    Google Scholar 

  • Scanlan, J. M., Vitaliano, P. P., Zhang, J., Savage, M. V., Borson, S., Short, R., and Ochs, H. D. (1999). Lymphocyte proliferation is associated with gender, caregiving and psychosocial variables in older adults. Paper presented at American Psychosomatic Society, Vancouver, Canada.

  • Schneiderman, N., and Skyler, J. S. (1995). Insulin metabolism, sympathetic nervous system regulation, and coronary heart disease prevention. In Orth-Gomer, K., and Schneiderman, N. (eds.), Behavioral Medicine Approaches to Cardiovascular Disease Prevention, Lawrence Erlbaum, Hillsdale, NJ.

    Google Scholar 

  • Schwaberger, G. (1987). Heart rate, metabolic and hormonal responses to maximal psychoemotional and physical stress in motor car racing drivers. Int. Arch. Occup. Environ. Health 59: 579–604.

    Google Scholar 

  • Seeman, T. E., and McEwen, B. S. (1996). Impact of social environment characteristics on neuroendocrine regulation. Psychsom. Med. 58: 459–471.

    Google Scholar 

  • Seeman, T. E., Berkman, L. F., Blazer, D., and Rowe, J. W. (1994). Social ties and support and neuroendocrine function: The MacArthur studies of successful aging. Ann. Behav. Med. 16: 95–106.

    Google Scholar 

  • Sonino, N., Fava, G. A., Raffi, A. R., Boscaro, M., and Fallo, F. (1998). Clinical correlates of major depression in Cushing's disease. Psychopathology 31: 302–306.

    Google Scholar 

  • Spielberger, C. D., Jacobs, G. A., Russell, S. S., and Crane, R. (1983). Assessment of anger: The State-Trait Anger Scale. In Butcher, J. N., and Spielberger, C. D. (eds.), Advances in Personality Assessment, Vol. 2, Lawrence Erlbaum, Hillsdale, NJ.

    Google Scholar 

  • Spielberger, C. D., Johnson, E. G., Russell, S. S., Crane, R. J., Jacobs, G. A., and Worden, T. J. (1985). The experience and expression of anger: Construction and validation of an anger expression scale. In Chesney, M. A., and Rosenman, R. H. (eds.), Anger and Hostility in Cardiovascular and Behavioral Disorders, Hemisphere, New York, pp. 5–30.

    Google Scholar 

  • Steiner, A., Raube, K., Stuck, A. E., Aronow, H. U., Draper, D., Rubenstein, L. Z., and Beck, J. C. (1996). Measuring psychosocial aspects of well-being in older community residents: Performance of four short scales. Gerontologist 36: 54–62.

    Google Scholar 

  • Suarez, E. C., Williams, R. B., Kuhn, C. M., Zimmerman, E. H., and Schanberg, S. M. (1991). Biobehavioral basis of coronary-prone behavior in middle-aged men. Part II: Serum cholesterol, the Type A behavior pattern, and hostility as interactive modulators of physiological reactivity. Psychosom. Med. 53: 528–537.

    Google Scholar 

  • Svec, F., Nastasi, K., Hilton, C., Bao, W., Srinivason, S. R., and Berenson, G. S. (1992). Blackwhite contrasts in insulin levels during pubertal development. The Bogalusa heart study. Diabetes 41: 313–317.

    Google Scholar 

  • Thomas, C., and Kelman, H. R. (1990). Gender and the use of health services among elderly persons. In Ory, M. G., and Warner, H. R. (eds.), Gender, Health, and Longevity: Multidisciplinary Perspectives, Springer, New York, pp. 137–156.

    Google Scholar 

  • Uchino, B. D., Kiecolt-Glaser, J. K., and Cacioppo, J. T. (1992). Age-related changes in cardiovascular response as a function of a chronic stressor and social support. J. Pers. Soc. Psych. 63: 839–846.

    Google Scholar 

  • Uchino, B. D., Kiecolt-Glaser, J. K., and Cacioppo, J. T. (1994). Construals of preillness relationship quality predict cardiovascular response in family caregivers of Alzheimer's disease victims. Psychol. Aging 9: 113–120.

    Google Scholar 

  • Van Eck, M., Berkhof, H., Nicolson, N., and Sulon, J. (1996). The effects of perceived stress, traits, mood states, and stressful daily events on salivary cortisol. Psychosom. Med. 58: 447–458.

    Google Scholar 

  • Vinick, B. H. (1984). Elderly men as caretakers of wives. J Geriatr. Psychiatry 17: 61–68.

    Google Scholar 

  • Vitaliano, P. P., Maiuro, R. D., Bolton, P. A., and Armsden, G. C. (1987). A psychoepidemiological approach to the study of disaster. J. Commun. Psychol. 15: 99–122.

    Google Scholar 

  • Vitaliano, P. P., Russo, J., Young, H. M., Teri, L., and Maiuro R. D. (1991). Predictors of burden in spouse caregivers of individuals with Alzheimer's disease. Psychol. Aging 6: 392–402.

    Google Scholar 

  • Vitaliano, P. P., Russo, J., Bailey, S., Young, H., and McCann, B. (1993). Psychosocial factors associated with cardiovascular reactivity in older individuals. Psychosom. Med. 55: 164–177.

    Google Scholar 

  • Vitaliano, P. P., Doughty, C. M., and Siegler, I. C. (1994). Biopsychosocial risks for cardiovascular disease in spouse caregivers of persons with Alzheimer's disease. In Abeles, R. P., Gift, H. C., and Ory, M. G. (eds.), Aging and Quality of Life, Springer, New York, pp. 145–159.

    Google Scholar 

  • Vitaliano, P. P., Russo, J., and Niaura, R. (1995). Plasma lipids and their relationship to psychosocial factors in older adults. J. Gerontol. Psychol. Sci. 50: 18–24.

    Google Scholar 

  • Vitaliano, P. P., Russo, J., Scanlan, J. M., and Greeno, K. (1996a). Weight changes in caregivers of Alzheimer's care recipients: Psychobehavioral predictors. Psychol. Aging 11: 155–163.

    Google Scholar 

  • Vitaliano, P. P., Scanlan, J. M., Krenz, C., and Fujimoto, W. (1996b). Insulin and glucose: Relationships with hassles, anger and hostility in non-diabetic older adults. Psychosom. Med. 58: 489–499.

    Google Scholar 

  • Vitaliano, P. P., Scanlan, J. M., Krenz, C., Schwartz, R. S., and Marcovina, S. M. (1996c). Psychological distress, caregiving, and metabolic variables. J. Gerontol. Psychol. Sci. 51B: 290–299.

    Google Scholar 

  • Vitaliano, P. P., Scanlan, J. M., Ochs, H. D., Syrjala, K., Siegler, I. C., and Snyder, E. A. (1998a). Psychosocial stress moderate the relationship of cancer history with natural killer cell activity. Ann. Behav. Med. 20: 199–208.

    Google Scholar 

  • Vitaliano, P. P., Scanlan, J. M., Zhang, J., Knopp, R., McCormick, and Hirsch, I. (1998b). A path model of chronic stress, the metabolic syndrome, and heart disease. Paper presented at the Fifth International Congress of Behavioral Medicine, Copenhagen, Denmark.

  • Weintraub, S., Barataz, R., and Mesulam, M. (1992). Daily living activities in the assessment of dementia. In Corkin, S., Davis, K., Cravden, J., Usdin, E., and Wurtman, J. (eds.), Alzheimer's Disease: A Report of Progress in Research, Raven Press, New York, pp. 189–192.

    Google Scholar 

  • Young, R. F., and Kahana, E. (1989). Specifying caregiver outcomes: Gender and relationship aspects of caregiver strain. Gerontologist 29: 660–666.

    Google Scholar 

  • Zubin, J., and Spring B. (1977). Vulnerability-A new view of schizophrenia. J. Abnorm. Psychol. 86: 103–126.

    Google Scholar 

Download references

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zhang, J., Vitaliano, P.P., Lutgendorf, S.K. et al. Sense of Coherence Buffers Relationships of Chronic Stress with Fasting Glucose Levels. J Behav Med 24, 33–55 (2001). https://doi.org/10.1023/A:1005634420653

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1005634420653

Navigation