17 - Stress, coping and cortisol dynamics in daily life

Summary

Introduction

Psychosocial stress is thought to play an important role in the development and course of many psychiatric and psychosomatic disorders. Major life events, such as the death of a family member or recent unemployment, have long been implicated as precipitating factors in illness (Dohrenwend & Dohrenwend, 1974). More recently, attention has shifted toward the possible impact of minor stressors or ‘daily hassles’ (Kanner et al., 1981). An inability to cope with the demands of everyday activities might contribute to the development of disorders or to the exacerbation of existing symptoms.

A wide range of physiological changes occur in response to stress. In most cases, these reflect normal, adaptive processes which prepare the body to cope with the situation by active behavioral strategies (for example, ‘fight’ or ‘flight’ reactions). However, when adequate behavioral or cognitive solutions to the problem are not available, physiological responses may be so exaggerated or prolonged that pathological processes are set in motion. One major impetus for research in stress psychobiology is to clarify the role stress reactivity plays in the pathophysiology of cardiovascular disease, diabetes, and aging, among others. Knowledge of the way in which physiological stress reactions might contribute to the development of psychopathology is currently limited, although promising theoretical models have been advanced (e.g., Anisman & Zacharcko, 1982; Ehlers et al., 1988). Apart from their possible causal role in psychiatric disorders, however, physiological responses provide a window on the nature and adequacy of psychological responses to the stresses of daily life.