STRESSORS MEDIATORS OUTCOME

PEARLIN - STRESS PROCESS

DIFFERENCES WITH SRRS

STRESS PROCESS

• 1. MUST LOOK AT CONTEXT AND MEANING

DIMENSIONS OF STRESSFUL LIFE EVENTS

• DESIRED VS. NOT DESIRED

• UNEXPECTED VS. EXPECTED

• POSITIVE VS. NEGATIVE PREEXISTING CONTEXT OF EVENT

• NEGATIVE POST-EVENT CONTEXT– SECONDARY STRESSORS

STRESS PROCESS (CONT.)

• 2. EVENTS NOT ISOLATED BUT EMBEDDED IN SOCIAL POSITIONS – GENDER, SOCIAL CLASS, ETHNIC

• 3. EVENTS NOT ISOLATED BUT INTERCONNECTED - STESS PROLIFERATION - PRIMARY AND SECONDARY STRESSORS

• 4. EMPHASIZES SOCIAL ROLES - OVERLOAD, CONFLICT, CAPTIVITY

NEW CATEGORIES OF STRESSORS (WHEATON)

• 1. CHRONIC STRESSORS

• 2. LIFETIME TRAUMAS

• 3. DAILY HASSLES

• 4. DISASTERS

DISASTERS

• 9/11 – 30% MDD or PTSD over next month

• Almost all had some symptoms

• Transient – few had disorder after 6 months

• Cambodian refugees – 50% had MDD after 20 years

• Social cause of chronic disorder

MEDIATORS

• WHY SOME PEOPLE WITH MANY STRESSORS HAVE LOW DISTRESS

• WHY SOME PEOPLE WITH FEW STRESSORS HAVE HIGH DISTRESS

MEDIATORS (TURNER)

• SOCIAL RESOURCES

• 1. SUPPORT - BEING CARED FOR, BELONGING, WANTED

• ONE INTIMATE

• STRONG FAMILY TIES, RELIGION

• 2. MATERIAL SUPPORT

SOCIAL COMPARISON

• STRESSFULNESS DEPENDS ON REFERENCE GROUP

• INCOME

• PARAPLEGICS

• DOWNWARD COMPARISONS BETTER THAN UPWARD COMPARISONS

CONTROL

• ACTIVE COPING BETTER THAN PASSIVE COPING (MASTERY VS. FATALISM)

OUTCOMES

• STANDARDIZED SCALES LIKE CES-D

• CONTINUOUS – FROM MILD TO SEVERE

• INDICATOR OF DISTRESS

• GENERAL NOT DIAGNOSTIC

TREATMENT

• ONLY THEORY WITH NO DIRECT TREATMENT ASPECT

• CHANGE ENVIRONMENT

• MUCH DISTRESS TRANSIENT (9-11)

• IMPORTANCE OF INFORMAL SUPPORT

CRITICISMS OF SOCIAL

• IGNORES HOW MENTAL SYMPTOMS ARE DEEPLY ROOTED IN INDIVIDUALS NOT SITUATIONS

• NOT GOOD FOR EXPLAINING MOST SERIOUS TYPES OF MENTAL ILLNESS

• UNSPECIFIC TREATMENT COMPONENT

STRENGTHS

• BETTER AT EXPLAINING DISTRESS THAN PARTICULAR MENTAL ILLNESSES

• BETTER AT LOOKING AT GROUP, RATHER THAN AT INDIVIDUAL, DIFFERENCES

• EMPHASIS ON EXTERNAL AND CURRENT CAUSES OF DISTRESS