Cognitive appraisal vs. exposure-based stress measures: links to perceived mental and physical health in low-income black women.

Although stress is linked to mental and physical health, self-reports of stress may be operationalized using measures that emphasize cognitive appraisals of stressors or that simply record stressor exposure. Theory and research suggest that appraisal-based measures may be superior in measuring self-reports of stress. However, use of exposure-based measures persists, especially in ethnic disparities research. This study examined the utility of appraisal-based versus exposure-based stress measures in linking stress to mental and physical health in low-income black women. Measures emphasizing cognitive appraisals were superior in predicting mental and physical health because global stress rating best predicted physical health whereas mental health was best predicted by perceived stress. A checklist of exposure to stressful events was not substantially predictive of either mental or physical health, suggesting that cognitive appraisals of stressors are important in linking stress to health perceptions in blacks. The results also suggest that stress impacts mental health first, which then, in turn, influences physical health. Overall, these results illuminate the importance of cognitive appraisals in linking stress to perceptions of mental and physical health in black women.