Introduction
The term “stress” is used to designate how human beings respond when they confront circumstances that they view as dangerous or threatening and that tax their coping capability. Stressful events, or stressors, elicit a wide range of responses in humans. They not only bring about immediate physiological changes but also affect people’s emotional state, the use of their intellectual abilities, their efficiency at solving problems, and their social behavior. When experiencing stress, people take steps to do something about the stressors eliciting the stress and to manage the emotional upset they are producing. These maneuvers are called coping responses. Coping is a key concept in the study of the stress process. Stress management intervention techniques are designed to teach people appropriate ways to cope with the stressors that they encounter in their everyday lives.
Anxiety and Phobias
The emotional state most directly affected by stress is anxiety. In fact, the term “state anxiety” is often used interchangeably with the terms “fear” and “stress” to denote a transitory emotional reaction to a dangerous situation. Stress, fear, and state anxiety are distinguished from trait anxiety, which is considered a relatively stable personality disposition or trait. According to psychologist Charles Spielberger, people high in trait or chronic anxiety interpret more situations as dangerous or threatening than do people who are low in trait anxiety, and they respond to them with more intense stress (state anxiety) reactions. Instruments that measure trait anxiety ask people to characterize how they usually feel, and therefore they measure how people characteristically respond to situations. Measures of trait anxiety, such as the State-Trait Anxiety Inventory, are especially useful in predicting whether people will experience high levels of stress in situations involving threats to self-esteem or threat of failure at evaluative tasks.
The two-dimensional circumplex model has been adopted for illustrating how emotion relates to stress. The activation-deactivation dimension of the circumplex relates to how much the emotion evokes a sense of alertness, energy, and mobilization (activation) versus a sense of drowsiness and lethargy (deactivation). The second dimension of the circumplex relates to the degree of pleasantness or unpleasantness associated with the emotion. For example, perceived stress and anxiety relate to unpleasant activation. In contrast, serenity is associated with deactivation and positive affect. Richard Lazarus has argued that the relational meaning of a stressful event determines the particular emotion associated with the event. For example, the relational meaning of anger is “a demeaning offense against me and mine.” The relational meaning of anxiety is “facing an uncertain or existential threat.” The relational meaning of fright is “facing an immediate, concrete, and overwhelming physical danger.” Coping alters the emotion by either changing reality (problem-focused coping) or changing the interpretation of the event (emotion-focused coping).
Common phobias
, or fears of specific situations, are not related to individual differences in general trait anxiety level, especially when the perceived threat has a strong physical component. Measures of general trait anxiety are therefore not good predictors of people’s stress levels when they are confronted by the objects of these phobias, such as snakes, an impending surgical operation, or the threat of electric shock. Such fears can be reliably predicted only by scales designed to evaluate proneness to experience fear in these particular situations.
Seemingly minor events that are a constant source of irritation can be very stressful, as can more focalized events that require major and sometimes sudden readjustments. Lazarus and Susan Folkman have dubbed these minor events “daily hassles.” The media focus attention on disasters such as plane crashes, earthquakes, and epidemics that suddenly disrupt the lives of many people; particularly gruesome crimes; and other occurrences that are likely to attract attention. For most people, however, much of the stress of daily life results from having to deal with ongoing problems pertaining to jobs, personal relationships, and everyday living circumstances.
People often have no actual experience of harm or unpleasantness caused by things that they come to fear. For example, most people are at least somewhat uneasy about flying on airplanes or about the prospect of having a nuclear power plant located near them, though few people have personally experienced harm caused by these things. Although people tend to pride themselves on how logical they are, they are often not very rational in appraising how dangerous or risky different events actually are. For example, there is great public concern about the safety of nuclear reactors, though they in fact have caused very few deaths. The same general public that smokes billions of cigarettes—a proved carcinogen and risk factor for heart disease that, between 2010 and 2014, caused more than 480,000 deaths per year—also supported banning an artificial sweetener because of a minuscule chance that it might cause cancer.
Positive Stress
People tend to think of stress as being uniformly negative, something to be avoided or at least minimized as much as possible. Psychologists Carolyn Aldwin and Daniel Stokols point out, however, that studies using both animals and humans have indicated that exposure to stress also has beneficial effects. Being handled is stressful for rats, but rats handled as infants are less fearful, are more exploratory, learn faster, and have more robust immune systems later in life. In humans, physical stature as adults is greater in cultures that expose children to stress (for example, circumcision, scarification, and sleeping apart from parents) than in those that are careful to prevent stress exposure—even when nutrition, climate, and other relevant variables are taken into account. Although failure experiences when dealing with stressful circumstances can inhibit future ability to function under stress, success experiences teach important coping and problem-solving skills that can then be used to deal effectively with future stressful encounters. Such success experiences also promote a positive self-concept and induce a generalized sense of self-efficacy that in turn enhances persistence in coping with future stressors.
Psychologists Stephen M. Auerbach and Sandra E. Gramling note that stress is a normal, adaptive reaction to threat. It signals danger and prepares people to take defensive action. Over time, individuals learn which coping strategies are successful for them in particular situations. This is part of the normal process of personal growth and maturation. Stress can, however, cause psychological problems if the demands posed by stressors overwhelm a person’s coping capabilities. If a sense of being overwhelmed and unable to control events persists over a period of time, a person’s stress signaling system ceases to work in an adaptive way. The person then misreads and overinterprets the actual degree of threat posed by situations, makes poor decisions about what coping strategies to use, and realizes that he or she is coping inefficiently; a cycle of increasing distress and ineffective coping may result. Some people who have experienced high-level stress for extended periods or who are attempting to deal with the aftereffects of traumatic stressors may become extremely socially withdrawn and show other signs of severe emotional dysfunction.
In severe cases in which these symptoms persist for over a month, a psychological condition known as post-traumatic stress disorder (PTSD)
may develop. Common symptoms of PTSD include reliving the traumatic event, avoiding anything that reminds the person of the event, insomnia, nightmares, wariness, poor concentration, chronic irritability resulting in angry or aggressive outbursts, and a numbing of emotions. The latter symptom has also been referred to as alexithymia, a condition in which people lack the ability to define and express their emotions to themselves and others. James W. Pennebaker believes that although alexithymics cannot express their emotions, those emotions are still present in an unconscious cycle of rumination, and this suppression and rumination of negative thoughts is associated with increased psychological and physiological arousal. In other words, it takes a lot of work to inhibit one’s emotions.
Although anxiety is the most common emotion associated with stress, chronic stress may induce chronic negative emotions such as hostility and depression. Chronic hostility and depression have been shown to have damaging effects on social relationships and physical health. The known physical costs of chronic stress include poor immune functioning; not engaging in health-promoting activities, such as exercise and following the advice of a physician; and a shortened life expectancy.
When people are faced with a stressful circumstance that overwhelms their coping mechanisms, they may react with depression and a sense of defeat and hopelessness. According to Martin E. P. Seligman,
learned helplessness
is the result of a person coming to believe that events are uncontrollable or hopeless, and it often results in depression.
Assessing and Measuring Stress
The fact that stress has both positive and negative effects can be exemplified in many ways. Interpersonally, stress brings out the “worst” and the “best” in people. A greater incidence of negative social behaviors, including less altruism and cooperation and more aggression, has generally been observed in stressful circumstances. Psychologist Kent Bailey points out that, in addition to any learning influences, this may result from the fact that stress signals real or imagined threats to survival and is therefore a potent elicitor of regressive, self-serving survival behaviors. The highly publicized murder of Kitty Genovese in Queens, New York, in 1964, which was witnessed by thirty-eight people in the safety of their apartments who ignored her pleas for help, exemplifies this tendency, as does the behavior during World War II of many Europeans who either did not stand up for the Jews and other minorities who were oppressed by the Nazis or conveniently turned their heads. Everyone has heard, however, of selfless acts of individual heroism being performed by seemingly ordinary people who in emergency situations rose to the occasion and risked their own lives to save others. After the terrorist attack on the World Trade Center on September 11, 2001, firefighters continued to help victims and fight fires after more than two hundred of their fellow firefighters had been killed in the buildings’ collapse. In addition, in stressful circumstances in which cooperation and altruism have survival value for all concerned, as in the wake of a natural disaster, helping-oriented activities and resource sharing are among the most common short-term reactions.
Stress may enhance as well as hinder performance. For example, the classic view of the relationship between stress and performance is represented in the Yerkes-Dodson inverted-U model, which posits that both high and low levels of arousal decrease performance, while intermediate levels enhance performance. Although this model has not been unequivocally validated, it seems to be at least partially correct, and its correctness may depend on the circumstances. On one hand, psychologists Gary Evans and Sheldon Cohen concluded that in learning and performance tasks, high levels of stress result in reduced levels of working-memory capacity and clearly interfere with performance of tasks that require rapid detection, sustained attention, or attention to multiple sources of input. On the other hand, Spielberger found that in less complex tasks, as learning progresses, high stress levels may facilitate performance.
Psychologist Irving Janis examined the relationship between preoperative stress in surgical patients and how well they coped with the rigors of the postoperative convalescent period. He found that patients with moderate preoperative fear levels adjusted better after surgery than those with low or high preoperative fear. He reasoned that patients with moderate fear levels realistically appraised the situation, determined how they would deal with the stressful aspects of the recovery period, and thus were better able to tolerate those stressors. Patients low in preoperative fear engaged in unrealistic denial and thus were unprepared for the demands of the postoperative period, whereas those high in preoperative fear became overanxious and carried their inappropriately high stress levels over into the recovery period, during which that stress continued to inhibit them from realistically dealing with the demands of the situation. Janis further found that giving people information about what to expect before the surgery reduced their levels of fear and stress and allowed them to recover from surgery more quickly.
Benefits of Control
Research by Judith Rodin and others has shown that interventions designed to increase the predictability of and perceived control over a stressful event can have dramatic effects on stress and health. In one control-enhancing intervention study, nursing-home residents were told by the hospital administrator to take responsibility for themselves, asked to decide what activities to participate in, and told what decisions were their responsibility to make. Patients who received the control-enhancing intervention reported being happier in the nursing home, and their death rate was half of that among nursing home residents who were told that it was the staff’s responsibility to care for them. Rodin’s research has been replicated by other researchers. More intensive stress-reduction interventions have even been shown to increase survival rates among patients with breast cancer.
The negative effect of unrealistically low fear levels is exemplified in the description by psychologists Walter Fenz and Seymour Epstein of two first-time skydivers who surprised everyone with their apparent total lack of concern during training and on the morning of their first jump. Their reactions changed dramatically, however, once they entered the aircraft: “One began vomiting, and the other developed a coarse tremor. Both pleaded for the aircraft to be turned back. On leaving, they stated that they were giving up jumping.”
Janis’s investigation was particularly influential because it drew attention to the question of how psychologists can work with people to help them cope with impending stressful events, especially those that they are committed to confronting and over which they have little control, such as surgery. Findings by Auerbach and Thomas Strentz indicate that in such situations it may be more useful to teach people emotion-focused coping strategies, designed to minimize stress and physiological arousal directly, rather than problem-focused strategies, which are designed to change the stressful situation itself. In a study with volunteers who were abducted and held hostage for four days in a stressful simulation, they found that hostages who were taught to use emotion-focused coping techniques, such as deep breathing, muscular relaxation, and directed fantasy, adjusted better and experienced lower stress levels than those who were taught problem-focused techniques, such as nonverbal communication, how to interact with captors, and how to gather intelligence.
In a series of studies, Pennebaker and others have found that writing for just twenty minutes a day for three or four consecutive days about one's most stressful experience has widespread beneficial effects that may last for several months. In a series of studies, Pennebaker found that the writing task improved immune functioning, reduced illness and perceived stress, and even improved students’ grade-point averages. He believes that it may help people release their inhibited emotions about past stressful events, which in turn decreases physiological arousal and psychological anxiety associated with repressing negative past events.
Adaptive and Maladaptive Functions
Stress has many important adaptive functions. Experiencing stress and learning how to cope with adversity are essential aspects of normal growth and development. Coping strategies learned in particular situations must be generalized appropriately to new situations.
Exposure to chronic stress that cannot be coped with effectively can have severe negative consequences. Work by pioneering stress researchers such as Hans Selye brought attention to the physiological changes produced by exposure to chronic stress, which contribute to diseases such as high blood pressure and cardiovascular disorders. Subsequent research by psychiatrists Thomas Holmes and Richard Rahe and their colleagues indicated that exposure to a relatively large number of stressful life events is associated with the onset of other diseases, such as cancer and psychiatric disorders, which are less directly a function of arousal in specific physiological systems.
Studies by these researchers have led psychologists to try to understand how best to teach people to manage and cope with stress. Learning to cope with stress is a complex matter because, as Lazarus has emphasized, the stressfulness of given events is determined by how they are cognitively appraised, and this can vary considerably among individuals. Further, the source of stress may be in the past, the present, or the future. The prospect of an impending threatening encounter, such as a school exam, may evoke high-level stress, but people also experience stress when reflecting on past unpleasant or humiliating experiences or when dealing with an immediate, ongoing danger. Sometimes people deal with past, present, and future stressors simultaneously.
It is important to distinguish among past, present, and future stressors, because psychological and behavioral responses to them differ, and different kinds of coping strategies are effective in dealing with them. For example, for stressors that may never occur but are so aversive that people want to avoid them if at all possible, such as cancer or injury in an automobile accident, people engage in preventive coping behavior—quitting smoking, wearing seat belts—even though they are not currently experiencing a high level of anxiety. In this kind of situation, an individual’s anxiety level sometimes needs to be heightened to motivate coping behavior.
When known stressors are about to affect people, such as a surgical operation the next morning, it is important for them to moderate their anxiety level so that they can function effectively when actually confronting the stressor. The situation is much different when they are trying to deal with a significant stressor that has already occurred but continues to cause emotional distress, such as sexual assault, the death of a loved one, or a war experience. Important aspects of coping with such stressors include conceptualizing one’s response to the situation as normal and rational rather than “crazy” or inadequate and reinstating the belief that one is in control of one’s life and environment rather than subject to the whims of circumstance.
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