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Several decades ago, Selye (1956) focused research attention on noxious stressors and laboratory animals' patterned physiological changes in reaction to them. The systematic study of stress in humans began to flourish some years later with the publication of Holmes and Rahe's (1967) checklist of major life changes and their associated readjustment weights.
Literally thousands of articles on the negative physical and mental health consequences of major life events were published subsequently. Since the late 1970s, a variety of new methods of measuring stress have been developed and refined (e.g., Bolger et al. 1989a; Brown and Harris 1978, 1989; Dohrenwend et al. 1993; Pearlin and Schooler 1978; Wheaton 1991; Zautra, Guamaccia, and Dohrenwend 1986), and stress theory has been elaborated to incorporate factors which moderate or buffer the effects of stress on physical and mental health. Each of these moderating factors-coping resources, coping strategies, and social support--now has its own thriving literature.
A thorough review of each of these topic areas, including measurement and methodological problems, is beyond the scope of this paper. Since 1985, over 3,000 papers on "stress and health" have been published in psychological and sociological journals alone. I will instead summarize briefly what we know with some certainty (drawing heavily on reviews and key articles), point to unanswered questions, and discuss promising new directions in research on
stressors, coping resources, coping strategies, and social support, taking each broad topic in turn.
The reader should be aware that much of the psychosocial literature on "stress and health" actually focuses on mental health conditions as outcomes. I will note wherever mental health findings also apply to physical health outcomes in the psychosocial literature. Because I have not delved into the medical or epidemiological journals where additional physical health findings are amassed and because my own expertise is in mental health, this overview and commentary will be heavily biased toward that subject area.
STRESSORS: EVENTS AND STRAINS
Definitions. "Stress" or "stressor" refers to any environmental, social, or internal demand which requires the individual to readjust his/her usual behavior patterns (Holmes and Rahe 1967). The term "stress reaction" refers to the state of physiological or emotional arousal that usually, but not inevitably, results from the perception of stress or demand. Theory generally holds that stressors motivate...