The role of predisposing and moderating factors in the stress-illness relationship.

Longitudinal data on 267 married couples are used to examine the interrelationships among predisposing factors, stress, moderating factors, and subsequent functioning. A model of the stress process that considers spouse symptoms and coping was estimated separately for three functioning criteria (depressed mood, physical symptoms, and alcohol, consumption) and across gender groups. Predisposing factors such as low social status and poor initialfunctioning were related to higher levels of stress. Women were more responsive to stressors and social resources (family support) than were men. The stress-illness relationship was strengthened by the use of avoidance coping responses, particularly if both partners relied on avoidance coping. There were no stress-buffering effects offamily support. The associations between self-esteem, coping responses, and later functioning depended on the partner's corresponding coping levels. These findings underscore the value of considering a significant other's symptoms and behavior as salient aspects of the stress process.