The Importance of the Self-Concept and Coping Responses in Explaining Physical Health Status and Depression among Older Women

This study examined a model specifying the links among the physical, functional, and subjective components of physical health status and depression among older women, and assessed the effects of the self-concept (i.e., health confidence and self-esteem) and coping responses (i.e., direct action, positive cognitive, and passive cognitive coping) at each point in the model. Based on cross-sectional interview data with 274 older women, a series of regression analyses indicated that the self-concept and coping responses were significantly involved at each step of the health process but that the specific effects of the self-concept were different earlier than later in the model. Earlier in the model, self-esteem and physical health status indirectly influenced subsequent health status through their effects on health confidence and the cognitive coping responses. At the final point in the model, physical health status continued to operate indirectly through health confidence and the cognitive coping responses, however, health confidence and positive cognitive coping responses then directly affected self-esteem which, together with health confidence, subsequently had direct negative effects on depression. These results were interpreted within a social psychological framework that incorporated self-concept theory with cognitive theories of depression.