The ability of the stress process model to explain mental health outcomes.

No theory adequately explicates the relationships between stress, social support, and health. The recently developed Stress Process Model incorporates multiple levels of support and stress at the individual, family, and community level, with a focus on predicting mental health outcomes. The purpose of this study was to use an existing database to assess the predictive value of the Stress Process Model in explaining mental health outcomes in community-dwelling subjects with and without panic attacks. This study is a secondary analysis using data obtained in 1990 through 1991 for the Panic Attack Care-Seeking Threshold (PACT) study. Subjects who agreed to participate completed an in-depth interview concerning demographic features, panic characteristics, chronic medical problems, family characteristics, illness attitudes and behaviors, coping strategies, symptom perceptions, psychiatric morbidity, health care utilization, and functional status. The utility of the Stress Process Model is supported by three lines of reasoning. First, most of the relationships predicted by the model were documented in this study. Second, the model accounted for significant amounts of variance in moderating factors, primary and secondary stressors, and mental health outcomes. Finally, two of the three hypotheses were supported by this study. The integration of family and neighborhood variables into the stress process should be attractive to mental health workers in primary care and community settings. Copyright 2002, Elsevier Science (USA). All rights reserved.