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INFORMATION TO USERS The most advanced technology has been used to photograph and reproduce this manuscript from the microfilm master. UMI films the text directly from the original or copy submitted. Thus, some thesis and dissertation copies are in typewriter face, while others may be from any type of computer printer. The quality of this reproduction is dependent upon the quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleedthrough, substandard margins, and improper alignment can adversely affect reproduction. In the unlikely event that the author did not send UMI a complete manuscript and there are missing pages, these will be noted. Also, if unauthorized copyright material had to be removed, a note will indicate the deletion. Oversize materials (e.g., maps, drawings, charts) are reproduced by sectioning the original, beginning at the upper left-hand corner and continuing from left to right in equal sections with small overlaps. Each original is also photographed in one exposure and is included in reduced form at the back of the book. Photographs included in the original manuscript have been reproduced xerographically in this copy. Higher quality 6" x 9" black and white photographic prints are available for any photographs or illustrations appearing in this copy for an additional charge. Contact UMI directly to order. University Microfilms International A Bell & Howell Information Company 300 North Zeeb Road. Ann Arbor. Ml 48106-1346 JSA 313 761-4700 800 521-0600 Order Number 9031121 The relationship of personal dispositional orientation, social support, and stress to physical health and psychological well-being: A theoretical model Nafziger, Mark Arnold, Ph.D. The Ohio State University, 1990 UMI 300 N. Zeeb Rd. Ann Arbor, MI 48106 THE RELATIONSHIP OF PERSONAL DISPOSITIONAL ORIENTATION, SOCIAL SUPPORT, AND STRESS TO PHYSICAL HEALTH AND PSYCHOLOGICAL WELL-BEING A THEORETICAL MODEL DISSERTATION Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the Graduate School of the Ohio State University by Mark Arnold Nafzlger, B.A., M.A. The Ohio State University 1990 Dissertation Committee: Approved by Theodore J. Raul, Ph.D. Richard K. Russell, Ph.D. Adviser Lyle D. Schmidt, Ph.D. Department of Psychology ACKNOWLEDGMENTS I want to express my gratitude to a number of people who helped me complete this project. First, to my advisor, Dr. Lyle Schmidt, both for his help with this manuscript and for his guidance and support during my time at Ohio State. Second, thank you to the other members of my committee; Dr. Theodore Kaul, for his helpful comments and suggestions, and Dr. Richard Russell, for his willingness to help me out once again. 1 also wish to thank Suyapa Silva and Cathy Carnot for their help with LISREL. To Kevin A., Susan K, Jim N., and Monica W., my appreciation for their intellectual and emotional support throughout this project and graduate school in general. And to my parents, Myrl and Twila Nafziger, my deeply-felt gratitude for their encouragement of my academic endeavors, and their love and support throughout my life. Finally, to my wife Cleo, thank you for the your endurance, your steadfast love and support, and your tireless efforts to facilitate the growth and development of our children, Justin, Seth, Alanna, and Adam. Contact with their spontaniety, creativity, and joyful approach to life has helped me maintain a sense of perspective and personal balance, and has taught me alot about health and well-being. ii VITA May 26, 1955 ................... Born - Akron, Ohio 1983 ............................ B.A., Goshen College, Goshen, Indiana 1983-19G4 ...................... Residential Counselor, Red Top Meadows Residential Treatment Center, Jackson, Wyoming 1986 ............................ M.A., Ohio State University, Columbus, Ohio 1989-1990 ...................... Psychology Intern, University of Notre Dame Predoctoral Internship Program, Notre Dame, Indiana FIELD OF STUDY or Field: Psychology TABLE OF CONTENTS ACKNOWLEDGEMENTS ............................................ ii VITA ............................................................ iii LIST OF T A B L E S ................................................... vii LIST OF F I G U R E S ..................................................vili CHAPTER PAGE I. INTRODUCTION ......................................... 1 Psyche and S o m a ................................ A The Biomedical Model ............................. A A Nonduallstlc View of Body and Mind .... 6 Cholesterol and heart disease .... 7 Asthma, allergies, and emotions . 8 Psyche and chemotherapy ................ 8 The Biopsychosoclal Model ...................... 9 Theoretical Model ................................ 12 Covariance Structure Modeling ................... 12 C o n c l u s i o n ...................................... 15 II. LITERATURE REVIEW ................................... 17 Stress and i l l n e s s ............................. 17 Response model ......................... 17 Stimulus model ......................... 19 Psychoneurolmmunology ................... 21 Interactional model ................... 26 Coping ...................................... 29 Definitions ............................. 29 Assessment of coping ................... 31 Personal Characteristics ...................... 33 Hardiness................................ 3A Sense of Coherence...................... 38 Coherence, Appraisal, and Coping . A2 O p t i m i s m ............................ AA Social Support ................................ A7 M o d e l s ................................... A8 Definitions ............................. A9 Functions of social support ............. 52 Social support and personal characteristics 5A iv Health and Well-Being ......................... 57 Models of h e a l t h ...................... 58 Counseling psychology and salutogenesis . 62 Psychological well-being ...................... 63 III. M E T H O D ............................................... 66 Participants and Procedures ................... 66 Data Analysis ................................... 68 M e a s u r e s ...................................... 77 Personal Dispositional Orientation .... 78 Sense of Coherence Questionnaire . 78 Life Orientation T e s t ................... 80 Social Support ............................ 80 Interpersonal Support Evaluation List. 80 Social Support Questionnaire .... 81 S t r e s s ...................................... 83 Life Experiences Survey ................ 83 Perceived Stress Scale ................... 84 Psychological Well-being ................... 85 Beck Depression Inventory ................ 85 Affectometer 2 ........................... 86 Satisfaction with Life S c a l e ............. 87 The Happiness Measures ................... 88 Physical Health ..... 89 C-H Inventory of Physical Symptoms . 89 Global self-rated health index .... 90 Demographic Variables ...................... 91 IV. RESULTS ................................................ 92 Descriptive Statistics ......................... 92 Part O n e ...................................... 96 Regression analyses ...................... 99 Part T w o ..........................................100 Initial model ............................ 100 Revised models ......................... 103 Regression analyses ...................... 114 Post-hoc analyses ...................... 114 V. DISCUSSION ............................................. 119 Introduction ................................... 119 Part one: Analysis of Findings.................... 120 Part one: Limitations............................. 121 Part two: Analysis of Findings.................... 125 Relationships between Independent Variables . 126 v Relationships Between IV's and DV"s . 127 Personal dispositional orientation . 128 Stress, health, and well-being . 131 Social support, health, and well-being . 131 Relationships Between Dependent Variables. 133 Limitations ................................ 136 Directions For Future Research ...... 140 Conclusion................................... 143 LIST OF REFERENCES................................................ 145 APPENDICES A. Solititation Announcement and Initial Instructions . 161 B. Debriefing statement ................................ 163 C. Sense of Coherence Questionnaire ...................... 165 D. Facet Design and Composition of the S O C ...........170 E. Life Orientation T e s t ............................. 172 F. Interpersonal Support Evaluation List ................ 174 G. Social Support Questionnaire - Short Form ............. 179 H. Life Experiences Survey ............................. 182 I. Perceived Stress Scale ................................ 186 L. Satisfaction with Life S c a l e ....................... 189 N. Cohen-Hoberman Inventory of Physical Symptoms . 191 0. Delighted-Terrible and Faces Health Index ............. 194 P. Formulas for Computing Goodness-of-fit Indexes . 195 vi LIST OF TABLES TABLE PAGE 1. Demographic Information ............................. 93 2. Mean scores and standard deviations (sample and normative data) ......................... 95 3. Correlation coefficients for variables used as LISREL input in part o n e ................... 97 A. Simultaneous multiple regression analysis of change in dependent indicators ................... 101 5. Correlation coefficients for variables used as LISREL input in part t w o ................... 102 6. Summary of overall goodness-of-fit