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Psychological stress, like the general term ‘stress,’ is a common term that deﬁes a universally agreed-upon deﬁnition. These diﬃculties are not due to a lack of interest in the concept; rather, they are due to a widespread fascination with psychological phenomena related to organism–environment interactions. It is the inherent complexity of this enterprise that attracts and vexes investigators. In the place of a standard deﬁnition of psychological stress, three diﬀerent perspectives have evolved with their own deﬁnitions, as well as their own conceptual and methodological traditions.
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1. Historical Considerations And Concerns
Interest in the implications of emotions for health is age-old, dating back to the origins of holistic approaches to medicine exempliﬁed by the writings of Hippocrates (400 BC). Interest in the inﬂuence of psychological factors on emotional functioning has consequently represented a parallel theme of interest over the centuries. The basic premise is that stress gives rise to distressing emotions, which in turn inﬂuence disease. Yet the connections between these words and ideas are quite rich, and more complex than current viewpoints suggest. Indeed, ‘stress’ is derived as a shortened form of ‘distress’; disease, in turn, originally referred to ‘disease,’ or distress (Rees 1976). It is in this lexicographic context that varied connections between stress, distress, and disease can be appreciated, only some of which are useful for scientiﬁc purposes.
As rich in explanatory power as psychological stress might be for understanding the causes of distress and disease, the linguistic overlap of these terms also signiﬁes problems. The intuitive appeal of the ideas and their relations may foster false theories and ﬁndings. There is a tendency to ‘explain away’ disorders of unknown etiology based on prevailing beliefs about the unwanted or adverse social or psychological circumstances (Monroe and McQuaid 1994). For example, before the physical causes of particular infectious diseases were discovered, the origins of these illnesses were commonly ascribed to psychological stress and distressing emotions (Sontag 1978). The intuitive appeal of explanations based on psychological stress and related ideas requires ﬁrm thinking and sound science to diﬀerentiate valid associations from plausible and convenient ﬁctions.
2. The Major Perspectives And Traditions
Two traditions may be discerned which, together, have given rise to three perspectives on psychological stress. The ﬁrst tradition derives from clinical observations and ﬁeld studies of humans exposed to threatening circumstances. The second tradition arises from the animal laboratory, where systematic control over stimulus conditions and response alternatives of the organism has been exerted. The common denominator of the three perspectives on psychological stress emerging from these traditions is an interest in the psychological concomitants and sequelae associated with challenging or threatening environmental conditions. The diﬀerences between these perspectives, as explained next, is the relative emphasis placed on the environment, organism, or environment–organism interactions over time as a deﬁning feature of psychological stress.
2.1 The Stimulus Or Environmental Perspective
The stimulus or environment perspective holds that psychological stress is anchored in the environment and its characteristics. The underlying assumption is that objective external circumstances can be classiﬁed as psychologically demanding, threatening, benign, and so forth. In human ﬁeld or laboratory research, the stimulus parameters were recorded in naturalistic contexts or manipulated in laboratory settings. Animal laboratory research, on the other hand, could readily control the environment, and thereby more easily operationalize and manipulate the stimulus conditions.
Other factors, too, were inﬂuential in promoting the environmental perspective. Attention to the environment for creating stress and illness became especially evident toward the mid-twentieth century; the experiences of World War II reshaped the ways in which a breakdown in human functioning was viewed. Prior to this time, it was thought that individual vulnerability (i.e., biological) largely accounted for who succumbed to stress. Normal people maintained health and survived the ravages of stress; the biologically predisposed or tainted broke down. Given that one-third of American casualties in World War II sustained no physical injury (Weiner 1992), the idea that severe stress could precipitate psychological and physical breakdown in previously normal individuals was incorporated into medical and psychiatric thinking (Dohrenwend 1998). This brought to the foreground the importance of extreme environments for deﬁning psychological stress.
Finally, a surge of interest and activity in psychological stress for an environmental perspective came from another avenue of inquiry: life events questionnaires. Thomas Holmes and Richard Rahe developed the idea that life events could be assessed in an objective manner. These researchers developed a list of 43 events observed to occur prior to the onset of disease, including such items as marriage, trouble with the boss, change in sleeping habits, death in the family, and vacation. The events were collated and weighted, producing the Schedule of Recent Experiences (SRE; Holmes and Rahe 1967). Literally thousands of studies were conducted with the SRE and the many derivative life event checklists it spawned (Monroe and McQuaid 1994).
2.2 The Response Perspective
The second perspective on psychological stress can be traced to the writings of Darwin and the theory of natural selection. It is in these ideas that the attention began to focus on the implications of challenges and dangers of the environment, forcing the organism’s adaptation to ever-altering external circumstances. The response features of stress take on special importance in this framework, as it is recognized that evolution also fostered skills in anticipation of dangers and adversity (Weiner 1992). Being able to prepare for and prevent problems in the future drew upon mental, emotional, and behavioral capabilities that, over time, enhanced survival and reproduction. From this perspective, psychological stress is viewed as the response of the organism to the complex adaptive demands of the environment.
The twentieth century brought more sustained and intense interest in probing the intricacies of psychological stress, with an emphasis on the response perspective. The work on physiology by Walter Cannon posed questions about how the body maintained its regulatory functions in the face of changing environmental demands. Hans Selye introduced the term ‘stress’ into more formal scientiﬁc arenas, and investigated the physiology of organisms in response to acute and extreme environmental conditions.
2.3 The Environment–Organism Interaction Perspective
The stimulus and response perspectives on psychological stress each possess certain limitations. For example, knowledge of the environment does not always predict the responses; individual diﬀerences in response to similar stimuli are a common ﬁnding. From a response perspective, there are numerous indicators to draw upon (diﬀerent emotions, psycho- physiologic, or hormonal indices), many of which displayed diﬀerent relationships with distinct environmental challenges (Weiner 1992).
To address some of these limitations, psychological stress has been proposed to represent a particular relationship between organism and environment. This third perspective holds that psychological stress is the product of the individual’s ongoing transactions with ambient circumstances, particularly circumstances that are perceived as taxing or exceeding adaptive resources. Several possibilities are entertained within this perspective, ranging from an emphasis on stressful experiences (Weiner 1992) through emphases on the ongoing process of event occurrence, appraisal, coping, reappraisal, and so on (Lazarus and Folkman 1984). The core feature of this perspective is that of denoting an active process between a dynamic environment and an adapting organism over time.
Broadening the deﬁnition of psychological stress to encompass the interactions between organism and environment over time also enlarged the conceptual scope of research. This shift raises additional considerations, to which we now turn.
3. Conceptual Challenges And Problems
After the 1950s, stress became a common term, cutting across sociology, psychology, medicine, physiology, and biology. A broad array of constructs were united under this common rubric. At least two issues arise from this explosive growth in research on stress: (a) individual diﬀerences, and (b) generality vs. speciﬁcity of psychological stress.
3.1 Individual Diﬀerences
Despite the promising leads of early research on psychological stress, it became apparent that there was individual variability in response to stressful circumstances. Not all people succumbed to even the most extreme of situations, while some people broke down in the face of apparently minimal demands. Theory and research needed to account for such variation, thereby introducing factors hypothesized to moderate stress eﬀects.
Many factors have been proposed as stress moderators. Attention to this matter invoked such individual diﬀerence variables as appraisal of threat and coping (Lazarus and Folkman 1984, Monroe and Kelley 1995) and more remotely a variety of other considerations believed to moderate the eﬀects of stress (e.g., personality factors, social support, etc.; Brown and Harris 1989, Goldberger and Breznitz 1993). The net eﬀect was to broaden the conceptual arena of stress research considerably and to introduce multifactorial models, taking into account a host of factors that could inﬂuence stressors and responses over time.
3.2 Generality Vs. Speciﬁcity Of Psychological Stress
A second concern was related to the omnibus nature of the stress concept. On the one hand, the stress united a variety of cognate constructs and emphasized the general nature of stress (e.g., Selye 1976). On the other hand, the unique implications of speciﬁc environmental challenges and responses could be obscured within such a general viewpoint (e.g., Weiner 1992). Recent research from both the animal laboratory and human ﬁeld studies suggests that responses to stressors can be very speciﬁc with respect to the particular demands imposed, with speciﬁcity being key for understanding many of the adaptive implications (Dohrenwend 1998, Weiner 1992).
Overall, the challenge for research on psychological stress was to remain true to its roots in extracting the ‘essence’ of psychological phenomena related to adversity, while at the same time not becoming so overly inclusive as to become essentially meaningless or obscure other underlying associations. Such an agenda raises important methodological issues, as discussed next.
4. Methodological Considerations
Measuring psychological stress in a reliable and valid manner has been a continuing challenge for stress researchers. For example, animal laboratory research has proven useful for more precise speciﬁcation of both stimulus parameters and response characteristics associated with psychological stress. Yet the methods adopted often constrained the array of possible responses, creating unnatural stressor conditions which, in turn, yielded misleading views about how adaptation proceeds under more ecologically valid conditions (Weiner 1992).
In terms of human ﬁeld research, there has been considerable debate about measurement procedures for assessing stressful life events. Research on self-report life event checklists such as the SRE revealed serious psychometric limitations (Brown and Harris 1989, Monroe and McQuaid 1994). Naıve research designs also led to spurious ﬁndings. For example, being depressed could cause life events such as ‘trouble at work,’ and ‘diﬃculties with spouse,’ rather than the life events causing subsequent depression. Additionally, many of the life events on the SRE and similar checklists were direct indicators of disorder or illness (i.e., ‘major change in eating habits,’ ‘major change in sleeping habits’). Although more reﬁned and comprehensive measures were developed to address such concerns, fundamental problems with self-report checklists remain (Brown and Harris 1989, Monroe and McQuaid 1994).
In response to these methodological concerns, other investigators designed semistructured interviews and developed explicit guidelines, decision rules, and operational criteria for deﬁning and rating life events (Brown and Harris 1989, Dohrenwend 1998). In general, these procedures enhance the reliability of life event assessments and provide better prediction of outcomes. Although these approaches are more time-and labor-intensive, they represent among the best available tools for measuring psychological stressors. Importantly, too, these approaches provide ﬂexibility in measuring life stress, allowing for ratings of speciﬁc dimensions of stress and for taking into account the inﬂuences of moderators of stress impact. Thus, in theory, such approaches can help to bridge the gap between a strictly stimulus perspective, and to incorporate useful features of the response and organism–environment interaction perspectives.
5. Future Directions
The three perspectives on psychological stress are converging on a viewpoint of psychological stress as a comprehensive process of complex transactions over time between organism and environment. Yet each approach continues to be of value for emphasizing particular features of these complex models that do not receive adequate attention within the other perspectives.
The stimulus perspective is essential to provide valid measures of the stressor characteristics of environments. Without standardized indices reﬂecting the input characteristics of the circumstances animals or people face, little can be said about ‘downstream’ elements of the models. For example, individual diﬀerences in appraisal or coping have little meaning without considering what is being appraised or coped with. It is in relation to well-speciﬁed environmental conditions that the implications of individual diﬀerences in appraisal and coping may be most readily understood in terms of the impact on health and wellbeing (Monroe and Kelley 1995). Future work may beneﬁt from further speciﬁcation and standardization of the stressor characteristics associated with adverse environments and their relations to varied outcomes (Monroe and McQuaid 1994).
The response perspective suggests a number of avenues to enrich future inquiry. With respect to animal laboratory research, simple singular response indices are being replaced by more complex patterns of behavioral and biological eﬀects. These may range from the immediate ‘exquisitely speciﬁc’ neuroendocrine response proﬁles through long-term structural changes in the central nervous system (Weiner 1992). With respect to human ﬁeld studies, retrospective recall of conditions and emotions may be enhanced through such developments as ecological momentary assessments. These procedures target multiple, immediate reports from people in their usual environments. These methods avoid many of the pitfalls of procedures based on the retrospective reconstruction of events and experiences (Stone et al. 1999).
Perhaps most promising but challenging is the interactional perspective. Formidable challenges in operationalizing key constructs exist (e.g., appraisal and coping; Monroe and Kelley 1995, Cohen et al. 1995). Yet interesting progress has been made recently, employing sophisticated longitudinal research designs with in-depth, microanalytic techniques evaluating day-to-day transactions between the person and environment (Lazarus 2000). Further work along these lines is essential for diﬀerentiating the facts from the ﬁctions in delineating the implications of psychological stress for health and well-being.
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