The Danish psychosocial work environment and symptoms of stress: The main, mediating and moderating role of sense of coherence

Aaron Antonovsky's sense of coherence (SOC) [(1987) Unraveling the Mystery of Health, How People Manage Stress and Stay Well, Jossey-Bass, San Francisco] ought to explain why some people manage stress and stay well while others break down. According to Antonovsky's formulation, SOC is strongly developed if a person sees the world as comprehensible (i.e. rational, understandable, consistent and predictable), as manageable, and as meaningful (i.e. challenging and that things are worth making commitments for). Sense of coherence has gained widespread attention and has been used as an explanatory variable in many studies. This paper discusses some aspects that have not sufficiently been considered in the SOC literature. First, an outline of the construct is given. Next, overlaps and differences with other concepts in the same domain are discussed. Little empirical evidence concerning the stability of SOC is available. Therefore, findings from experimental social psychological studies on self-esteem are applied to SOC. Third, it can be assumed that SOC is an attitude of people who are well educated, are in rather privileged societal positions, and with opportunities for decision-making. Finally, the empirical basis is reviewed. Statistical relationships between SOC and symptoms/disease are in the predicted direction, but due to the simultaneous assessment of variables it is open to debate whether a low SOC has some effect on the probability of falling ill or whether it is the other way around. Very high negative correlations between SOC and depression/anxiety suggest that the instruments used may assess the same phenomenon, but with inverse signs. Based on these considerations, directions for further research are proposed.