Life Events, Stress

BIBLIOGRAPHY

Interest in the relationship between life events and stress has sparked thousands of studies over the past several decades. The thrust of this research was that any event that required a person to change aspects of his or her life would have negative consequences for psychological and physical health. According to this perspective, whether the event was positive or negative did not matter. Rather, the most important variable in linking stress and illness was whether the event changed the status quo in one’s life and required change. Therefore getting married (presumably a happy event for most) is considered more stressful than getting fired at work or the death of a close friend.

The stress associated with life events can be measured in a variety of ways. The Social Readjustment Rating Scale (SSRS) (Holmes and Rahe 1967) is the most widely used of such measures. It consists of a list of forty-three events in nine categories: personal, family, community, social, religious, economic, occupational, residential, and vocational life. The events are intended to represent significant changes in life that require adaptive or coping behavior. Each event is given a score: for example, death of a spouse is given a 100, marriage a 50, and troubles with boss a 23. Individuals are asked to indicate which of the events listed have occurred over a designated period (from six months to two years). The sum of the weights for the checked items is then summed as the life-change score for a given individual.

Although the SRRS has been widely used, it has also been widely criticized. The relationship between life events and illness is thought to be small, and problems such as validity of the weights applied, biases in how people remember personal life events, overlap between life events and illness (e.g., change in sleeping habits) that might be related to illness all point to limitations in measuring a relationship between life events and stress (Smith 1993). Importantly, however, the use of this measure has led to an understanding of the type of life events that seem to have the greatest impact on stress levels; those include events that are unwanted, random, uncontrollable, and close together in time.

More recent perspectives on stress and illness appreciate that stress is a complex process involving different types of appraisals and coping as well as short- and longterm consequences. Perhaps the most applied theory of stress—the transactional model (Lazarus and Folkman 1984)—defines stress as a relationship between the person and the environment that is appraised by the person as taxing or exceeding his or her resources and endangering his or her well-being. According to this view, stress is conceptualized in terms of cognitive appraisal and coping, and stress is considered a continuous process. Furthermore patterns of coping are thought to change from one stage of a stressful encounter to another. For example, in the early stages of coping with the breakup of a relationship, one may seek social support from friends in order to get sympathy, understanding, or another perspective. In time one may find it more effective to cope by reinterpreting the breakup in a positive light, such as how it contributed to personal growth or opened up new and better possibilities.

Research has concluded that an important resource for dealing with stress is social support. People who have strong ties with other people are generally healthier and better able to cope with stressful life events. Other people can help reduce stress in a variety of ways by providing different forms of emotional support (e.g., intimacy and a sense of value), informational support (e.g., advice and guidance), and instrumental support (e.g., physical and material assistance). All these sources of support relate to a range of better health outcomes.

Applications of the stress and coping model to a specific stressor, discrimination, illustrates that exposure to potentially stressful events does not necessarily lead to reduced well-being. A stress and coping approach to understanding the experience of discrimination highlights the importance of examining how stressors are cognitively appraised; the coping strategies targets use to deal with stressful events; and the personal, situational, and structural factors that affect cognitive appraisals and coping processes (Major, Quinton, and McCoy 2002). Members of stigmatized groups confront discriminatory events by engaging in a variety of coping responses that can protect them from or make them more vulnerable to the adverse effects of stress (e.g., James, Hartnett, and Kalsbeek 1983; Krieger and Sidney 1996). The ways one responds to stress in general and discrimination in particular are important in understanding outcomes associated with stress.

SEE ALSO Coping; Diathesis-Stress Model; Hypertension; John Henryism; Racism; Resiliency; Stress; Stress-Buffering Model; Vulnerability

BIBLIOGRAPHY

Holmes, T. H., and R. H. Rahe. 1967. The Social Readjustment Rating Scale. Journal of Psychosomatic Research 11: 213–218.

James, S. A., S. A. Hartnett, and W. D. Kalsbeek. 1983. John Henryism and Blood Pressure Differences among Black Men. Journal of Behavioral Medicine 6: 259–278.

Krieger, N., and S. Sidney. 1996. Racial Discrimination and Blood Pressure: The CARDIA Study of Young Black and White Adults. American Journal of Public Health 86: 1370–1378.

Lazarus, R. S., and S. Folkman. 1984. Stress, Appraisal, and Coping. New York: Springer.

Major, B., W. J. Quinton, and S. J. McCoy. 2002. Antecedents and Consequences of Attributions to Discrimination: Theoretical and Empirical Advances. In Advances in Experimental Social Psychology, vol. 34, ed. M. P. Zanna, 251–330. San Diego, CA: Academic.

Smith, J. C. 1993. Understanding Stress and Coping. New York: Macmillan.

Laura S. Richman