An expanded theory of social stress: The case of chronic physical illness in inner-city minority mothers

This study proposes an expanded theory of social stress. Two of the most widely cited theories of social stress today are Leonard Pearlin's sociological Stress Process Theory and Richard Lazarus' social psychological Transactional Model of Stress. It is hypothesized that integrating cognitive appraisal, a key component of Lazarus' model, into Pearlin's structural theory can enhance the explanatory power of Pearlin's model. The proposed integrated theoretical model is tested by empirically examining the process through which one potential chronic stressor, chronic physical illness, may precipitate psychological distress. The sample is comprised of 267 African American and Puerto Rican inner-city mothers who were part of a larger survey research project on social support funded by the National Institute of Mental Health. One-third of the 267 mothers studied have a chronic physical illness. Data are cross sectional and are analyzed using path analysis. To complement the quantitative analysis, in-depth qualitative interviews were conducted with seven chronically ill mothers who were part of the larger sample.;Quantitative results did not support the hypothesized integrated model. Findings indicated that chronic physical illness is associated with psychological distress and that stress process theory provides a viable explanation of the mechanisms through which a stressor such as chronic physical illness may bring about psychological distress. However, cognitive appraisal did not mediate the stressor-distress relationship, and the addition of cognitive appraisal did not enhance the explanatory power of the stress process model. Results suggested that key to understanding the pathways from chronic illness to distress in the sample studied were level of activity restrictions associated with illness, adequacy of social support, and degree of parental role strain. Qualitative data provided insight into potential reasons why cognitive appraisal did not emerge as a critical component of the process of social stress and suggested the importance of including the concepts of coping and mastery in a stress process model. Limitations of the present research are addressed and ideas for future research are proposed.