The Psychological Theories of Stress - Literature review Example

Stress and Illness by There seems to be a common notion that stress causes illness but is this really true? The answer lies in the psychological theories of stress – in both the cognitive theories and in the theories that establish the connection between stress and the physical body. All theories regarding stress somehow point out to the idea that stress indeed causes mental and physical illness and this is proven by empirical evidence. The cognitive theories may not actually point out or explain the direct relationship between illness and stress but they do imply the direct link between stress and mental illnesses. The Cognitive Appraisal Theory was actually formulated by Lazarus and Folkman in 1984, and is a model that emphasizes stress as a “two way process,” with both environmental stressors and the individual coping with them (Sturt 2013). This is akin to psychoanalytic theories where the individual struggles with his environment and copes with it through the use of certain defense mechanisms. Based on the Cognitive Appraisal Theory, people usually undergo a mental process, i.e. appraising a current or perceived situation, by considering two factors: the threat of a demand on their well-being, and the resources these people have in order to meet the pressures of the demand or the stressor. There are two types of appraisal – primary and secondary, although both of them may be similar (Sturt 2013). In primary appraisal, the person assesses the situation based on how it will generally affect him or her. In this case, there are usually three choices: the situation is irrelevant, the situation is good or benign-positive, or the situation is stressful. In the case of secondary appraisal, the person concerned will now determine, after determining whether situations are stressful or not, whether he has the capacity to deal with such situation. Thus, secondary appraisal may involve responses to these previously identified stressful situations such as, “I can’t do it-I know I’ll fail” or “I will try, but my chances are slim” (Sturt 2013). In short, according to Lazarus and Folkman, stress is all about either recognizing the fact that one will not be able to cope with a particularly stressful situation, or imagining the same thing as a possibility. However, unlike primary appraisal, which does not necessarily explain the connection between stress and illness, secondary appraisal may actually provide an explanation. This is because the anxiety produced by the mere recognition of the fact or possibility that one would not be able to handle the stressful situation may actually be already stressful. As an example, according to Gibbs and Montagnino (n.d.), “Psychological research has shown that disasters can cause serious mental health consequences for victims.” This means that the outcomes of disasters about which an individual feels there is nothing he can do may actually lead to mental health illnesses. Another cognitive theory related to stress is that of Sigmund Freud. For Freud, “Humans maintain a level of instinctual tension that arises from both internal sources and external sources that attack our ego or identity” (“Managing Stress” 2013). This means that just like the Cognitive Appraisal Theory, the psychoanalytic theory of Freud agrees that stress results from the fact or imagined possibility that the individual has no means of dealing with the situation that is confronting him. Thus, in order to be able to handle this, the individual’s ego is the one that copes with stress and resorts to various mechanisms of defense namely “denial, repression, projection, rationalization, displacement, and humor” (“Managing Stress” 2013). For example, if a man is caught cheating on his spouse, he is apt to defend himself and the “validity” of his actions by saying that “Anyway, everyone does it,” despite the fact that it is an invalid reason. Freud’s theory does not actually exactly explain a direct link between stress and illness. However, the mere fact that the defense mechanisms of the ego are actually symptoms of various psychiatric illnesses somehow point out that stress causes, at least, mental illnesses. For example, neurosis, which is a psychological disorder that needs psychiatric hospitalization, has symptoms that include displacement and rationalization, which are the same as the ego’s defense mechanisms as described by Freud (Barry 2002). However, unlike Lazarus and Freud, who both contended that stress is all about a dual relationship between the stressful situation and the capacity of the individual to handle the situation, Jung believes that the real source of stress is the impaired connection between the conscious and the unconscious. According to Carl Jung, “There is a certain level of innate tension, psychic tension, which exists due to the language barrier between the conscious and unconscious minds” (“Managing Stress” 2013). Nevertheless, Jung provides a solution through individuation by stating that it could actually bridge the gap between the conscious and the unconscious (“Managing Stress” 2013). Therefore, Jung, through his theory of the conscious and the unconscious minds, implies that it is the disconnection between the conscious and subconscious thoughts that causes stress. Although Jung’s theory does not exactly point out the connection between stress and illness, conflicting beliefs and desires are present among people with mental illnesses. For example, among people with schizophrenia, there is a “specific impairment of voluntary response inhibition” (Huddy et al. 2009). This means that schizophrenia is somehow based on the conflict between conscious and unconscious desires. In fact, according to Robert Sylwester of Johns Hopkins University (2001), “A successful response to many of life’s challenges requires the two systems [conscious and unconscious] to collaborate, and illness can occur if they don’t.” Moreover, according to Brosschot et al. (2010), unconscious stress is often the reason for later disease outcomes through “perseverative cognition” or “repetitive or sustained activation of cognitive representations of past stressful events or feared events in the future.” This means that some physical illnesses are actually a reaction to the unconscious thoughts that bother the present consciousness. On the other hand, unlike the Cognitive Theories of stress, the theories that involve physiology actually provide direct explanation for the claim that stress causes illness. According to the Stress-Response theory by Selye, which he proposed in 1976, stress is the “common denominator of all adaptive reactions in the body and complete freedom from stress [is] death” (Rice 2011). This means that as long as the body is alive, then it has to undergo stress because it is changing and it is constantly being affected by various factors. In 1956, Selye himself formulated the theory regarding the General Adaptation Syndrome, or GAS, which consists of three stages of how a person normally copes with stress: the alarm reaction, which is the fight or flight response to an emergency situation and where there are changes in blood pressure as well as secretion of hormones like ACTH, adrenaline, noradrenaline, and cortisol; the stage of resistance, where the body does its best to adapt to the stressor with the body having to replenish the hormones previously released by the adrenal glands, and where ulcers, asthma, high blood pressure and other illnesses may result from an impaired immune system; and the stage of exhaustion, where the body’s immune system is severely weakened until disease, physiological damage or even death may result (Sturt 2013). This means that, according to Selye, as soon as the body experiences stress, the automatic reaction is that it prepares itself to destruction through the mere production of hormones. Although Selye does not take into consideration the mental factor in handling stress or the degree to which certain hormones are produced in a stressful reaction, his Stress-Response Theory has so much validity as proven by empirical data. For example, in a recently conducted study published in the Swiss Medical Weekly, the production of the stress hormone called “copeptin” occurs in illnesses like sepsis, lower respiratory tract infections, pneumonia, stroke and other acute illnesses, thus the hormone acts like a biomarker for stress-related illnesses (Katan & Christ-Crain 2010). This means that as copeptin only occurs during stress and as it occurs only in certain diseases, then it means that stress is responsible for the physiological development of particular diseases. On the other hand, according to Cannon and Bard in the late 1920s, emotions and bodily changes occur simultaneously following an event that triggers them such as a stressful event. Backed up by the principles of neurological science and empirical data, Cannon and Bard theorized that sensory signals from the stressful event are transmitted to the thalamus and then to the amygdala and to the brain cortex. Both the amygdala and the brain cortex trigger the autonomic nervous system or ANS to produce a series of physiological reactions in response to the stressful situation such as tensing of muscle and other parts of the body, as well as increase in heart rate, and other related physiological responses (Sincero 2012). Although the Cannon-Bard theory does not exactly state the connection between stress and illness, it does state that too much stress would somehow be tantamount to the production of a greater and presumably harmful degree of physiological reactions. Thus, the Cannon-Bard theory implies that stress indeed causes illness. Moreover, in addition to the studies mentioned earlier, there are others that prove the role of stress in causing mental illnesses. According to Monroe and Simons (1991), stress is a possible cause of schizophrenia and clinical depression. Moreover, according to Griffin and Clarke (2009), and based on the burnout model of stress, emotional exhaustion and depersonalization as a response to works stress can actually predispose on to neurosis. Post-traumatic stress disorder is also present among veterans of wars like those of the 1991 Persian Gulf War, where they have impaired cholinergic and dopaminergic neurotransmitter systems as well as dysfunctions in white matter and basal ganglia, which cause hyperarousal in these people (Tillman et al. 2012). MacGeorge et al. (2004) also point out that both depression and physical illness after the 9/11 terrorist attacks on the World Trade Center were caused by stress from the event. Lastly, childhood sexual abuse and recurring thoughts of such experiences can cause childhood trauma (Mulvihill 2005). All these data somehow point out to the validity of the claim that stress indeed causes mental illnesses, and illness in general. According to Watts (2012), stress causes heart attack, eczema and high blood pressure but that the connection is oftentimes behavioral. For example, stressed people usually take in more substances like alcohol and nicotine and sleep less. According to Herbert & Cohen (1994), stress causes a significant reduction in the B and T lymphocytes of the body, which is actually the body’s line of defense. Also, a negative family emotional environment consisting of family and parenting problems may be the one responsible for childhood asthma attacks (Klinnert et al. 2008). All these data point out to the fact that stress can cause physical illnesses, whether or not this is mediated by behavioral, cognitive, or purely physiological responses. Stress can indeed cause illness and this is proven not only by the cognitive theories of stress but also by the theories that establish the link between stress and biology or physiology. The cognitive theories provide the implication that stress causes mental illnesses by assessing the current situation based on how it will affect the person observing it, and the anxiety that ensues from it will certainly be already stressful and may cause illnesses in the invidual concerned. For example, the Cognitive Appraisal Theory of Lazarus and Folkman has proven that disasters can cause illnesses in people who worry about them. The psychoanalytic theories of Freud and Jung also establish symptoms of stress that are similar to the symptoms of certain mental illnesses. These symptoms are primarily either due to the tension that results from internal and external sources directed against the ego, as proposed by Freud, or due to the presence of conflicting beliefs and desires in someone, as theorized by Jung. Moreover, the theories that establish the link between stress and the physical body imply that it is stress that causes certain diseases such as ulcers, eczema and high blood pressure, and these theories establish their claim through the idea that chemical substances produced by stress or behavioral responses to stress trigger physical changes in the body. One of these is the Stress-Response theory by Selye, which defines stress as the end result of the three stages of how the body physiologically reacts to stress. Thus, for Selye, stress eventually weakens the immune system of the body as the body copes with handling the stress. Moreover, according to Cannon-Bard, too much stress will produce a harmful degree of physiological reactions, and this may translate as getting sick. Moreover, these aforementioned theories are all backed up by data from reliable experiments. (2111 words) REFERENCES Barry, P. D. (2002). Mental Health and Mental Illness. 7th ed. Lippincott Williams and Wilkins: Philadelphia, PA, p. 177. Brosschot, J. F., Verkuil, B. & Thayer, J. F. (2010). Conscious and unconscious perseverative cognition: Is a large part of prolonged physiological activity due to unconscious stress?. Journal of Psychosomatic Research 69:4, 407-416. Griffin, M. A. & Clarke, S. (2009). Stress and Well-Being at Work. Handbook of Industrial/Organizational Psychology 3. Herbert, T. & Cohen, S. (1994). “Stress and Illness.” Carnegie Mellon University, viewed 15 Feb 2013, Huddy, V. C., Aron, A. R., Harrison, M., Barnes, T. R. E., Robbins, T. W. & Joyce, E. M. (2009). Impaired conscious and preserved unconscious inhibitory processing in recent onset schizophrenia. Psychological Medicine 39:6, 907-916. Katan, M. & Christ-Crain, M. (2010). The stress hormone copeptin: a new prognostic biomarker in acute illness. Swiss Medical Weekly, doi:10.4414/smw.2010.13101, 1-6. Klinnert, M. D., Kaugars, A. S., Strand, M. & Silveira, L. (2008). Family Psychological Factors in Relation to Children’s Asthma Status and Behavioral Adjustment at Age 4. Family Process 47:1, 41-61. MacGeorge, E. L., Samter, W., Feng, B. & Gillihan, S. J. (2004). Stress, Social Support, and Health Among College Students After September 11, 2001. Journal of College Student Development 45:6, 655-670. Managing Stress.” (2013). Cerritos College, viewed 13 Feb 2013, Monroe, S. M. & Simons, A. D. (1991). Diathesis: Stress Theories in the Context of Life Stress Research Implications for the Depressive Disorders. Psychological Bulletin 110:3, 406-425. Mulvihill, D. (2005). The Health Impact of Childhood Trauma: An Interdisciplinary Review, 1997-2003. Issues in Comprehensive Pediatric Nursing 28, 115-136. Rice, V. H. (2011). Handbook of Stress, Coping, and Health: Implications for Nursing Research, Theory and Practice. 2nd ed. SAGE Publications , Inc.: London, p. 22-24. Sincero, S. M. (2012). “Physiological Theories of Stress.” Explorable, viewed 13 Feb 2013, Sturt, G. (2013). “Theories of Stress.” Canberra University, viewed 13 Feb 2013, Sylwester, R. (2001). “Unconscious Emotions, Conscious Feelings, and Curricular Challenges.” Johns Hopkins University, viewed 13 Feb 2013, Tillman, G. D., Calley, C. S. & Green, T. A. (2012). Visual event-related potentials as markers of hyperarousal in Gulf War illness: Evidence against a stress-related etiology. Psychiatry Research: Neuroimaging, doi: 10.1016/j.pscychresns.2012.08.004, 1-11. Watts, G. (2012). “Stress and illness: The decades-long search for a link.” BBC, viewed 14 Feb 2013, Read More