Chapter 1. Some Conceptual Perspectives on the Ori

PartI.AnEmergingSynthesisintheSocialStressModelofMentalHealthandMentalDisorder:ContextualizedProcess1Chapter1.SomeConceptualPerspectivesontheOriginsandPreventionofSocialStressLeonardI.PearlinUniversityofMaryland,CollegePark1Overaperiodofseveraldecades,manyresearchershavebeentantalizedbytheintellectualyieldpromisedbythenotionofstress.Theattractionofstressresearchliespartlyinitsmultidisciplinarycharacter;indeed,thereisprobablynootherareaofinquirythathassosuccessfullycapturedtheinterestsofresearchersfromsuchabroadspectrumofdisciplines.Atoneendofthespectrumareresearchersorientedtotheorganizationoflarge-scalesocialandculturalsystemsandtheireffects;attheotherendareneuroscientistsandimmunologicalresearchersconcernedwiththemicrocosmicfunctioningoftheorganism.Thesheervolumeanddiversityofconvergingattentionhasstimulatedthehopethatcross-fertilizationofideaswilleventuallyleadtoamoreintegratedunderstandingofstressanditsconsequences.Scientistswhostudytheinterconnectednessofanindividual’senvironmentandhisorherinnerlifefindstressaveryfetchingconstruct.TheworkinwhichmycolleaguesandIhavebeenengagedinlargeparthasbeendrivenbythisvision.Wehaveattemptedtojoinourempiricalresearchtothedevelopmentofaconceptualframeworkthatwouldencompasstheintricatechainofrelationshipslinkingsociallifeandpersonallife.Thedevelopmentofthisconceptualframework,whichisreferredtoasthestressprocess,isataskthatwillneverbecompleted;itisanon-goingandself-fuelingchallengetoextendandelaborateideas,toabandonpassionatelyheldnotionsthatrefusetobeupheldbyresearchfindings,andtoincorporatenewideasthathintatpayoff.Thus,thestressprocess1TheresearchreportedinthischapterwassupportedbyaNationalInstituteofMentalHealthMERITaward(MH42122)totheauthor.2frameworkessentiallysupportsadialectic:Ithelpstoguidetheresearchandtoorganizewhatinformationtheresearchyields;inturn,theresearchfindingshelpusmodifytheframework.Someassumptionsunderlyingthestressprocesshavebeenseenintheliteratureforseveralyears(Pearlin,Lieberman,Menaghan,&Mullan),1981)and,consequently,thispaperwillhaveafamiliarringtothosestudyingsocialstress.Oneparticularthemeofearlierwriting(Pearlin,1989)deservestoberevisitedbriefly:thedistinctivecharacterofsocialstress.Stressanditsattendantprocessescanbedescribedassocialwhentheirvariationsfollowlinesofstatusdemarcation,suchathosedividingeconomicandoccupationalclasses,gender,orageechelons.Thesekindsofvariations,whichhavebeenrecognizedforseveraldecades(e.g.,Langer&Michael,1963;Srole,Langer,Michael,Opler,&Rennie,1961;),pointtotheinseparabilityofthelargersocialstructuresinwhichpeoplearelocatedandtheirwellbeing.Socialstructures--especiallythoseinwhichpower,prestigeandeconomicresourcesareunequallydistributed--canaffectvirtuallyallaspectsofthestressprocess,includingthekindsandintensitiesofstressorstowhichpeopleareexposed,thewaystheyareabletorespondtoanddealwiththesestressors,andthenatureoftheeffectsexertedbythestressors.Ofcourse,notallstressarisesoutofsocialcircumstances.Forexample,onecanexperiencetraumaticeventsasaresultofnaturaldisastersorofdiseaseswhoseepidemiologyappearstobesociallyandeconomicallyblind,suchasAlzheimer's.Itcanbeobserved,however,thatininstanceswhereexposuretostressorsisnotinfluencedbysocialfactors,theprocessesthataresetinmotionbythenonsocialstressorsmayhavesocialunderpinnings.Naturaldisaster,forexample,mightnotrecognizethesocialandeconomiccharacteristicsofthepeopleinitspath,butsuchcharacteristicsarelikelytogoverntherecoveryofindividualsfromitsdestructiveeffects.Theconnectionsbetweenelementsofthestressprocessandsocialforcesmakestressanareaofvitalinteresttosocialandbehavioralscientists.Withoutsuchconnections,stressresearchcouldbeleftentirelytobiologistsandclinicians.Similarly,ifexposuretostressorsweresolelyaresultofrandomlyoccurringcircumstances,itwouldbedifficulttothinkofsystematicpreventivemeasures.Theirveryrandomnesswouldindicatethattheirappearancecannotbepredictedand,therefore,cannotbeprevented.3Althoughanumberofthethemesandperspectivesofthestressprocessarefamiliartoresearchersintosocialstress,Ishallattempttohighlightsomeoftherecentrefinementsofrecentyearsthattakeusbeyondearlierformulations.Thesedevelopmentsarelargelytheaccumulatedproductsofinvestigationsintovariousaspectsofstress.Ourowncontributionstotheelaborationsofthestressprocessframeworkstemfromseveralsources,includingalong-termstudyofpeopleprovidingcaretorelativeswithAlzheimer'sDisease,thatallowedustotrackasituationofenduringhardshipoveraspanoffiveyears(Aneshensel,Pearlin,Mullan,Zarit,&Whitlatch,1995).Anotherstudy,alsostrategicallyappropriatetotheobservationofchronicstress,involvedalargesampleofinformalcaregiversforpeoplewithAIDS(Pearlin,Mullan,Aneshensel,Wardlaw&Harrington,1994)Inaddition,mycolleaguesandIhaveconductedandanalyzedanumberofqualitativeinterviewsthatwereintended,inpart,tochartthechanginglandscapeofstressorstowhichpeopleareexposedastheytraversethelifecourse.Thesestudies,aswellasthoseofotherinvestigators,haveprovidedtheopportunitytorethinkandelaborateourconceptualizationofthestressprocessanditsi