Cognitive processes that shape the perception of stress
Stress may be conceived as an array of neurological and physiological responses that performs an adaptive purpose (Bernard & Krupat, 1994). Research into stress has been dominated by the body's reaction to stress and the cognitive processes that shape the perception of stress. Socio-cultural influences of stress are also relevant. This essay presents three theories of stress: a systemic theory, a transactional theory, and a conservation of resources theory. The transactional theory of stress proposed by Lazarus and Folkman (1984) is arguably the most popular conceptualization, and provides the framework for strategies to manage stress.
THEORIES OF STRESS
Stress is the state that results when the transactions between an individual and the environment result in a perceived discrepancy, whether actual or not, between the requirements of a situation and the resources of the individual's constitutional, psychological, or social systems (Lazarus, 2006). Theories that focus on the specific relationship between stressors (external demands) and stress (bodily processes) can be grouped in two different categories: approaches to `systemic stress' based in physiology and psychobiology and approaches to `psychological stress' developed within the field of cognitive psychology (Nairne, 2009). This essay will be discussing three theories of stress with subsequent example for the management of stress.
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Initial theories of stress concentrated on physiological processes and evolutionary considerations, biological aspects, and can be grouped as biological or systemic stress theories. The phrase "fight or flight" (Cannon, 1914) was an early example of the attempt to describe the physiological changes that a threatened organism undergoes. These physiological changes are highly adaptive as those organisms that utilize them have an increased likelihood of survival than those that don't (Bernard & Krupat, 1994). Early Humans may have benefited from the fight or flight response as it allowed our ancestors to manage dangerous situations (Narine 2009). However, while a certain amount of stress may encourage survival; health may be adversely affected by persistent stress (Bernard & Krupat, 1994).
Modern humans typically do not experience the same life and death situations of our ancestors, yet the innate nature of biological responses, indicative of the fight or flight mechanism, continue to occur (Simeons, 1961). According to Simeons (1961), whilst stress may have driven evolutionary change, where the species that have adapted best to the causes of stress, stressors, have survived and evolved, evolutionary speaking, the human brain has failed to adapt to the stressors of modern living (e.g., threats to self-esteem) and modern stress is the result of all this energy having no outlet. The fight or flight response (Seyle, 1976), however, was only the first in a series of neurological and physiological reactions to stress (Bernard & Krupat, 1994; Nairne, 2009).
Two mechanisms work in tandem to activate the fight or flight response, the fast acting nervous system and the longer lasting endocrine system (Nairne, 2009). The sympathetic nervous system reacts to perceived danger, activating the fight or flight response, whilst simultaneously, the endocrine system releases 'stress' hormones until the parasympathetic nervous system engages to relax the physiological systems post threat (Nairne, 2009). In modern living, however, the parasympathetic nervous system does not get activated (Simeons, 1961) and the hormones remain in the system, compelling the body to work harder than it needs to and eventually leading to stress related illness (Nairne, 2009). This stereotypical response pattern was identified by Selye (1946) and labelled General Adaptation Syndrome (GAS).
An individual exposed to prolonged stress progresses through a set of responses, or three phases: alarm reaction, resistance, and exhaustion (Nairne, 2009). According to Selye (1946, 1976), regardless of the stimulus event, common effects are produced. The fundamental notion of a nonspecific causation of the GAS has been criticised, however, finding that the hormonal GAS responses followed specific affective impact of the stimulus event rather than the stimulus as such (Mason 1971, 1975). Furthermore, Lazarus (2006) reports that, in relation to corticosteroid response, the GAS may actually be a product of psychological, rather than physical, threat. Systemic stress theories have also attempted to quantify causes of stress.
Holmes and Rahe's (1967) model, a derivative of the systemic approach to stress and an attempt to quantify the cause of stress by what happens to the individual, is based on Selye's work, suggested that it is the variations in life routines, positive or negative critical life events, rather than the threat or meaning of critical events, that is involved in causing stress. Research, however, suggests that it is negative events, rather than positive, that is associated with physiological and psychological consequences of stress (Anderson, Wethington & Kamarck, 2011). There is also a failure to acknowledge personality factors (Kobasa, 1982) or the duration of exposure to a stressor (Cooper & Dewem, 2004).
The focus on the biology of stress led early theorists to a simple theory: stress is caused by what happens to you. Biological, or systemic stress theories such as Selye's (1946), suggest a reductionist view, as they focus on the physiological, stereotypical response pattern, and do not account for mechanisms that may clarify the cognitive changes that occur, or the coping mechanisms that mediate the results of stress (Lazarus & Folkman, 1986). Biological theories of stress inform what happens to an individual who is stressed but not the aetiology of that stress. Lazarus and Folkman (1986) proposed a theory of stress that highlights the transactional nature of psychological stress.
A transactional theory of stress proposes an interaction between environmental and personal components, a transaction, involving the individual's cognitive processes (Lazarus, 1984). The perception of stress depends on the existence of a stressor/s in conjunction with how the stressor is evaluated and what coping mechanisms exist to manage it (Lazarus, 1980); the manifestation of stress is unique to the individual. Lazarus (1980) places the emphasis on the meaning that a stressor has for an individual and not on the physiological responses; psychological stress. Psychological stress concerns the relationship to the environment that the individual appraises as a significant subjective threat and in which subsequent demands challenge or surpass available coping resources (Lazarus & Folkman, 1986).
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Objectively, stress may be a neutral, negative, or positive experience, but from an individual's perspective stress is a subjective experience. This theory moves away from defining stress as a specific kind of external stimulation or a specific pattern of physiological, behavioural, or subjective reactions. An individual's situational perspective defines whether a potential stressor is experienced as stressful or not, making stress the consequence of appraisal (Lazarus & Folkman, 1986). An individuals' evaluation of the meaning of what is happening, appraisal, and the subsequent cognitive and behavioural attempt to manage the specific demands, coping, are both concepts that are fundamental to this transactional stress theory (Lazarus, 1993).
Appraisal is based on the idea that stress is dependent on an individual's beliefs or expectations in relation to the meaning and outcome of a stressor (Lazarus, 1991, 1993) and underscores the unique variance observed in relation to the quality, intensity, and duration of stress in the context of an objectively equal stressor (Lazarus, 1993). Personal and situational factors contribute to appraisals (Lazarus, 1991). Two forms of appraisal are significant, primary and secondary appraisal. Primary appraisal concerns whether something significant to the individual's well-being occurred, whereas secondary appraisal concerns coping options (Lazarus, 2006). Different varieties of stress reflect underlying specific patterns of primary and secondary appraisal; harm, threat, and challenge (Lazarus & Folkman, 1986).
Coping may be conceived as cognitive and behavioural attempts to control, endure, or lessen external and internal demands associated with a stressor (Folkman & Lazarus, 1980). Thus, coping actions refer to certain characteristics of the coping process that can be both behavioural and cognitive; creating a coping episode that is comprised of different single acts, and interconnects with other coping episodes, that emphasize different parts of the stressor (Lazarus & Folkman, 1984). As a consequence, coping can be problem focused, change the situational factors, or affect focused, change the affective state or the appraisal of the stressor (Lazarus & Folkman, 1986).
As with biological theory attempts to quantify stress, the transactional theory is not without problems. In regards to appraisal, Lazarus and Folkman's (1986) theory has a somewhat mechanistic view of stress, a sharp and fixed switch between affect, and does not account for affective experiences in which a person vacillates between one or more positive and negative affective states (Sullivan & Strongman, 2003) or 'irrational' affective states in which an individual cannot articulate why they feel a particular way (Barlow, 2002). Also, as cognition is hypothesized to precede affect, and the presence of cognitive processes cannot always be recognized, according to the theory it must have nevertheless taken place, a circular line of reasoning (Zajonc, 1984) although Reisenzein and Schönpflug (1992) suggest this is a misinterpretation.
In regards to coping, the coping strategy chosen by an individual does not predict the outcome or the subsequent affective state and, therefore, does not predict health effects Ursin & Eriksen (2004). Furthermore, qualitative data indicate that the efficacy of coping behaviours and the adequacy of external resources are repeatedly ignored in quantitative measures of coping (Oakland & Ostell, 1996). Whilst individual coping strategies are frequently distinctive, coping strategies and dispositions are essentially learned from the social environment; individuals' coping behaviours are predominantly social in nature (Pearlin, 1982). A transactional theory of stress informs an intrapsychic aetiology of stress but to a degree ignores the sociocultural, environmental, context.
Developed as an alternative to systemic (Selye, 1976) and transactional (Lazarus & Folkman, 1986) theories of stress, the conservation of resources theory (Hobfoll, 1989) is another psychological stress theory. This theory holds that the context of an individual's environment, both actual and socially construed, is significant in determining the stress progression, rather than solely the outcome of stress as in systemic theories or, in the case of transactional theory, the individual's cognitive appraisal of stressors (Hobfoll, 1989). This theory integrates the environmental side of stress by recognizing interrelationships between the individual, immediate social group, and the wider community (Hobfoll, 2011).
Health promotion and the prevention of stress, according to the conservation of resources theory, depend on the accessibility and effective management of resources (Hobfoll, 2001). Individuals endeavour to defend resources they value, such as objects, individual characteristics, situations, and energies, and psychological stress occurs, therefore, when these resources are gone, vulnerable to loss, or if after significant investment, resources are not replenished by the individual (Hobfoll, 2001); a cycle of using and replenishing resources develops (Hobfoll, 1989). Change in and of itself is not the source of stress but, rather, changes occasioning a loss of significant resources (Hobfoll, 1989).
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The concept of loss is central to Hobfoll's theory (Lazarus, 2001). Three central tenets underpin this cycle (Hobfoll, 1989, 2001). Firstly, the loss of resources is significantly more salient to the individual than acquiring resources. Secondly, there is the importance to an individual of investing in their resources to prevent losses; individuals with the greatest resources are less vulnerable to loss, and find resource investment easiest (Hobfoll, 2001). Finally, when resources are low, absent, or invested without subsequent improvement, individuals become vulnerable to psychological and physical disorders and functional impairment (Hobfoll, 1988). The approach to stress, therefore, is a focus on external demands rather than internal demands (Hobfoll, 2001).
In the transactional theory, whether a potential stressor is stressful or not is dependent on the individual's appraisal of whether or not they have the resources to meet the demands of the stressor (Lazarus, 2006). The conservation of resources theory makes this link more distinct, proposing that the match between resources and situational demands determines the level of stress regardless of appraisal (Hobfoll, 2001). However, resources are still susceptible to appraisal as individuals do not necessarily value resources equally (Lazarus, 2006). Also, there is no clear evidence of an exhaustive list of resources that make a significant contribution to coping and stress, making the theory too general (Lazarus, 2006).
Whilst the conservation of resources theory is simple, avoiding the subjectivity and individual differences associated with appraisal, and can be readily operationalized for research involving groups as well as individuals, Hobfoll (1998) suggests the dominant theory of stress when he notes that ``appraisals are the best proximal indicators in the stress process'' (p. 359). The transactional theory of stress, therefore, presents useful strategies to manage stress. Cognitive reappraisal, then, may be a protective factor in relation to stress as learning to modify appraisals is considered to be fundamental to various psychological interventions, such as cognitive (Beck, 1983) and cognitive behavioural therapy (Rachman, 1997).
In essence, reappraisals and appraisals don't differ (Lazarus & Folkman, 1984). By directly targeting appraisals, cognitive reappraisal involves the individual reframing an event, in the case of stress, a stressor, so as to alter the affective response to it (Gross, 1998). That cognition can significantly influence affect forms the basis of cognitive therapy whereby reappraisal reduces negative affective experience (Hajcak & Nieuwenhuis, 2006). Long term exposure to stress increases the likelihood of more negative cognition, the greater the experienced stress the more negative the cognitions become, increasing an individual's stress, and so on (Lazarus, 2006). Cognitive reappraisal, as a stress management tool, endeavours to disrupt this cycle.
Positive cognitive reappraisal (stressor is framed in a more positive way) has been associated with reduced physiological and psychological stress in patients with HIV (Carrico, Antoni, Weaver, Lechner, & Schneiderman, 2005; Moskowitz, Hult, Bussolari, & Acree, 2009), carers of patients with multiple sclerosis (Pakenham, 2005), patients with PTSD (Marks, Lovell, Noshirvani, Livanou, & Thrasher, 1998), and cardiovascular recovery (Larsen & Christenfeld, 2011). In these studies, cognitive reappraisal, like cognitive, and cognitive behavioural therapy, allows the individual to actively engage in their own management, in this instance, their stress.
This essay has presented three theories of stress: a systemic theory which explains the effects of stress but does not address the causes; a transactional theory which describes the causes of stress and how they are evaluated as stressful; and a conservation of resources theory that describes the sociocultural, environmental, context of stress. The transactional theory of stress proposed by Lazarus and Folkman (1984) is arguably the most popular conceptualization, and was chosen to briefly outline a strategy to manage stress, specifically in relation to cognitive reappraisal.
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