{"id":193,"date":"2019-08-07T16:56:03","date_gmt":"2019-08-07T20:56:03","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/psychologyh5p\/chapter\/what-is-stress\/"},"modified":"2021-07-14T00:11:25","modified_gmt":"2021-07-14T04:11:25","slug":"what-is-stress","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/psychologyh5p\/chapter\/what-is-stress\/","title":{"raw":"What Is Stress?","rendered":"What Is Stress?"},"content":{"raw":"<div class=\"textbox textbox--learning-objectives\"><header class=\"textbox__header\">\r\n<p class=\"textbox__title\">Learning Objectives<\/p>\r\n\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\nBy the end of this section, you will be able to:\r\n<ul>\r\n \t<li>Differentiate between stimulus-based and response-based definitions of stress<\/li>\r\n \t<li>Define stress as a process<\/li>\r\n \t<li>Differentiate between good stress and bad stress<\/li>\r\n \t<li>Describe the early contributions of Walter Cannon and Hans Selye to the stress research field<\/li>\r\n \t<li>Understand the physiological basis of stress and describe the general adaptation syndrome<\/li>\r\n<\/ul>\r\n<\/div>\r\n<\/div>\r\n<p id=\"fs-idm168825216\">The term <span class=\"no-emphasis\" data-type=\"term\">stress<\/span> as it relates to the human condition first emerged in scientific literature in the 1930s, but it did not enter the popular vernacular until the 1970s (Lyon, 2012). Today, we often use the term loosely in describing a variety of unpleasant feeling states; for example, we often say we are stressed out when we feel frustrated, angry, conflicted, overwhelmed, or fatigued. Despite the widespread use of the term, stress is a fairly vague concept that is difficult to define with precision.<\/p>\r\n<p id=\"fs-idm173370256\">Researchers have had a difficult time agreeing on an acceptable definition of stress. Some have conceptualized stress as a demanding or threatening event or situation (e.g., a high-stress job, overcrowding, and long commutes to work). Such conceptualizations are known as stimulus-based definitions because they characterize stress as a stimulus that causes certain reactions. Stimulus-based definitions of stress are problematic, however, because they fail to recognize that people differ in how they view and react to challenging life events and situations. For example, a conscientious student who has studied diligently all semester would likely experience less stress during final exams week than would a less responsible, unprepared student.<\/p>\r\n<p id=\"fs-idm1279600\">Others have conceptualized stress in ways that emphasize the physiological responses that occur when faced with demanding or threatening situations (e.g., increased arousal). These conceptualizations are referred to as response-based definitions because they describe stress as a response to environmental conditions. For example, the endocrinologist Hans <span class=\"no-emphasis\" data-type=\"term\">Selye<\/span>, a famous stress researcher, once defined stress as the \u201cresponse of the body to any demand, whether it is caused by, or results in, pleasant or unpleasant conditions\u201d (Selye, 1976, p. 74). Selye\u2019s definition of stress is response-based in that it conceptualizes stress chiefly in terms of the body\u2019s physiological reaction to any demand that is placed on it. Neither stimulus-based nor response-based definitions provide a complete definition of stress. Many of the physiological reactions that occur when faced with demanding situations (e.g., accelerated heart rate) can also occur in response to things that most people would not consider to be genuinely stressful, such as receiving unanticipated good news: an unexpected promotion or raise.<\/p>\r\n<p id=\"fs-idm189868112\">A useful way to conceptualize <span data-type=\"term\">stress<\/span> is to view it as a process whereby an individual perceives and responds to events that he appraises as overwhelming or threatening to his well-being (Lazarus &amp; Folkman, 1984). A critical element of this definition is that it emphasizes the importance of how we appraise\u2014that is, judge\u2014demanding or threatening events (often referred to as <span data-type=\"term\">stressors<\/span>); these appraisals, in turn, influence our reactions to such events. Two kinds of appraisals of a stressor are especially important in this regard: primary and secondary appraisals. A <span data-type=\"term\">primary appraisal<\/span> involves judgment about the degree of potential harm or threat to well-being that a stressor might entail. A stressor would likely be appraised as a threat if one anticipates that it could lead to some kind of harm, loss, or other negative consequence; conversely, a stressor would likely be appraised as a challenge if one believes that it carries the potential for gain or personal growth. For example, an employee who is promoted to a leadership position would likely perceive the promotion as a much greater threat if she believed the promotion would lead to excessive work demands than if she viewed it as an opportunity to gain new skills and grow professionally. Similarly, a college student on the cusp of graduation may face the change as a threat or a challenge.<\/p>\r\n\r\n<div id=\"CNX_Psych_14_01_Graduation\" class=\"bc-figure figure\">\r\n\r\n[caption id=\"\" align=\"aligncenter\" width=\"325\"]<img src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2293\/2017\/08\/01161106\/CNX_Psych_14_01_Graduation.jpg\" alt=\"A photo shows a smiling person wearing a graduation cap and gown.\" width=\"325\" height=\"244\" data-media-type=\"image\/jpeg\" \/> Graduating from college and entering the workforce can be viewed as either a threat (loss of financial support) or a challenge (opportunity for independence and growth). (credit: Timothy Zanker)[\/caption]\r\n\r\n<\/div>\r\n<p id=\"fs-idm160892544\">The perception of a threat triggers a <span data-type=\"term\">secondary appraisal<\/span>: judgment of the options available to cope with a stressor, as well as perceptions of how effective such options will be (Lyon, 2012). As you may recall from what you learned about self-efficacy, an individual\u2019s belief in his ability to complete a task is important (Bandura, 1994). A threat tends to be viewed as less catastrophic if one believes something can be done about it (Lazarus &amp; Folkman, 1984). Imagine that two middle-aged women, Robin and Maria, perform breast self-examinations one morning and each woman notices a lump on the lower region of her left breast. Although both women view the breast lump as a potential threat (primary appraisal), their secondary appraisals differ considerably. In considering the breast lump, some of the thoughts racing through Robin\u2019s mind are, \u201cOh my God, I could have breast cancer! What if the cancer has spread to the rest of my body and I cannot recover? What if I have to go through chemotherapy? I\u2019ve heard that experience is awful! What if I have to quit my job? My husband and I won\u2019t have enough money to pay the mortgage. Oh, this is just horrible\u2026I can\u2019t deal with it!\u201d On the other hand, Maria thinks, \u201cHmm, this may not be good. Although most times these things turn out to be benign, I need to have it checked out. If it turns out to be breast cancer, there are doctors who can take care of it because the medical technology today is quite advanced. I\u2019ll have a lot of different options, and I\u2019ll be just fine.\u201d Clearly, Robin and Maria have different outlooks on what might turn out to be a very serious situation: Robin seems to think that little could be done about it, whereas Maria believes that, worst case scenario, a number of options that are likely to be effective would be available. As such, Robin would clearly experience greater stress than would Maria.<\/p>\r\n\r\n<div id=\"CNX_Psych_14_01_Appraisals\" class=\"bc-figure figure\">\r\n\r\n[caption id=\"\" align=\"aligncenter\" width=\"731\"]<img src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2293\/2017\/08\/01161110\/CNX_Psych_14_01_Appraisals.jpg\" alt=\"A concept map begins with a box titled \u201cStressor\u201d at the top with an arrow underneath that leads to a box labeled \u201cPrimary appraisal: challenge or threat?\u201d Below \u201cPrimary appraisal: challenge or threat?\u201d is a line leading to the word \u201cchallenge\u201d on the left side and \u201cthreat\u201d on the right side. Below the word \u201cchallenge\u201d is a box labeled \u201cPotential for gain or growth.\u201d There are no additional lines, arrows, or boxes under \u201cPotential for gain or growth.\u201d Below the word \u201cthreat,\u201d there is a box labeled \u201cMay lead to harm, loss, or negative consequences.\u201d Underneath the box, there is an arrow leading to another box labeled \u201cSecondary appraisal: potential options and how effective?\u201d The box has a line underneath that leads to the words \u201ceffective option\u201d on the left side and \u201cineffective\/no option\u201d on the right side. Below the words \u201ceffective option,\u201d there is an arrow leading to a box labeled \u201cLow threat.\u201d Below the words \u201cineffective\/no option,\u201d there is an arrow leading to a box labeled \u201cHigh threat.\u201d\" width=\"731\" height=\"853\" data-media-type=\"image\/jpeg\" \/> When encountering a stressor, a person judges its potential threat (primary appraisal) and then determines if effective options are available to manage the situation. Stress is likely to result if a stressor is perceived as extremely threatening or threatening with few or no effective coping options available.[\/caption]\r\n\r\n<\/div>\r\n<p id=\"fs-idp12433280\">To be sure, some stressors are inherently more stressful than others in that they are more threatening and leave less potential for variation in cognitive appraisals (e.g., objective threats to one\u2019s health or safety). Nevertheless, appraisal will still play a role in augmenting or diminishing our reactions to such events (Everly &amp; Lating, 2002).<\/p>\r\n<p id=\"fs-idm29877712\">If a person appraises an event as harmful and believes that the demands imposed by the event exceed the available resources to manage or adapt to it, the person will subjectively experience a state of stress. In contrast, if one does not appraise the same event as harmful or threatening, she is unlikely to experience stress. According to this definition, environmental events trigger stress reactions by the way they are interpreted and the meanings they are assigned. In short, stress is largely in the eye of the beholder: it\u2019s not so much what happens to you as it is how you respond (Selye, 1976).<\/p>\r\n\r\n<div id=\"fs-idm11968432\" class=\"bc-section section\" data-depth=\"1\">\r\n<h1 data-type=\"title\">Good Stress?<\/h1>\r\n<p id=\"fs-idm112400896\">Although stress carries a negative connotation, at times it may be of some benefit. Stress can motivate us to do things in our best interests, such as study for exams, visit the doctor regularly, exercise, and perform to the best of our ability at work. Indeed, Selye (1974) pointed out that not all stress is harmful. He argued that stress can sometimes be a positive, motivating force that can improve the quality of our lives. This kind of stress, which Selye called <span data-type=\"term\">eustress<\/span> (from the Greek <em data-effect=\"italics\">eu<\/em> = \u201cgood\u201d), is a good kind of stress associated with positive feelings, optimal health, and performance. A moderate amount of stress can be beneficial in challenging situations. For example, athletes may be motivated and energized by pregame stress, and students may experience similar beneficial stress before a major exam. Indeed, research shows that moderate stress can enhance both immediate and delayed recall of educational material. Male participants in one study who memorized a scientific text passage showed improved memory of the passage immediately after exposure to a mild stressor as well as one day following exposure to the stressor (Hupbach &amp; Fieman, 2012).<\/p>\r\n<p id=\"fs-idm61780208\">Increasing one\u2019s level of stress will cause performance to change in a predictable way. As stress increases, so do performance and general well-being (eustress); when stress levels reach an optimal level (the highest point of the curve), performance reaches its peak. A person at this stress level is colloquially at the top of his game, meaning he feels fully energized, focused, and can work with minimal effort and maximum efficiency. But when stress exceeds this optimal level, it is no longer a positive force\u2014it becomes excessive and debilitating, or what Selye termed <span data-type=\"term\">distress<\/span> (from the Latin <em data-effect=\"italics\">dis<\/em> = \u201cbad\u201d). People who reach this level of stress feel burned out; they are fatigued, exhausted, and their performance begins to decline. If the stress remains excessive, health may begin to erode as well (Everly &amp; Lating, 2002).<\/p>\r\n\r\n<div id=\"CNX_Psych_14_01_Performance\" class=\"bc-figure figure\">\r\n\r\n[caption id=\"\" align=\"aligncenter\" width=\"731\"]<img src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2293\/2017\/08\/01161114\/CNX_Psych_14_01_Performance.jpg\" alt=\"A graph features a bell curve that has a line going through the middle labeled \u201cOptimal level.\u201d The curve is labeled \u201ceustress\u201d on the left side and \u201cdistress\u201d on the right side. The x-axis is labeled \u201cStress level\u201d and moves from low to high, and the y-axis is labeled \u201cPerformance level\u201d and moves from low to high.\u201d The graph shows that stress levels increase with performance levels and that once stress levels reach optimal level, they move from eustress to distress.\" width=\"731\" height=\"372\" data-media-type=\"image\/jpeg\" \/> As the stress level increases from low to moderate, so does performance (eustress). At the optimal level (the peak of the curve), performance has reached its peak. If stress exceeds the optimal level, it will reach the distress region, where it will become excessive and debilitating, and performance will decline (Everly &amp; Lating, 2002).[\/caption]\r\n\r\n<\/div>\r\n<\/div>\r\n<div id=\"fs-idm93066656\" class=\"bc-section section\" data-depth=\"1\">\r\n<h1 data-type=\"title\">The Prevalence of Stress<\/h1>\r\n<p id=\"fs-idm154031696\">Stress is everywhere and, it has been on the rise over the last several years. Each of us is acquainted with stress\u2014some are more familiar than others. In many ways, stress feels like a load you just can\u2019t carry\u2014a feeling you experience when, for example, you have to drive somewhere in a crippling blizzard, when you wake up late the morning of an important job interview, when you run out of money before the next pay period, and before taking an important exam for which you realize you are not fully prepared.<\/p>\r\n\r\n<div id=\"CNX_Psych_14_01_StressRise\" class=\"bc-figure figure\">\r\n\r\n[caption id=\"\" align=\"aligncenter\" width=\"649\"]<img src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2293\/2017\/08\/01161117\/CNX_Psych_14_01_StressRise.jpg\" alt=\"A pie chart is labeled \u201cChange in Stress Levels Over Past 5 Years\u201d and split into three sections. The largest section is labeled \u201cIncreased\u201d and accounts for 44% of the pie chart. The second largest section is labeled \u201cStayed the same\u201d and accounts for 31% of the pie chart. The smallest section is labeled \u201cDecreased\u201d and accounts for 25% of the pie chart.\" width=\"649\" height=\"418\" data-media-type=\"image\/jpeg\" \/> Nearly half of U.S. adults indicated that their stress levels have increased over the last five years (Neelakantan, 2013).[\/caption]\r\n\r\n<\/div>\r\n<p id=\"fs-idm166655728\">Stress is an experience that evokes a variety of responses, including those that are physiological (e.g., accelerated heart rate, headaches, or gastrointestinal problems), cognitive (e.g., difficulty concentrating or making decisions), and behavioral (e.g., drinking alcohol, smoking, or taking actions directed at eliminating the cause of the stress). Although stress can be positive at times, it can have deleterious health implications, contributing to the onset and progression of a variety of physical illnesses and diseases (Cohen &amp; Herbert, 1996).<\/p>\r\n<p id=\"fs-idm166481008\">The scientific study of how stress and other psychological factors impact health falls within the realm of <span data-type=\"term\">health psychology<\/span>, a subfield of psychology devoted to understanding the importance of psychological influences on health, illness, and how people respond when they become ill (Taylor, 1999). Health psychology emerged as a discipline in the 1970s, a time during which there was increasing awareness of the role behavioral and lifestyle factors play in the development of illnesses and diseases (Straub, 2007). In addition to studying the connection between stress and illness, health psychologists investigate issues such as why people make certain lifestyle choices (e.g., smoking or eating unhealthy food despite knowing the potential adverse health implications of such behaviors). Health psychologists also design and investigate the effectiveness of interventions aimed at changing unhealthy behaviors. Perhaps one of the more fundamental tasks of health psychologists is to identify which groups of people are especially at risk for negative health outcomes, based on psychological or behavioral factors. For example, measuring differences in stress levels among demographic groups and how these levels change over time can help identify populations who may have an increased risk for illness or disease.<\/p>\r\n<p id=\"fs-idm185276784\">The results of three national surveys in which several thousand individuals from different demographic groups completed a brief stress questionnaire; the surveys were administered in 1983, 2006, and 2009 (Cohen &amp; Janicki-Deverts, 2012). All three surveys demonstrated higher stress in women than in men. Unemployed individuals reported high levels of stress in all three surveys, as did those with less education and income; retired persons reported the lowest stress levels. However, from 2006 to 2009 the greatest increase in stress levels occurred among men, Whites, people aged 45\u201364, college graduates, and those with full-time employment. One interpretation of these findings is that concerns surrounding the 2008\u20132009 economic downturn (e.g., threat of or actual job loss and substantial loss of retirement savings) may have been especially stressful to White, college-educated, employed men with limited time remaining in their working careers.<\/p>\r\n\r\n<div id=\"CNX_Psych_14_01_StressLev\" class=\"bc-figure figure\">\r\n\r\n[caption id=\"\" align=\"aligncenter\" width=\"975\"]<img src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2293\/2017\/08\/01161125\/CNX_Psych_14_01_StressLev.jpg\" alt=\"Graphs a through f show mean stress scores in 1983, 2006, and 2009, and how they have been impacted by different factors. Graph a shows the relationship between mean stress score and sex. The mean stress score for men steadily increased from 12 in 1983 to a little over 14 in 2006 to a little over 15 in 2009. The mean stress score for women increased rapidly from a little under 13 in 1983 to 16 in 2006 and remained the same in 2009. The graph indicates that the mean stress score for women is higher than the mean stress score for men overall. Graph b shows the relationship between mean stress score and age. The mean stress scores for people under 25 years old increased from a little over 14 in 1983 to a little over 18 in 2006, and then decreased to 17 in 2009. The mean stress scores for people 25 to 34 years old increased from a little under 14 in 1983 to 18 in 2006, then decreased to a little over 16 in 2009. The mean stress scores for people 35\u201344 years old increased from 13 in 1983 to a little under 17 in 2006, then decreased to a little over 16 in 2009. The mean stress scores for people 45\u201354 years old from a little under 13 in 1983 to 15 in 2006, then increased to a little under 17 in 2009. The mean stress scores for people 55\u201364 years old steadily increased from 12 in 1983 to a little over 13 in 2006 to a little over 14 in 2009. The mean stress scores for people 65 years old or older decreased from 12 in 1983 to a little under 11 in 2006, then slightly increased to 11 in 2009. Graph c shows the relationship between mean stress score and race. The mean stress scores for White people steadily increased from a little under 13 in 1983 to 15 in 2006 to a little over 15 in 2009. The mean stress scores for Black people increased from a little over 15 in 1983 to a little over 16 in 2006, then slightly decreased to a little over 15 in 2009. The mean stress scores for Hispanic people steadily increased from 14 in 1983 to a little under 16 in 2006 to 17 in 2009. The mean stress score for people classified as \u201cOther\u201d increased from 14 in 1983 to a little over 17 in 2006 where it remained. Graph d shows the relationship between mean stress scores and education. The mean stress scores for those with less than a high school education steadily increased from a little over 14 in 1983 to a little over 17 in 2006 to 19 in 2009. The mean stress scores for those with a high school education increased from 12 in 1983 to a little over 16 in 2006 and remained the same in 2009. The mean stress scores for those with some college education increased from 12 in 1983 to a little over 15 in 2006, then slightly increased to a little under 16 in 2009. The mean stress scores for those with a bachelor\u2019s degree steadily increased from 12 in 1983 to a little over 13 in 2006 to 15 in 2009. The mean stress scores for those with advanced degrees also steadily increased, from a little over 11 in 1983 to 13 in 2006 to a little under 15 in 2009. Graph e shows the relationship between mean stress scores and employment status. The mean stress scores for those with full time employment status steadily increased from a little over 12 in 1983 to 15 in 2006 to 16 in 2009. The mean stress scores for those with part time employment status increased from 14 in 1983 to 16 in 2006, then decreased to 15 in 2009.The mean stress scores for those who were unemployed rapidly increased from a little over 16 in 1983 to 20 in 2006, then decreased back to a little over 16 in 2009. The mean stress scores for those who were retired remained lower than the other groups, remaining at a little under 12 in 1983 and 2006, then slightly increasing to a little over 12 in 2009. Graph f shows the relationship between the mean stress score and income in U.S. dollars. The mean stress scores for those with an income of $25,000 or lower steadily increased from a little over 15 in 1983 to 17 in 2006 to a little under 18 in 2009. The mean stress scores for those with an income of $25,001 to $35,000 steadily increased from 14 in 1983 to 16 in 2006 to a little under 17 in 2009. The mean stress scores for those with an income of $35,001\u2013$50,000 steadily increased from a little under 13 in 1983 to a little over 15 in 2006 to a little over 16 in 2009. The mean stress scores for those with an income of $50,001\u2013$75,000 increased rapidly from 12 in 1983 to a little under 15 in 2006, then slightly increased to a little over 15 in 2009. The mean stress scores for those with an income of $75,001 or more steadily increased from 12 in 1983 to a little under 13 in 2006 to a little over 14 in 2009.\" width=\"975\" height=\"914\" data-media-type=\"image\/jpeg\" \/> The charts above, adapted from Cohen &amp; Janicki-Deverts (2012), depict the mean stress level scores among different demographic groups during the years 1983, 2006, and 2009. Across categories of sex, age, race, education level, employment status, and income, stress levels generally show a marked increase over this quarter-century time span.[\/caption]\r\n\r\n<\/div>\r\n<\/div>\r\n<div id=\"fs-idm74580224\" class=\"bc-section section\" data-depth=\"1\">\r\n<h1 data-type=\"title\">Early Contributions to the Study of Stress<\/h1>\r\n<p id=\"fs-idm231134096\">As previously stated, scientific interest in stress goes back nearly a century. One of the early pioneers in the study of stress was Walter <span class=\"no-emphasis\" data-type=\"term\">Cannon<\/span>, an eminent American physiologist at Harvard Medical School. In the early part of the 20th century, Cannon was the first to identify the body\u2019s physiological reactions to stress.<\/p>\r\n\r\n<div id=\"CNX_Psych_14_01_Cannon\" class=\"bc-figure figure\">\r\n\r\n[caption id=\"\" align=\"aligncenter\" width=\"244\"]<img src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2293\/2017\/08\/01161129\/CNX_Psych_14_01_Cannon2.jpg\" alt=\"A photo of Walter Cannon is shown.\" width=\"244\" height=\"313\" data-media-type=\"image\/jpeg\" \/> Harvard physiologist Walter Cannon first articulated and named the fight-or-flight response, the nervous system\u2019s sympathetic response to a significant stressor.[\/caption]\r\n\r\n<\/div>\r\n<div id=\"fs-idm148122176\" class=\"bc-section section\" data-depth=\"2\">\r\n<h2 data-type=\"title\">Cannon and the Fight-or-Flight Response<\/h2>\r\n<p id=\"fs-idm15011904\">Imagine that you are hiking in the beautiful mountains of Colorado on a warm and sunny spring day. At one point during your hike, a large, frightening-looking black bear appears from behind a stand of trees and sits about 50 yards from you. The bear notices you, sits up, and begins to lumber in your direction. In addition to thinking, \u201cThis is definitely not good,\u201d a constellation of physiological reactions begins to take place inside you. Prompted by a deluge of epinephrine (adrenaline) and norepinephrine (noradrenaline) from your adrenal glands, your pupils begin to dilate. Your heart starts to pound and speeds up, you begin to breathe heavily and perspire, you get butterflies in your stomach, and your muscles become tense, preparing you to take some kind of direct action. Cannon proposed that this reaction, which he called the <span data-type=\"term\">fight-or-flight response<\/span>, occurs when a person experiences very strong emotions\u2014especially those associated with a perceived threat (Cannon, 1932). During the fight-or-flight response, the body is rapidly aroused by activation of both the sympathetic nervous system and the endocrine system. This arousal helps prepare the person to either fight or flee from a perceived threat.<\/p>\r\n\r\n<div id=\"CNX_Psych_14_01_FightFlight\" class=\"bc-figure figure\">\r\n\r\n[caption id=\"\" align=\"aligncenter\" width=\"975\"]<img src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2293\/2017\/08\/01161133\/CNX_Psych_14_01_Fightflight.jpg\" alt=\"A figure shows the basic outline of a human body and indicates the body\u2019s various responses to fight or flight, including: pupils dilate, heart rate increases, muscles tense and may tremble, respiration quickens, bronchial tubes dilate, and perspiration begins.\" width=\"975\" height=\"546\" data-media-type=\"image\/jpeg\" \/> Fight or flight is a physiological response to a stressor.[\/caption]\r\n\r\n<\/div>\r\n<p id=\"fs-idm68759552\">According to Cannon, the fight-or-flight response is a built-in mechanism that assists in maintaining homeostasis\u2014an internal environment in which physiological variables such as blood pressure, respiration, digestion, and temperature are stabilized at levels optimal for survival. Thus, Cannon viewed the fight-or-flight response as adaptive because it enables us to adjust internally and externally to changes in our surroundings, which is helpful in species survival.<\/p>\r\n\r\n<\/div>\r\n<div id=\"fs-idm167533888\" class=\"bc-section section\" data-depth=\"2\">\r\n<h2 data-type=\"title\">Selye and the General Adaptation Syndrome<\/h2>\r\n<p id=\"fs-idm133716464\">Another important early contributor to the stress field was Hans <span class=\"no-emphasis\" data-type=\"term\">Selye<\/span>, mentioned earlier. He would eventually become one of the world\u2019s foremost experts in the study of stress. As a young assistant in the biochemistry department at McGill University in the 1930s, Selye was engaged in research involving sex hormones in rats. Although he was unable to find an answer for what he was initially researching, he incidentally discovered that when exposed to prolonged negative stimulation (stressors)\u2014such as extreme cold, surgical injury, excessive muscular exercise, and shock\u2014the rats showed signs of adrenal enlargement, thymus and lymph node shrinkage, and stomach ulceration. Selye realized that these responses were triggered by a coordinated series of physiological reactions that unfold over time during continued exposure to a stressor. These physiological reactions were nonspecific, which means that regardless of the type of stressor, the same pattern of reactions would occur. What Selye discovered was the <span data-type=\"term\">general adaptation syndrome<\/span>, the body\u2019s nonspecific physiological response to stress.<\/p>\r\n\r\n<div id=\"CNX_Psych_14_01_Hans_Selye\" class=\"bc-figure figure\">\r\n\r\n[caption id=\"\" align=\"aligncenter\" width=\"325\"]<img src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2293\/2017\/08\/01161137\/CNX_Psych_14_01_Hans.jpg\" alt=\"A stamp featuring Hans Selye is shown.\" width=\"325\" height=\"189\" data-media-type=\"image\/jpeg\" \/> Hans Selye specialized in research about stress. In 2009, his native Hungary honored his work with this stamp, released in conjunction with the 2nd annual World Conference on Stress.[\/caption]\r\n\r\n<\/div>\r\n<p id=\"fs-idm151327392\">The general adaptation syndrome,\u00a0consists of three stages: (1) alarm reaction, (2) stage of resistance, and (3) stage of exhaustion (Selye, 1936; 1976). <span data-type=\"term\">Alarm reaction<\/span> describes the body\u2019s immediate reaction upon facing a threatening situation or emergency, and it is roughly analogous to the fight-or-flight response described by Cannon. During an alarm reaction, you are alerted to a stressor, and your body alarms you with a cascade of physiological reactions that provide you with the energy to manage the situation. A person who wakes up in the middle of the night to discover her house is on fire, for example, is experiencing an alarm reaction.<\/p>\r\n\r\n<div id=\"CNX_Psych_14_01_Adaptation\" class=\"bc-figure figure\">\r\n\r\n[caption id=\"\" align=\"aligncenter\" width=\"649\"]<img src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2293\/2017\/08\/01161140\/CNX_Psych_14_01_Adaptation.jpg\" alt=\"A graph shows the three stages of Selye\u2019s general adaption syndrome: alarm reaction, resistance, and exhaustion. The x-axis represents time while the y-axis represents stress levels. The x-axis is labeled \u201cTime\u201d and the y-axis is labeled \u201cStress resistance.\u201d The graph shows that an increase in time and stress ultimately leads to exhaustion.\" width=\"649\" height=\"447\" data-media-type=\"image\/jpeg\" \/> The three stages of Selye\u2019s general adaptation syndrome are shown in this graph. Prolonged stress ultimately results in exhaustion.[\/caption]\r\n\r\n<\/div>\r\n<p id=\"fs-idm76588112\">If exposure to a stressor is prolonged, the organism will enter the <span data-type=\"term\">stage of resistance<\/span>. During this stage, the initial shock of alarm reaction has worn off and the body has adapted to the stressor. Nevertheless, the body also remains on alert and is prepared to respond as it did during the alarm reaction, although with less intensity. For example, suppose a child who went missing is still missing 72 hours later. Although the parents would obviously remain extremely disturbed, the magnitude of physiological reactions would likely have diminished over the 72 intervening hours due to some adaptation to this event.<\/p>\r\n<p id=\"fs-idm172708576\">If exposure to a stressor continues over a longer period of time, the <span data-type=\"term\">stage of exhaustion<\/span> ensues. At this stage, the person is no longer able to adapt to the stressor: the body\u2019s ability to resist becomes depleted as physical wear takes its toll on the body\u2019s tissues and organs. As a result, illness, disease, and other permanent damage to the body\u2014even death\u2014may occur. If a missing child still remained missing after three months, the long-term stress associated with this situation may cause a parent to literally faint with exhaustion at some point or even to develop a serious and irreversible illness.<\/p>\r\n<p id=\"fs-idm169450544\">In short, Selye\u2019s general adaptation syndrome suggests that stressors tax the body via a three-phase process\u2014an initial jolt, subsequent readjustment, and a later depletion of all physical resources\u2014that ultimately lays the groundwork for serious health problems and even death. It should be pointed out, however, that this model is a response-based conceptualization of stress, focusing exclusively on the body\u2019s physical responses while largely ignoring psychological factors such as appraisal and interpretation of threats. Nevertheless, Selye\u2019s model has had an enormous impact on the field of stress because it offers a general explanation for how stress can lead to physical damage and, thus, disease. As we shall discuss later, prolonged or repeated stress has been implicated in development of a number of disorders such as hypertension and coronary artery disease.<\/p>\r\n\r\n<\/div>\r\n<\/div>\r\n<div id=\"fs-idm112329408\" class=\"bc-section section\" data-depth=\"1\">\r\n<h1 data-type=\"title\">The Physiological Basis of Stress<\/h1>\r\n<p id=\"fs-idm130839824\">What goes on inside our bodies when we experience stress? The physiological mechanisms of stress are extremely complex, but they generally involve the work of two systems\u2014the <span class=\"no-emphasis\" data-type=\"term\">sympathetic nervous system<\/span> and the <span data-type=\"term\">hypothalamic-pituitary-adrenal (HPA) axis<\/span>. When a person first perceives something as stressful (Selye\u2019s alarm reaction), the sympathetic nervous system triggers arousal via the release of adrenaline from the adrenal glands. Release of these hormones activates the fight-or-flight responses to stress, such as accelerated heart rate and respiration. At the same time, the HPA axis, which is primarily endocrine in nature, becomes especially active, although it works much more slowly than the sympathetic nervous system. In response to stress, the hypothalamus (one of the limbic structures in the brain) releases corticotrophin-releasing factor, a hormone that causes the pituitary gland to release adrenocorticotropic hormone (ACTH). The ACTH then activates the adrenal glands to secrete a number of hormones into the bloodstream; an important one is cortisol, which can affect virtually every organ within the body. <span data-type=\"term\">Cortisol<\/span> is commonly known as a stress hormone and helps provide that boost of energy when we first encounter a stressor, preparing us to run away or fight. However, sustained elevated levels of cortisol weaken the immune system.<\/p>\r\n\r\n<div id=\"CNX_Psych_14_01_HPAAxis\" class=\"bc-figure figure\">\r\n\r\n[caption id=\"\" align=\"aligncenter\" width=\"731\"]<img src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2293\/2017\/08\/01161143\/CNX_Psych_14_01_HPAAxis.jpg\" alt=\"A figure shows an outline of the human body that indicates various parties of the body related to the hypothalamic-pituitary-adrenal axis. The hypothalamus, pituitary gland, and adrenal glands are labeled. There is an arrow from hypothalamus to pituitary gland and another arrow from pituitary gland to adrenal glands. These arrows represent the flow between these organs.\" width=\"731\" height=\"546\" data-media-type=\"image\/jpeg\" \/> This diagram shows the functioning of the hypothalamic-pituitary-adrenal (HPA) axis. The hypothalamus activates the pituitary gland, which in turn activates the adrenal glands, increasing their secretion of cortisol.[\/caption]\r\n\r\n<\/div>\r\n<p id=\"fs-idm76602496\">In short bursts, this process can have some favorable effects, such as providing extra energy, improving <span class=\"no-emphasis\" data-type=\"term\">immune system<\/span> functioning temporarily, and decreasing pain sensitivity. However, extended release of cortisol\u2014as would happen with prolonged or chronic stress\u2014often comes at a high price. High levels of cortisol have been shown to produce a number of harmful effects. For example, increases in cortisol can significantly weaken our immune system (Glaser &amp; Kiecolt-Glaser, 2005), and high levels are frequently observed among depressed individuals (Geoffroy, Hertzman, Li, &amp; Power, 2013). In summary, a stressful event causes a variety of physiological reactions that activate the adrenal glands, which in turn release epinephrine, norepinephrine, and cortisol. These hormones affect a number of bodily processes in ways that prepare the stressed person to take direct action, but also in ways that may heighten the potential for illness.<\/p>\r\n<p id=\"fs-idm176188608\">When stress is extreme or chronic, it can have profoundly negative consequences. For example, stress often contributes to the development of certain psychological disorders, including post-traumatic stress disorder, major depressive disorder, and other serious psychiatric conditions. Additionally, we noted earlier that stress is linked to the development and progression of a variety of physical illnesses and diseases. For example, researchers in one study found that people injured during the September 11, 2001, World Trade Center disaster or who developed post-traumatic stress symptoms afterward later suffered significantly elevated rates of heart disease (Jordan, Miller-Archie, Cone, Morabia, &amp; Stellman, 2011). Another investigation yielded that self-reported stress symptoms among aging and retired Finnish food industry workers were associated with morbidity 11 years later. This study also predicted the onset of musculoskeletal, nervous system, and endocrine and metabolic disorders (Salonen, Arola, Nyg\u00e5rd, &amp; Huhtala, 2008). Another study reported that male South Korean manufacturing employees who reported high levels of work-related stress were more likely to catch the common cold over the next several months than were those employees who reported lower work-related stress levels (Park et al., 2011). Later, you will explore the mechanisms through which stress can produce physical illness and disease.<\/p>\r\n\r\n<\/div>\r\n<div id=\"fs-idm75801888\" class=\"summary\" data-depth=\"1\">\r\n<h1 data-type=\"title\">Test Your Understanding<\/h1>\r\n<div class=\"textbox shaded\">[h5p id=\"285\"]<\/div>\r\n&nbsp;\r\n<h1 data-type=\"title\">Summary<\/h1>\r\n<p id=\"fs-idm58292432\">Stress is a process whereby an individual perceives and responds to events appraised as overwhelming or threatening to one\u2019s well-being. The scientific study of how stress and emotional factors impact health and well-being is called health psychology, a field devoted to studying the general impact of psychological factors on health. The body\u2019s primary physiological response during stress, the fight-or-flight response, was first identified in the early 20th century by Walter Cannon. The fight-or-flight response involves the coordinated activity of both the sympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis. Hans Selye, a noted endocrinologist, referred to these physiological reactions to stress as part of general adaptation syndrome, which occurs in three stages: alarm reaction (fight-or-flight reactions begin), resistance (the body begins to adapt to continuing stress), and exhaustion (adaptive energy is depleted, and stress begins to take a physical toll).<\/p>\r\n\r\n<\/div>\r\n<div id=\"fs-idm168940208\" class=\"review-questions\" data-depth=\"1\">\r\n<h1 data-type=\"title\">Review Questions<\/h1>\r\n<div id=\"fs-idm145714288\" class=\"exercise\" data-type=\"exercise\">\r\n<div id=\"fs-idm231708384\" class=\"problem\" data-type=\"problem\">\r\n<div class=\"textbox shaded\">[h5p id=\"415\"]<\/div>\r\n&nbsp;\r\n\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<div id=\"fs-idm166091184\" class=\"critical-thinking\" data-depth=\"1\">\r\n<h1 data-type=\"title\">Critical Thinking Questions<\/h1>\r\n<div id=\"fs-idm170722912\" class=\"exercise\" data-type=\"exercise\">\r\n<div id=\"fs-idp12419552\" class=\"problem\" data-type=\"problem\">\r\n<div class=\"textbox shaded\"><details><summary><span style=\"font-size: 14pt\">\u00a0 \u00a0 Provide an example (other than the one described earlier) of a situation or event that could be appraised as either threatening or challenging.<\/span>\r\n\r\n<\/summary>Answers will vary. One example is divorce. People may perceive a divorce as a threat if they believe it will result in loneliness, change of lifestyle (due to loss of additional income), or humiliation in the eyes of their family. However, divorce may be perceived as a challenge if they view it as an opportunity to find somebody more compatible, and if they consider the process of finding a new partner a pleasant one, perhaps involving mystery and excitement.\r\n\r\n<\/details>&nbsp;\r\n\r\n<details><summary><span style=\"font-size: 14pt\">\u00a0 \u00a0 Provide an example of a stressful situation that may cause a person to become seriously ill. How would Selye\u2019s general adaptation syndrome explain this occurrence?<\/span>\r\n\r\n<\/summary>Answers will vary. One example is when somebody\u2019s spouse dies or is unexpectedly diagnosed with a fatal disease. In both cases, the stress experienced by the surviving spouse would be intense, continuous, and\u2014according the general adaptation syndrome\u2014would eventually increase vulnerability to illness or disease (exhaustion stage).\r\n\r\n<\/details><\/div>\r\n&nbsp;\r\n\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<div id=\"fs-idm73665168\" class=\"personal-application\" data-depth=\"1\">\r\n<h1 data-type=\"title\">Personal Application Question<\/h1>\r\n<div id=\"fs-idm37760512\" class=\"exercise\" data-type=\"exercise\">\r\n<div id=\"fs-idm8300480\" class=\"problem\" data-type=\"problem\">\r\n<p id=\"fs-idm157333616\">Think of a time in which you and others you know (family members, friends, and classmates) experienced an event that some viewed as threatening and others viewed as challenging. What were some of the differences in the reactions of those who experienced the event as threatening compared to those who viewed the event as challenging? Why do you think there were differences in how these individuals judged the same event?<\/p>\r\n\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<div data-type=\"glossary\">\r\n<h1 data-type=\"glossary-title\">Glossary<\/h1>\r\n[h5p id=\"417\"]\r\n\r\n<\/div>","rendered":"<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<p class=\"textbox__title\">Learning Objectives<\/p>\n<\/header>\n<div class=\"textbox__content\">\n<p>By the end of this section, you will be able to:<\/p>\n<ul>\n<li>Differentiate between stimulus-based and response-based definitions of stress<\/li>\n<li>Define stress as a process<\/li>\n<li>Differentiate between good stress and bad stress<\/li>\n<li>Describe the early contributions of Walter Cannon and Hans Selye to the stress research field<\/li>\n<li>Understand the physiological basis of stress and describe the general adaptation syndrome<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<p id=\"fs-idm168825216\">The term <span class=\"no-emphasis\" data-type=\"term\">stress<\/span> as it relates to the human condition first emerged in scientific literature in the 1930s, but it did not enter the popular vernacular until the 1970s (Lyon, 2012). Today, we often use the term loosely in describing a variety of unpleasant feeling states; for example, we often say we are stressed out when we feel frustrated, angry, conflicted, overwhelmed, or fatigued. Despite the widespread use of the term, stress is a fairly vague concept that is difficult to define with precision.<\/p>\n<p id=\"fs-idm173370256\">Researchers have had a difficult time agreeing on an acceptable definition of stress. Some have conceptualized stress as a demanding or threatening event or situation (e.g., a high-stress job, overcrowding, and long commutes to work). Such conceptualizations are known as stimulus-based definitions because they characterize stress as a stimulus that causes certain reactions. Stimulus-based definitions of stress are problematic, however, because they fail to recognize that people differ in how they view and react to challenging life events and situations. For example, a conscientious student who has studied diligently all semester would likely experience less stress during final exams week than would a less responsible, unprepared student.<\/p>\n<p id=\"fs-idm1279600\">Others have conceptualized stress in ways that emphasize the physiological responses that occur when faced with demanding or threatening situations (e.g., increased arousal). These conceptualizations are referred to as response-based definitions because they describe stress as a response to environmental conditions. For example, the endocrinologist Hans <span class=\"no-emphasis\" data-type=\"term\">Selye<\/span>, a famous stress researcher, once defined stress as the \u201cresponse of the body to any demand, whether it is caused by, or results in, pleasant or unpleasant conditions\u201d (Selye, 1976, p. 74). Selye\u2019s definition of stress is response-based in that it conceptualizes stress chiefly in terms of the body\u2019s physiological reaction to any demand that is placed on it. Neither stimulus-based nor response-based definitions provide a complete definition of stress. Many of the physiological reactions that occur when faced with demanding situations (e.g., accelerated heart rate) can also occur in response to things that most people would not consider to be genuinely stressful, such as receiving unanticipated good news: an unexpected promotion or raise.<\/p>\n<p id=\"fs-idm189868112\">A useful way to conceptualize <span data-type=\"term\">stress<\/span> is to view it as a process whereby an individual perceives and responds to events that he appraises as overwhelming or threatening to his well-being (Lazarus &amp; Folkman, 1984). A critical element of this definition is that it emphasizes the importance of how we appraise\u2014that is, judge\u2014demanding or threatening events (often referred to as <span data-type=\"term\">stressors<\/span>); these appraisals, in turn, influence our reactions to such events. Two kinds of appraisals of a stressor are especially important in this regard: primary and secondary appraisals. A <span data-type=\"term\">primary appraisal<\/span> involves judgment about the degree of potential harm or threat to well-being that a stressor might entail. A stressor would likely be appraised as a threat if one anticipates that it could lead to some kind of harm, loss, or other negative consequence; conversely, a stressor would likely be appraised as a challenge if one believes that it carries the potential for gain or personal growth. For example, an employee who is promoted to a leadership position would likely perceive the promotion as a much greater threat if she believed the promotion would lead to excessive work demands than if she viewed it as an opportunity to gain new skills and grow professionally. Similarly, a college student on the cusp of graduation may face the change as a threat or a challenge.<\/p>\n<div id=\"CNX_Psych_14_01_Graduation\" class=\"bc-figure figure\">\n<figure style=\"width: 325px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2293\/2017\/08\/01161106\/CNX_Psych_14_01_Graduation.jpg\" alt=\"A photo shows a smiling person wearing a graduation cap and gown.\" width=\"325\" height=\"244\" data-media-type=\"image\/jpeg\" \/><figcaption class=\"wp-caption-text\">Graduating from college and entering the workforce can be viewed as either a threat (loss of financial support) or a challenge (opportunity for independence and growth). (credit: Timothy Zanker)<\/figcaption><\/figure>\n<\/div>\n<p id=\"fs-idm160892544\">The perception of a threat triggers a <span data-type=\"term\">secondary appraisal<\/span>: judgment of the options available to cope with a stressor, as well as perceptions of how effective such options will be (Lyon, 2012). As you may recall from what you learned about self-efficacy, an individual\u2019s belief in his ability to complete a task is important (Bandura, 1994). A threat tends to be viewed as less catastrophic if one believes something can be done about it (Lazarus &amp; Folkman, 1984). Imagine that two middle-aged women, Robin and Maria, perform breast self-examinations one morning and each woman notices a lump on the lower region of her left breast. Although both women view the breast lump as a potential threat (primary appraisal), their secondary appraisals differ considerably. In considering the breast lump, some of the thoughts racing through Robin\u2019s mind are, \u201cOh my God, I could have breast cancer! What if the cancer has spread to the rest of my body and I cannot recover? What if I have to go through chemotherapy? I\u2019ve heard that experience is awful! What if I have to quit my job? My husband and I won\u2019t have enough money to pay the mortgage. Oh, this is just horrible\u2026I can\u2019t deal with it!\u201d On the other hand, Maria thinks, \u201cHmm, this may not be good. Although most times these things turn out to be benign, I need to have it checked out. If it turns out to be breast cancer, there are doctors who can take care of it because the medical technology today is quite advanced. I\u2019ll have a lot of different options, and I\u2019ll be just fine.\u201d Clearly, Robin and Maria have different outlooks on what might turn out to be a very serious situation: Robin seems to think that little could be done about it, whereas Maria believes that, worst case scenario, a number of options that are likely to be effective would be available. As such, Robin would clearly experience greater stress than would Maria.<\/p>\n<div id=\"CNX_Psych_14_01_Appraisals\" class=\"bc-figure figure\">\n<figure style=\"width: 731px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2293\/2017\/08\/01161110\/CNX_Psych_14_01_Appraisals.jpg\" alt=\"A concept map begins with a box titled \u201cStressor\u201d at the top with an arrow underneath that leads to a box labeled \u201cPrimary appraisal: challenge or threat?\u201d Below \u201cPrimary appraisal: challenge or threat?\u201d is a line leading to the word \u201cchallenge\u201d on the left side and \u201cthreat\u201d on the right side. Below the word \u201cchallenge\u201d is a box labeled \u201cPotential for gain or growth.\u201d There are no additional lines, arrows, or boxes under \u201cPotential for gain or growth.\u201d Below the word \u201cthreat,\u201d there is a box labeled \u201cMay lead to harm, loss, or negative consequences.\u201d Underneath the box, there is an arrow leading to another box labeled \u201cSecondary appraisal: potential options and how effective?\u201d The box has a line underneath that leads to the words \u201ceffective option\u201d on the left side and \u201cineffective\/no option\u201d on the right side. Below the words \u201ceffective option,\u201d there is an arrow leading to a box labeled \u201cLow threat.\u201d Below the words \u201cineffective\/no option,\u201d there is an arrow leading to a box labeled \u201cHigh threat.\u201d\" width=\"731\" height=\"853\" data-media-type=\"image\/jpeg\" \/><figcaption class=\"wp-caption-text\">When encountering a stressor, a person judges its potential threat (primary appraisal) and then determines if effective options are available to manage the situation. Stress is likely to result if a stressor is perceived as extremely threatening or threatening with few or no effective coping options available.<\/figcaption><\/figure>\n<\/div>\n<p id=\"fs-idp12433280\">To be sure, some stressors are inherently more stressful than others in that they are more threatening and leave less potential for variation in cognitive appraisals (e.g., objective threats to one\u2019s health or safety). Nevertheless, appraisal will still play a role in augmenting or diminishing our reactions to such events (Everly &amp; Lating, 2002).<\/p>\n<p id=\"fs-idm29877712\">If a person appraises an event as harmful and believes that the demands imposed by the event exceed the available resources to manage or adapt to it, the person will subjectively experience a state of stress. In contrast, if one does not appraise the same event as harmful or threatening, she is unlikely to experience stress. According to this definition, environmental events trigger stress reactions by the way they are interpreted and the meanings they are assigned. In short, stress is largely in the eye of the beholder: it\u2019s not so much what happens to you as it is how you respond (Selye, 1976).<\/p>\n<div id=\"fs-idm11968432\" class=\"bc-section section\" data-depth=\"1\">\n<h1 data-type=\"title\">Good Stress?<\/h1>\n<p id=\"fs-idm112400896\">Although stress carries a negative connotation, at times it may be of some benefit. Stress can motivate us to do things in our best interests, such as study for exams, visit the doctor regularly, exercise, and perform to the best of our ability at work. Indeed, Selye (1974) pointed out that not all stress is harmful. He argued that stress can sometimes be a positive, motivating force that can improve the quality of our lives. This kind of stress, which Selye called <span data-type=\"term\">eustress<\/span> (from the Greek <em data-effect=\"italics\">eu<\/em> = \u201cgood\u201d), is a good kind of stress associated with positive feelings, optimal health, and performance. A moderate amount of stress can be beneficial in challenging situations. For example, athletes may be motivated and energized by pregame stress, and students may experience similar beneficial stress before a major exam. Indeed, research shows that moderate stress can enhance both immediate and delayed recall of educational material. Male participants in one study who memorized a scientific text passage showed improved memory of the passage immediately after exposure to a mild stressor as well as one day following exposure to the stressor (Hupbach &amp; Fieman, 2012).<\/p>\n<p id=\"fs-idm61780208\">Increasing one\u2019s level of stress will cause performance to change in a predictable way. As stress increases, so do performance and general well-being (eustress); when stress levels reach an optimal level (the highest point of the curve), performance reaches its peak. A person at this stress level is colloquially at the top of his game, meaning he feels fully energized, focused, and can work with minimal effort and maximum efficiency. But when stress exceeds this optimal level, it is no longer a positive force\u2014it becomes excessive and debilitating, or what Selye termed <span data-type=\"term\">distress<\/span> (from the Latin <em data-effect=\"italics\">dis<\/em> = \u201cbad\u201d). People who reach this level of stress feel burned out; they are fatigued, exhausted, and their performance begins to decline. If the stress remains excessive, health may begin to erode as well (Everly &amp; Lating, 2002).<\/p>\n<div id=\"CNX_Psych_14_01_Performance\" class=\"bc-figure figure\">\n<figure style=\"width: 731px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2293\/2017\/08\/01161114\/CNX_Psych_14_01_Performance.jpg\" alt=\"A graph features a bell curve that has a line going through the middle labeled \u201cOptimal level.\u201d The curve is labeled \u201ceustress\u201d on the left side and \u201cdistress\u201d on the right side. The x-axis is labeled \u201cStress level\u201d and moves from low to high, and the y-axis is labeled \u201cPerformance level\u201d and moves from low to high.\u201d The graph shows that stress levels increase with performance levels and that once stress levels reach optimal level, they move from eustress to distress.\" width=\"731\" height=\"372\" data-media-type=\"image\/jpeg\" \/><figcaption class=\"wp-caption-text\">As the stress level increases from low to moderate, so does performance (eustress). At the optimal level (the peak of the curve), performance has reached its peak. If stress exceeds the optimal level, it will reach the distress region, where it will become excessive and debilitating, and performance will decline (Everly &amp; Lating, 2002).<\/figcaption><\/figure>\n<\/div>\n<\/div>\n<div id=\"fs-idm93066656\" class=\"bc-section section\" data-depth=\"1\">\n<h1 data-type=\"title\">The Prevalence of Stress<\/h1>\n<p id=\"fs-idm154031696\">Stress is everywhere and, it has been on the rise over the last several years. Each of us is acquainted with stress\u2014some are more familiar than others. In many ways, stress feels like a load you just can\u2019t carry\u2014a feeling you experience when, for example, you have to drive somewhere in a crippling blizzard, when you wake up late the morning of an important job interview, when you run out of money before the next pay period, and before taking an important exam for which you realize you are not fully prepared.<\/p>\n<div id=\"CNX_Psych_14_01_StressRise\" class=\"bc-figure figure\">\n<figure style=\"width: 649px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2293\/2017\/08\/01161117\/CNX_Psych_14_01_StressRise.jpg\" alt=\"A pie chart is labeled \u201cChange in Stress Levels Over Past 5 Years\u201d and split into three sections. The largest section is labeled \u201cIncreased\u201d and accounts for 44% of the pie chart. The second largest section is labeled \u201cStayed the same\u201d and accounts for 31% of the pie chart. The smallest section is labeled \u201cDecreased\u201d and accounts for 25% of the pie chart.\" width=\"649\" height=\"418\" data-media-type=\"image\/jpeg\" \/><figcaption class=\"wp-caption-text\">Nearly half of U.S. adults indicated that their stress levels have increased over the last five years (Neelakantan, 2013).<\/figcaption><\/figure>\n<\/div>\n<p id=\"fs-idm166655728\">Stress is an experience that evokes a variety of responses, including those that are physiological (e.g., accelerated heart rate, headaches, or gastrointestinal problems), cognitive (e.g., difficulty concentrating or making decisions), and behavioral (e.g., drinking alcohol, smoking, or taking actions directed at eliminating the cause of the stress). Although stress can be positive at times, it can have deleterious health implications, contributing to the onset and progression of a variety of physical illnesses and diseases (Cohen &amp; Herbert, 1996).<\/p>\n<p id=\"fs-idm166481008\">The scientific study of how stress and other psychological factors impact health falls within the realm of <span data-type=\"term\">health psychology<\/span>, a subfield of psychology devoted to understanding the importance of psychological influences on health, illness, and how people respond when they become ill (Taylor, 1999). Health psychology emerged as a discipline in the 1970s, a time during which there was increasing awareness of the role behavioral and lifestyle factors play in the development of illnesses and diseases (Straub, 2007). In addition to studying the connection between stress and illness, health psychologists investigate issues such as why people make certain lifestyle choices (e.g., smoking or eating unhealthy food despite knowing the potential adverse health implications of such behaviors). Health psychologists also design and investigate the effectiveness of interventions aimed at changing unhealthy behaviors. Perhaps one of the more fundamental tasks of health psychologists is to identify which groups of people are especially at risk for negative health outcomes, based on psychological or behavioral factors. For example, measuring differences in stress levels among demographic groups and how these levels change over time can help identify populations who may have an increased risk for illness or disease.<\/p>\n<p id=\"fs-idm185276784\">The results of three national surveys in which several thousand individuals from different demographic groups completed a brief stress questionnaire; the surveys were administered in 1983, 2006, and 2009 (Cohen &amp; Janicki-Deverts, 2012). All three surveys demonstrated higher stress in women than in men. Unemployed individuals reported high levels of stress in all three surveys, as did those with less education and income; retired persons reported the lowest stress levels. However, from 2006 to 2009 the greatest increase in stress levels occurred among men, Whites, people aged 45\u201364, college graduates, and those with full-time employment. One interpretation of these findings is that concerns surrounding the 2008\u20132009 economic downturn (e.g., threat of or actual job loss and substantial loss of retirement savings) may have been especially stressful to White, college-educated, employed men with limited time remaining in their working careers.<\/p>\n<div id=\"CNX_Psych_14_01_StressLev\" class=\"bc-figure figure\">\n<figure style=\"width: 975px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2293\/2017\/08\/01161125\/CNX_Psych_14_01_StressLev.jpg\" alt=\"Graphs a through f show mean stress scores in 1983, 2006, and 2009, and how they have been impacted by different factors. Graph a shows the relationship between mean stress score and sex. The mean stress score for men steadily increased from 12 in 1983 to a little over 14 in 2006 to a little over 15 in 2009. The mean stress score for women increased rapidly from a little under 13 in 1983 to 16 in 2006 and remained the same in 2009. The graph indicates that the mean stress score for women is higher than the mean stress score for men overall. Graph b shows the relationship between mean stress score and age. The mean stress scores for people under 25 years old increased from a little over 14 in 1983 to a little over 18 in 2006, and then decreased to 17 in 2009. The mean stress scores for people 25 to 34 years old increased from a little under 14 in 1983 to 18 in 2006, then decreased to a little over 16 in 2009. The mean stress scores for people 35\u201344 years old increased from 13 in 1983 to a little under 17 in 2006, then decreased to a little over 16 in 2009. The mean stress scores for people 45\u201354 years old from a little under 13 in 1983 to 15 in 2006, then increased to a little under 17 in 2009. The mean stress scores for people 55\u201364 years old steadily increased from 12 in 1983 to a little over 13 in 2006 to a little over 14 in 2009. The mean stress scores for people 65 years old or older decreased from 12 in 1983 to a little under 11 in 2006, then slightly increased to 11 in 2009. Graph c shows the relationship between mean stress score and race. The mean stress scores for White people steadily increased from a little under 13 in 1983 to 15 in 2006 to a little over 15 in 2009. The mean stress scores for Black people increased from a little over 15 in 1983 to a little over 16 in 2006, then slightly decreased to a little over 15 in 2009. The mean stress scores for Hispanic people steadily increased from 14 in 1983 to a little under 16 in 2006 to 17 in 2009. The mean stress score for people classified as \u201cOther\u201d increased from 14 in 1983 to a little over 17 in 2006 where it remained. Graph d shows the relationship between mean stress scores and education. The mean stress scores for those with less than a high school education steadily increased from a little over 14 in 1983 to a little over 17 in 2006 to 19 in 2009. The mean stress scores for those with a high school education increased from 12 in 1983 to a little over 16 in 2006 and remained the same in 2009. The mean stress scores for those with some college education increased from 12 in 1983 to a little over 15 in 2006, then slightly increased to a little under 16 in 2009. The mean stress scores for those with a bachelor\u2019s degree steadily increased from 12 in 1983 to a little over 13 in 2006 to 15 in 2009. The mean stress scores for those with advanced degrees also steadily increased, from a little over 11 in 1983 to 13 in 2006 to a little under 15 in 2009. Graph e shows the relationship between mean stress scores and employment status. The mean stress scores for those with full time employment status steadily increased from a little over 12 in 1983 to 15 in 2006 to 16 in 2009. The mean stress scores for those with part time employment status increased from 14 in 1983 to 16 in 2006, then decreased to 15 in 2009.The mean stress scores for those who were unemployed rapidly increased from a little over 16 in 1983 to 20 in 2006, then decreased back to a little over 16 in 2009. The mean stress scores for those who were retired remained lower than the other groups, remaining at a little under 12 in 1983 and 2006, then slightly increasing to a little over 12 in 2009. Graph f shows the relationship between the mean stress score and income in U.S. dollars. The mean stress scores for those with an income of $25,000 or lower steadily increased from a little over 15 in 1983 to 17 in 2006 to a little under 18 in 2009. The mean stress scores for those with an income of $25,001 to $35,000 steadily increased from 14 in 1983 to 16 in 2006 to a little under 17 in 2009. The mean stress scores for those with an income of $35,001\u2013$50,000 steadily increased from a little under 13 in 1983 to a little over 15 in 2006 to a little over 16 in 2009. The mean stress scores for those with an income of $50,001\u2013$75,000 increased rapidly from 12 in 1983 to a little under 15 in 2006, then slightly increased to a little over 15 in 2009. The mean stress scores for those with an income of $75,001 or more steadily increased from 12 in 1983 to a little under 13 in 2006 to a little over 14 in 2009.\" width=\"975\" height=\"914\" data-media-type=\"image\/jpeg\" \/><figcaption class=\"wp-caption-text\">The charts above, adapted from Cohen &amp; Janicki-Deverts (2012), depict the mean stress level scores among different demographic groups during the years 1983, 2006, and 2009. Across categories of sex, age, race, education level, employment status, and income, stress levels generally show a marked increase over this quarter-century time span.<\/figcaption><\/figure>\n<\/div>\n<\/div>\n<div id=\"fs-idm74580224\" class=\"bc-section section\" data-depth=\"1\">\n<h1 data-type=\"title\">Early Contributions to the Study of Stress<\/h1>\n<p id=\"fs-idm231134096\">As previously stated, scientific interest in stress goes back nearly a century. One of the early pioneers in the study of stress was Walter <span class=\"no-emphasis\" data-type=\"term\">Cannon<\/span>, an eminent American physiologist at Harvard Medical School. In the early part of the 20th century, Cannon was the first to identify the body\u2019s physiological reactions to stress.<\/p>\n<div id=\"CNX_Psych_14_01_Cannon\" class=\"bc-figure figure\">\n<figure style=\"width: 244px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2293\/2017\/08\/01161129\/CNX_Psych_14_01_Cannon2.jpg\" alt=\"A photo of Walter Cannon is shown.\" width=\"244\" height=\"313\" data-media-type=\"image\/jpeg\" \/><figcaption class=\"wp-caption-text\">Harvard physiologist Walter Cannon first articulated and named the fight-or-flight response, the nervous system\u2019s sympathetic response to a significant stressor.<\/figcaption><\/figure>\n<\/div>\n<div id=\"fs-idm148122176\" class=\"bc-section section\" data-depth=\"2\">\n<h2 data-type=\"title\">Cannon and the Fight-or-Flight Response<\/h2>\n<p id=\"fs-idm15011904\">Imagine that you are hiking in the beautiful mountains of Colorado on a warm and sunny spring day. At one point during your hike, a large, frightening-looking black bear appears from behind a stand of trees and sits about 50 yards from you. The bear notices you, sits up, and begins to lumber in your direction. In addition to thinking, \u201cThis is definitely not good,\u201d a constellation of physiological reactions begins to take place inside you. Prompted by a deluge of epinephrine (adrenaline) and norepinephrine (noradrenaline) from your adrenal glands, your pupils begin to dilate. Your heart starts to pound and speeds up, you begin to breathe heavily and perspire, you get butterflies in your stomach, and your muscles become tense, preparing you to take some kind of direct action. Cannon proposed that this reaction, which he called the <span data-type=\"term\">fight-or-flight response<\/span>, occurs when a person experiences very strong emotions\u2014especially those associated with a perceived threat (Cannon, 1932). During the fight-or-flight response, the body is rapidly aroused by activation of both the sympathetic nervous system and the endocrine system. This arousal helps prepare the person to either fight or flee from a perceived threat.<\/p>\n<div id=\"CNX_Psych_14_01_FightFlight\" class=\"bc-figure figure\">\n<figure style=\"width: 975px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2293\/2017\/08\/01161133\/CNX_Psych_14_01_Fightflight.jpg\" alt=\"A figure shows the basic outline of a human body and indicates the body\u2019s various responses to fight or flight, including: pupils dilate, heart rate increases, muscles tense and may tremble, respiration quickens, bronchial tubes dilate, and perspiration begins.\" width=\"975\" height=\"546\" data-media-type=\"image\/jpeg\" \/><figcaption class=\"wp-caption-text\">Fight or flight is a physiological response to a stressor.<\/figcaption><\/figure>\n<\/div>\n<p id=\"fs-idm68759552\">According to Cannon, the fight-or-flight response is a built-in mechanism that assists in maintaining homeostasis\u2014an internal environment in which physiological variables such as blood pressure, respiration, digestion, and temperature are stabilized at levels optimal for survival. Thus, Cannon viewed the fight-or-flight response as adaptive because it enables us to adjust internally and externally to changes in our surroundings, which is helpful in species survival.<\/p>\n<\/div>\n<div id=\"fs-idm167533888\" class=\"bc-section section\" data-depth=\"2\">\n<h2 data-type=\"title\">Selye and the General Adaptation Syndrome<\/h2>\n<p id=\"fs-idm133716464\">Another important early contributor to the stress field was Hans <span class=\"no-emphasis\" data-type=\"term\">Selye<\/span>, mentioned earlier. He would eventually become one of the world\u2019s foremost experts in the study of stress. As a young assistant in the biochemistry department at McGill University in the 1930s, Selye was engaged in research involving sex hormones in rats. Although he was unable to find an answer for what he was initially researching, he incidentally discovered that when exposed to prolonged negative stimulation (stressors)\u2014such as extreme cold, surgical injury, excessive muscular exercise, and shock\u2014the rats showed signs of adrenal enlargement, thymus and lymph node shrinkage, and stomach ulceration. Selye realized that these responses were triggered by a coordinated series of physiological reactions that unfold over time during continued exposure to a stressor. These physiological reactions were nonspecific, which means that regardless of the type of stressor, the same pattern of reactions would occur. What Selye discovered was the <span data-type=\"term\">general adaptation syndrome<\/span>, the body\u2019s nonspecific physiological response to stress.<\/p>\n<div id=\"CNX_Psych_14_01_Hans_Selye\" class=\"bc-figure figure\">\n<figure style=\"width: 325px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2293\/2017\/08\/01161137\/CNX_Psych_14_01_Hans.jpg\" alt=\"A stamp featuring Hans Selye is shown.\" width=\"325\" height=\"189\" data-media-type=\"image\/jpeg\" \/><figcaption class=\"wp-caption-text\">Hans Selye specialized in research about stress. In 2009, his native Hungary honored his work with this stamp, released in conjunction with the 2nd annual World Conference on Stress.<\/figcaption><\/figure>\n<\/div>\n<p id=\"fs-idm151327392\">The general adaptation syndrome,\u00a0consists of three stages: (1) alarm reaction, (2) stage of resistance, and (3) stage of exhaustion (Selye, 1936; 1976). <span data-type=\"term\">Alarm reaction<\/span> describes the body\u2019s immediate reaction upon facing a threatening situation or emergency, and it is roughly analogous to the fight-or-flight response described by Cannon. During an alarm reaction, you are alerted to a stressor, and your body alarms you with a cascade of physiological reactions that provide you with the energy to manage the situation. A person who wakes up in the middle of the night to discover her house is on fire, for example, is experiencing an alarm reaction.<\/p>\n<div id=\"CNX_Psych_14_01_Adaptation\" class=\"bc-figure figure\">\n<figure style=\"width: 649px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2293\/2017\/08\/01161140\/CNX_Psych_14_01_Adaptation.jpg\" alt=\"A graph shows the three stages of Selye\u2019s general adaption syndrome: alarm reaction, resistance, and exhaustion. The x-axis represents time while the y-axis represents stress levels. The x-axis is labeled \u201cTime\u201d and the y-axis is labeled \u201cStress resistance.\u201d The graph shows that an increase in time and stress ultimately leads to exhaustion.\" width=\"649\" height=\"447\" data-media-type=\"image\/jpeg\" \/><figcaption class=\"wp-caption-text\">The three stages of Selye\u2019s general adaptation syndrome are shown in this graph. Prolonged stress ultimately results in exhaustion.<\/figcaption><\/figure>\n<\/div>\n<p id=\"fs-idm76588112\">If exposure to a stressor is prolonged, the organism will enter the <span data-type=\"term\">stage of resistance<\/span>. During this stage, the initial shock of alarm reaction has worn off and the body has adapted to the stressor. Nevertheless, the body also remains on alert and is prepared to respond as it did during the alarm reaction, although with less intensity. For example, suppose a child who went missing is still missing 72 hours later. Although the parents would obviously remain extremely disturbed, the magnitude of physiological reactions would likely have diminished over the 72 intervening hours due to some adaptation to this event.<\/p>\n<p id=\"fs-idm172708576\">If exposure to a stressor continues over a longer period of time, the <span data-type=\"term\">stage of exhaustion<\/span> ensues. At this stage, the person is no longer able to adapt to the stressor: the body\u2019s ability to resist becomes depleted as physical wear takes its toll on the body\u2019s tissues and organs. As a result, illness, disease, and other permanent damage to the body\u2014even death\u2014may occur. If a missing child still remained missing after three months, the long-term stress associated with this situation may cause a parent to literally faint with exhaustion at some point or even to develop a serious and irreversible illness.<\/p>\n<p id=\"fs-idm169450544\">In short, Selye\u2019s general adaptation syndrome suggests that stressors tax the body via a three-phase process\u2014an initial jolt, subsequent readjustment, and a later depletion of all physical resources\u2014that ultimately lays the groundwork for serious health problems and even death. It should be pointed out, however, that this model is a response-based conceptualization of stress, focusing exclusively on the body\u2019s physical responses while largely ignoring psychological factors such as appraisal and interpretation of threats. Nevertheless, Selye\u2019s model has had an enormous impact on the field of stress because it offers a general explanation for how stress can lead to physical damage and, thus, disease. As we shall discuss later, prolonged or repeated stress has been implicated in development of a number of disorders such as hypertension and coronary artery disease.<\/p>\n<\/div>\n<\/div>\n<div id=\"fs-idm112329408\" class=\"bc-section section\" data-depth=\"1\">\n<h1 data-type=\"title\">The Physiological Basis of Stress<\/h1>\n<p id=\"fs-idm130839824\">What goes on inside our bodies when we experience stress? The physiological mechanisms of stress are extremely complex, but they generally involve the work of two systems\u2014the <span class=\"no-emphasis\" data-type=\"term\">sympathetic nervous system<\/span> and the <span data-type=\"term\">hypothalamic-pituitary-adrenal (HPA) axis<\/span>. When a person first perceives something as stressful (Selye\u2019s alarm reaction), the sympathetic nervous system triggers arousal via the release of adrenaline from the adrenal glands. Release of these hormones activates the fight-or-flight responses to stress, such as accelerated heart rate and respiration. At the same time, the HPA axis, which is primarily endocrine in nature, becomes especially active, although it works much more slowly than the sympathetic nervous system. In response to stress, the hypothalamus (one of the limbic structures in the brain) releases corticotrophin-releasing factor, a hormone that causes the pituitary gland to release adrenocorticotropic hormone (ACTH). The ACTH then activates the adrenal glands to secrete a number of hormones into the bloodstream; an important one is cortisol, which can affect virtually every organ within the body. <span data-type=\"term\">Cortisol<\/span> is commonly known as a stress hormone and helps provide that boost of energy when we first encounter a stressor, preparing us to run away or fight. However, sustained elevated levels of cortisol weaken the immune system.<\/p>\n<div id=\"CNX_Psych_14_01_HPAAxis\" class=\"bc-figure figure\">\n<figure style=\"width: 731px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/2293\/2017\/08\/01161143\/CNX_Psych_14_01_HPAAxis.jpg\" alt=\"A figure shows an outline of the human body that indicates various parties of the body related to the hypothalamic-pituitary-adrenal axis. The hypothalamus, pituitary gland, and adrenal glands are labeled. There is an arrow from hypothalamus to pituitary gland and another arrow from pituitary gland to adrenal glands. These arrows represent the flow between these organs.\" width=\"731\" height=\"546\" data-media-type=\"image\/jpeg\" \/><figcaption class=\"wp-caption-text\">This diagram shows the functioning of the hypothalamic-pituitary-adrenal (HPA) axis. The hypothalamus activates the pituitary gland, which in turn activates the adrenal glands, increasing their secretion of cortisol.<\/figcaption><\/figure>\n<\/div>\n<p id=\"fs-idm76602496\">In short bursts, this process can have some favorable effects, such as providing extra energy, improving <span class=\"no-emphasis\" data-type=\"term\">immune system<\/span> functioning temporarily, and decreasing pain sensitivity. However, extended release of cortisol\u2014as would happen with prolonged or chronic stress\u2014often comes at a high price. High levels of cortisol have been shown to produce a number of harmful effects. For example, increases in cortisol can significantly weaken our immune system (Glaser &amp; Kiecolt-Glaser, 2005), and high levels are frequently observed among depressed individuals (Geoffroy, Hertzman, Li, &amp; Power, 2013). In summary, a stressful event causes a variety of physiological reactions that activate the adrenal glands, which in turn release epinephrine, norepinephrine, and cortisol. These hormones affect a number of bodily processes in ways that prepare the stressed person to take direct action, but also in ways that may heighten the potential for illness.<\/p>\n<p id=\"fs-idm176188608\">When stress is extreme or chronic, it can have profoundly negative consequences. For example, stress often contributes to the development of certain psychological disorders, including post-traumatic stress disorder, major depressive disorder, and other serious psychiatric conditions. Additionally, we noted earlier that stress is linked to the development and progression of a variety of physical illnesses and diseases. For example, researchers in one study found that people injured during the September 11, 2001, World Trade Center disaster or who developed post-traumatic stress symptoms afterward later suffered significantly elevated rates of heart disease (Jordan, Miller-Archie, Cone, Morabia, &amp; Stellman, 2011). Another investigation yielded that self-reported stress symptoms among aging and retired Finnish food industry workers were associated with morbidity 11 years later. This study also predicted the onset of musculoskeletal, nervous system, and endocrine and metabolic disorders (Salonen, Arola, Nyg\u00e5rd, &amp; Huhtala, 2008). Another study reported that male South Korean manufacturing employees who reported high levels of work-related stress were more likely to catch the common cold over the next several months than were those employees who reported lower work-related stress levels (Park et al., 2011). Later, you will explore the mechanisms through which stress can produce physical illness and disease.<\/p>\n<\/div>\n<div id=\"fs-idm75801888\" class=\"summary\" data-depth=\"1\">\n<h1 data-type=\"title\">Test Your Understanding<\/h1>\n<div class=\"textbox shaded\">\n<div id=\"h5p-285\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-285\" class=\"h5p-iframe\" data-content-id=\"285\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"(14.1) Stress Crash Course\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<h1 data-type=\"title\">Summary<\/h1>\n<p id=\"fs-idm58292432\">Stress is a process whereby an individual perceives and responds to events appraised as overwhelming or threatening to one\u2019s well-being. The scientific study of how stress and emotional factors impact health and well-being is called health psychology, a field devoted to studying the general impact of psychological factors on health. The body\u2019s primary physiological response during stress, the fight-or-flight response, was first identified in the early 20th century by Walter Cannon. The fight-or-flight response involves the coordinated activity of both the sympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis. Hans Selye, a noted endocrinologist, referred to these physiological reactions to stress as part of general adaptation syndrome, which occurs in three stages: alarm reaction (fight-or-flight reactions begin), resistance (the body begins to adapt to continuing stress), and exhaustion (adaptive energy is depleted, and stress begins to take a physical toll).<\/p>\n<\/div>\n<div id=\"fs-idm168940208\" class=\"review-questions\" data-depth=\"1\">\n<h1 data-type=\"title\">Review Questions<\/h1>\n<div id=\"fs-idm145714288\" class=\"exercise\" data-type=\"exercise\">\n<div id=\"fs-idm231708384\" class=\"problem\" data-type=\"problem\">\n<div class=\"textbox shaded\">\n<div id=\"h5p-415\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-415\" class=\"h5p-iframe\" data-content-id=\"415\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Ch.14 What Is Stress? (OS Questions)\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"fs-idm166091184\" class=\"critical-thinking\" data-depth=\"1\">\n<h1 data-type=\"title\">Critical Thinking Questions<\/h1>\n<div id=\"fs-idm170722912\" class=\"exercise\" data-type=\"exercise\">\n<div id=\"fs-idp12419552\" class=\"problem\" data-type=\"problem\">\n<div class=\"textbox shaded\">\n<details>\n<summary><span style=\"font-size: 14pt\">\u00a0 \u00a0 Provide an example (other than the one described earlier) of a situation or event that could be appraised as either threatening or challenging.<\/span><\/p>\n<\/summary>\n<p>Answers will vary. One example is divorce. People may perceive a divorce as a threat if they believe it will result in loneliness, change of lifestyle (due to loss of additional income), or humiliation in the eyes of their family. However, divorce may be perceived as a challenge if they view it as an opportunity to find somebody more compatible, and if they consider the process of finding a new partner a pleasant one, perhaps involving mystery and excitement.<\/p>\n<\/details>\n<p>&nbsp;<\/p>\n<details>\n<summary><span style=\"font-size: 14pt\">\u00a0 \u00a0 Provide an example of a stressful situation that may cause a person to become seriously ill. How would Selye\u2019s general adaptation syndrome explain this occurrence?<\/span><\/p>\n<\/summary>\n<p>Answers will vary. One example is when somebody\u2019s spouse dies or is unexpectedly diagnosed with a fatal disease. In both cases, the stress experienced by the surviving spouse would be intense, continuous, and\u2014according the general adaptation syndrome\u2014would eventually increase vulnerability to illness or disease (exhaustion stage).<\/p>\n<\/details>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"fs-idm73665168\" class=\"personal-application\" data-depth=\"1\">\n<h1 data-type=\"title\">Personal Application Question<\/h1>\n<div id=\"fs-idm37760512\" class=\"exercise\" data-type=\"exercise\">\n<div id=\"fs-idm8300480\" class=\"problem\" data-type=\"problem\">\n<p id=\"fs-idm157333616\">Think of a time in which you and others you know (family members, friends, and classmates) experienced an event that some viewed as threatening and others viewed as challenging. What were some of the differences in the reactions of those who experienced the event as threatening compared to those who viewed the event as challenging? Why do you think there were differences in how these individuals judged the same event?<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div data-type=\"glossary\">\n<h1 data-type=\"glossary-title\">Glossary<\/h1>\n<div id=\"h5p-417\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-417\" class=\"h5p-iframe\" data-content-id=\"417\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Ch.14 What Is Stress? (OS Glossary)\"><\/iframe><\/div>\n<\/div>\n<\/div>\n","protected":false},"author":103,"menu_order":1,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-193","chapter","type-chapter","status-publish","hentry"],"part":190,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/psychologyh5p\/wp-json\/pressbooks\/v2\/chapters\/193","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/psychologyh5p\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/psychologyh5p\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/psychologyh5p\/wp-json\/wp\/v2\/users\/103"}],"version-history":[{"count":7,"href":"https:\/\/pressbooks.bccampus.ca\/psychologyh5p\/wp-json\/pressbooks\/v2\/chapters\/193\/revisions"}],"predecessor-version":[{"id":1074,"href":"https:\/\/pressbooks.bccampus.ca\/psychologyh5p\/wp-json\/pressbooks\/v2\/chapters\/193\/revisions\/1074"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/psychologyh5p\/wp-json\/pressbooks\/v2\/parts\/190"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/psychologyh5p\/wp-json\/pressbooks\/v2\/chapters\/193\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/psychologyh5p\/wp-json\/wp\/v2\/media?parent=193"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/psychologyh5p\/wp-json\/pressbooks\/v2\/chapter-type?post=193"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/psychologyh5p\/wp-json\/wp\/v2\/contributor?post=193"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/psychologyh5p\/wp-json\/wp\/v2\/license?post=193"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}