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Life events theory

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Life events theory
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STRESS
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‘exhaustion’, which was reached when the individual had been repeatedly exposed to the
stressful situation and was incapable of showing further resistance. This model is shown
in Figure 10.1.
Fig. 10-1 Selye’s (1956) three-stage general adaptation syndrome
Problems with Cannon’s and Selye’s models
Cannon’s early fight/flight model and Selye’s GAS laid important foundations for stress
research. However there are several problems with them.
i) Both regarded the individual as automatically responding to an external stressor and
described stress within a straightforward stimulus–response framework. They therefore did not address the issue of individual variability and psychological factors were
given only a minimal role. For example, whilst an exam could be seen as stressful for
one person it might be seen as an opportunity to shine to another.
ii) Both also described the physiological response to stress as consistent. This response
is seen as non specific in that the changes in physiology are the same regardless of
the nature of the stressor. This is reflected in the use of the term ‘arousal’ which has
been criticized by more recent researchers. Therefore, these two models described
individuals as passive and as responding automatically to their external world.
Life events theory
In an attempt to depart from both Selye’s and Cannon’s models of stress, which
emphasized physiological changes, the life events theory was developed to examine stress
and stress-related changes as a response to life experiences. Holmes and Rahe (1967)
developed the schedule of recent experiences (SRE), which provided respondents with an
extensive list of possible life changes or life events. These ranged in supposed objective
severity from events such as ‘death of a spouse’, ‘death of a close family member’
and ‘jail term’ to more moderate events such as ‘son or daughter leaving home’ and
‘pregnancy’ to minor events such as ‘vacation’, ‘change in eating habits’, ‘change
in sleeping habits’ and ‘change in number of family get-togethers’. Originally, the SRE
was scored by simply counting the number of actual recent experiences. For example,
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236 HEALTH PSYCHOLOGY
someone who had experienced both the death of a spouse and the death of a close family
member would receive the same score as someone who had recently had two holidays. It
was assumed that this score reflected an indication of their level of stress. Early research
using the SRE in this way showed some links between individuals’ SRE score and their
health status. However, this obviously crude method of measurement was later replaced
by a variety of others, including a weighting system whereby each potential life event
was weighted by a panel creating a degree of differentiation between the different life
experiences.
Problems with life events theory
The use of the SRE and similar measures of life experiences have been criticized for the
following reasons.
The individual’s own rating of the event is important It has been argued by many
researchers that life experiences should not be seen as either objectively stressful or
benign, but that this interpretation of the event should be left to the individual. For
example, a divorce for one individual may be regarded as extremely upsetting, whereas
for another it may be a relief from an unpleasant situation. Pilkonis et al. (1985) gave
checklists of life events to a group of subjects to complete and also interviewed them
about these experiences. They reported that a useful means of assessing the potential
impact of life events is to evaluate the individual’s own ratings of the life experience in
terms of (1) the desirability of the event (was the event regarded as positive or negative);
(2) how much control they had over the event (was the outcome of the event determined
by the individual or others); and (3) the degree of required adjustment following the
event. This methodology would enable the individual’s own evaluation of the events to
be taken into consideration.
The problem of retrospective assessment Most ratings of life experiences or
life events are completed retrospectively, at the time when the individual has become ill
or has come into contact with the health profession. This has obvious implications for
understanding the causal link between life events and subsequent stress and stressrelated illnesses. For example, if an individual has developed cancer and is asked to rate
their life experiences over the last year, their present state of mind will influence their
recollection of that year. This effect may result in the individual over-reporting negative
events and under-reporting positive events if they are searching for a psychosocial cause
of their illness (‘I have developed cancer because my husband divorced me and I was
sacked at work’). Alternatively, if they are searching for a more medical cause of their
illness they may under-report negative life events (‘I developed cancer because it is a
family weakness; my lifestyle and experiences are unrelated as I have had an uneventful
year’). The relationship between self-reports of life events and causal models of illness is
an interesting area of research. Research projects could select to use this problem of
selective recall as a focus for analysis. However, this influence of an individual’s present
state of health on their retrospective ratings undermines attempts at causally relating life
events to illness onset.
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Life experiences may interact with each other When individuals are asked
to complete a checklist of their recent life experiences, these experiences are regarded
as independent of each other. For example, a divorce, a change of jobs and a marriage
would be regarded as an accumulation of life events that together would contribute
to a stressful period of time. However, one event may counter the effects of another
and cancel out any negative stressful consequences. Evaluating the potential
effects of life experiences should include an assessment of any interactions between
events.
What is the outcome of a series of life experiences? Originally, the SRE was
developed to assess the relationship between stressful life experiences and health status.
Accordingly, it was assumed that if the life experiences were indeed stressful then
the appropriate outcome measure was one of health status. The most straightforward
measure of health status would be a diagnosis of illness such as cancer, heart attack or
hypertension. Within this framework, a simple correlational analysis could be carried
out to evaluate whether a greater number of life experiences correlated with a medical
diagnosis. Apart from the problems with retrospective recall, etc., this would allow some
measure of causality – subjects with higher numbers of life events would be more likely
to get a medical diagnosis. However, such an outcome measure is restrictive, as it ignores
lesser ‘illnesses’ and relies on an intervention by the medical profession to provide the
diagnosis. In addition, it also ignores the role of the diagnosis as a life event in itself. An
alternative outcome measure would be to evaluate symptoms. Therefore, the individual
could be asked to rate not only their life experiences but also their health-related symptoms (e.g. pain, tiredness, loss of appetite, etc.). Within this framework, correlational
analysis could examine the relationship between life events and symptoms. However,
this outcome measure has its own problems: Is ‘a change in eating habits’ a life event or
a symptom of a life event? Is ‘a change in sleeping habits’ a stressor or a consequence of
stress? Choosing the appropriate outcome measure for assessing the effects of life events
on health is therefore problematic.
Stressors may be short-term or ongoing Traditionally, assessments of life
experiences have conceptualized such life events as short-term experiences. However,
many events may be ongoing and chronic. Moos and Swindle (1990) identified domains
of ongoing stressors, which they suggested reflect chronic forms of life experiences:
I physical health stressors (e.g. medical conditions);
I home and neighbourhood stressors (e.g. safety, cleanliness);
I financial stressors;
I work stressors (e.g. interpersonal problems, high pressure);
I spouse/partner stressors (e.g. emotional problems with partner);
I child stressors;
I extended family stressors;
I friend stressors.
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