Differences in stress coping between individuals from Germany and American Samoa and their relation to obesity, perceived stress, and depressive symptoms.

Stress and how individuals cope with it can have substantial implications for health. As the socio-cultural environment influences individual perceptions of stress and coping behavior, differences between cultural groups may have different effects on physical and mental health. Using qualitative interviews and questionnaires, this study examined cultural differences in stress coping and their interplay with perceived stress (Perceived Stress Questionnaire, Trier Inventory for Chronic Stress), BMI (normal-weight, obesity), and depressive symptoms (Beck Depression Inventory Short Form) in young adults from Germany (individualistic society, n = 120) and American Samoa (collectivistic society, n = 56). Stress coping strategies were assessed through interviews, after which the data were quantified as problem-focused, emotion-focused, or avoidance coping. Group differences in coping strategies were analyzed using Gamma generalized linear models, group differences in perceived stress and depressive symptoms were analyzed using univariate ANCOVAs. The results showed that the German group used more problem-focused coping, while the Samoan group used more avoidance coping. The use of avoidance coping was associated with higher perceived stress in the German group but with lower perceived stress in the Samoan group. In general, depressive symptoms were higher among participants from the Samoan than the German group. However, Samoan individuals with obesity who used avoidance coping had lower depressive symptoms than Samoan individuals with obesity who did not. This difference was not observed in the German group. Irrespective of cultural background, individuals with obesity tended to use more avoidance and less emotion-focused coping, and to report eating more during stress compared to individuals with normal-weight. On the one hand, our findings may contribute to a better understanding of how the cultural environment influences stress coping and its potential adaptive effects on perceived stress and depressive symptoms, highlighting the need for culturally appropriate stress management interventions. On the other hand, the association between weight status and avoidance coping might be relatively stable across cultures, offering opportunities for intervention.