Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Anthony R. Hatch, PhD

Second Advisor

Daniel Carlson, PhD

Third Advisor

Erin Ruel, PhD


Chronic illness affects nearly half of all American adults, yet this experience is often regarded as socially normative for older adults. In this study, I examined chronic illness onset early in the life course and its effects on mastery, a person’s self-perception as capable of coping with and managing life’s circumstances, and depressive symptoms as informed by the life course perspective and the stress process model. Using multilevel modeling of American Changing Lives Survey (ACLS) data, I examined the following questions: What is the relationship between early onset chronic illness and mastery? Second, what is the relationship between early onset chronic illness and depressive symptoms? Does mastery mediate the relationship between early onset chronic illness and depressive symptoms? Is early onset chronic illness (24-35) more strongly associated with decreased mastery and increased depressive symptoms than illness onset at the more socially normative life stages of mid-life (36-64) and late-life (65 years and older)? Lastly, does mastery mediate or moderate the relationship between timing of illness onset and depressive symptoms? Through this study, I aim to contribute to sociological knowledge of whether and how chronic illness impacts mastery and depression among young adults. I argue that ill-timed chronic illness impacts young adults’ sense of control over their lives, which has enduring psychological and social consequences. Findings support that healthy and chronically ill young adults do not significantly differ on mastery, but ill young adults report significantly higher depressive symptoms than healthy same age peers. Mastery moderates the effects of timing of illness onset on depressive symptoms with older adults reaping greater benefit from mastery against depressive symptoms than young adults with early onset illness. These findings suggest that early onset chronic illness positions people at greater risk for poor mental health outcomes and that the chronic illness experience and its effects are not uniform across the life course. Consequently, work in this area must consider age as an important context in which the life event of chronic illness onset occurs.

Available for download on Wednesday, May 01, 2019