Carolyn Aldwin’s research addresses the impacts of stress. (Illustration: Santiago Uceda)

In general, the researchers found only a few protective factors against these higher levels of stress – people who self-reported that they had good health tended to live longer and married men also fared better. Moderate drinkers also lived longer than non-drinkers.

“Being a teetotaler and a smoker were risk factors for mortality,” said Carolyn Aldwin, lead author of the study and a professor of human development and family sciences at Oregon State University. “So perhaps trying to keep your major stress events to a minimum, being married and having a glass of wine every night is the secret to a long life.”

This is the first study to show a direct link between stress trajectories and mortality in an aging population. Unlike previous studies that were conducted in a relatively short term with smaller sample sizes, this study was modified to document major stressors – such as death of a spouse or a putting a parent into a retirement home – that specifically affect middle-aged and older people.

“Most studies look at typical stress events that are geared at younger people, such as graduation, losing a job, having your first child,” Aldwin said. “I modified the stress measure to reflect the kinds of stress that we know impacts us more as we age, and even we were surprised at how strong the correlation between stress trajectories and mortality was.”

Aldwin said that previous studies examined stress only at one time point, while this study documented patterns of stress over a number of years.

The study, out now in the Journal of Aging Research, used longitudinal data surveying almost 1,000 middle-class and working-class men for an 18-year period, from 1985 to 2003. All the men in the study were picked because they had good health when they first signed up to be part of the Boston VA Normative Aging Study in the 1960s.

Those in the low-stress group experienced an average of two or fewer major life events in a year, compared with an average of three for the moderate group and up to six for the high stress group. One of the study’s most surprising findings was that the mortality risk was similar for the moderate versus high stress group.

“It seems there is a threshold and perhaps with anything more than two major life events a year and people just max out,” Aldwin said. “We were surprised the effect was not linear and that the moderate group had a similar risk of death to the high-risk group.”

While this study looked specifically at major life events and stress trajectories, Aldwin said the research group will next explore chronic daily stress as well as coping strategies.

“People are hardy, and they can deal with a few major stress events each year,” Aldwin said. “But our research suggests that long-term, even moderate stress can have lethal effects.”

Michael Levenson, Heidi Igarashi, Nuoo-Ting Molitor and John Molitor with Oregon State University and Avron Spiro III with Boston University all contributed to this study, which was funded by the National Institute on Aging as well as an award from the U.S. Department of Veterans Affairs.

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For more on Carolyn Aldwin’s research, see The Stress Paradox.

Drawing on a lifetime of ups and downs and knowing that overreacting is not only futile but can be physically harmful, many elders make a reasoned appraisal of events that allows them to stay balanced, says Aldwin, a specialist in stress and aging who has done a number of longitudinal studies with elders, many of them combat veterans.

“Older people simply appraise situations differently,” she notes. “Wisdom tells them when to just let something go or laugh it off or say, ‘It’s in God’s hands’.”

Significantly, the toughening effects of trauma aren’t only psychosocial. Researchers have turned up clear health benefits to what Aldwin calls “stress-related growth” or “post-traumatic growth,” such as more robust immune systems and better heart-attack survival rates.

“To me, coping with stress is the crux of mental health,” Aldwin says. “Stress is ubiquitous. We’re all going to have bad stuff happen to us. What trauma does is show you what’s important – that is, if you can learn from it.”

Carolyn Aldwin's research reveals the power that stems from successfully coping with stress. (Illustration: Santiago Uceda)

Carolyn Aldwin has been privy to countless untold secrets, heartbreaking stories from war zones, hospital wards and prisoner-of-war camps. People from all walks of life have confided their everyday problems and their worst nightmares to her.

“I talked to someone who was a lawyer at the Nuremberg Trials,” she says. “I’ve talked to people who’ve committed murder. I’ve talked to people who’ve lost children to cancer. I’m very humbled by the things people tell me.”

Aldwin, a professor in OSU’s Department of Human Development and Family Sciences, has interviewed thousands of people across the United States, many of them combat veterans, for longitudinal studies of aging. Her findings have shaken up conventional notions about stress and trauma across the lifespan.

“When I was in grad school in the ‘70s, old people were viewed as frail, lonely, depressed and beset by overwhelming stresses and losses,” says Aldwin. “We’ve since learned that stress is fairly constant across the lifespan — that no stage is necessarily more or less stressful than another. What does change as we age is the way we view our troubles and the way we deal with them.”

Events as horrifying as 9/11 or as threatening as today’s tottering economy take on new perspective when seen through eyes that witnessed the Battle of the Bulge or the Great Depression. Aldwin continues to explore coping strategies through her research and to share what she learns with students. She currently teaches a University Honors College class, Coping with Stress.

Double Puzzle

At Leisure World, Carolyn Aldwin stuck out like a sore thumb. The blond, blue-jeaned 29-year-old researcher, crashing temporarily at her uncle’s townhouse, was easy to spot among the silver-haired retirees.

But this newly minted Ph.D. in the field of aging and adult development was thrilled. For her, the sprawling retirement community in Irvine, California, was a big metaphorical petri dish. Eager to discover how elders cope with life’s stressors, the young social scientist spent the next few months talking with her neighbors (average age: 78) about their struggles and worries. Scientists were just beginning to study stress-related health risks, both physical (high blood pressure, immune system suppression, heart disease) and mental (anxiety, depression). The impact of coping strategies on health and well-being was mainly theoretical at that point.

Certain puzzling patterns popped up early on. First, despite their seeming vulnerability to loss and illness, elders tend to report less stress in their lives. “If late life is supposed to be such a miserable time, why are old people reporting fewer stressors than younger people?” Aldwin wondered. This is Paradox One.

Second, most adults find positive aspects — the proverbial silver lining — in even the most wrenching events. This is Paradox Two.

“As a developmental psychologist, I believe events are connected, rather than being discrete, isolated episodes,” Aldwin says. “I wanted to investigate the ways people draw upon earlier experiences, even traumatic ones, when coping with current problems or crises.”

Teasing out the truths behind these two paradoxes has been Aldwin’s driving motivation in the decades since Leisure World. How, she wanted to know, did a soldier whose buddies perished on the battlefield convert that searing trauma into psychosocial strength over time? How could watching one’s child die of cancer mitigate the ill effects of daily stress down the road?

Ask the Right Questions

Aldwin turned up one crucial clue to the first paradox in her Leisure World study. Researchers, she discovered, were asking the wrong questions. The standard survey instrument for major life events was loaded with younger people’s milestones and struggles — marriage, parenting, military service, divorce, unemployment, incarceration. By broadening the questioning, Aldwin found that elders face not fewer stressors, just different ones. It turns out that as people age, they fret less about themselves and more about loved ones. These indirect stressors — a grown child’s job loss, a spouse’s move to a nursing home, a sibling’s struggle with Alzheimer’s — Aldwin calls “network” stressors.

She designed a new survey instrument, the Elders Life Stress Inventory, to account for them.

The new survey, however, failed to resolve the paradox. Instead, the question mark shifted from the amount of stress to the response to stress. With the new instrument, older subjects were reporting life stressors roughly equal in number to those of younger subjects. Yet still they claimed fewer worries. When prodded — “Certainly, you must have some problems”— one man parsed the wording for Aldwin. “I don’t have problems,” the octogenarian told her. “I have concerns.” The biggest of these concerns was his 90-year-old sister suffering from dementia and living alone in New York City. She refused to move, despite his entreaties. So he settled into a philosophical stance (“There’s nothing more I can do”), thereby keeping his emotional equilibrium.

This ability to stave off stress derives from what Aldwin calls “perspective.” Having survived the slings and arrows of life for 60, 70, 80 years, elders often are able to step back and assess new challenges with a steadier gaze. As one man told her, “Once you’ve watched your 20-year-old daughter die of cancer, it’s hard to get really upset about other things.”

Silver Linings

Aldwin and her adviser at the University of California, Irvine, Dan Stokols, both should have grown up to be drug-using dropouts — that is, if you believed the psychological research literature of the 1970s and 1980s. Each had lost a parent in childhood, and delinquency was the expected outcome for kids so bereft. Sitting together in Stokols’ office one autumn afternoon, these two highly accomplished PhDs wondered aloud how they had defied expert predictions. Maybe, they speculated, those predictions were off-base. After all, it was known that geniuses often had older parents who died. Other emerging evidence suggested that remarkable resilience was not only possible, but actually common, in the wake of tragedy. Their curiosity evolved into a research thread.

“We started asking, ‘Are there circumstances under which stress can have positive effects?’” she recalls. “This was a very radical notion at the time.”

No formal, quantitative studies existed then. But the trauma literature from records of tragic events turned up promising leads for further research. In tragedy’s aftermath, many victims reported closer community ties, increased mastery and heightened altruism. The extraordinary lives of many Holocaust survivors, such as Nobel laureates Elie Wiesel and Daniel Kahneman, also seemed to refute the view of trauma as inevitably and irretrievably damaging to the psyche.

To explore this intriguing phenomenon, Aldwin added one question to the 1,000-subject Normative Aging Study then under way in Boston: Was there anything in your earlier life that was useful in helping you deal with a current problem? She was stunned by the response — not so much because 80 percent of the respondents said yes, but because they identified serious, even horrific, occurrences as teachable moments. Battlefield traumas came up often for this population of men, who were mostly veterans of the Korean and Second World wars.

“One guy said, ‘I was shot down at Midway in the Pacific,’” Aldwin recalls. “‘I spent three days bobbing in a lifeboat while the battled raged around me. I thought, if I can survive this, I can survive anything.’” Midway became the yardstick against which he measured every tough spot he faced in later years.

Another veteran said he watched three commanders die on the European frontlines. Being next in rank, he was promoted on the battlefield. He managed to lead his men to safety. Ever after, he gauged life’s challenges against that life-or-death test of his mettle.

Over and over, Aldwin heard this story. Even the fiercest conflict in a boardroom or a courtroom is manageable after you’ve faced down death on the battlefield, the old soldiers said. Psychologists call the phenomenon post-traumatic growth or stress-related growth. “This is not to suggest that combat is good — not at all,” says Aldwin, who has taken flak from colleagues for suggesting that anything positive could come out of the horrors of war. “Trauma has long-term effects. But the guys who were able to find benefits in their military service — whether it was unit cohesion or believing in the mission — were much less likely to exhibit symptoms of post-traumatic stress disorder.”

Aldwin found similar results in another Boston study, the Health and Personality Style Survey. A majority of subjects, 70 percent, reported that trauma led to positive outcomes including closer family ties, better coping skills, more positive values and deeper spirituality.

Observes Aldwin: “Older people understand that problems are finite, that grief is time-limited. They also know that letting yourself get upset when you have a chronic illness like hypertension can trigger a cascade of harmful physiological responses.”

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