Resilience, misfortune, and mortality: evidence that sense of coherence is a marker of social stress adaptive capacity.

Objective: The purpose of this study is to test the hypothesis that sense of coherence (SOC) distinguishes adaptive capacity to adverse event experience.

Methods: A population-based cohort of 20,921 men and women completed a postal assessment of their lifetime experience of specific adverse events and a measure of their SOC. Reports of 111,857 events allowed construction of measures of event impact and adaptation.

Results: Those with a weak SOC reported significantly slower adaptation to the adverse effects of their event experiences than those with a strong SOC (P<.0001). During mean follow-up of 6.7 years, 1617 deaths were recorded. A one standard deviation increase in mean adaptation score (representing slower adaptation) was associated with a 6% increase in mortality rate (P=.03) after adjusting for age and sex. Measures of event occurrence and impact were less strongly associated with SOC and were not significantly associated with mortality.

Conclusion: These results suggest that SOC is a potential marker of an individual's social stress adaptive capacity, which is predictive of mortality.