Institute of Sociology NASU

Stress exposure, perceived stress severity, and their effects on health

stmm. 2024 (1): 187-197

DOI https://doi.org/10.15407/sociology2024.01.187

Full text: https://stmm.in.ua/archive/ukr/2024-1/12.pdf

MALTSEVA, KATERYNA Candidate of Sciences in Philosophy, PhD in Anthropology, Associate Professor, Head of the Department of Sociology, NaUKMA (8/5, Volos'ka St., Build. 4, Kyiv, 04655)

maltsevaKS@ukma.edu.ua

http://orcid.org/0000-0001-6540-8734

While stress is one of the central concepts in many contemporary theories of health, there is no universal definition of stress or stressors. Stress is usually understood as a subjective experience of tension, pressure, distress, fear or negative emotions that occurs as a result of a perceived threat to one’s mental or physical well-being and is accompanied by an evolved biological response that facilitates adaptive reaction. While stress is conceptualized as a taxing condition, it is not understood as uniformly harmful per se. In fact, stress response is often cited as an adaptive reaction. Moreover, not every incident of stress exposure results in a disease or has an undermining effect on health. Mere exposure to stress does not warrant the healthy organism’s falling ill. Yet stress has been shown to affect health both directly and indirectly, having impact on multiple chronic conditions. Stressors vary in their severity and their ability to leave their mark on health, and it is therefore important to develop reliable methods of measuring stress to better understand how stress affects health and instigates pathology. One of the difficulties of measuring the effects of stress is connected to the distinction between external stressors and their internal appraisal. More recently, stress researchers began to make a distinction between stress exposure (i.e., facing an objectively measurable stressor) and perceived stress severity (i.e., a subjective experience of stress resulting from individual’s facing a stressor). The latter has been shown to have a superior predictive ability in terms of negative health outcomes (both breadth and depth of observed effects) compared to the former. Measurement-wise, subjective stress also tends to yield more precise results, which makes it preferable as a stress-assessment tool. The present article is a literature review study that delves into this distinction and attempts to shed light onto its implications for measuring stress and its effects on health.

Keywords: stress; health; stress severity; mental health; physical health; assessment; measurement

References

1. Adler, N., Boyce, T., Chesney, M., Cohen, S. et al. (1994). Socioeconomic status and health: The challenge of the gradient. American Psychologist, 49(1), 15-24. https://doi.org/10.1037/0003-066X.49.1.15

2. Anda, R.F., Felitti, V.J., Bremner, J.D., Walker, J.D., Whitfield, C., Perry, B.D., Giles, W. H. (2006). The enduring effects of abuse and related adverse experiences in childhood. European Archives of Psychiatry and Clinical Neuroscience, 256(3), 174-186. https://doi.org/10.1007/s00406-005-0624-4

3. Blascovich, J. (2008a). Challenge and threat. In: A.J. Elliot (Ed.), Handbook of approach and avoidance motivation (pp. 431-445). Psychology Press.

4. Blascovich, J. (2008b). Challenge, threat, and health. In: J.Y. Shah & W.L. Gardner (Eds.), Handbook of motivation science (pp. 481-493). Guildford Press.

5. Blascovich, J. & Tomaka, J. (1996). The biopsychosocial model of arousal regulation. In: M. Zanna (Ed.), Advances in experimental social psychology (pp. 1-51). Academic Press. https://doi.org/10.1016/S0065-2601(08)60235-X

6. Bosch, N.M., Riese, H., Reijneveld, S.A., Bakker, M.P., Verhulst, F.C., Ormel, J., & Oldehinkel, A.J. (2012). Timing matters: Long term effects of adversities from prenatal period up to adolescence on adolescents' cortisol stress response. The TRAILS study. Psychoneuroendocrinology, 37(9), 1439-1447. https://doi.org/10.1016/j.psyneuen.2012.01.013

7. Brinkhof, L.P., Chambon, M., Ridderinkhof, K.R., van Harreveld, F., Murre, J.M. J., Krugers, H.J., & de Wit, S. (2023). Resilience among older individuals in the face of adversity: How demographic and trait factors affect mental-health constructs and their temporal dynamics. Clinical Psychological Science, 0(0). First published online August 11, 2023. https://doi.org/10.1177/21677026231190294

8. Chen, E. & Miller, G.E. (2012). "Shift-and-persist" strategies: Why low socioeconomic status isn't always bad for health. Perspectives in Psychological Science, 7(2), 135-158. https://doi.org/10.1177/1745691612436694

9. Cohen, S., Doyle, W.J., Turner, R.B., Alper, C.M., & Skoner, D.P. (2004). Childhood socioeconomic status and host resistance to infectious illness in adulthood. Psychosomatic Medicine, 66(4), 553-558. https://doi.org/10.1097/01.psy.0000126200.05189.d3

10. Cohen, S., Murphy, M.L.M., & Prather, A.A. (2018). Ten surprising facts about stressful life events and disease risk. Annual Review of Psychology, 70(1), 1-21. https://doi.org/10.1146/annurev-psych-010418-102857

11. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385-396. https://doi.org/10.2307/2136404

12. Cole, S. (2010). Elevating the perspective on human stress genomics. Psychoneuroendocrinology, 35(7), 955-962. https://doi.org/10.1016/j.psyneuen.2010.06.008

13. Del Giudice, M., Ellis, B.J., & Shirtcliff, E.A. (2011). The Adaptive Calibration Model of stress responsivity. Neuroscience and Biobehavioral Reviews, 35(7), 1562-1592. https://doi.org/10.1016/j.neubiorev.2010.11.007

14. Epel, E.S., Blackburn, E.H., Lin, J., Dhabhar, F.S., Adler, N.E., & Cawthon, R.M. (2004). Accelerated telomere shortening in response to life stress. Proceedings of National Academy of Sciences U. S. A., 101(49), 17312-17315. https://doi.org/10.1073/pnas.0407162101

15. Epel, E.S., Crosswell, A.D., Mayer, S.E., Prather, A.A., Slavich, G.M., Puterman, E., & Mendes, W.B. (2018). More than a feeling: A unified view of stress measurement for population science. Frontiers in Neuroendocrinology, 49, 146-169. https://doi.org/10.1016/j.yfrne.2018.03.001

16. Fassett-Carman, A. N., DiDomenico, G.E., von Steiger, J., & Snyder, H.R. (2020). Clarifying stress-internalizing associations: Stress frequency and appraisals of severity and controllability are differentially related to depression-specific, anxiety-specific, and transdiagnostic internalizing factors. Journal of Affective Disorders, 260, 638-645. https://doi.org/10.1016/j.jad.2019.09.053

17. Felitti, V.J. (2002). The relation between adverse childhood experiences and adult health: Turning gold into lead. The Permanente Journal, 6(1), 44-47.

18. Felitti, V.J. (2009). Adverse childhood experiences and adult health. Academic Pediatrics, 9(3), 131-132. https://doi.org/10.1016/j.acap.2009.03.001

19. Fink, G. (2016). Stress, definitions, mechanisms, and effects outlined: Lessons from anxiety. In: G. Fink (Ed.), Stress concepts, cognition, emotion, and behavior. Handbook of Stress Series (vol. 1, ch. 1, pp. 3-12). New York, NY: Academic Press. https://doi.org/10.1016/B978-0-12-800951-2.00001-7

20. Fitzgerald, K.N., Hodges, R., Hanes, D., Stack, E., Cheishvili, D., Szyf, M., & Bradley, R. (2021). Potential reversal of epigenetic age using a diet and lifestyle intervention: a pilot randomized clinical trial. Aging, 13(7), 9419-9432. https://doi.org/10.18632/aging.202913

21. Friedman, H.S. (2008). The multiple linkages of personality and disease. Brain, Behavior, and Immunity, 22, 668-675. https://doi.org/10.1016/j.bbi.2007.09.004

22. Glaser, R. & Kiecolt-Glaser, J.K. (2005). Stress-induced immune dysfunction: implications for health. Nature reviews. Immunology, 5(3), 243-251. https://doi.org/10.1038/nri1571

23. Goldstein, D.S. & McEwen, B. (2002). Allostasis, homeostats, and the nature of stress. Stress: The International Journal on the Biology of Stress, 5(1), 55-58. https://doi.org/10.1080/102538902900012345

24. Harris, M.L., Loxton, D., Sibbritt, D.W., & Byles, J.E. (2013). The influence of perceived stress on the onset of arthritis in women: findings from the Australian Longitudinal Study on women's health. Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine, 46(1), 9-18. https://doi.org/10.1007/s12160-013-9478-6

25. Hughes, B.M., Steffen, P.R., & Thayer, J.F. (2018). The psychophysiology of stress and adaptation: Models, pathways, and implications. International Journal of Psychophysiology: Official Journal of the International Organization of Psychophysiology, 131, 1-3. https://doi.org/10.1016/j.ijpsycho.2018.06.003

26. Katsampouris, E., Turner-Cobb, J.-M., Barnett, J.C., & Arnold, R.S. (2020). Can ancient and modern stressors be distinguished? A mixed-methods exploration of psychosocial characteristics and health symptoms in young and older adults. Journal of Health Psychology, 27(3), 1-13. https://doi.org/10.1177/1359105320965654

27. Kawachi, K. & Kennedy, B.P. (1999). Income inequality and health: pathways and mechanisms. Health Services Research, 34(1), 215-227.

28. Kiecolt-Glaser, J.K. (1999). Stress, personal relationships, and immune function: Health implications. Brain, Behavior and Immunity, 13, 61-72. https://doi.org/10.1006/brbi.1999.0552

29. Kiecolt-Glaser, J.K., Marucha, P.T., Malarkey, W.B., Mercado, A.M., & Glaser, R. (1995). Slowing of wound healing by psychological stress. Lancet, 346, 1194-1196. https://doi.org/10.1016/S0140-6736(95)92899-5

30. King, C.D., Keil, A., & Sibille, K.T. (2016). Chronic pain and perceived stress. In: G. Fink (Ed.), Stress Concepts, Cognition, Emotion, and Behavior. Handbook of Stress Series (vol. 1, ch. 52, pp. 413-422). New York, NY: Academic Press. https://doi.org/10.1016/B978-0-12-800951-2.00053-4

31. Knol, M.J., Twisk, J.W., Beekman, A.T., Heine, R.J., Snoek, F.J., & Pouwer, F. (2006). Depression as a risk factor for the onset of type 2 diabetes mellitus. A meta-analysis. Diabetologia, 49(5), 837-845. https://doi.org/10.1007/s00125-006-0159-x

32. Krishnan, V. & Nestler, E.J. (2008). The molecular neurobiology of depression. Nature, 455(7215), 894-902. https://doi.org/10.1038/nature07455

33. Lazarus, R.S. & Folkman, S. (1984). Stress, appraisal and coping. NY: Springer.

34. Mason, J. Psychological influences on the pituitary-adrenal cortical system. In: G. Pincus (Ed.), Recent Progress in Hormone Research (pp. 345-389). New York, NY: Academic Press.

35. Matthews, K.A., Gallo, L.C., & Taylor, S.E. (2010). Are psychosocial factors mediators of socioeconomic status and health connections? A progress report and blueprint for the future. Annals of the New York Academy of Sciences, 1186, 146-173. https://doi.org/10.1111/j.1749-6632.2009.05332.x

36. McEwen, B.S. (2019). The good side of "stress." Stress, 1-2. https://doi.org/10.1080/10253890.2019.1631794

37. McEwen, B.S. (2016). Central role of the brain in stress and adaptation: Allostasis, biological embedding, and cumulative change. In: G. Fink (Ed.), Stress Concepts, Cognition, Emotion, and Behavior. Handbook of Stress Series (vol. 1, ch. 5, pp. 39-56). New York, NY: Academic Press. https://doi.org/10.1016/B978-0-12-800951-2.00005-4

38. McEwen, B.S. (2015). Biomarkers for assessing population and individual health and disease related to stress and adaptation. Metabolism: Clinical and Experimental, 64(3 Suppl. 1), S2-S10. https://doi.org/10.1016/j.metabol.2014.10.029

39. McEwen, B.S. & Stellar, E. (1993). Stress and the individual. Mechanisms leading to disease. Archives of Internal Medicine, 153(18), 2093-2101. https://doi.org/10.1001/archinte.1993.00410180039004

40. McLeod, J. (2012). The meanings of stress. Society and Mental Health, 2(3), 172-186. https://doi.org/10.1177/2156869312452877

41. McLoughlin, E., Arnold, R., & Moore, L.J. (2023). The tendency to appraise stressful situations as more of a threat is associated with poorer health and well-being. Stress and Health: Journal of the International Society for the Investigation of Stress, 10.1002/smi.3358. Advance online publication. https://doi.org/10.1002/smi.3358

42. Miller, G., Chen, E., Fok, A., Walker, H., Lim, A., & Nicholls, E. et al. (2009). Low early-life social class leaves a biological residue manifested by decreased glucocorticoid and increased proinflammatory signaling. Proceedings of the National Academy of Sciences, 106(34), 14716-14721. https://doi.org/10.1073/pnas.0902971106

43. O'Donovan, A., Tomiyama, A.J., Lin, J., Puterman, E., Adler, N.E., Kemeny, M., Epel, E.S. & Blackburn, E.H. (2012). Stress appraisals and cellular aging: A key role for anticipatory threat in the relationship between psychological stress and telomere length. Brain, Behaviour, and Immunity, 26(4), 573-579. https://doi.org/10.1016/j.bbi.2012.01.007

44. Pearlin, L.I. (1989). The sociological study of stress. Journal of Health and Social Behavior, 30(3), 241-256. https://doi.org/10.2307/2136956

45. Pedersen, A., Zachariae, R., & Bovbjerg, D.H. (2010). Influence of psychological stress on upper respiratory infection-a meta-analysis of prospective studies. Psychosomatic Medicine, 72(8), 823-832. https://doi.org/10.1097/PSY.0b013e3181f1d003

46. Pepper, G. & Nettle, D. (2017). The behavioural constellation of deprivation: Causes and consequences. Behavioral and Brain Sciences, 40, 1-66. https://doi.org/10.1017/S0140525X1600234X

47. Porges, S.W. (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation. W W Norton & Co.

48. Power, T. & Hill, L. (2010). Individual differences in appraisal of minor, potentially stressful events: A cluster analytic approach. Cognition and Emotion, 24(7), 1081-1094. https://doi.org/10.1080/02699930903122463

49. Proctor, C. & Tweed, R. (2016). Measuring eudaimonic well-being. In: J. Vittersø (Ed.), Handbook of Eudaimonic Well-Being (ch. 18, pp. 277-294). Springer International Publishing, Switzerland. https://doi.org/10.1007/978-3-319-42445-3_18

50. Quinn, M. E. & Shields, G. S. (2023). The insidious influence of stress: An integrated model of stress, executive control, and psychopathology. Clinical psychological science: A Journal of the Association for Psychological Science, 11(5), 773-800. https://doi.org/10.1177/21677026221149736

51. Reynolds, J. R. & Turner, R. J. (2008). Major life events: Their personal meaning, resolution, and mental health significance. Journal of Health and Social Behavior, 49 (2), 223-237. https://doi.org/10.1177/002214650804900208

52. Rumbold, J., Fletcher, D., & Daniels, K. (2020). An experience sampling study of organizational stress processes and future playing time in professional sport. Journal of Sports Sciences, 38(5), 559-567. https://doi.org/10.1080/02640414.2020.1717302

53. Schattuck, E. C. (2021). Networks, cultures, and institutions: Toward a social immunology. Brain, Behavior, & Immunity - Health, 18, 100367. https://doi.org/10.1016/j.bbih.2021.100367

54. Schnell, T. (2009). The sources of meaning and meaning in life questionnaire (SoMe): Relations to demographics and well-being. The Journal of Positive Psychology, 4(6), 483-499. https://doi.org/10.1080/17439760903271074

55. Segerstrom, S.C. & O'Connor, D.B. (2012). Stress, health and illness: Four challenges for the future. Psychology & Health, 27(2), 128-140. https://doi.org/10.1080/08870446.2012.659516

56. Selye, H. (Ed.). (1956). The Stress of Life. New York, NY: McGraw Hill.

57. Shields, G.S., Fassett-Carman, A., Gray, Z.J., Gonzales, J.E., Snyder, H.R., & Slavich, G.M. (2023). Why is subjective stress severity a stronger predictor of health than stressor exposure? A preregistered two-study test of two hypotheses. Stress and Health: Journal of the International Society for the Investigation of Stress, 39(1), 87-102. https://doi.org/10.1002/smi.3165

58. Slavich, G.M. (2020). Social Safety Theory: A biologically based evolutionary perspective on life stress, health and behavior. Annual Review of Clinical Psychology, 16(1), 265-295. https://doi.org/10.1146/annurev-clinpsy-032816-045159

59. Slavich, G.M. (2016). Life stress and health: A review of conceptual issues and recent findings. Teaching of Psychology (Columbia, Mo.), 43(4), 346-355. https://doi.org/10.1177/0098628316662768

60. Slavich, G.M. & Shields, G.S. (2018). Assessing lifetime stress exposure using the Stress and Adversity Inventory for Adults (Adult STRAIN): An overview and initial validation. Psychosomatic Medicine, 80, 17-27. https://doi.org/10.1097/PSY.0000000000000534

61. Song, H., Fall, K., Fang, F., Erlendsdóttir, H., Lu, D., Mataix-Cols, D., Fernández de la Cruz, L., D'Onofrio, B.M., Lichtenstein, P., Gottfreðsson, M., Almqvist, C., & Valdimarsdóttir, U.A. (2019). Stress related disorders and subsequent risk of life threatening infections: population based sibling controlled cohort study. BMJ (Clinical Research Ed.), 367, l5784. https://doi.org/10.1136/bmj.l5784

62. Sterling, P. (2021). What is health? Allostasis and the evolution of human design. Cambridge, MA: MIT Press. https://doi.org/10.7551/mitpress/11472.001.0001

63. Tafet, G.E. & Nemeroff, C.B. (2016). The links between stress and depression: Psychoneuroendocrinological, genetic, and environmental interactions. The Journal of Neuropsychiatry and Clinical Neurosciences, 28(2), 77-88. https://doi.org/10.1176/appi.neuropsych.15030053

64. Tawakol, A., Osborne, M.T., Wang, Y., Hammed, B., Tung, B., Patrich, T., Armstrong, K.A. (2019). Stress-associated neurobiological pathway linking socioeconomic disparities to cardiovascular disease. Journal of the American College of Cardiology, 73(25), 3243-3255. https://doi.org/10.1016/j.jacc.2019.04.042

65. Thoits, P.A. (2010). Stress and health: Major findings and policy implications. Journal of Health and Social Behavior, 51(1 suppl), S41-S53. https://doi.org/10.1177/0022146510383499

66. Tomaka, J., Palacios, R., Champion, C., & Monks, S. (2018). Development and validation of an instrument that assesses individual differences in threat and challenge appraisal. Journal of Depression and Anxiety, 7(3), 1-10. https://doi.org/10.4172/2167-1044.1000313

67. Trotman, G.P., Williams, S.E., Quinton, M.L., & Veldhuijzen Van Zanten, J.J.C.S. (2018). Challenge and threat states: Examining cardiovascular, cognitive, and affective responses to two distinct laboratory stress tasks. International Journal of Psychophysiology, 126, 42-51. https://doi.org/10.1016/j.ijpsycho.2018.02.004

68. West, P. (1991). Rethinking the health selection explanation for health inequalities. Social Science and Medicine, 32(4), 373-384. https://doi.org/10.1016/0277-9536(91)90338-D

69. Windle, M., Haardorfer, R., Getachew, B., Shah, J., Payne, J., Pillai, D., & Berg, C.J. (2018). A multivariate analysis of adverse childhood experiences and health behaviors and outcomes among college students. Journal of American College Health, 66(4), 246-251. https://doi.org/10.1080/07448481.2018.1431892

70. Yang, L., Zhao, Y., Wang, Y., Liu, L., Zhang, X., Li, B., & Cui, R. (2015). The effects of psychological stress on depression. Current Neuropharmacology, 13(4), 494-504. https://doi.org/10.2174/1570159X1304150831150507

71. Yang, Y.C., Gerken, K., Schorpp, K., Boen, C., & Harris, K. M. (2017). Early-life socioeconomic status and adult physiological functioning: A life course examination of biosocial mechanisms. Biodemography and Social Biology, 63(2), 87-103. https://doi.org/10.1080/19485565.2017.1279536

Received 08.02.2024