Stress and Illness in Adolescence: Issues of Race and Gender

Article excerpt

Research has indicated that stress is a contributory factor in a variety of physical and mental health problems (Brantley & Jones, 1993; Holmes & Masuda, 1974; Newberry, Baldwin, Madden, & Gerstenberger, 1987). The notion that life events contribute significantly to the development of physical and psychological disorders has spawned a diagnostic category called "psychological factors affecting physical conditions" in the Diagnostic and Statistical Manual of Mental Disorders (Third Edition, Revised).

One period of life characterized by rapid physiological, social, and cognitive changes that may generate stress is adolescence. According to Nielsen (1987), the adolescent is faced with numerous demands (e.g., family, school, peer groups), and "miscoping"' responses to these demands (e.g., truancy, drug abuse, isolation) can intensify the stressful transition to adulthood. Although most adolescents are free of serious health problems, studies have consistently shown a positive correlation between the accumulation of recent negative life events and reported psychological and physical health problems (see review by Johnson, 1986). For example, Greene, Walker, Hickson, and Thompson (1985) found that life stress was positively associated with recurrent pain and behavioral problems among adolescents seen at an outpatient clinic.

To date, there has been limited research on individual differences (e.g., race and gender) that may influence the experience of stress and subsequent illness among adolescents. With regard to gender, research on adults has shown that men and women tend not to differ on the number of undesirable life events experienced. However, women tend to be more vulnerable when such events occur to someone in their "social network" (Kessler & McLeod, 1984). More specifically, women appear to be more sensitive to the quality of interpersonal relationships than are men. For example, McIntosh, Keywell, Reifman, and Ellsworth (1994) reported greater stress due to sexism, lack of free time, and lack of time spent with spouse among female law students as compared with-their male counterparts. In addition, the female students displayed more depression and physical symptoms at the end of the semester. Similarly, adolescent females have been found to be more reactive to stressful life events affecting other individuals than are their male counterparts (Gore, Aseltine, & Colten, 1993).

With regard to race, Veroff, Douvan, and Kulka (1981) concluded that adult African-Americans tend to experience greater stress than do their Euro-American counterparts. Further, the realities of discrimination create a high base level of stress among adult African-Americans, which may contribute to their increased risk for disease, instability, and premature death (Gary, 1993). African-American male adolescents are faced with additional stressors (e.g., fewer job opportunities, lower income, increased exposure to violence), which may place them at greater risk for developing hypertension (Hediger, Schell, Katz, Gruskin, & Eveleth, 1984) and recurring symptomatology (Jones, 1989).

The purpose of this study was to further assess the stress-illness relationship, specifically with respect to race and gender, among adolescents. Since it is well documented that the measurement of adolescent stress is complex (Newcomb, Huba, & Bentler, 1981; Youngs, Rathge, Mullis, & Mullis, 1990), two different stress inventories were used. In order to measure the amount of readjustment or change associated with a given experience, a life event survey was administered. In order to take into account differences in cognitive appraisal, participants were asked to complete a perceived stress questionnaire. It was hypothesized that reported stress levels would be positively associated with reported symptomatology, and that there would be significant differences on the dependent measures as a function of race and gender. …