What are theories of stress?
Researchers are trying to answer questions regarding how thoughts and feelings can be translated to changes in the body and whether prolonged stress alters health in life-threatening ways. These questions are new versions of much older ones that for centuries have addressed the dichotomy between mind and body. Unlike most areas within psychology, the study of stress did not begin until well into the twentieth century. Theories of stress began to play an important role as the physiological responses to stress and the potential relationships between stress and illness were systematically investigated.
The first important theorist who attempted to account for stress was Walter Bradford Cannon. He claimed that the sympathetic nervous system is activated by signals from the brain when a person is exposed to an emotionally arousing stimulus. This produces a series of physiological reactions that includes increases in heart rate, blood pressure, and respiration. This fight-or-flight response prepares the person for potential vigorous physical activity. According to Cannon, the confrontation with an arousing stimulus produces both the feelings and physiological reactions that are associated with stress. Although the contributions of Cannon were important, they did not take into consideration the role played by psychological and behavioral factors in the overall stress response.
The work of Cannon paved the way for the efforts of the most renowned stress theorist, Hans Selye, who claimed that stress is nonspecifically induced and can be caused by diverse stimuli. It does not matter if the event is a major disaster, an uncooperative colleague, or a disobedient child. The important point to remember is that if the event is stressful for a person, the person’s bodily reaction remains the same. Selye labeled the body’s response to stress the general adaptation syndrome. This process occurs in three stages. Stage one is the alarm reaction, during which the body activates to handle the perceived danger at hand. This activation resembles Cannon’s fight-or-flight response. Blood is diverted to the skeletal muscles to prepare them for action. The second phase of the general adaptation syndrome is the resistance stage. During this stage, the person either adapts to or resists the source of stress. The longer this stage lasts, the greater is the danger to the person. If the individual accepts the source of stress as a necessary part of life, the stressor may persist indefinitely. The person then gradually becomes more susceptible to a wide range of stress-related problems and diseases including fatigue, headaches, hypertension, certain forms of cancer, and cardiovascular disease. These are but a few of the physical problems that are potentially related to stress. The third stage is the exhaustion stage. This demonstrates the finite nature of the body’s ability to battle or adapt to stress. If the stressor is extremely intense and persists over a long period of time, the exhaustion stage sets in and the risk of emotional and physical problems increases. In Selye’s system, the precise nature of the source of the stress is unimportant. The reaction is hypothesized to be the same in the face of physiological and psychological stressors.
Cannon and Selye clearly focused on stress as a person’s biological response to a wide range of stimuli. Selye emphasized the nonspecific nature of the stress response. This position was criticized by John Mason, who maintained that while the general adaptation syndrome does exist, responses differ according to the stimuli. He viewed stress as dependent on emotional responses to situations. It is the nature of a person’s emotional response that will play an important role in the probability that stress will lead to disease. People who are not psychologically aware of the existence of a potentially stressful event are least likely to experience a stress response. Mason believed that Selye’s approach is too simplistic and does not provide ample opportunities to explain why some people develop stress-related disorders and others do not.
In 2000, Shelley Taylor and her colleagues proposed that although fight-or-flight may characterize the primary physiological responses to stress for both men and women, behaviorally women’s responses are more marked by a pattern of “tend and befriend.” Tending, or the nurturing activities that protect the self and offspring, promotes safety and reduces distress; befriending is the creation and maintenance of social networks that may aid in this process. The brain-behavior mechanism that underlies the tend-and-befriend pattern appears to draw on the attachment-caregiving system. Evidence from animal and human studies suggests that the neuropeptide oxytocin, in conjunction with female reproductive hormones and endogenous opioid peptide mechanisms, may be at its core of this previously unexplored stress regulatory system.
The theories of Cannon and Selye emphasize biological factors, while Mason’s theory is typically described as an interactionist approach to stress. The psychological approach to stress is best represented by the work of Richard Lazarus. He claims that the key to a stress response cannot be found in either the nature of a specific stressful event or people’s psychological responses to that event. Rather, the most important factors are cognitive ones. Lazarus believes that it is people’s perception of an event that is crucial. This involves a combination of people’s perceptions regarding the potential danger of an event and their ability to cope with it. Stress will occur in those circumstances in which people perceive that they do not have the ability or resources needed to cope with the situation.
Clearly, an important factor within the stress equation provided by Lazarus is appraisal of the situation. Along with his colleague Susan Folkman, Lazarus has described three types of appraisal of a potentially stressful situation. The first to occur is the primary appraisal. When people are exposed to a new event such as a spouse returning to work, the situation can be judged as irrelevant, positive, or potentially stressful. The key to the stress is the people’s appraisal of the situation, rather than the situation itself. Next in the appraisal process is the secondary appraisal. It is at this point that people determine their ability to control, handle, or cope with the new situation. During this process, people examine potential options for dealing with an event, that is, their ability to make use of one or more of these options and a consideration of the success potential of each option, or whether they are likely to be successful in making this option work for themselves. The final type of appraisal is reappraisal. During this process, people reevaluate the stressful potential of a situation based on access to new thoughts and information. This can lead to an increase or decrease in stress. For example, the man who might have been mildly stressed by his wife’s return to work may experience a decrease in stress as the family finances improve and he learns that many domestic tasks which he must now perform are less noxious than he originally thought. On the other hand, his stress may increase if he determines that he has less free time and that the cost of babysitters has removed the potential for financial improvement associated with his wife’s return to work outside the home.
An alternative to the appraisal-based conception of stress and coping developed by Lazarus and Folkman is the resource-based approach to the stress process first proposed by S. E. Hobfoll in the late 1980s. Resources were defined as those things that people value or that act as a means to obtaining that which they value and include social, personal, object, and condition resources. The conservation of resource theory has been applied, for example, to assess the impact of resource losses and gains that occur in women’s lives. One study found that resource losses better predicted postpartum anger and depression than resource gains (in the opposite direction).
Whether they support a biological, interactionist, or psychological approach to stress, all theorists agree that stress has the capability of increasing the risk of suffering various forms of illness. In addition, many theorists believe that important relationships exist between stress, personality, and susceptibility to disease.
Potentially stressful events occur in everyone’s life. Many people, however, never develop stress-related symptoms and illnesses. This may result in part from issues pertaining to lifestyle and personality. One interesting approach to this problem has been provided by Suzanne Kobasa. She found that several personality factors are helpful in people’s efforts to avoid illness in the face of stress. These factors are control, commitment, and challenge. When faced with difficult events, people can view the situation either as hopeless or as one over which they have a degree of control. In a situation in which a man is notified that the factory in which he works is going to close in three years, it is normal initially to treat the news with shock and disappointment, but it is the worker’s long-term response that is critical. On one hand, he can continue to report for work during the next three years and commiserate with his colleagues. He can make the statement that the factory is going to close and there is nothing he can do about it. This response is likely to lead to gradual increases in stress and susceptibility to illness. On the other hand, he could take control of the situation by looking for other work, entering a job retraining program, or returning to school on a part-time basis. This approach is likely to decrease his risk of stress-related illness.
The second factor, commitment, involves people’s dedication to and involvement with other people, activities, institutions, and themselves. Some people have nowhere to turn in the presence of a stressful event. They have no friends, family ties have been severed, and they are loners who have no goal in life other than to wake up the next morning. These individuals will find it extremely difficult to cope with a stressful event such as the death of a parent or loss of a job. They may feel that they have nowhere to turn in the face of adversity; they lack the social supports that help one cope with stressful situations. These people are highly susceptible to those illnesses that are associated with stress. Conversely, people with many friends, strong family ties, and a sense of purpose in life will be better able to cope with significant stress.
The final factor, challenge, relates to people’s view of changes in their life. For example, a secretary who is transferred from one department at work to another, and who views this change as presenting interesting and new challenges, is likely to remain healthy. However, if she views the new position as a threat that should be avoided at all costs, she is likely to become ill. The three factors of control, commitment, and challenge make up an overall factor known as hardiness. The person who maintains high levels of these three factors has a high level of hardiness and is not a likely candidate for stress-related illnesses.
Perhaps the most talked-about and researched personality factor that has been related to stress is the type A personality. Type A people are always on the go and are extremely driven. They walk fast, talk fast, are impatient with others, and are easily angered. Type A people are workaholics who measure life in numbers. They are concerned about money earned and saved, hours worked, praise received, and clients served. They always have a sense of time urgency. Type B people are just the opposite. They are relaxed and easygoing and never seem in a hurry to do anything.
Research on the topic of the type A personality, spearheaded by Meyer Friedman and Ray Rosenman, has traditionally maintained that the type A personality is associated with increased stress and, more important, an increased risk of heart disease. This finding has been supported in at least forty research studies. For many years, the notion that type A behavior was a risk factor for heart disease was taken for granted by many health professionals; however, several studies have failed to support this relationship. Researchers have attempted to account for these discrepancies. The mystery appears to have been solved in that it has been discovered that not all type A behaviors are associated with increased risk of heart disease. The key factors appear to be anger and hostility. Those type A people who are angry and hostile are likely to convert potentially stressful situations into disease. The best advice that can be given to the typical type A angry person is to learn to respond to situations without anger. This does not mean that anger that is felt should be held inside. Rather, the person should learn to respond to situations with feelings and emotions other than anger.
Evidence increasingly indicates that stress can influence the immune response, the body’s defense against many types of illness. Research with animals has demonstrated the direct impact of various stressors on the immune system and, consequently, on infectious, malignant, and autoimmune diseases. Human studies also suggest that stress can adversely affect the body’s immune response.
People must learn to cope with situations in ways that do not lead to increased stress and increased risk of disease. The good news is that many such strategies have proved to be very effective in helping people deal with those potentially stressful situations that seem to occur in the lives of everyone. The work of pioneers such as Cannon and Selye as well as that of late twentieth- and early twenty-first-century scientists has opened up many new avenues of research related to stress and stress management. The potential role of stress in a wide range of diseases including cancer is being explored. It can be anticipated that the future will bring to light many new and unexpected relationships between stress and health.
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