Expectancies, Socioeconomic Status, and Self-Rated Health: Use of the Simplified TOMCATS Questionnaire
Coping has traditionally been measured with inventories containing many items meant to identify specific coping strategies. An alternative is to develop a shorter inventory that focusses on coping expectancies which may determine the extent to which an individual attempts to cope actively.
This paper explores the usefulness and validity of a simplified seven-item questionnaire (Theoretically Originated Measure of the Cognitive Activation Theory of Stress, TOMCATS) for response outcome expectancies defined either as positive (“coping”), negative (“hopelessness”), or none (“helplessness”). The definitions are based on the Cognitive Activation Theory of Stress (CATS; Ursin and Eriksen, Psychoneuroendocrinology, 29(5):567–92, 2004). The questionnaire was tested in two different samples. First, the questionnaire was compared with a traditional test of coping and then tested for validity in relation to socioeconomic differences in self-reported health.
The first study was a comparison of the brief TOMCATS with a short version of the Utrecht Coping List (UCL; Eriksen et al., Scand J Psychol, 38(3):175–82, 1997). Both questionnaires were tested in a population of 1,704 Norwegian municipality workers. The second study was a cross-sectional analysis of TOMCATS, subjective and objective socioeconomic status, and health in a representative sample of the Swedish working population in 2003–2005 (N = 11,441).
In the first study, the coping item in the TOMCATS questionnaire showed an expected significant positive correlation with the UCL factors of instrumental mastery-oriented coping and negative correlations with passive and depressive scores. There were also the expected correlations for the helplessness and hopelessness scores, but there was no clear distinction between helplessness and hopelessness in the way they correlated with the UCL. In the second study, the coping item in TOMCATS and the three-item helplessness scores showed clear and monotonous gradients over a subjective socioeconomic status (SES) ladder. Positive response outcome expectancy (“coping”) was related to high subjective SES and no expectancy (“helplessness”) to low subjective SES. In a model including age and sex, TOMCATS scores explained more variance (r 2 = 0.16) in self-reported health than both subjective (r 2 = 0.08) and objective SES (r 2 = 0.02).
The brief TOMCATS questionnaire showed acceptable and significant correlations with a traditional coping questionnaire and is sensitive enough to register systematic differences in response outcome expectancies across the socioeconomic ladder. The results furthermore confirm that psychological and learning factors contribute to the socioeconomic gradient in health.
- Lazarus R, Folkman S. Stress, appraisal and coping. New York: Springer; 1984.
- Ursin H, Eriksen HR. The cognitive activation theory of stress. Psychoneuroendocrinology. 2004;29(5):567–92. CrossRef
- DeSalvo K, Bloser N, Reynolds K, He J, Muntner P. Mortality prediction with a single general self-rated health question. J Gen Intern Med. 2006;21(3):267–75. doi:10.1111/j.1525-1497.2005.00291.x. CrossRef
- Rohland BM, Kruse GR, Rohrer JE. Validation of a single–item measure of burnout against the Maslach Burnout Inventory among physicians. Stress Heal. 2004;20(2):75–9. doi:10.1002/smi.1002. CrossRef
- Zhang Y, Rohrer J, Borders T, Farrell T. Patient satisfaction, self-rated health status, and health confidence: an assessment of the utility of single-item questions. Am J Med Qual. 2007;22(1):42–9. doi:10.1177/1062860606296329. CrossRef
- Robins RW, Hendin HM, Trzesniewski KH. Measuring global self-esteem: construct validation of a single-item measure and the Rosenberg Self-Esteem Scale. Pers Soc Psychol Bull. 2001;27(2):151–61. doi:10.1177/0146167201272002. CrossRef
- Davey HM, Barratt AL, Butow PN, Deeks JJ. A one-item question with a Likert or visual analog scale adequately measured current anxiety. J Clin Epidemiol. 2007;60(4):356–60. doi:16/j.jclinepi.2006.07.015. CrossRef
- Chochinov HM, Wilson KG, Enns M, Lander S. “Are you depressed?” Screening for depression in the terminally ill. Am J Psychiatry. 1997;154(5):674–6.
- Kawase E, Karasawa K, Shimotsu S, Imasato S, Ito K, Matsuki H, et al. Evaluation of a one-question interview for depression in a radiation oncology department in Japan. Gen Hosp Psychiatry. 2006;28(4):321–2. CrossRef
- Lloyd-Williams M, Dennis M, Taylor F, Baker I. Is asking patients in palliative care, “are you depressed?” appropriate? Prospective study. Br Med J. 2003;327(7411):372–3. CrossRef
- Reme SE, Eriksen HR. Is one question enough to screen for depression? Scand J Public Health. 2010;38(6):618–24. doi:10.1177/1403494810376559. CrossRef
- Dalstra J, Kunst A, Borrell C, Breeze E, Cambois E, Costa G, et al. Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries. Int J Epidemiol. 2005;34(2):316–26. doi:10.1093/ije/dyh386. CrossRef
- Marmot MG. Inequalities in health. N Engl J Med. 2001;345(2):134–6. CrossRef
- Kristenson M, Eriksen HR, Sluiter JK, Starke D, Ursin H. Psychobiological mechanisms of socioeconomic differences in health. Soc Sci Med. 2004;58(8):1511–22. doi:10.1016/S0277-9536(03)00353-8. CrossRef
- Eriksen HR, Olff M, Ursin H. The CODE: a revised battery for coping and defense and its relations to subjective health. Scand J Psychol. 1997;38(3):175–82. CrossRef
- Kinsten A, Magnusson Hanson L, Hyde M, Oxenstierna G, Westerlund H, Theorell T. SLOSH—Swedish Longitudinal Occupational Survey of Health: a nationally representative psychosocial survey of the Swedish working population. Stress Research Reports. Stockholm: Stress Research Institute; 2007.
- Magnusson Hanson LL, Theorell T, Oxenstierna G, Hyde M, Westerlund H. Demand, control and social climate as predictors of emotional exhaustion symptoms in working Swedish men and women. Scand J Public Health. 2008;36(7):737–43. doi:10.1177/1403494808090164. CrossRef
- Eriksen HR, Murison R, Pensgaard AM, Ursin H. Cognitive activation theory of stress (CATS): from fish brains to the Olympics. Psychoneuroendocrinology. 2005;30(10):933–8. doi:10.1016/j.psyneuen.2005.04.013. CrossRef
- Schreurs K, van de Willige G, Brosschot J. De Utrechtse Coping Lijst [Utrecht Coping Questionnaire]. Lisse: Swets and Zeitlinger; 1993.
- Idler EL, Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997;38(1):21–37. doi:10.2307/2955359. CrossRef
- Miilunpalo S, Vuori I, Oja P, Pasanen M, Urponen H. Self-rated health status as a health measure: the predictive value of self-reported health status on the use of physician services and on mortality in the working-age population. J Clin Epidemiol. 1997;50(5):517–28. doi:10.1016/S0895-4356(97)00045-0. CrossRef
- Mossey JM, Shapiro E. Self-rated health: a predictor of mortality among the elderly. Am J Public Health. 1982;72(8):800–8. doi:10.2105/AJPH.72.8.800. CrossRef
- Operario D, Adler NE, Williams DR. Subjective social status: reliability and predictive utility for global health. Psychol Health. 2004;19(2):237–46. doi:10.1080/08870440310001638098. CrossRef
- Miyakawa M, Magnusson Hanson LL, Theorell T, Westerlund H. Subjective social status: its determinants and association with health in the Swedish working population (the SLOSH Study). Eur J Public Health. 2012. doi:10.1093/eurpub/ckr064.
- Singh-Manoux A, Adler NE, Marmot MG. Subjective social status: its determinants and its association with measures of ill-health in the Whitehall II Study. Soc Sci Med. 2003;56(6):1321–33. doi:10.1016/S0277-9536(02)00131-4. CrossRef
- Cohen J. Applied multiple regression/correlation analysis for the behavioral sciences (vol. 3). Mahwah, NJ: Lawrence Erlbaum; 2003.
- Chen G, Gully SM, Eden D. Validation of a new general self-efficacy scale. Organ Res Methods. 2001;4(1):62–83. doi:10.1177/109442810141004. CrossRef
- Leganger A, Kraft P, Røysamb E. Perceived self-efficacy in health behaviour research: conceptualisation, measurement and correlates. Psychol Health. 2000;15(1):51–69. doi:10.1080/08870440008400288. CrossRef
- Eriksen HR, Ursin H. Social inequalities in health: biological, cognitive and learning theory perspectives. Norsk Epidemiologi. 2002;12(1):33–8.
- Odéen M, Kristensen LO, Ursin H. Coping and return to work: measurement and theoretical issues. Norsk Epidemiologi. 2010;19(2):173–8.
- Bandura A. Self-efficacy the exercise of control. New York: Freeman; 1997.
- Schwarzer R, Jerusalem M. The Generalized Self-Efficacy scale. In: Weinmann J, Wright S, Johnston M, editors. Measures in health psychology: a user’s portfolio. Causal and control beliefs. Windsor, UK: Nfer-Nelson; 1995. p. 35–7.
- Bandura A, Barbaranelli C, Caprara GV, Pastorelli C. Self–efficacy beliefs as shapers of children’s aspirations and career trajectories. Child Dev. 2001;72(1):187–206. doi:10.1111/1467-8624.00273. CrossRef
- Lent RW, Brown SD, Larkin KC. Relation of self-efficacy expectations to academic achievement and persistence. J Couns Psychol. 1984;31(3):356–62. doi:10.1037/0022-0188.8.131.526. CrossRef
- Judge TA, Bono JE. Relationship of core self-evaluations traits—self-esteem, generalized self-efficacy, locus of control, and emotional stability—with job satisfaction and job performance: a meta-analysis. J Appl Psychol. 2001;86(1):80–92. doi:10.1037/0021-9010.86.1.80. CrossRef
- Zajacova A, Dowd JB. Reliability of self-rated health in US adults. Am J Epidemiol. 2011;174(8):977–83. doi:10.1093/aje/kwr204. CrossRef
- Expectancies, Socioeconomic Status, and Self-Rated Health: Use of the Simplified TOMCATS Questionnaire
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
International Journal of Behavioral Medicine
Volume 20, Issue 2 , pp 242-251
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Cognitive Activation Theory of Stress (CATS)
- Socioeconomic gradient in health
- TOMCATS inventory
- SES ladder
- Author Affiliations
- 1. Uni Health, Uni Research, Bergen, Norway
- 3. Clinic Physical Medicine and Rehabilitation, Kysthospitalet, Vestfold Hospital Trust, Stavern, Norway
- 5. Uni helse, Postboks 7810, 5020, Bergen, Norway
- 2. Stress Research Institute, Stockholm University, Stockholm, Sweden
- 4. Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway