Date of Award

Summer 8-16-2024

Level of Access Assigned by Author

Open-Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

Advisor

Emily A. P. Haigh

Second Committee Member

Jeff Hecker

Third Committee Member

Fayeza Ahmed

Additional Committee Members

Thane Fremouw

Rebecca MacAulay

Craig Mason

Abstract

As our global population age rises, so does the need for quality, age-informed healthcare (World Health Organization, n.d.). To clarify treatment priorities, age-appropriate measures are needed to articulate sources of adversity in aging (Wulsin et al., 2022). A key target proposed in the aging literature is cumulative life stress, or the totality of acute and chronic stress experiences that individuals encounter in their lifespan (Epel, 2020). Life course developmental theories point to the role of cumulative life stress in aging health outcomes. However, relevant research is limited and yields mixed results due in part to the lack of age-specific tools for quantifying cumulative life stress (Aldwin, 1990). Mindful of this gap, the present study sought to develop and validate a novel measure of cumulative life stress, the Older Adulthood Stress and Adversity Inventory (Older Adult STRAIN), to help 1) identify aging adults at higher risk for adverse health outcomes, 2) clarify personalized treatment targets, and 3) inform the development of effective individual and population level interventions for healthy aging. Developed in collaboration with the target population and expert reviewers, the Older Adult STRAIN was then validated, using a cross-sectional design, in a sample of 126 community-dwelling older adults (ages 59-95 years). Participants completed the Older Adult STRAIN as well as measures of stress (past year, present, daily hassles), mental health (depression, anxiety, quality of life, cognitive function), and physical health (sleep quality, doctor diagnoses). As expected, the Older Adult STRAIN demonstrated good concurrent validity with all stress measures as well as with those assessing mental and physical health. Findings also revealed significant variability in the associations between stress experiences and various health outcomes as a function of stressor type, timing, life domain, and psychosocial characteristic, highlighting the potential for and value of more granular analytical approaches. The present study advances stress research by developing and providing initial validation for a precision tool for assessing cumulative life stress from the perspective of older adulthood. The Older Adult STRAIN is well-positioned to contribute to research that improves clinical care and healthcare policies for aging adults as well as their families and communities.

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