Health, Stress, Coping

Stress is the negative physical and psychological adjustment to circumstances that disrupt, or threaten to disrupt, a person's functioning. Stress always involves a relationship between people (stress reactions) and their environments (stressors). Mediating factors affect the severity of stress reactions. Examples of mediating factors include perceived control over stressors, available social support, and quality of stress-coping skills.

A. Psychological Stressors

Both pleasant and unpleasant events or situations can cause stress. Catastrophic events that are life-threatening, such as assault, combat, fire, and tornadoes, can lead to serious psychological disorders. Life changes and strains can be stressors, especially if they force a person to adapt. Examples of such changes include divorce, marriage, bad grades, graduation, a new job, a promotion, and death. Daily hassles, such as minor irritations, pressures, and annoyances, when experienced regularly, can act as stressors.

B. Measuring Stressors

Several ways of measuring stress have been developed based on the premise that stress is a process that requires a person to make some sort of life adjustment. One instrument, called the Social Readjustment Rating Scale, measures stress in terms of life-change units (LCUs). Research suggests that people who experience a greater number of LCUs are more likely to suffer physical and mental illness. The Life Experiences Survey (LES), another instrument for measuring stress, also considers an individual's perceptions of the positive or negative impact of a given stressor. By examining perceptions of stress, the LES is able to measure the role that gender and cultural differences play in experiences of stress.

The general adaptation syndrome (GAS) is a stress response composed of three stages. The fight-or-flight syndrome (FFS), or alarm reaction, is the first stage. The sequence of events causing the FFS is controlled by the sympatho-adreno-medullary system (SAM); the hypothalamus triggers the sympathetic ANS, which stimulates the adrenal medulla, which in turn secretes catecholamines into the bloodstream. Catecholamines stimulate the heart, liver, kidneys, and lungs, thereby causing rapid breathing and increases in heart rate, blood pressure, blood sugar level, and muscle tension.

• Persistent stressors initiate the resistance, or second, stage, which is controlled by the hypothalamic-pituitary-adrenocortical (HPA) system. The hypothalamus triggers the pituitary to secrete adrenocorticotropic hormone (ACTH), which stimulates adrenal cortex corticosteroid secretion. Corticosteroids generate the emergency energy needed to handle stress.
• A continual depletion of energy eventually causes exhaustion, the third stage. The body eventually succumbs to diseases of adaptation caused by damaged heart and blood vessels, suppressed immune system functioning, and prolonged strain on systems that were weak even prior to the onset of the stressor.
• Psychobiological models have expanded Selye's theory of the general adaptation syndrome to include an individual's emotional state and perceptions of the stressor.

B. Psychological Responses

1. Emotional Responses. Most physical stress responses are accompanied by emotional stress responses. Emotional responses come and go with the onset and termination of stressors. Prolonged stress causes tension, irritability, short-temperedness, and increased anxiety.
2. Cognitive Responses. An inability to concentrate, think clearly, or remember information accurately is a common cognitive reaction to stress. Ruminative thinking, the persistent interruption of thoughts about stressful events, is a cause of the reduction in thinking ability. When catastrophizing, a person tends to dwell on and overemphasize the potentially negative consequences of events. Overarousal causes the normal range of attention to narrow. People under stress are more likely to use mental sets and experience functional fixedness.
3. Behavioral Responses. Behavioral stress responses such as a shaky voice, changed body posture, and facial expressions provide clues about physiological and emotional stress responses. Escape and aggression are common behavioral stress responses.

C. Linkages: Stress and Psychological Disorders

1. Burnout and Posttraumatic Stress Disorder. Burnout is a gradually intensifying pattern of physical, psychological, and behavioral dysfunction in response to a continual flow of stressors. Those experiencing burnout may become indifferent, impulsive, accident-prone, drug-abusing, suspicious, depressed, and withdrawn. Posttraumatic stress disorder is a pattern of adverse reactions following a traumatic event. The disorder may appear immediately or weeks to years after the event. Symptoms include anxiety, irritability, jumpiness, inability to concentrate or work, sexual dysfunction, and difficulty in interpersonal relationships. In rare cases, flashbacks may occur.

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