MALADAPTIVE
RESPONSES TO STRESS
The stress response,
which, as indicated earlier facilitates adapta-tion to threatening situations,
has been retained from our evolu-tionary past. The “fight-or-flight” response,
for example, is an anticipatory response that mobilized the bodily resources of
our ancestors to deal with predators and other harsh factors in their
environment. This same mobilization comes into play in re-sponse to emotional
stimuli unrelated to danger. For example, a person may get an “adrenaline rush”
when competing over a de-cisive point in a ball game, or when excited about
attending a party.
When the responses to
stress are ineffective, they are referred to as maladaptive. Maladaptive responses are chronic, recurrent responses
or patterns of response over time that do not promote the goals of adaptation.
The goals of adaptation are somatic or physical health (optimal wellness);
psychological health or hav-ing a sense of well-being (happiness, satisfaction
with life, morale); and enhanced social functioning, which includes work,
social life, and family (positive relationships). Maladaptive re-sponses that
threaten these goals include faulty appraisals and in-appropriate coping
(Lazarus, 1991a).
The frequency,
intensity, and duration of stressful situations contribute to the development
of negative emotions and sub-sequent patterns of neurochemical discharge. By
appraising sit-uations more adequately and coping more appropriately, it is
possible to anticipate and defuse some of these situations. For example,
frequent potentially stressful encounters (eg, marital discord) might be
avoided with better communication and prob-lem solving, or a pattern of
procrastination (eg, delaying work on tasks) could be corrected to reduce
stress when deadlines approach.
Coping processes that
include the use of alcohol or drugs to reduce stress increase the risk of
illness. Other inappropriate cop-ing patterns may increase the risk of illness
less directly. For ex-ample, people who demonstrate “type A” personality behaviors
such as impatience, competitiveness, and achievement orienta-tion and have an
underlying hostile approach to life are more prone than others to develop
stress-related illnesses. Type A be-haviors increase the output of
catecholamines, the adrenal-medullary hormones, with their attendant effects on
the body.
Other forms of
inappropriate coping include denial, avoid-ance, and distancing. Denial may be
illustrated by the woman who feels a lump in her breast but downplays its
seriousness and delays seeking medical attention. The intent of denial is to
con-trol the threat, but it may also endanger life.
Models of illness
frequently cite stress and maladaptation as precursors to disease. A general
model of illness, based on Selye’s theory, suggests that any stressor elicits a
state of disturbed phys-iologic equilibrium. If this state is prolonged or the
response is ex-cessive, it will increase the susceptibility of the person to
illness. This susceptibility, coupled with a predisposition in the person (whether
from genetic traits, health, or age), leads to illness. If the sympathetic
adrenal-medullary response is prolonged or exces-sive, a state of chronic
arousal develops that may lead to high blood pressure, arteriosclerotic
changes, and cardiovascular dis-ease. If the production of the ACTH is
prolonged or excessive, behavior patterns of withdrawal and depression are
seen. In ad-dition, the immune response is decreased, and infections and
tu-mors may develop.
Selye (1976) proposed a
list of disorders that he called diseases of maladaptation: high blood
pressure, diseases of the heart and blood vessels, diseases of the kidney,
hypertension of pregnancy, rheumatic and rheumatoid arthritis, inflammatory
diseases of the skin and eyes, infections, allergic and hypersensitivity
diseases, ner-vous and mental diseases, sexual derangements, digestive
diseases, metabolic diseases, and cancer.
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