Abstract

Stress is an important determinant of health across the lifespan. Stress is a ubiquitous term that captures several interrelated constructs that are often examined in isolation, including stressor exposure, psychological response, and physiological response to stressors. Existing research with children and adolescents has predominantly focused on stressful life events (particularly event count) as the sole indicator of stressor exposure. Other stressor attributes (i.e., timescales, chronicity, life domains, severity of stressful life events) may be inconsistently measured in existing pediatric measures. There is far less research attention on global subjective stress in children and adolescents, a measure of one’s psychological response. Moreover, there is a paucity of research disentangling differences in the conceptualization and measurement of stressful life events and global subjective stress, and how that may decipher their disparate associations with health outcomes. The overarching goal of this research programme was to refine the conceptualization and measurement of stressor exposure and psychological response in children and adolescents.
Three complementary studies were conducted. Study 1, a systematic review, outlined the historical context of major milestones and paradigm shifts in the conceptualization and measurement of stress, and synthesized available pediatric stress measures. Study 1 showed that the majority of measures assess stressor exposure, particularly life events, with few measures examining psychological stress; and, stressor attributes were not comprehensively assessed in these measures (e.g., assessment timeframes chronicity, life domains, severity). Study 2 demonstrated the predictive utility of improving select stressor attributes in the measurement of stressful life events. Yet, even after improving these stressor attributes, global subjective stress still better predicted a range of health outcomes, compared to stressful life events. Study 2 also demonstrated that the stress and health association may be inflated due to mono-informant bias. Using a longitudinal, repeated-measures design, Study 3 suggested that global subjective stress may be a less dynamic construct than originally conceptualized, and demonstrated stable individual differences in adolescents’ global subjective stress.
Overall, the current dissertation programme aimed to harmonize the vast literature on childhood and adolescent stress, and to address select gaps related to the conceptualization and measurement of stressor exposure and psychological response. Research to further dissect the construct of global subjective stress is warranted. This line of inquiry has important implications for the field of stress science.