Stress Processes, Personality and Disease Etiology

This is a short post on stress from the view of health psychology (obviously with my own bias).  I wrote it to summarize a number of readings on this topic for comprehensive exams.  The physiological consequents of stress are left out because they are not the focus of this exam (but I am very interested in them and may edit this post to include later).

Stress is a negative experience that occurs when a person perceives an event as requiring more resources than he or she has available or more than is readily available.  The perception may or may not match reality, psychological and physiological stress responses will occur as long as the individual believes or “feels” that it is stressful.

Claude Bernard was a 19th century French physiologist who studied the dynamic adaption and regulation of the body’s systems to maintain the internal environment or milieu intérieur.  Walter Cannon, another early stress researcher, later termed this “homeostasis” or maintaining a constant or consistent internal state through change and adaptation.  Cannon focused on the fight-or-flight response to stress (this maps on interestingly with a common split of coping strategies as approach-oriented or avoidance-oriented, although the coping literature developed after the fight-or-flight literature, perhaps influenced by it).  He also After Walter Cannon, Hans Selye was influenced by Claude Bernard and Walter Cannon, and was famous for his general adaptation syndrome theory of stress.  He also differentiated between distress (negative stress, such as death of loved one) and eustress (positive stress, such as marriage).  He also began characterizing the physiological systems that respond to stress.  Selye focused primarily on events and physiology, with relatively little attention to psychological factors and the perception or appraisal of events.

Beyond Cannon’s fight-or-flight response, Shelley Taylor and colleagues developed the “tend-and-befriend” theory.  That is, under stress, in addition to fighting or fleeing, people may form groups, or move closer to existing groups to seek protection of self and others.  This may be more true in females than males, perhaps because evolutionarily females cared for offspring, and with children, fighting or fleeing may not be feasible.  Whereas epinephrine and norepinephrine have been studied with the fight-or-flight response, oxytocin is a hormone possibly implicated with the tend-and-befriend response.

Lazarus and Folkman (separate people, but often discussed together) conducted extensive research into stress, focusing on psychological processes.  They developed scales to measure stressful events (although Sheldon Cohen’s Perceived Stress Scale is perhaps the most popular and widely used scale for measuring stress) and argued for the importance of appraisal.  Folkman and Lazarus also developed the Ways of Coping scale to measure different ways of coping with stress.

Another major theory in stress is that of allostatic load, developed by Bruce McEwen.  This is the idea that there is a cumulative effect of stress.  That is, over time, repeated “hits” of stress wear down the body’s ability to mount a stress response and “exhaustion” occurs or wear and tear on the system.  A variety of physiological measures of allostatic load have been developed that aggregate many individual systems (such as blood pressure and inflammation) to create a composite load score shown to predict some disease outcomes.

Things to think about: What makes something stressful?  What types of stressors or what type of person can adapt to stress?  What are the long term consequences of stress?

One thought on “Stress Processes, Personality and Disease Etiology

  1. Pingback: Coping and Adjustment to Illness | Joshua Wiley

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