Predictors of Stress As Moderated By Criterion Groups - Healthy Versus Drug Addicted Adults: Implications for Preventing Stress-Related Problems

Introduction: This study is guided by the research question, “When compared with individuals with normal lifestyles, how do individuals with unhealthy lifestyles, e.g., drug addicted individuals, differ on cognitive and behavioral determinants of stress?”

For the outcome variable of stress, we examined how a criterion group variable, (healthy adults versus drug addicted adults) may moderate the effects of three predictors: (a) health motivation, (b) treat-urgency and (c) perceived control.

Methods: This is a sub-study from a larger QUAL + QUAN mixed methods study of stress-coping and resilience. This study sample consisted of: (a) 56 adults from a local community and (b) 64 drug addicted adults from that same community. Given that most drug users have a distinctly unhealthy lifestyle, we compared them with normal non-addicted individuals. Participants were administered a 2 to 3 hour in-depth interview that assessed stress ratings in response to a  difficult life event experienced within the past five years. The health lifestyle predictor variables were: a Health Motivation scale, and two stress-coping variables from the Lazarus and Folkman paradigm: (a) threat – urgency (primary stage of appraisal), and (b) perceived personal control (secondary stage of appraisal). Threat-urgency and Control were rated by two independent coders. Later, non-agreements were reconciled in a “round table” review. The quantitative variables utilized as predictors in this regression model were: (a) Health Motivation (a 10 item scale, α= .55), and (b) the Criterion Groups (drug addict, normal individual), (c) threat-urgency, and (d) perceived control.

Results: Zero-order correlations confirmed the hypothesized associations of three interaction variables with Stress: (a) Health Motivation by Criterion Groups (r = -.16, p=.04), (b) threat-urgency by Criterion Groups (r = .34, p< 001.), and (c) perceived control by Criterion Groups (r= -.17, p=.03).  The final hierarchical regression model analyses then identified significant predictors of stress levels: (a) Threat-Urgency (STD β=.32, p=<.001), (b) Control (STD β=-.22, p=.01), and (c) the Criterion Group x Health Motivation interaction (STD β= -.40, p= .03. This final model was significant, F (10,109) =3.48, p=.001, R² =.24).

Conclusions: In this study, a process analysis of the classic Stress-Coping model yielded new knowledge applicable to the design of an intervention to prevent stress-related disorders. High threat-urgency, and low control predicted higher stress levels, and these effects differed for drug addicted individuals when compared with non-drug addicted normal community residents.
These findings offer implications for the design and implementation of prevention interventions to promote efficacious coping among persons grappling with a stressful life problem.