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Abstract

The reference to stress is ubiquitous in modern society, yet it is a relatively new field of research. The following article provides an overview of the history of stress research and its iterations over the last century. In this article, I provide an overview of the earliest stress research and theories introduced through physiology and medicine and eventually as a concept in psychology. I begin with an exploration of the research of biological stressors 1st explored by experimental physiologist Claude Bernard and eventually adopted as a foundational concept in stress research when Walter Cannon expanded on Bernard’s work and identified homeostasis. The contributions of Hans Selye, considered the father of stress research; Sir William Osler; Yerkes and Dodson; and Richard Lazarus are also discussed. Finally, I discuss how, in the new millennium, research on psychological stress has expanded across disciplines ranging from physiology to medicine, chemistry, endocrinology, neurosciences, epidemiology, psychiatry, epigenetics, and psychology, reflecting the complexity of the construct both theoretically and biologically.
Review of General Psychology
Let’s Talk About Stress: History of Stress Research
Alexandra M. Robinson
Online First Publication, February 1, 2018. http://dx.doi.org/10.1037/gpr0000137
CITATION
Robinson, A. M. (2018, February 1). Let’s Talk About Stress: History of Stress Research. Review
of General Psychology. Advance online publication. http://dx.doi.org/10.1037/gpr0000137
Let’s Talk About Stress: History of Stress Research
Alexandra M. Robinson
University of Calgary
The reference to stress is ubiquitous in modern society, yet it is a relatively new field of research. The
following article provides an overview of the history of stress research and its iterations over the last
century. In this article, I provide an overview of the earliest stress research and theories introduced
through physiology and medicine and eventually as a concept in psychology. I begin with an exploration
of the research of biological stressors 1st explored by experimental physiologist Claude Bernard and
eventually adopted as a foundational concept in stress research when Walter Cannon expanded on
Bernard’s work and identified homeostasis. The contributions of Hans Selye, considered the father of
stress research; Sir William Osler; Yerkes and Dodson; and Richard Lazarus are also discussed. Finally,
I discuss how, in the new millennium, research on psychological stress has expanded across disciplines
ranging from physiology to medicine, chemistry, endocrinology, neurosciences, epidemiology, psychi-
atry, epigenetics, and psychology, reflecting the complexity of the construct both theoretically and
biologically.
Keywords: stress, homeostasis, history, health, hormones
Stress in health and disease is medically, sociologically, and philo-
sophically the most meaningful subject for humanity that I can think
of.
—Hans Selye (1907–1982)
The reference to stress is ubiquitous in modern society, and the
term stressful is a recurrent descriptor of negative experiences
related to anything from daily hassles, relationship issues, and
pressures at work to health concerns and debilitating phobias. It is
interesting that most popular definitions would likely describe
purely psychological phenomena, yet less than 100 years ago, the
term stress as a psychological phenomenon did not exist. Today
the concept of stress is pervasive in popular as well academic
literature. Despite its prevalence, stress remains an elusive con-
cept.
Modern stress research was birthed out of divergent interests in
medicine and physiology before it was introduced as a novel
concept in psychology. Stress research eventually evolved to in-
clude the consideration of cognitive processes that influence how
an individual responds to both ordinary and extraordinary condi-
tions of daily life. Perhaps what is missing in both the popular and
scientific discussion of stress is the recognition of a shared history
with medicine and physiology before its introduction as a novel
concept in psychology. So why study the history of stress, or any
discipline for that matter? There are arguably several reasons, with
the most obvious being that one must understand the major devel-
opments in that body of research in order to systematically and
scientifically build on it. Studying the history of stress research
may also elucidate the vast possibilities yet to be explored in the
discipline. Having conducted stress research over the past decade
ranging from the basic sciences using the laboratory rat to epide-
miology studies with thousands of participants, I have found it
increasingly obvious that those who talk about or even study stress
may use the same language but do not necessarily share the same
operational definition of stress. This may be due in part to the
diversity of stress research applications, and it may also be due to
a lack a historical understanding of how the concept of stress
developed. To address this knowledge gap, the following article is
meant to provide a brief history of stress research for students of
health psychology, those new in the field of stress research, and
those who are curious about the evolvement of stress research.
The following article outlines the major developments in stress
research beginning in the late 19th century through to the most recent
developments. In the process of tracing the historical events that led to
the subdiscipline of stress research in psychology, I developed two
distinct orientations regarding the development of the concept of
stress— one physiological and the other psychological—that would
eventually converge post–World War II. Finally, postwar develop-
ments of stress research are described, as well as the current advances
in the field.
Early Use of the Word Stress
Prior to the term stress being used as a psychological term, it
was used to describe various types of physical pressures. The
concept of stress (not the word) was understood by the ancient
Romans, who, understanding the significance of forces acting
upon an object, built arched bridges and coliseums utilizing com-
pressive stresses (Baratta & Colletta, 1998). The word stress is a
derivative of the Latin verb strictus, meaning “to draw tight”
(Strictus, n.d.). Strictus could also mean “to graze, touch, pluck, or
prune” (Stress, n.d.). The term strictus was incorporated into Old
French as estresse, signifying “narrowness, constriction, oppres-
sion” (Stress, n.d.), and the Middle English distress, denoting
“hardship or force exerted on a person” (Stress, n.d.). By the 16th
Correspondence concerning this article should be addressed to Alexan-
dra M. Robinson, Counseling Psychology, Faculty of Education, Univer-
sity of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4,
Canada. E-mail: alix.psych@gmail.com
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1
century, the term distress was used to indicate a form of physical
injury. The early use of the term in both French and English
referred to some sort of unpleasant environmental condition. The
first account of the term stress being used to describe a combina-
tion of external and internal responses appears in William Shaw
Mason’s Statistical Account of Ireland (1814 –1819), in which he
identified that the poor, “particularly females, die in their youth, of
what they call stresses, that is violent heats from hard work” (as
cited in Hayward, 2005, para. 3). However, these sorts of obser-
vations, which have actually been noted across the centuries
(Hinkle, 1973), were not systematically explored until the 19th
century.
Claude Bernard (1813–1878)
The French physiologist Claude Bernard (1813–1878), provided
perhaps the most significant foundational contribution to stress
research. Bernard is considered by many to be the father of
experimental medicine (Gross, 1998). Although not much of a
success in other domains, according to his obituary, Bernard was
tirelessly devoted to experimental medicine (“Obituary: Claude
Bernard,” 1878). Bernard’s work in experimental physiology
brought him international recognition. Despite his poor perfor-
mance in medical school, upon graduation Bernard apprenticed in
the lab of internationally renowned physiologist François Ma-
gendie (1783–1855) at the College de France. Eventually, Bernard
took over Magendie’s laboratory and chair at the College de
France. Bernard made many important discoveries in his lifetime,
including the glycogenic function of the liver, the role of the
pancreas in secreting digestive fluids, and the vagal control of
cardiac function. In 1865, Bernard published a highly influential
textbook, An Introduction to the Study of Experimental Medicine,
which was so well received he was elected into the prestigious
French Academy in 1869. There is a great deal more that can be
said about Claude Bernard, but of critical importance to the de-
velopment of the modern concept of stress was his theory of the
milieu intérieur, translated as “the environment within” (Bernard,
1872). Bernard noted that the body is constantly working to
maintain a stable, well-balanced internal environment. In particu-
lar, Bernard identified the portion of the nervous system that
controls the constriction and dilation of the blood vessels in
relation to the control of internal temperature. For example, when
an organism is cold, the blood vessels narrowed in order to prevent
body heat from escaping, and the opposite occurred on hot days.
He also discovered the glycogenic function of the liver in regulat-
ing blood sugar levels. With these two relatively limited observa-
tions, Bernard developed his novel hypothesis of a regulated
internal environment. These discoveries laid the foundation for
what has come to be understood as homeostatic mechanisms,
which is a cornerstone of stress research.
Initially, Bernard considered the blood to be what maintained
the internal environment. However, he eventually expanded his
idea to consider that the bodily fluids (i.e., humors) and their
regulators (e.g., glycogenic mechanisms) are under the control of
a central regulation.
The fixity of milieu supposes a perfection of the organism such that the
external variation are at each instant compensated for and equilibrated
[emphasis added]....Allofthevital mechanisms, however varied they
may be, have always one goal, to maintain the uniformity of the condi-
tions of life in the internal environment. (Bernard, 1878/1974, p. 188)
Although this seems like an intuitive idea, at the time, most
scientists believed that the organs functioned independently. Sur-
prisingly, Bernard’s concept of an internal environment did not
gain popularity until nearly 50 years later when, as will be dis-
cussed, Walter Cannon expanded on Bernard’s ideas of homeo-
static mechanisms in response to noxious insults.
Sir William Osler (1849 –1919)
One of the earliest contributors to the concept of stress and
health outcomes was Sir William Osler, born in Ontario, Canada.
Osler studied pathology and then taught at many of the most
prestigious schools in Europe and North America, finally in the
most esteemed position in Great Britain as the Regius Professor of
Medicine at Oxford University (Roland, 1982). Osler was the
opposite of Bernard in personality; he was a warm and compas-
sionate doctor who seemed to be liked by all. At the time of his
death, Osler was considered the most influential doctor of his era
(“Obituary: Sir William Osler,” 1920).
The Hippocratic rule that states physicians are to treat diseases,
not symptoms, was based on Osler’s philosophy of medicine
(Ghaemi, 2008). The current practice of medicine is based on an
approach developed by Osler that uses algorithmic analysis of
symptoms to diagnose disease (Osler, 1892) as well as a method to
generate symptoms through testing (Institute of Medicine, 2011).
In collecting information about presenting symptoms, one of the
important observations that Osler made was that the bodily re-
sponse to environmental conditions might have long-term conse-
quences on health. He described the personality of the typical heart
disease patient as a highly driven and ambitious man—long before
the Type A personality connection to cardiovascular disease was
explored (Brody, 1993). As a pathologist, Osler also noted that a
patient’s general disposition and outlook had an influence on the
trajectory of disease (Osler, 1913). Although Osler did not directly
identify a causal relationship between stress and health, he did
recognize the role of cognition in health outcomes, something that
was not taken under consideration at that time.
Walter Cannon (1871–1945)
Although Claude Bernard was the first to systematically explore
the regulatory mechanisms involved in stabilizing the internal
environment, his ideas were not taken up until Walter Cannon
began to further explore these mechanisms. With a keen interest in
science, Cannon set off to study medicine, entering Harvard Col-
lege in 1892. Putting himself through school, he was hired as a
research assistant at a lab studying digestion using the new X-ray
technology. One of Cannon’s first experiments was studying the
movement of a button through a dog’s digestive system. His first
article, “The Movements of the Stomach Studied by Means of the
Röntgen Rays,” was published in the American Journal of Phys-
iology in 1898 (W. B. Cannon, 1898). According to a biography of
Cannon written by his son, Bradford Cannon (1994), it was
through these experiments that he serendipitously observed the
phenomenon of a change in peristaltic motion. Bradford Cannon
wrote that while observing peristalsis in a cat, his father had
noticed that when the cat became distressed or alarmed, peristalsis
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2ROBINSON
ceased. It was this rather serendipitous observation that led to
Cannon’s interest in the emotional effects of stimuli on internal
functions. Like Bernard, Cannon’s main interest was in physiol-
ogy, and having the advantage of advances in both experimental
psychology and physiology, he was able to elaborate on Bernard’s
theory of the milieu intérieur as well as develop an alternative to
the dominant theory of emotion that had been developed (primar-
ily) by William James, which is also discussed later.
Another significant influence on Cannon’s research occurred
when he was commissioned to France, along with a Harvard
Medical unit, to study the phenomena of “shell shock” soon after
World War I broke out (Myers, 1916). The war provided a sort of
natural experiment on the psychological impact of extreme stress.
World War I introduced unexpected and unprecedented mass ex-
posure to the horrors of combat. As soldiers returned from the front
lines, many of them exhibited peculiar symptoms that were not
easily explained by physical injury. They exhibited symptoms such
as dizziness, headaches, fatigue, amnesia, tinnitus, sweating, and
tremors (Myers, 1916). In World War I, some thought that the
symptomatic phenomenon of soldiers who had experienced com-
bat was due to neural damage resulting from blast injuries or toxic
exposure (Jones, Fear, & Wessely, 2007). Military doctors, neu-
ropathologists, and psychologists were divided as to whether to
attribute the symptoms to psychological or physical trauma (Ben-
ison, Barger, & Wolfe, 1991). Unfortunately, there was a push
from commanders to attribute the symptoms to physical trauma in
order to “treat” soldiers and, once physical injury could be ruled
out, send them back into combat (Shephard, 1999).
Eventually, due in part to the research of Capt. Charles S.
Myers, the term shell shock was used to describe this presentation
of symptoms of trauma when no obvious injury or brain lesion
could be identified (Myers, 1940). Myers, a specialist in psycho-
logical medicine, was commissioned to study the phenomena of
shell shock. In 1915, he published an article in the Lancet com-
paring the case studies of three soldiers suffering a variety of
symptoms that could not be explained by physical injuries such as
loss of memory, vision, olfaction, and sensations (Myers, 1940).
Myers treated each patient with hypnosis and reported a reduction
of symptoms posthypnosis. A year later, after spending another
year observing patients, he submitted a follow-up article that
explored various cutaneous symptoms of shell shock (Myers,
1916). Myers suggested the label hyperasthesia to describe the
increase in sensitivity to heat, cold, and touch in addition to
previously identified observations of anesthesia. He proposed that
delayed onset of anesthesia was due to emotional stress (terror,
horror) that initially triggers bodily pain (or hyperasthesia) before
inducing a period of loss of sensation. It was estimated that
approximately 10% of soldiers presented with shell shock in
World War I (Mitchell & Smith, 1931).
Unlike Myers, who was concerned with the long-term conse-
quences of shell shock, Cannon focused his interest during the war
on acute bodily changes in response to fear (W.B. Cannon, 1929a).
Throughout the war, Cannon focused his research on shock related
to physical trauma. Due to his observations of soldiers suffering
from shock, both in vivo and postmortem, he became specifically
interested in the role of the circulatory system. He observed that
patients in shock had decreased blood pressure, acidosis, altered
dispersion of blood, and decreased blood volume (W. B. Cannon,
Fraser, & Hooper, 1918). He proposed various treatments focused
on increasing circulation and blood volume (including blood trans-
fusions) and decreasing acidosis. He differentiated traumatic shock
from shell shock that Myers and others were primarily interested
in. Based on his observations during the war, Cannon published an
article on traumatic shock, “Some Alterations in Distribution and
Character of Blood in Shock and Hemorrhage” (W. B. Cannon et
al., 1918). He also maintained his interest in the role of hormones
in response to fear and introduced the idea of the “sympathico-
adrenal system” in his book Bodily Changes in Pain, Hunger,
Fear, and Rage (W. B. Cannon, 1915), a book he had been
working on prior to leaving for France.
Homeostasis
Following the war, Cannon continued his research on the inter-
nal responses to trauma and fear. In 1929, Cannon wrote one of his
more influential articles, “Organization for physiological homeo-
stasis” (W. B. Cannon, 1929b). It is in this article that Cannon built
on the earlier and otherwise forgotten work of Claude Bernard’s
milieu intérieur. He began his article with a description of how
organisms maintain internal stability. Cannon proceeded to de-
scribe the process by which bodily systems have built an internal
system, a fluid matrix, to help organisms maintain a stable internal
state, which he defined as homeostasis. Cannon proposed two
ways that homeostasis is maintained: through the sense organs and
through the negative feedback of the autonomic nervous system.
These two systems work together to maintain stable internal states,
he asserted, providing several examples of the working systems
when responding to external changes such temperature regulation
in a cool room or physiologic adaptations to oxygen deprivation
(W. B. Cannon, 1929a). He further emphasized the important role
of the autonomic nervous system in the establishment and main-
tenance of homeostasis: “If a state remains steady, it does so
because any tendency toward change is automatically met by
increased effectiveness of the factor or factors which resist the
change” (W. B. Cannon, 1929a, p. 425). Homeostasis was an
important development in physiology and medicine, but it contin-
ued to be understood as a fully automatic process, so not yet close
to a psychological notion of stress.
Later in his career, Cannon began to explore the connection
between psychological stress and psychosomatic symptoms. In his
provocative article “‘Voodoo’ Death,” W. B. Cannon (1942) ex-
plored the phenomenon of death from fear. Cannon considered
various reports from anthropologists and others concerning obser-
vations of death after being vexed by a curse. He posited that
prolonged exposure to an ominous and persistent state of fear
could in fact produce a fatal outcome. This observation was a
critical bridge between psychological and psychosomatic medi-
cine.
It is interesting that Cannon did not incorporate the actual term
stress in his writings until 1935, and even then the term appears in
the title, “Stresses and Strains of Homeostasis,” but the actual term
stress is not defined, referenced, or explained in the body of the
article (W. B. Cannon, 1935). Regardless, the article describes the
adaptive physiological responses of the body to what he identifies
as “disturbances” (p. 5), which have come to be understood as
“stressors”. To fully appreciate the importance of Cannon’s obser-
vations, one must understand the held theory of emotions devel-
oped by William James and Carl Lange.
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3
HISTORY OF STRESS RESEARCH
Refuting the James–Lange Theory of Emotion
William James (1842–1910) is considered by many to be the
father of American psychology. One of the contributions James
made was to offer a functionalist theory of emotional conscious-
ness. Building on his interest in the conditions that afford various
experiences, he began to contemplate emotional life. He was
particularly interested in how feelings are evoked from physical
experiences. In his article “What Is Emotion?” James, 1884 argued
that when an object activates a sense organ(s) an afferent impulse
is produced and sent to the cortex. The cortical response is trans-
lated to the viscera and muscles before returning to the cortex. It
is upon return to the cortex that an object is emotionally felt. Thus,
the emotion is secondary. He used the following example to
explain emotional responses: “It is not that we see a bear, fear it,
and run; we see a bear and run; consequently, we fear the bear. Our
mind’s perception of the higher adrenaline level, heartbeat, and so
forth is the emotion” (p. 190). Expanding on this theory in James,
1894 wrote an article for the Psychological Review titled “The
Physical Basis of Emotion”. In this article, James attempted to
connect cognition to physiology. The theory holds that emotion is
the mind’s perception of physiological conditions that result from
some stimulus. Around the same time, Carl Lange, a Danish
physician, was working on a similar theory of emotion, attributing
the experience of an emotional life to the vasomotor system
(Lange, 1885). Like James, he argued that emotions are a second-
ary response to stimulus. The main idea shared by James and
Lange was that emotion did not begin with the conscious experi-
ence of an affect (Lang, 1994).
In 1927, Cannon wrote a critique of the James–Lange theory of
emotions based on physiological and experimental evidence. Can-
non began his article by challenging James’s idea that emotional
feelings arise primarily from visceral organs as well as from the
muscles and Lange’s idea that the vasomotor center is responsible
for emotional experience. To challenge this idea, Cannon cited the
earlier work of Sherrington’s (most disturbing) experiments with
transected cats and dogs (p. 570). Sherrington’s research eluci-
dated the role of neural processing in that even once the vasomotor
center was abolished, the animals still demonstrated emotional
responses such as fear, excitement, and rage (Sherrington, 1900).
Furthermore, according to Sherrington, when visceral changes are
induced artificially (e.g., using adrenalin), it does not elicit specific
emotional responses.
Cannon’s (1927) next point of contention was that the same
visceral changes occur in very different emotional and nonemo-
tional states. He compared various physical responses such as
pupil dilation, heart rate increases, respiration increases, and blood
sugar increase to various states of excitement and observed a
similar response whether the stimulus was evoking fear or rage.
Cannon argued that physical responses are too uniform to be used
to interpret the wide range of emotions. He also noted that the
viscera are relatively insensitive structures—people are generally
unaware of contractions of their smooth muscles or the processes
of their liver. Not only are they mostly unaware of visceral organs
but most of the visceral organs are too slow to be a source of
emotional feeling. Working with his graduate student Philip Bard,
he proposed an alternative theory that came to be known as the
Cannon–Bard theory of emotion. The Cannon–Bard theory pro-
poses instead that there are emotional centers in the brain, specif-
ically the thalamic areas, that organize different emotional expres-
sions.
Fight or Flight Response
Combining his theory of emotion with his theory of homeosta-
sis, Cannon moved beyond exploring the physiological mecha-
nisms of the response to physical emergencies and psychological
stress and developed a theory to answer the reasons for the
observed changes in bodily function when an organism is con-
fronted stressor. In the second edition of his book Bodily Changes
in Pain, Hunger, Fear and Rage, Cannon (1929b) proposed that
the release of adrenalin (i.e., epinephrine) into the bloodstream has
several adaptive functions that allow an organism to respond to an
acute stressor by preparing it to “fight” or to take “flight”. He
noted that the release of adrenalin has differential effects on the
body’s organs, which combine to help maintain homeostasis. In
the peripheral organs such as skeletal muscles, adrenaline facili-
tates blood flow by relaxing the blood vessels. The increase in
blood flow provides the skeletal muscles with glucose and in-
creases the removal of metabolic by-products that would otherwise
accumulate and interfere with performance. Conversely, adrena-
line constricts cutaneous blood vessels, minimizing blood loss
from physical trauma and promoting clotting. Again, building on
Bernard’s work, he concluded that adrenaline is the hormone that
signals the liver to release glucose into the bloodstream. He also
noted that adrenaline increases respiration. It is important to note
that Cannon saw all the adaptive responses as regulated by adren-
alin and did not appreciate the role of other biochemical interac-
tions or the psychological influences on these responses. Despite
this limitation, Cannon offered a new theory of emotion-associated
behaviors and biological responses. Although Cannon’s critique of
the James–Lange theory of emotion has generally shifted the
understanding of emotional processing, the matter is not entirely
decided. For example, contemporary studies in neuroscience such
as those conducted by Damasio over the past 20 years (e.g.,
Damasio, 1994/2005) adhere to the idea that much of the process-
ing for the fear response occurs in the amygdalae at a subthreshold
level. If the brain perceives that signals from external stimuli
reached the threshold of emotional competence (e.g., a shrill
scream), only then would it activate nuclei in other regions of the
brain (e.g., hypothalamus) to produce the requisite physiological
responses leading to the emotional state of fear.
Hans Selye (1907–1982)
While Cannon was conducting experiments and prolifically
writing on his theories about the acute stress responses (although
he did not use that term), Hans Selye was noticing something
different in response to chronic stress. Like Bard, Cannon, and
Osler, Selye was trained as a medical doctor. Selye’s main interest
was research, and he managed to avoid clinical practice. It should
also be noted that although Cannon published an article that used
the term stress in its title in 1935, Hans Selye is regularly credited
with being the first to reference stress in the medical literature
(Hinkle, 1973). However, according to Selye’s students, Selye
would regularly point out that although he coined the term stress
response, he was not the first to use the term (Szabo, Tache, &
Somogyi, 2012). Selye borrowed the word stress from a term
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4ROBINSON
already used in physics and engineering. He defined stress as
mutual actions of forces that take place across any section of the
body, physical or psychological.
One of Selye’s first experiments was injecting ovarian extract to
discover the unknown influence of sex hormones on physiology
(Selye, 1936). In the process, he discovered an unexpected wide-
spread nonspecific physiological response on several organs ac-
companying the injection of ovarian extract. He decided to use
other substances agents (e.g., formaldehyde, morphine, adrenaline)
to see whether there would be a similar effect. In a brief commu-
nication to the editor of Nature titled “A Syndrome Produced by
Diverse Nocuous Agents,” described how, in using rat models to
study the physiological effects of diverse nocuous insults, he
observed patterns of enlarged adrenal glands, damage to the lym-
phatic system, and stomach ulcers. He also observed these effects
in response to adverse situations such as surgery, extreme cold,
and excessive physical strain. He concluded that these physiolog-
ical changes were the nonspecific adaptive responses to various
types of stress (Selye, 1936, 1950).
Selye (Selye, 1936), using the same rat model, also recognized
a consistent three-stage pattern of physiological responses to stress
that he referred to as the general adaptation syndrome (GAS),
which he later renamed the stress response. In the first stage, the
alarm reaction, the body prepares to fight or flee. This is followed
by a stage of resistance, where the body prepares for sustained
attack against the stressor. In this second stage, the immune
response continues to increase and the body adapts to the specific
stressor. For example, if the stressor is nutritional deprivation, the
body may become lethargic to conserve energy while the absorp-
tion of nutrients is maximized. In the third stage, exhaustion, the
system becomes exhausted and resistance to the stressor cannot be
sustained. Selye’s central point was that the prolonged effect of
stress would have a negative impact on general health. This ob-
servation was the beginning of an understanding of why stress,
really distress, can be pathological and is the reason the word
stress has earned such a negative association. The physiological
effects of stress were important for giving the concept a place in
medicine, but psychologists had yet to incorporate this knowledge
into a comprehensive theory of psychological stress.
In addition to describing various ways the body responds to
stress, Selye was able to isolate and identify several specific
hormones involved in the stress response, in particular, glucocor-
ticoids (Selye, 1943). One of his doctoral-level students, Roger
Guillemin, even received a Nobel Prize for isolating the hypotha-
lamic releasing factors– hormones (Szabo et al., 2012). With the
identification of specific stress hormones and a better understand-
ing of the hypothalamic–pituitary–adrenal (HPA) axis, researchers
are now able to study the multiple ways that the body responds to
stress rather than the one general adaptation. Although Selye’s
theories have been significantly elaborated upon since the time of
their inception, even in some of his own later works, such as Stress
Without Distress (Selye, 1974), his research and theories laid the
foundation for the study of the deleterious effects of prolonged
distress on health outcomes. It was Hans Selye’s pioneering work
on the effects of chronic stress on the HPA axis that led to
contemporary research’s exploring the causal relationship of
chronic stress and the hyperactivity of the HPA axis (e.g., Zhu et
al., 2014). It is important to highlight that the major difference
between the theory and research conducted by Selye and Cannon
was that Selye was interested in the effect of chronic stress
whereas Cannon was more interested in transient responses to
acute stressors.
Yerkes–Dodson Law (1908)
Deserving of at least brief mention in the literature on stress
research is the Yerkes–Dodson Law, developed by Robert Yerkes
(1876 –1956) and John Dodson (1879 –1955) quite independently
of the studies conducted by Cannon and Selye. In 1908 at Harvard
University, Yerkes and Dodson conducted experiments with mice
to test the relationship between the strength of stimulus and habit
formation (Yerkes & Dodson, 1908). Mice were placed in a
rectangular box that was divided into an open area (nesting cham-
ber), entrance chamber, and two electrical boxes: one white and
one black. If the mouse entered the black box (which would likely
be its natural inclination), an electric shock was administered. The
shock given in each condition was weak, medium, or strong.
Yerkes and Dodson tracked the number of days it took for the
mouse to learn to enter only the white box. To their surprise, the
results indicated that the medium shock produced an optimum
amount of stimulus in the learning task. Mice that were given a
mild shock did not seem motivated to learn to enter the white box,
even after 20 days of testing. Conversely, mice that were given the
medium shock learned the white– dark discrimination task in an
average of 4 days. However, the strong shock did not improve
habit formation, and the strong shock condition results were sim-
ilar to those in the weak shock condition.
From these findings, the Yerkes–Dodson Law was developed.
Although the men did not explicitly state the law as such, today the
law is generally expressed as performance increases with physio-
logical or mental arousal, but only up to a point. When levels of
arousal become too high, performance decreases. This law is often
represented by an inverted Uto describe the optimal level of
arousal. As appealing as this model was, and as influential as it
was in the study of anxiety, it was eventually recognized that the
main problem with any U-shaped function is that it can explain
anything and everything, and therefore it explains nothing. Re-
gardless, Yerkes went on to apply these ideas to the testing and
training of pilots in World War II (Dewsbury, 1992).
World War II
Just as with World War I, the second was horrific and, for many,
psychologically traumatizing. It would hardly be possible to talk
about stress research without including the findings related to the
massive scale of stress introduced by World War II. It is interesting
that Myers, one of the main researchers and a theorist on shell
shock during the World War I (as already discussed), was so
frustrated at the military’s dismissal of his recognition of psycho-
logical trauma as it related to shell shock that he refused to conduct
further research (Shephard, 1999). At the dawn of World War II,
the British actually banned the use of the term shell shock in an
attempt to avoid a repeat epidemic and potential malingering
(Shephard, 1999). As an alternative, the term post trauma concus-
sive state was proposed by Schaller (1939), and after many de-
bates, the term post concussion syndrome was agreed upon (Jones
et al., 2007). The following symptoms were identified: dizziness,
fatigue, tinnitus, memory loss, and poor concentration. The med-
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5
HISTORY OF STRESS RESEARCH
ical community continued to argue that based on these diagnostic
criteria, it was difficult to distinguish postconcussion syndrome
from an organic concussion. Psychologists and psychiatrists alike
offered alternative diagnostic labels such as operational fatigue or
combat neurosis to try to capture the psychological aspect of the
symptoms (Grinker & Spiegel, 1945).
Grinker and Spiegel, psychiatrists from America who were
commissioned to the U.S. Army Medical Corps in North Africa
during World War II, contributed to the growing body of research
on psychological stress. In 1945, Grinker and Spiegel wrote a book
titled Men Under Stress, which explored the psychodynamics
underlying various stress responses of World War II pilots. The
authors focused primarily on the cumulative effects of being under
chronic threat that could lead to a range of “psychotic-like states”
such as aggressiveness, paranoia, depression, pervasive guilt, and
psychosomatic symptoms (as already described with shell shock).
Grinker and Spiegel attributed the symptoms of “combat neurosis”
(p. 63) to the psychological strain of combat rather than the
physical strain. They also described adjustment problems of men
returning home with “war neuroses” (p. 132) that included symp-
toms strikingly similar to the criteria for posttraumatic stress
disorder in the fourth edition of the Diagnostic and Statistical
Manual of Mental Disorders (American Psychiatric Association,
1994). Regardless of the politically correct labels, it was due to this
tragic time in history that the medical and psychological commu-
nity could no longer dispute the deleterious effects of extreme
stress in the absence of an organic insult.
Postwar Research
As discussed, early research on stress focused primarily on
physical stressors (e.g., noxious substances, nutritional depriva-
tion, temperature deregulation). The world wars brought attention
to the psychological contribution of extreme stressors. By the end
of World War II, psychological stress was recognized as an im-
portant factor in the onset of certain psychopathologies and psy-
chosomatic symptoms. Medical doctors were particularly inter-
ested in the influence of stress on the etiology of disease. In 1949,
Adolf Meyer presented an article at the annual Association for
Research in Nervous and Mental Diseases, which that year focused
on the topic “Life Stress and Bodily Disease”. He was also the first
to propose using a life chart to map out significant life events to be
used as an aid for medical diagnosis. This line of research led to a
whole branch of epidemiology devoted to exploring the correla-
tions between stress and metabolic disease, which is briefly de-
scribed in a later section.
Another area of postwar stress research was to learn the effects
of “ordinary” psychological stressors (i.e., noncombative). Stress
researchers began to explore the effects of various types of psy-
chological stressors (e.g., anticipation of a negative event, threat,
anxiety, grief). As further attempts were made to offer psycholog-
ical explanations for the biological responses to external nonphys-
ical stressors, psychologists began to recognize that the simple
stimulus–response explanation offered by Selye did not capture the
dynamic of how a stimulus is interpreted as stressful.
Richard Lazarus (1922–2002)
One of the individuals to first challenge Selye’s general adap-
tation syndrome (GAS) theory was Richard Lazarus (1922–2002).
He was educated as a cognitive psychologist at a time when
behaviorism was losing its foothold in psychology, but there was
still little interest in stress research save the military’s interest.
Lazarus played an important role in advancing stress research,
synthesizing fragmented findings from multiple disciplines in an
attempt to develop a theory that considered the multiple factors
involved in the “stress response”. Most of his research and work
was conducted at the University of California, Berkley, where he
was a professor from 1957 to 1991 (Ekman & Campos, 2003).
Lazarus introduced the idea of individual differences and vari-
ance in response to stress. At the time Lazarus began his research,
Selye, with his dominant GAS theory, and those promoting the
behaviorist models in psychology were not interested in individual
differences and were focused on establishing general laws of
stimulus–response. Lazarus argued that the study of psychological
stress required a unique type of analysis that is necessarily differ-
ent from the study of exclusively physiological stressors, such as
noxious injections (Lazarus, 1966).
Lazarus argued that what makes psychological stress unique is
that it involves personal meaning, or appraisal, as well as emo-
tions. However, he soon recognized that there is a remarkable
variance in how individuals interpret or appraise stressful condi-
tions (Lazarus & Eriksen, 1952). He attributed this variance to
individual differences in motivational and cognitive variables that
intervene between the stressor and the reaction (Lazarus & Erik-
sen, 1952). This highlights the importance of individual appraisal,
because one individual may interpret an environmental situation as
innocuous, whereas another may perceive the same situation as
stressful.
Unlike the behaviorists, Lazarus introduced cognition and sub-
sequent emotions as important considerations in the behavioral
response to a stimulus. In an attempt to incorporate various aspects
of psychological and environmental interactions, he developed the
transactional model of stress (Lazarus, 1966). The transactional
model focuses primarily on the psychology of stress and offers an
explanation for the variety of responses to environmental or psy-
chological stressors. The transactional model highlights the cog-
nitive process of appraisal as a mediator when confronted with a
stressor— how a person thinks about, or appraises, an event me-
diates the stress reaction.
Lazarus identified that there are primary appraisals and second-
ary appraisals. In his book Psychological Stress and the Coping
Process, Lazarus (1966) highlighted three outcomes of primary
appraisals
1
that are critical to the emotional response to a stimulus:
Is the transaction benign, challenging, or harmful
2
–threatening?
Harm refers to psychological damage that was already done (e.g.,
a loss), whereas threat is the anticipation of harm that has not yet
taken place but may be imminent. Once the primary appraisal has
been processed, the secondary appraisal can evaluate the effective-
ness of available coping resources. The delineation of stress into
primary and secondary appraisals is important to psychology be-
cause it moves stress research away from a purely physiological
exploration of stimulus and response to a cognitive mediation
involving numerous factors and feedback loops that include both
1
In his later works (e.g., Lazarus, 1975), he identified a fourth appraisal:
Will the transaction produce positive well-being?
2
Damaging is the term he subsequently used.
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6ROBINSON
cognitive and somatic responses (Lazarus, 1975). Lazarus (1975)
also identified four main classes of reactions to stress: (a) disturbed
affect, (b) motor behavioral reactions, (c) change in cognitive
functioning, and (d) physiological changes (i.e., biochemical and
autonomic).
Lazarus continued to expand the field of stress research by
introducing coping as one of the mediators of stress. In 1980,
Lazarus along with his graduate student Susan Folkman, posited
that people use two general coping styles that are highly contextual
(i.e., based on the appraisal of the situation; Folkman & Lazarus,
1980). First, if individuals identify a situation as something that
can be resolved using resources available to them (e.g., physical,
communicative, interpersonal), they will take actions to ameliorate
the situation. This is what Folkman and Lazarus identified as
problem-focused coping (although I think it should be called
solution-focused coping). For example, if a work supervisor con-
tinually places unrealistic demands on an employee’s time, the
employee could negotiate a more reasonable schedule. If the
supervisor and employee can agree to the proposed schedule,
the communication is no longer challenging and the threat of being
fired or reprimanded is eliminated or at least minimized. However,
if the stressor is something that is beyond a person’s control, such
as terminal illness, layoffs at work, and so forth, individuals tend
to engage in what Lazarus and Folkman identified as emotion-
focused coping. In emotion-focused coping, individuals try to
prevent having an emotional response to a stressor. Examples of
emotion-focused coping strategies could be avoidance of the threat
(i.e., stressor), denial, distraction, procrastination, distancing.
Lazarus and Folkman described emotion-focused coping as an
ego-defense mechanism (Folkman & Lazarus, 1980). Lazarus
went on to conduct several more experiments and refine his
theories throughout the 1980s and 1990s. He pioneered a new
exploration of stress research that introduced cognitive apprais-
als and coping strategies as a mediator of emotional outcomes.
He expanded stress research to consider the complex interac-
tions between stimulus, appraisal, and responses.
Proliferation of Stress Research
By the early 1980s, stress research had blossomed to include a
wide variety of approaches. In the field of psychology, stress
research has been incorporated into almost every subdiscipline,
and psychologists further differentiated the various types of psy-
chological stressors, including mental illness. To be noted, the
Diagnostic and Statistical Manual of Mental Disorders (American
Psychiatric Association, 2013), which has the most widely ac-
cepted nomenclature used by clinicians and researchers for the
classification of mental disorders, includes the requirement of the
presence of distress to be considered as part of the diagnostic
criteria for the classification of most mental disorders. In addi-
tion to clinical considerations, psychologists have operational-
ized and empirically studied the impact of various types stres-
sors, ranging from daily hassles (Rollins, Garrison, & Pierce,
2002), workplace stress (Borteyrou, Truchot, & Rascle, 2014),
parenting stress (Lee, Gopalan, & Harrington, 2016), and per-
ceived stress (Nielsen et al., 2016) to posttraumatic stress
(Torres, Skidmore, & Gross, 2012).
Stress Research Into the Next Millennium
Today stress is recognized as ubiquitous in people’s daily lives
and is considered a driving force in evolution as well as physical
and mental health. From the early works of Selye and Cannon,
there has been a growing interest in the deleterious effects of stress
over time. With the relatively new appreciation of how acute and
chronic types of stress impact physical and mental health out-
comes, epidemiologists and public health researchers have been
exploring the impact of stress on population health (Operario,
Adler, & Williams, 2004; Whitehead & Dahlgren, 2006).
Perhaps the most recent advancement in stress research is the
study of transgenerational effects of stress. For centuries, evolu-
tionary biologists have observed that physical and behavioral traits
are often passed on to subsequent generations (Gould, 2002; Wil-
son, 1978). Over the past three decades, advances in the under-
standing of genetics, including the use of the polymerase chain
reaction, have helped scientists study gene expression. By the late
1980s, scientists were better able to understand how gene expres-
sion produced phenotypic changes. This understanding was a
catalyst for Hales and Barker to develop the “thrifty phenotype”
hypothesis as a potential explanation for the association between
poor fetal and infant growth and increased risk of developing
impaired glucose tolerance and metabolic syndrome in adult life
(Hales & Barker, 1992, p. 595). The thrifty phenotype hypothesis
proposes that poor fetal and infant growth, resulting from the
effects of poor maternal uterine conditions, can produce permanent
deleterious phenotypic changes (Hales & Barker, 2001). This
theory suggests that the maternal environment acts as a non-
genomic factor involved in an organism’s phenotype. The next
section discusses what this has to do with future directions of stress
research.
Stress and Epigenetics
Recently, nongenomic inheritance has gained considerable at-
tention. In particular, the field of epigenetics introduced a pro-
found shift in the basic understanding of disease inheritance (Bird,
2007). Epigenetic changes are heritable changes in gene expres-
sion within the genome that do not directly change genomic DNA
(Anway & Skinner, 2008). Epigenetic research explores mecha-
nisms involved in the heritable changes in gene expression and
subsequent phenotypic changes. There is a growing body of re-
search in perinatal epidemiology exploring the transgenerational
epigenetic effect of maternal psychosocial stress on health out-
comes (Drake & Liu, 2009; Yao et al., 2014). By identifying health
outcomes that are strongly correlated with an environmental factor
such as psychosocial stress, researchers can target potential dis-
eases that may be linked to nongenomic disease inheritance. There
is also a burgeoning body of research on prenatal stress and the
developmental origins of health and disease that incorporates the
biological, psychological, physiological, genetic, and neurochem-
ical impact (Gluckman, Buklijas, & Hanson, 2016). Prenatal stress
has been correlated with adverse birth outcomes such as preterm
birth, metabolic disease, cardiovascular disease, and psychopatho-
logy (Dominguez, Schetter, Mancuso, Rini, & Hobel, 2005;
Malaspina et al., 2008). Even more stunning is that the impact of
prenatal exposure to stress has been shown to cause epigenetic
changes affecting phenotypic expression across generations (Yao
et al., 2014). Needless to say, this new and exciting field of
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7
HISTORY OF STRESS RESEARCH
research on the transgenerational effects of prenatal exposure to
stress highlights the enduring significance of stress research at
every level of human development.
Conclusion
Throughout the past 100 years, the study of stress has captured
the interest of many disciplines, ranging from physiology, medi-
cine, chemistry, genetics, endocrinology, neurosciences, and epi-
demiology to psychiatry and psychology, reflecting the complexity
of the construct both theoretically and biologically. Early research
was conducted through rather narrow lenses of either physiological
processes or psychological phenomena. Occasionally, one would
be almost forced to acknowledge the other, but only to receive
honorable mention. The onset of World Wars I and II created a sort
of natural experiment that forced the disciplines to work together
to better understand the biological impact of psychological stress.
The foundational ideas of Osler, Cannon, James, Selye, and Ye-
rkes converged by sharing a language for the phenomena that is
now called “stress”. Lazarus reintroduced cognition as a factor in
stress responses and firmly established stress as a psychological
interest. However, the discipline continues to be challenged with
the problem of operationalizing the concept: The ways in which
the term stress is used in research is almost as subjective as an
individual’s experience of a stress. Despite the term’s definitional
problems, almost every discipline in the biological and social
sciences today has some sort of subdiscipline devoted to the study
of stress, reflecting both its relevance and mystery.
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Received August 8, 2017
Revision received November 6, 2017
Accepted November 6, 2017
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9
HISTORY OF STRESS RESEARCH
... A cornerstone of stress studies is the concept of "homeostasis," which originated from the work of Claude Bernard (1813-78) (Robinson, 2018). Bernard came up with the idea of "milieu interieur," which means that organisms keep their interior environment stable to adapt to the external environment. ...
... Bernard came up with the idea of "milieu interieur," which means that organisms keep their interior environment stable to adapt to the external environment. Bernard had the important insight that all vital systems and organs work together to maintain internal stability (Bernard [1878(Bernard [ ] 1974Robinson, 2018). Walter B. Cannon (1871Cannon ( -1945 expanded the work of Claude Bernard and coined the concepts of "Fight or Flight Response" and homeostasis (Cannon, 1932). ...
... Walter B. Cannon (1871Cannon ( -1945 expanded the work of Claude Bernard and coined the concepts of "Fight or Flight Response" and homeostasis (Cannon, 1932). Cannon's research focused on the transient response of the body to stress, especially the function of adrenaline in regulating the adaptive responses in an emergency (Robinson, 2018). While Cannon mainly examined the transient response to stressors, Hans Selye focused on the impact of chronic stress (Robinson, 2018). ...
Chapter
This chapter reviews the causes and health consequences of the Irish famine, the China famine, and the Dutch Hunger Winter, and the genetic and biocultural mechanisms that link the early exposure to famine and health risks in later life. Famine survivors suffer from adverse health consequences such as metabolic abnormalities, cancer, and premature death. We review four hypotheses that may explain the health consequences of experiencing famine: the thrifty gene hypothesis, the thrifty phenotype hypothesis, the epigenetic changes, and the cultural food-related changes. The thrifty gene hypothesis argues that those who can absorb and process food efficiently have survival advantages during a historical time when human were subject to frequent cycles of feast and famine. Such trait, however, becomes maladaptive in an environment with constant abundance of food, leading to metabolic diseases. The thrifty phenotype hypothesis argues that prenatal malnutrition is detrimental to pancreas development, elevating the risk of type 2 diabetes. Epigenetics mechanisms suggest that fetal environment influence the expression and non-expression of genes, resulting in different states of phenotypes in later life. Finally, studies show that those who experienced food restrictions tend to engage in overeating, thus the traumatic experience might influence people’s health through behavioral mechanisms. We argue that a better understanding of how early life adversity influence health in later life could inform the intervention programs that promote the maternal and infant health.
... In the last 70 years, stress became a popular concept which is studied in a heterogeneous research field in many different disciplines Robinson, 2018). In my dissertation, I will use a psychological perspective on stress. ...
Thesis
Full-text available
Being a parent of young children is associated with both joy and stress. High parental stress was shown to be associated with decreased parental wellbeing and negative child outcomes. Thus, it is important that parents successfully cope with stress. Research has shown that becoming a parent often results in constraints on time allocation and a perceived state of isolation, making it harder to cope with stress. Smartphones might be a useful tool for parental stress management. For most parents, smartphones are always and easily accessible. Moreover, smartphones can provide many resources such as social support and information and can be used for short periods. Accordingly, first studies show that parents often use their smartphones to cope with stress. However, parental smartphone use has been widely problematized in academic and public discussions because smartphones are said to distract parents from interacting with their children. Research on how parents use smartphones to their benefit is still limited. Moreover, we do not know yet whether and under what circumstances coping using smartphones effectively reduces parental stress. To fill this knowledge gap, I examined in my dissertation how mothers of young children use their smartphones for coping with stress and under what circumstances coping using smartphones is effective. As mothers are still the primary caregivers, my dissertation mainly focuses on mothers. In a first theoretical step, I conducted a systematic scoping review summarizing and integrating the previous literature on media use for coping. Many studies assessed how media are used for coping. However, the literature had not clearly identified where media have their place in stress management models. In the scoping review, I suggested placing media in the transactional model of stress and coping by differentiating between coping strategies, such as social support or distraction and coping tools, such as talking to a friend or using a smartphone. When confronted with a stressful encounter, individuals choose a combination of coping tools and coping strategies to cope with stress. The fit of this combination with the situational circumstances determines whether the coping efforts are successful. Based on this conceptualization, I conducted a qualitative focus groups study and a quantitative experience sampling study (ESS). In the focus group study, building on a synthesis of the literature on digital media use for parenting and smartphone use while parenting, I interviewed parents in a medium-sized city and a parent-child health retreat clinic about how they use their smartphones for stress management. In the ESS, I additionally drew on theoretical conceptualizations from mobile communication and digital wellbeing research. Over 200 mothers filled in four questionnaires a day for one week and answered questions about a stressful situation that had happened in the last two hours. Both studies showed that when mothers are in stressful situations with their children, they mainly use their phones to distract themselves from the stressful encounter and to find information and support. In the focus groups study, parents reported many instances in which they successfully used their phones for stress coping. In the ESS, mothers, however, experienced a smaller stress decrease in stressful situations in which they used their phone than in situations involving no phone use. Using positive phone content, though, was related to increased coping effectiveness. My dissertation also demonstrated that social norms around maternal smartphone use play an important role when mothers use their phones for coping with stress. To explore this, I suggested a social constructivist viewpoint on media use and media effects. This viewpoint posits that the perception of and feelings around ones own media use are just as important for media effects as characteristics of objectively measurable media use, such as usage time. Further, I argue that these media use perceptions are influenced by what others say about media use and are, thus, socially constructed. Confirming the value of this viewpoint, I show in the ESS that mothers who perceived stronger injunctive norms against parental phone use experienced increased guilt when they used their phone for stress coping. Feelings of guilt around phone use in turn were related to a diminished coping effectiveness. Overall, my dissertation shows that by using positive content, mothers can use their smartphones to their benefit when they are confronted with stressful situations. Negative social norms against parental smartphone use can, by inducing guilt, be associated with diminished coping effectiveness when mothers use their phone to cope with stress. Therefore, academic and public discussions around smartphone use should consider the benefits of smartphone use for parents so that a more nuanced debate does not lead to social pressure and feelings of guilt among parents.
... In order to enhance MT-FCC, the needs of the individual family members must be tended to, including parents' mental health. Effective stress management is an emerging area of research in the medical and wellness field today (Robinson, 2018). Research shows that chronic and/or high stress levels can lead to poor health outcomes and can contribute to illness (Keller et al., 2012). ...
Article
The perinatal experience contains many stressors that can impact parental mental health. We examined the integration of music therapy (MT), an evidence-based health profession, and its stress reduction role in parents during their inpatient maternity and neonatal intensive care unit (NICU) experience. The Perceived Stress Scale (PSS) and Stress Numeric Rating Scale (SNRS-11) were used to measure stress reduction in 34 maternity and NICU parents (17 maternity patients and 17 NICU parents). Participants included parents on the antepartum unit (expecting parents on bedrest), laboring parents, pre-operation parents before cesarean delivery, parents of full-term healthy infants on the postpartum unit, and parents of premature infants on the NICU. Results were calculated based upon number of sessions rather than total number of participants and indicated that after one MT session, a 50% reduction in the SNRS-11 was measured in NICU and antepartum parents. The PSS score demonstrated a more modest stress reduction in the NICU parents but failed to achieve a statistically significant decrease in the maternity group. Findings were in line with existing literature in MT-associated stress reduction levels and may be integrated as part of an ongoing continuity of care during pregnancy, delivery, and NICU hospitalization. Earlier screening for stress may benefit parents during their perinatal hospital stay. Further research exploring the benefits of MT, as part of continuum of care and stress management for the inpatient perinatal parent population, may encourage the inclusion of MT services and improve quality of care.
Chapter
Stress is a complex phenomenon that silently rises and contributes to mental health disorders and chronic health conditions, decreasing work productivity, reducing our quality of life, and increasing our medical expenditures exponentially. Although a certain amount of stress is positive and beneficial for performance, such as “eustress,” chronic stress experienced for an extended time overwhelms the body’s coping mechanisms. We begin our chapter by briefly mentioning historical milestones related to stress research, followed by the definitions of stress. We then discuss the most recent epidemiological data related to stress prevalence and incidence, followed by a short description of the different types of stress across the lifespan. The following sections are dedicated to Burnout Syndrome, Stress-induced Exhaustion Disorder, and other types of stress-related experiences typical for our modern societies, such as Financial Stress and Stress due to Mental Illness Stigmatization. Finally, we conclude our chapter with the latest information on Caregiver Stress and Secondary Traumatic Stress.
Article
Environmental epigenetics has become a site of growing attention related to the intergenerational effects of stress, trauma, and adversity. This article draws on a multi‐sited ethnography of epigenetic knowledge production in the United States and Canada to document how scientists conceptualize, model, and measure these experiences and their effects on children's neurodevelopmental and behavioral health. We find that scientists’ efforts to identify the molecular effects of stress, trauma, and adversity results in a temporal focus on the mother–child dyad during early life. This has the effect of biologizing early childhood adversity, positioning it as a consequence of caregiving, and producing epigenetic findings that often align with individually oriented interventions rather than social and structural change. Our analysis suggests that epigenetic models of stress, trauma, and adversity therefore situate histories of oppression, inequality, and subjugation in discrete and gendered family relations, resulting in the temporal embedding of adversity during early life.
Article
The insidious coronavirus disease-2019 (COVID-19) has been a global public health concern affecting almost everyone physically and/or psychologically. The psychological consequences like concern about COVID-19 and increased perceived stress are primarily results of preventive measures like social distancing, lockdown, etc. The present study examined whether perceived social support predicts stress or lessens the effect between concern and stress during social distancing. More specifically , we tested whether (a) the greater social support is associated with lesser perceived stress, and (b) the greater an individual perceives social support, the weaker will be the concern-to-stress relationship (a prediction from buffering hypothesis). We utilized the data from the Bangladeshi respondents (n = 204, 54% males) as part of the COVIDiSTRESS global survey. The three-step hierarchical regression analysis revealed social support as a predictor of stress along with coronavirus concerns rather than protector. The findings have implications for professionals (in providing psychological support to vulnerable people), policymakers (in implementing steps in the future that would less impact on perceived social support), and future researchers (in solving the ultimate role of social support to the association between fear and stress).
Article
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Despite a growing body of research, there is no systematic body of evidence that establishes the rigour of existing measures of stress among police. The aim of this scoping review was to investigate (1) the diversity of stress measures used in police research and (2) the psychometric properties of such measures and the ways in which they are utilised. The systematic literature search discovered 16,216 records, which were reduced to 442 records of relevance. A total of 20 qualitative and 422 quantitative studies were found to be relevant, including a total of 129 unique measures, of which the majority showed satisfactory reliability (Cronbach’s alpha ≥ 0.80). The identified measures pertain to four main categories: police-specific, perceived stress, psychological and physiological outcomes (including mood and affect changes), and assessment batteries. The measures have a general tendency to emphasise illness, and police-specific stressors pertain mostly to traditional police work. Measures should be chosen based on the aspect of the stress phenomenon that is to be investigated. This study provides detailed recommendations concerning how to use these measures to advance research concerning stress among police.
Article
Full-text available
The rapid outbreak of the coronavirus disease (COVID-19) has affected citizens' daily lives in an unprecedented way. To curb the spread of the pandemic, governments have taken numerous measures such as social distancing and quarantine, which may be associated with psychological consequences, namely stress and loneliness globally. To understand differential associations of personality traits with psychological consequences of COVID-19, we utilize data from a sample of 99,217 individuals from 41 countries collected as part of the COVIDiSTRESS Global Survey. Data were analyzed using multigroup confirmatory factor analysis and multilevel regression models. Findings showed that while some of the associations were rather weak, Big Five personality traits were significantly associated with perceived stress and loneliness during the pandemic. Our study illustrates that neuroticism especially can be a vulnerability factor for stress and loneliness in times of crisis and can contribute to detection of at-risk individuals and optimization of psychological treatments during or after the COVID-19 pandemic.
Article
Purpose of the study To assess the stress factors affecting operating theater nurses during the perioperative period. Patients and methods The study was conducted as a cross-sectional survey by means of a specifically drawn-up questionnaire based on the data available in the literature. Stress was measured on a 0/100 visual analogue scale (VAS). Results Six hundred and twelve (612) persons responded. Stress associated with an operation amounted to 31.8; it was higher at the time of the procedure (49.6) and immediately beforehand (39.4), particularly among the least experienced nurses. The most widely represented stress factors were associated with the surgical team (perceived incompetence, lack of confidence), relational problems with regard to the surgeon, and team members’ disruptive behavior. By contrast, familiarity with the team or the procedure seemed to shield the nurses from stress. Feelings of stress had a relatively frequent impact on quality of life (33%), family and personal life (26%), with chronic (recurrent or constant) stress symptoms reported among 20% of respondents. Conclusion Among operating theater nurses, stress associated with an operation was particularly strong among the least experienced professionals, when the type of procedure or the other team members were unfamiliar, and in the event of disruptive behavior. Stress factor improvement should be a priority, the objective being to enhance professional and personal quality of life, while better ensuring patient safety.
Article
Résumé But de l’étude Évaluer les facteurs de stress en période périopératoire chez les infirmier(es) instrumentistes. Patients et méthodes L’étude a été réalisée de façon transversale, au moyen d’un questionnaire spécifique construit à partir des données disponibles dans la littérature. Le stress était évalué par Échelle Visuelle Analogique/100. Résultats Au total, 612 personnes ont répondu. Le stress lié à une intervention chirurgicale était évalué à 31,8 ; il était plus important au moment de la procédure (49,6) et immédiatement avant (39,4), particulièrement chez les infirmier(es) les moins expérimenté(e)s. Les facteurs de stress les plus représentés étaient liés à l’équipe chirurgicale (incompétence perçue, manque de confiance), ainsi qu’aux problèmes relationnels avec le chirurgien ou à des comportements perturbateurs de membres de l’équipe. Au contraire, la connaissance de l’équipe ou de l’intervention protégeaient du stress. Le stress ressenti avait un impact au moins fréquemment sur la qualité de vie (33 %), la vie familiale et privée (26 %), avec des symptômes chroniques rapportés au stress chez 20 % des répondants de façon fréquente ou permanente. Conclusion Chez les infirmier(es) instrumentistes, le stress lié à l’intervention chirurgicale est particulièrement ressenti par les professionnels les moins expérimentés, lorsque le type d’intervention ou les autres membres de l’équipe ne sont pas connus ou en cas de comportements perturbateurs. L’amélioration des facteurs de stress devrait être une priorité afin d’améliorer la qualité de vie professionnelle et privée et dans la perspective d’améliorer la sécurité des patients.
Article
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Objectives: There has been little examination of the structural validity of the Parenting Stress Index-Short Form (PSI-SF) for minority populations in clinical contexts in the Unites States. This study aimed to test prespecified factor structures (one-factor, two-factor, and three-factor models) of the PSI-SF. Methods: This study used confirmatory factor analysis in a sample of 240 predominantly Black and Latino caregivers of children with behavioral difficulties. Results: The three-factor model fit was reasonable, and the criterion validity for the subscale and total scores was good supporting continued cautious use of the PSI-SF for clinical minority populations. Conclusions: The PSI-SF could be integrated as part of screening and intake assessment procedures, which could allow social work practitioners to make more informed decisions about treatment planning, as well as facilitate conversations with caregivers around identifying sources of stress and developing healthy coping strategies.
Article
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Background Chronic stress is considered to be one of many causes of human preterm birth (PTB), but no direct evidence has yet been provided. Here we show in rats that stress across generations has downstream effects on endocrine, metabolic and behavioural manifestations of PTB possibly via microRNA (miRNA) regulation. Methods Pregnant dams of the parental generation were exposed to stress from gestational days 12 to 18. Their pregnant daughters (F1) and grand-daughters (F2) either were stressed or remained as non-stressed controls. Gestational length, maternal gestational weight gain, blood glucose and plasma corticosterone levels, litter size and offspring weight gain from postnatal days 1 to 30 were recorded in each generation, including F3. Maternal behaviours were analysed for the first hour after completed parturition, and offspring sensorimotor development was recorded on postnatal day (P) 7. F0 through F2 maternal brain frontal cortex, uterus and placenta miRNA and gene expression patterns were used to identify stress-induced epigenetic regulatory pathways of maternal behaviour and pregnancy maintenance.
Chapter
The “developmental origins of health and disease” (DOHaD) is a concept that has emerged over the past 50 years, linking the state of health and risk from disease in later childhood and adult life with the environmental conditions of the early life. Originally based on epidemiologic observations, the concept has given rise to a field that brings together clinical studies in a range of specialties, public and global health, experimental physiology, molecular biology (especially epigenetics), developmental biology, anthropology, the social sciences, and evolutionary biology. This chapter examines the evolution of thinking about the relationship between developmental influences and later-life health and disease; examines the establishment of DOHaD as a conceptual framework and a research field in its own right; discusses criticisms of DOHaD and barriers to its acceptance within the broader research community as well as to its recent integration into public health policy; and, finally, considers future directions that the field may take.