A long and resilient life: the role of coping strategies and variability in their use in lifespan among women

ABSTRACT

Objectives

Associations of stress-related coping strategies with lifespan among the general population are understudied. Coping strategies are characterized as being either adaptive or maladaptive, but it is unknown the degree to which variability in tailoring their implementation to different contexts may influence lifespan.

Method

Women (N = 54,353; M_age= 47) completed a validated coping inventory and reported covariate information in 2001. Eight individual coping strategies (e.g., Acceptance, Denial) were considered separately. Using a standard deviation-based algorithm, participants were also classified as having lower, moderate, or greater variability in their use of these strategies. Deaths were ascertained until 2019. Accelerated failure time models estimated percent changes and 95% confidence intervals (CI) in predicted lifespan associated with coping predictors.

Results

In multivariable models, most adaptive and maladaptive strategies were associated with longer and shorter lifespans, respectively (e.g., per 1-SD increase: Active Coping = 4.09%, 95%CI = 1.83%, 6.41%; Behavioral Disengagement = −6.56%, 95%CI = −8.37%, −4.72%). Moderate and greater (versus lower) variability levels were similarly and significantly related to 8-10% longer lifespans. Associations were similar across age, racial/ethnic, residential income, and marital status subgroups.

Conclusions

Findings confirm the adaptive and maladaptive nature of specific coping strategies, and further suggest benefits from both moderate and greater variability in their use for lifespan among women.

KEYWORDS:

• Adjustment
• flexibility
• longevity
• regulation
• stress
• variability

Acknowledgements

The authors would like to thank the participants and the staff of the Nurses’ Health Study at the Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA, for their valuable contributions. The authors would also like to acknowledge the contribution to this study from central cancer registries supported through the Centers for Disease Control and Prevention’s National Program of Cancer Registries (NPCR) and/or the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program. Central registries may also be supported by state agencies, universities, and cancer centers. Participating central cancer registries include the following: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Maine, Maryland, Michigan, Mississippi, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, Seattle SEER Registry, South Carolina, Tennessee, Texas, Utah, Virginia, West Virginia, Wyoming. The authors assume full responsibility for analyses and interpretation of these data.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Institute on Aging of the National Institutes of Health [grant no R01-AG053273]. The Nurses’ Health Study II was funded by the National Cancer Institute of the National Institutes of Health [grant no U01 CA176726, U01 HL145386]. CTF is the Junior Research Chair on Social Disparities, Stress-Related Coping, and Health at Université du Québec à Trois-Rivières and received salary support from the Lee Kum Sheung Center for Health and Happiness. AJG received salary support from the Lee Kum Sheung Center for Health and Happiness at the Harvard T.H. Chan School of Public Health and the Canadian Institutes of Health Research. LOL [grant no K08-AG048221, RF1-AG064006] and RC [grant no 4K00AG068431-02] were supported by the National Institute on Aging of the National Institutes of Health and PJ [grant no R00-CA201542] was supported by the National Cancer Institute of the National Institutes of Health. This study was also informed by the Michigan Integrative Well-Being and Inequality (MIWI) Training Program, which is funded by a grant from the National Institutes of Health [grant no R25-AT0106641]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. Further information including the procedures to obtain and access data from the Nurses’ Health Studies is described at https://www.nurseshealthstudy.org/researchers (contact email: [email protected]); study materials are available at: https://www.nurseshealthstudy.org/participants/questionnaires. Analytic methods will be provided upon request to the first author. This study was not preregistered.