Author's School

Brown School of Social Work

Author's Department/Program

Social Work


English (en)

Date of Award

January 2009

Degree Type


Degree Name

Doctor of Philosophy (PhD)

Chair and Committee

Nancy Morrow-Howell


Alcohol misuse by older adults is a significant public health concern and is projected to worsen with the aging of the "baby boom" generation. To help understand the nature of older adult alcoholism, it is crucial to investigate factors such as stress that may influence consumption and problem use among older adults. Findings are mixed on the role of stress and coping in alcohol use, and studies comparing the role of stress and coping in alcohol use on different age groups are rare. Therefore, this study had the following aims: 1) To test a stress and coping model of current alcohol use, at-risk drinking, and alcohol-related problems in a nationally representative sample of older adults; 2) To investigate cohort differences in the Stress and Coping model between young adult: 20-39), early middle age: 40-59), and older adult: 60+) life stages. This investigator conducted secondary analysis of the National Epidemiologic Survey of Alcohol and Related Conditions: NESARC). An overall model of stress and coping was tested using structural equation modeling: SEM) with a subsample of older adult, middle-aged, and young adult current drinkers. Multiple group models tested group differences in the overall model, and interaction tests were conducted to test for a stress buffering effect of social support. Older adults endorsed lower levels of stressful life events, cognitive appraisal of stress and social support than younger age groups; alcohol consumption, at-risk drinking and rate of alcohol problems were also lower. In all age groups, higher levels of stressful events were associated with cognitive appraisal of stress, but in older adults, cognitive appraisal was associated with decreases in alcohol use. Among younger age groups, cognitive appraisal was associated with problem use, but not at-risk drinking or increased consumption. Interaction models were nonsignificant, suggesting that social support does not buffer the effect of stressful events on cognitive appraisal. The overall findings highlight limits of a global stress and coping model of alcohol use. Implications include the need to consider contextual and developmental factors in stress-related drinking including unique stresses in late life, and changing relationships between stress and drinking in older adulthood.


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