A Note on ‘Stress’

 

The term ‘stress’ continues to be used in several fundamentally different ways: (a) as an environmental condition; (b) as an appraisal of an environ­mental situation; (c) as the response to that condition; and (d) as some form of relationship between the environmental demands and the person’s ability to meet the demands. Furthermore, within each of these broad categories of usage, many definitions of stress abound. Given this situation, it would seem that one cannot make much progress in the stress field until investigators agree on definitions, achieve greater conceptual precision, and improve on the operational methodology. In this paper, however, I wish to take the position that the aetiological role of stressful life experiences in disease can be examined and discussed without having to improve on the term ‘stress’ beyond its loose and imprecise vernacular usage. The more specific questions we can propose and answer, the less we have a need for the troublesome and recalcitrant concept of stress: Which life events have adverse health consequences? Which do not? Why the difference? What biological mech­anisms are involved? What is the role of behavioral variables and psycho­logical processes? Other questions like: Does the SRE measure stress? What makes events stressful (e.g., undesirability vs. change)? When does stress lead to disease outcomes? may or may not be meaningful, but they do not appear essential to the business at hand.