California State University, Northridge

Stress

by Ingrid M. Cordon
(spring 1997)

At one time or another, most people experience stress. The term stress has been used to describe a variety of negative feelings and reactions that accompany threatening or challenging situations. However, not all stress reactions are negative. A certain amount of stress is actually necessary for survival. For example, birth is one of the most stressful experiences of life. The high level of hormones released during birth, which are also involved in the stress response, are believed to prepare the newborn infant for adaptation to the challenges of life outside the womb. These biological responses to stress make the newborn more alert promoting the bonding process and, by extension, the child's physical survival. The stress reaction maximizes the expenditure of energy which helps prepare the body to meet a threatening or challenging situation and the individual tends to mobilize a great deal of effort in order to deal with the event. Both the sympathetic/adrenal and pituitary/adrenal systems become activated in response to stress. The sympathetic system is a fast-acting system that allows us to respond to the immediate demands of the situation by activating and increasing arousal. The pituitary/adrenal system is slower-acting and prolongs the aroused state. However, while a certain amount of stress is necessary for survival, prolonged stress can affect health adversely (Bernard & Krupat, 1994).

Stress has generally been viewed as a set of neurological and physiological reactions that serves an adaptive function (Franken, 1994). Traditionally, stress research has been oriented toward studies involving the body's reaction to stress and the cognitive processes that influence the perception of stress. However, social perspectives of the stress response have noted that different people experiencing similar life conditions are not necessarily affected in the same manner (Pearlin, 1982). Research into the societal and cultural influences of stress may make it necessary to re-examine how stress is defined and studied.

There are a number of definitions of stress as well as number of events that can lead to the experience of stress. People say they are stressed when they take an examination, when having to deal with a frustrating work situation, or when experiencing relationship difficulties. Stressful situations can be viewed as harmful, as threatening, or as challenging. With so many factors that can contribute to stress it can be difficult to define the concept of "stress". Hans Selye (1982) points out that few people define the concept of stress in the same way or even bother to attempt a clear-cut definition. According to Selye, an important aspect of stress is that a wide variety of dissimilar situations are capable of producing the stress response such as fatigue, effort, pain, fear, and even success. This has led to several definitions of stress, each of which highlights different aspects of stress. One of the most comprehensive models of stress is the Biopsychosocial Model of Stress (Bernard & Krupat, 1994). According to the Biopsychosocial Model of Stress, stress involves three components: an external component, an internal component, and the interaction between the external and internal components.

The external component of the Biopsychosocial Model of stress involves environmental events that precede the recognition of stress and can elicit a stress response. A previously mentioned, the stress reaction is elicited by a wide variety of psychosocial stimuli that are either physiologically or emotionally threatening and disrupt the body's homeostasis (Cannon, 1932). We are usually aware of stressors when we feel conflicted, frustrated, or pressured. Most of the common stressors fall within four broad categories: personal, social/familial, work, and the environment. These stressful events have been linked to a variety of psychological physical complaints. For example bereavement is a particularly difficult stressor and has provided some of the first systematic evidence of a link between stress and immune functioning. Bereavement research generally supports a relationship between a sense of loss and lowered immune system functioning. Health problems and increased accidents are also associated with stressful work demands, job insecurity and changes in job responsibilities (Bernard & Krupat, 1994). Stressors also differ in their duration. Acute stressors are stressors of relatively short duration and are generally not considered to be a health risk because they are limited by time. Chronic stressors are of relatively longer duration and can pose a serious health risk due to their prolonged activation of the body's stress response.

The internal component of stress involves a set of neurological and physiological reactions to stress. Hans Selye (1985) defined stress as "nonspecific" in that the stress response can result from a variety of different kinds of stressors and he thus focused on the internal aspects of stress. Selye noted that a person who is subjected to prolonged stress goes through three phases: Alarm Reaction, Stage of Resistance and Exhaustion. He termed this set of responses as the General Adaptation Syndrome (GAS). This general reaction to stress is viewed as a set of reactions that mobilize the organism's resources to deal with an impending threat. The Alarm Reaction is equivalent to the fight-or-flight response and includes the various neurological and physiological responses when confronted with a stressor. When a threat is perceived the hypothalamus signals both the sympathetic nervous system and the pituitary. The sympathetic nervous system stimulates the adrenal glands. The adrenal glands release corticosteroids to increase metabolism which provides immediate energy. The pituitary gland releases adrenocorticotrophic hormone (ACTH) which also affects the adrenal glands. The adrenal glands then release epinephrine and norepinephrine which prolongs the fight-or-flight response. The Stage of Resistance is a continued state of arousal. If the stressful situation is prolonged, the high level of hormones during the resistance phase may upset homeostasis and harm internal organs leaving the organism vulnerable to disease. There is evidence from animal research that the adrenal glands actually increase in size during the resistance stage which may reflect the prolonged activity. The Exhaustion stage occurs after prolonged resistance. During this stage, the body's energy reserves are finally exhausted and breakdown occurs. Selye has noted that, in humans, many of the diseases precipitated or caused by stress occur in the resistance stage and he refers to these as "diseases of adaptation." These diseases of adaptation include headaches, insomnia, high blood pressure, and cardiovascular and kidney diseases. In general, the central nervous system and hormonal responses aid adaptation. However, it can sometimes lead to disease especially when the state of stress if prolonged or intense.

Richard Dienstbier (1989) questions the emphasis the GAS places on the role of chronic stress and proposes another model of stress, Physiological Toughening, which focuses on the duration of stressful events. He points out that stressors vary in their durations. Acute stressors are the briefest and often involve a tangible threat that is readily identified as a stressor. Chronic stressors are those of a longer duration and are not readily identified as stressors because they are often ambiguous and intangible. Because chronic stressors have become such a part of modern life, they may be taken for granted and can therefore pose a serious health risk if they are not recognized and properly managed. Physiological Toughening is concerned with the third category of stressors, intermittent stressors. Intermittent stressors are the most variable in duration, alternating between periods of stress and calm. If an intermittent stressor is viewed as a challenge, it may improve one's physiological resistance to stress by causing repeated, periodic increases in sympathetic arousal which conditions the body to better withstand subsequent stressors. This can be seen from research indicating that experienced subjects show few or none of the deleterious effects of environmental stressors. For example, Astronauts are trained to have available response sequences, plans, and problem-solving strategies for all imaginable emergencies. Emergencies are therefore transformed into routine situations decreasing the intensity of the stressful situation (Mandler, 1982).

Mandler's (1982) Interruption Theory of stress provides a transition between the internal component of stress and the interaction component. Mandler defines stress as an emergency signaling interruption. The basic premise is that autonomic activity results whenever some organized action or thought process is interrupted. The term interruption is used in the sense that any event, whether external or internal to the individual, prevents completion of some action, thought sequences, or plan and is considered to be interrupted. Interruption can occur in the perceptual, cognitive, behavioral, or problem-solving domains. The consequences of the interruption will always be autonomic activity and will be interpreted emotionally in any number of ways, ranging from the most joyful to the most noxious.

The third component of the biopsychosocial model of stress is the interaction between the external and internal components, involving the individual's cognitive processes. Lazarus and colleagues (1984b; 1978) have proposed a cognitive theory of stress which addresses this interaction. They refer to this interaction as a transaction, taking into account the ongoing relationship between the individual and the environment. Their theory places the emphasis on the meaning that an event has for the individual and not on the physiological responses. Lazarus et al. believe that one's view of a situation determines whether an event is experienced as stressful or not, making stress the consequence of appraisal and not the antecedent of stress. According to this theory, the way an individual appraises an event plays a fundamental role in determining, not only the magnitude of the stress response, but also the kind of coping strategies that the individual may employ in efforts to deal with the stress.

According to the Transaction Theory of stress, the cognitive appraisal of stress is a two-part process which involves a primary appraisal and a secondary appraisal. Primary appraisal involves the determination of an event as stressful. During primary appraisal, the event or situation can be categorized as irrelevant, beneficial, or stressful. If the event is appraised as stressful, the event is then evaluated as either a harm/loss, a threat, or a challenge. A harm/loss refers to an injury or damage that has already taken place. A threat refers to something that could produce harm or loss. A challenge event refers to the potential for growth, mastery, or some form of gain. Lazarus argues that we cannot assess the origins of stress by looking soley at the nature of the environmental event, rather stress is a process that involves the interaction of the individual with the environment. These categories are based mostly on one's own prior experiences and learning. Also, each of these categories generates different emotional responses. Harm/loss stressors can elicit anger, disgust, sadness, or disappointment. Threatening stressors can produce anxiety and challenging stressors can produce excitement. This theory helps to integrate both the motivational aspects of stress and the varying emotions that are associated with the experience of stress. Secondary appraisal occurs after assessment of the event as a threat or a challenge. During secondary appraisal the individual now evaluates his or her coping resources and options. According to the theory of transactions, stress arises only when a particular transaction is appraised by the person as relevant to his or her well-being. In order for an event to be appraised as a stressor, it must be personally relevant and there must be a perceived mismatch between a situation's demands and one's resources to cope with it.

Dienstbier (1989) offers a reformulation of the Transaction theory, which focuses on the emotional consequences of appraising an event as a stressor or as a challenge. He asserts that when an event is appraised as a challenge, it lead to different physiological consequences than when it is appraised as a harm/loss or threat. Dienstbier uses the term stress to refer to transactions that lead only to negative emotions and he uses the term challenge to describe a transaction that could lead both to positive and negative emotions. A series of studies by Marianne Frankenhaeuser (1986) and colleagues provide some support for Dienstbier's assertion that a stressor evaluated as a challenge should be viewed more positively than a harm/loss or threat event. According to Frankenhaeuser, physiological reactions to stressors depend on two factors: effort and distress. She found that there are three categories of physiological responses to stress. Effort with distress leads to increases of both catecholamine and cortisol secretion and result from daily hassles. These stressors are experienced as negative emotions. This category corresponds to Dienstbier's characterization of the negative emotions present in an event appraised as a harm/loss or as a threat. Effort without distress leads to an increase of catecholamine and suppression of cortisol secretion. These stressors are experienced as positive emotions. This category corresponds to Dienstbier's characterization of the positive emotions present in events appraised as challenging. Distress without effort leads to increased cortisol secretion but not necessarily to catecholamine secretion. This is the pattern often found in depressed individuals.

Traditionally, stress research has been oriented toward studies involving the body's reaction to stressors (a physiological perspective) and the cognitive processes that appraise the event or situation as a stressor (a cognitive perspective). However, current social perspectives of the stress response have noted that different people experiencing similar life conditions are not necessarily affected in the same manner. There is a growing interest in the epidemiology of diseases thought to result from stress. It has been noted that the incidence of hypertension, cardiovascular ailments, and depression varies with such factors as race, sex, marital status, and income. This kind of socioeconomic variation of disease indicates that the stressors that presumably dispose people toward these illnesses are somehow linked to the conditions that people confront as they occupy their various positions and status's in the society. Pearlin (1982) observes that individuals' coping strategies are primarily social in nature. The manner in which people attempt to avoid or resolve stressful situations, the cognitive strategies that they use to reduce threat, and the techniques for managing tensions are largely learned from the groups to which they belong. Although the coping strategies used by individuals are often distinct, coping dispositions are to a large extent acquired from the social environment.

The orientation toward stress research is changing as awareness of the social and cultural contexts involved in stress and coping are examined. The biopsychosocial model of stress incorporates a variety of social factors into its model that influence stress reaction and perception. However, research into the cultural differences that may exist in stress reactions are also needed to examine how various social and cultural structures influence the individual's experience of stress. Culture and society may shape what events are perceived as stressful, what coping strategies are acceptable to use in a particular society, and what institutional mechanisms we may turn to for assistance (Fumiko Naughton, personal communication). Pearlin (1982) suggests that society, its value systems, the stratified ordering of its populations, the organization of its institutions, and the rapidity and extent of changes in these elements can be sources of stress. For example, Merton (1957) suggests that society can elicit stress by promoting values that conflict with the structures in which they are acted upon. Merton argues that the system of values in the United States promotes attainment of monetary and honorable success among more people than could be accommodated by the opportunity structures available. As a consequence, many of those individuals who internalize these culturally prized goals are doomed to failure.

As researchers incorporate a social-cultural perspective to stress research, the definitions of stress, which currently incorporate the physiological and cognitive components of stress, need to be re-examined and re-defined to reflect both social and cultural differences. These social and cultural differences may increase our knowledge about stress and how stress can be effectively managed given the constraints imposed upon the individual by the existing values in a particular culture. A re-definition of stress, that would reflect cultural mediation in the experience of stress, might be that "stress is a set of neurological and physiological reactions that serve an adaptive function in the environmental, social, and cultural values and structures within which the individual acts upon."

This Web site provides information on the characteristics of three different types of stress: Acute, Episodic, and Chronic stress. The information is adapted from The Stress Solution by Lyle H. Miller and Dell Smith. The authors point out that stress management is complicated by the fact that there different types of stress that have their own characteristics, duration and treatment approaches. The different types of stress and their impact on health is discussed.

This Web site is a non-profit organization that serves as a clearing house for information on stress related subjects. The Board of Trustees includes physicians and health professionals with expertise in various stress related subjects. Among the founders of the AIS were Hans Selye and Norman Cousins. They maintain a large library of information on stress related topics.

This Web site provides information on the stress axis involving the neurological and physiological reactions of stress. It is taken from an article in Research News, 1995.

This Web site discusses how a certain amount of stress is necessary and beneficial. Suggestions are provided on how to manage stress so that it can be used in a positive way and prevent it from becoming distress.

The STAR organization is a multidiciplinary, international organization of researchers who exchange research findings and clinical applications on a wide range of stress and anxiety related phenomena.

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