Showing papers on "Social stress published in 2000"

Deinstitutionalization, social rejection, and the self-esteem of former mental patients.

Abstract: Modified labeling theorists have long argued that the stigma of mental illness has important consequences for the lives ofpeople with mental illness. We propose that social rejection is an enduring force in the lives ofpeople with mental illness and that these experiences are central to understanding the poor selfconcepts described by many former psychiatric patients. We explore changes in a cohort of recently deinstitutionalized mental patients' (N = 88) self-esteem and experiences with social rejection using data from a three wave panel survey conducted while institutionalized and over a two-year periodfollowing the patients' discharge from a long-term state hospital. Our results indicate that social rejection is a persistent source of social stress for the discharged patients. Moreover, these experiences increase feelings of self-deprecation that, in turn, weaken their sense of mastery. Where the patients' received their follow-up care-whether in a community setting or in another state hospital-had little impact on their self-relatedfeelings or on their experiences of social rejection. Our results provide further support for modified labeling theory and underscore the need to consider the dynamic relationship between stigmatizing experiences and self-related changes.

Autonomic, Neuroendocrine, and Immune Responses to Psychological Stress

Abstract: Summary Although stress may be necessary for survival, it can also alter susceptibility to disease. Stress, particularly if prolonged or repeated, can produce cardiovascular changes that can contribute to a narrowing of blood vessels and to heart attacks or strokes and reduce the strength of immunological activities in the body. Stress may alter cardiovascular function, immune function, and health through various pathway. Stress may obscure symptoms, increase appraisal and patient delays and reduce medical compliance. Stress can activate maladaptive behaviors that reflect attempts to cope with negative emotional responses. Persons experiencing psychological stress may engage in unhealthy practices such as smoking, not eating or sleeping properly, and not exercising, and these behaviors may foster accidents, cardiovascular disease, and suppressed immune function. Nerve fibers connecting the central nervous system and immune tissue provide another path by which stress may influence immunity. Stress also evokes a variety of adaptational somatic responses, including stimulation of the hypothalamic-pituitary-adrenal axis (HPA) and the sympathetic adrenal medullary (SAM) system. The pituitary and adrenal hormones and other neuropeptides play an important role in the modulation of the immune system. Hormones such as epinephrine, norepinephrine, and cortisol circulate in the blood and can act on visceral as well as cellular immune receptors. These neuroendocrines, therefore, are an important gateway through which psychological stressors affect the cellular immune response. The association between stress and immune function has received considerable attention in recent years. This review focus on the association between autonomic, neuroendocrine, and immune responses to psychological stress. Key words: stress, immune response, cardiovascular system. As we approach the 21st century the world is increasingly burdened by preventable illness, injury, and disability. Heart disease, for instance, accounts for approximately three quarters of a million deaths annually in the U.S., cancer more than another half million; and respiratory and viral infections remain a major cause of morbidity and mortality among older adults (Baum, Cacioppo, Melamed, Gallant, & Travis, 1995; McGlone & Arden, 1987). In 1960, 5% of the Gross National Product (GNP) went to medical services; in 1990 this share had grown to 12% (U.S. Public Health Service, 1990). Injury now costs more than $100 billion annually, cardiovascular disease about $135 billion, and cancer over $70 billion. Many of these health problems, and the consequent human, societal, and economic costs, have affective bases ranging from anxiety, anger, and depression to unrealistic or druginduced feelings of euphoria and invulnerability. According to the US Public Health Service, of the 10 leading causes of death, at least seven could be reduced substantially if people at risk would change just five behaviors: compliance (e.g., use of antihypertensive medication), diet, smoking, exercise, and alcohol and drug abuse. For instance, approximately 65% of instances of cancer are thought to be caused by smoking, diet, and exposure to sun; workplace carcinogens, chemical interactions among compounds like tobacco and asbestos or alcohol, and viruses such as hepatitis B are thought to account for another 20-30%. Epidemological studies have established a relationship between such social factors as social isolation and health. In a recent review of prospective studies, for instance, House, Landis, and Umberson (1988) found social isolation to be a major risk factor for morbidity and mortality from widely varying causes, even after statistically controlling for known biological risk factors, social status, and baseline measures of health. The strength of social isolation as a risk factor is comparable to health risk factors such as smoking, blood pressure, obesity, and physical activity (House et al. …

Patterns of children's coping with life stress: implications for clinicians.

Abstract: In a study of children's patterns of coping with daily stressors, boys and girls 9-17 years old were asked to complete a coping checklist in response to one of four types of stressors--school, parents/family, siblings, or peer/interpersonal. Patterns of coping-strategy use were found to be similar across the various stressors, with wishful thinking, problem-solving, and emotional regulation being among those most frequently used. Older adolescents, compared to younger children, tended to use a broader range of coping strategies, regardless of stressor. Implications for clinical practice are discussed.

Vigilance, active coping, and cardiovascular reactivity during social interaction in young men.

Abstract: This study of 72 undergraduate men examined the effects of two determinants of cardiovascula r response—active coping and vigilance—on blood pressure and heart rate responses to social stressors. Observation of a future debate partner (i.e., vigilance) evoked larger increases in blood pressure than did observation of a less relevant person, apparently through the combination of increases in cardiac output and vascular resistance. Preparation and enactment of efforts to exert social influence (i.e., active coping) evoked heightened blood pressure and heart rate responses through increased cardiac contractility and output. Thus, both vigilance and active coping in social contexts increased cardiovascular reactivity, but apparently through different psychophysiological processes.

A Synthesis of Research on the Causes, Effects, and Reduction Strategies of Teacher Stress

Abstract: Occupational stress has been a topic of significant research for the last two decades, reflecting the detrimental effects of employees. In particular, teacher stress is borne out of the demands on the individual teacher. Strong evidence suggests that many substitute teacher costs are a direct result of teacher stress. The costs associated with this stressful occupation can be high in phsycial, economical, and academic terms. Human Resource Managers can detect the early stages of stress and advocate organizational stress management programs. Research on the causes of, effects of, and reduction strategies for teacher stress are discussed. Stress is a biological phenomena that is experienced by all persons regardless of their socio-economic status, occupation, or age. While there is a lack of universal agreement on the meaning of stress, a few articles attempt to define stress. McGrath (1976) and Schuler (1980) generally define stress as a dynamic condition, in which an individual is confronted with an opportunity, constraint, or demand on being, having, andor doing what he or she desires. Beehr and Newman (1978) provide a more specific definition: job stress is a condition wherein job-related factors interact with the worker to change her psychological or physiological condition such that she is forced to deviate from normal functioning. Their definition is useful because it describes stress as a type of person-environment fit encompassing both individual and workplace stressors. Hans Selye (1976) gives a thorough overview of stress from a practical and medical perspective in his book, The Stress of Life. He reports that stress is essentially the rate of wear and tear on the body. Moreover, it is impossible to live without experiencing some amount of stress all the time. Very simple activities and problems as well as the most complex ones can cause stress. They simply vary in degree. For example, crossing a busy intersection, exposure to a draft, or even sheer joy are significant enough to activate the body's stress mechanism. Therefore, stress is not necessarily something bad, nor is it necessarily something good. It is simply something that cannot be avoided. The same stress that makes one person ill, makes for an invigorating experience for another. A major factor to consider in order to avoid harmful stress is whether you are adjusting correctly to life situations. This, in Selye's (1976) estimation, is the very root of the disease producing conflicts, (i.e., improper reactions to life situations). During his years and many autopsies, he has never seen a person die of old age. Rather, there is always one part of the body that wears out first and wrecks the whole human machinery, merely because the other parts cannot function without it. With this in mind, Selye (1976) states that an ever increasing proportion of people die from the so-called wear and tear diseases, diseases of civilization, or degenerative diseases, which are primarily stress. The main issue is that the human body wears longest when it wears evenly. As we look at "stress" among teachers we might question how evenly they wear themselves out. Wearing oneself out is as living, and it is inevitable. However, I would guess that few teachers would venture to say that they are wearing themselves out evenly. The Need For Synthesis State and local school administrators are increasingly concerned with the issue of stress in teaching (Hudson and Meagher, 1983). Public school teachers spend roughly half their waking lives in work-related activities. It seems likely then, that job related psychological and physical stress factors may have important influences on their health. To better understand the causes and effects of stress in teaching, the existing research needs to be synthesized. One important reason for studying teacher stress is that their work experiences can have detrimental effects on them, their students, and the learning environment. …

Cortisol and social stressors in children with fragile X: a pilot study.

Abstract: Evidence of neuroendocrine dysfunction, behavioral features of social anxiety and avoidance, and neuroanatomical abnormalities suggest that abnormal hypothalamic-pituitary-adrenal (HPA) function may be a component of the fragile X (fra X) syndrome. In this preliminary study, salivary cortisol levels of males (n = 8, mean age = 13.5 yr) and females (n = 7, mean age = 13.9 yr) with the fra X full mutation were studied for 3 days. Day 1 was an experimental day, during which subjects experienced a Social Stressor task midmorning. Days 2 and 3 were routine days, during which the subjects were engaged in their typical activities. Saliva samples were collected before breakfast, lunch, dinner, and bedtime. On the experimental day, the prelunch sample collection occurred 30 and 90 minutes after the Social Stressor task. Compared with children's norms, the combined group of males and females with fra X had significantly higher cortisol levels in the prelunch and the prebedtime samples for the routine days. Comparisons between the two fra X groups for the experimental day revealed similar diurnal patterns for cortisol level. However, compared with females with fra X, males with fra X had significantly higher cortisol levels at two points during the day: 30 minutes after the social stressor and at bedtime. These preliminary data suggest that individuals with fra X have abnormal HPA function. Understanding the relations among HPA dysfunction, abnormalities in brain structure and/or function, and maladaptive behavior and cognition in fra X could inform the design of early interventions using pharmacological or environmental measures designed to normalize neuroendocrine function.

The Effect of Sociodemographics, Social Stressors, Health Status and Psychosocial Resources on the Age-Depression Relationship

Abstract: This study examines how an extensive set of covariates identified in previous research--sociodemographics, social stressors, health status and psychosocial resources--influence the age-depression relationship The analyses were based on data collected for the 1994 National Population Health Survey (N = 16,291) by Statistics Canada Analyses were conducted using OLS regression for generalized distress and logistic regression for major depressive episode The relationship between age and both outcomes was linear and negative after controlling for sociodemographics Controlling for social stress reduced levels of depression among younger cohorts while controlling for poor health status reduced levels of depression among the elderly Controlling for psychosocial resources generally reduced the level of depression among older cohorts, however, the results were mixed across outcomes The inclusion of all covariates appears to negate the effects of one another in that the fully adjusted relationships between age and depression across both outcomes were not significantly different from their bivariate relationships

Interpersonal and achievement orientations and specific stressors predicting depressive and aggressive symptoms in children

Abstract: This prospective study of 486 fifth and sixth grade children examined the contributions of interpersonal (Neediness and Connectedness) and achievement (Self-Criticism and Individualistic-Achievement) orientations, specific stressors, and their interactions to the prediction of depressive symptoms and level of anger/aggression. For both genders, Neediness directly predicted increases in depressive symptoms, whereas Connectedness interacted with social stressors to predict level of anger/aggression. There was a significant main effect of Connectedness for girls and a significant Connectedness × social stressors interaction for boys when predicting depressive symptoms. Neither achievement orientation factor directly predicted or interacted with achievement stressors to predict depressive symptoms. In contrast, the I-Achievement factor interacted with achievement stressors to predict level of anger/aggression for girls, but not boys. Results were consistent with the personality–event congruence hypothesis in that none of the vulnerability factors interacted with noncongruent stressors to predict either depressive symptoms or level of anger/aggression.

Generalization of social anxiety to sporting and athletic situations: gender, sports involvement, and parental pressure.

Abstract: Although researchers have documented that social anxiety may occur in a wide range of interpersonal and performance situations, little attention has been paid to the potential influence of social anxiety on participation in athletics or physical activity. The performance demands of sport and potential social evaluative nature of exercise make it likely that social anxiety would generalize to these situations. Given the physical and psychological benefits of engaging in regular physical activity, avoidance of such activities by socially anxious individuals may have profound health consequences. One-hundred and eighty undergraduate university students completed a battery of standardized social anxiety measures, and a series of 5-point Likert-type questions examining fear and avoidance of sporting and athletic situations. Results indicated that social anxiety and fear of negative evaluation were generally related to social-evaluative fears in sporting or athletic situations, particularly for women. Furthermore, social anxiety was positively correlated with avoidance of individual sporting activities, but not with avoidance of team activities. Further analyses revealed social anxiety did not differ by competition level. However, for men, familial pressure to play sports during high school was associated with higher fear of negative evaluation. Implications for the assessment and treatment of social anxiety disorder are discussed.

Effects of social stress on heart rate and heart rate variability in growing pigs

Abstract: The effects of social stress on heart rate, heart rate variability and the occurrence of cardiac arrhythmias were studied in 12 growing pigs. Social stress was induced during a good competition tes...

Why take social anxiety disorder seriously

Abstract: Social anxiety disorder (social phobia) is a disabling psychiatric condition, characterized by a fear of negative evaluation by others. Epidemiological studies have shown a high prevalence of the condition in the general population; the disorder is more common in women than in men. Social anxiety disorder has a typical onset during adolescence and a chronic course; remission rarely occurs without therapeutic intervention. Comorbid psychiatric conditions such as depression and alcoholism commonly occur in patients with preexisting social anxiety disorder, and increase the burden of the condition. Two subtypes of social anxiety disorder have been identified: "nongeneralized" and "generalized"; the latter form causes greater disability and is more often associated with comorbidity. The socioeconomic impact of social anxiety disorder on both sufferers and the community is considerable. For a person with social anxiety disorder, quality of life is greatly reduced; work, social, and personal relationships are all affected. Social anxiety disorder demands increased recognition, so that sufferers receive the treatment they need, in order to improve their quality of life through better social functioning.

Stress, Coping, and Cardiovascular Disease

Abstract: Contents: Preface. R.W. Winters, P.M. McCabe, E.J. Green, N. Schneiderman, Stress Responses, Coping, and Cardiovascular Neurobiology: Central Nervous System Circuitry Underlying Learned and Unlearned Affective Responses to Stressful Stimuli. B.R. Dworkin, T. Elbert, H. Rau, Blood Pressure Elevation as a Coping Response. C.A. Shively, M.R. Adams, J.R. Kaplan, J.K. Williams, Social Stress, Gender, and Coronary Heart Disease Risk in Monkeys. B.E. Hurwitz, R. Goldstein, C.A. Massie, M.M. Llabre, N. Schneiderman, Low-Flow Circulatory State and the Pathophysiological Development of Cardiovascular Disease: A Model of Autonomic Mediation of Cardiovascular Regulation. I. Nyklicek, A.J.J.M. Vingerhoets, G.L. Van Heck, Blood Pressure, Appraisal, and Coping With Stressors. P.G. Saab, M.M. Llabre, A. Fernander-Scott, R. Copen, M. Ma, V. DiLillo, J.R. McCalla, M. Davolos, C. Gallaher, Ethnic Differences in Blood Pressure Regulation. N. Schneiderman, M. Gellman, A. Peckerman, B. Hurwitz, P. Saab, M.M. Llabre, G. Ironson, L. Durel, J. Skyler, P. McCabe, Cardiovascular Reactivity as an Indicator of Risk for Future Hypertension. N. Frasure-Smith, F. Lesperance, M. Talajic, The Prognostic Importance of Depression, Anxiety, Anger, and Social Support Following Myocardial Infarction: Opportunities for Improving Survival. K. Orth-Gomer, Stress and Social Support in Relation to Cardiovascular Health.

The many faces of social anxiety disorder.

Abstract: Social anxiety disorder, also known as social phobia, is one of the most prevalent anxiety disorders, affecting 7-13% of subjects in the community at some time in their lives. Despite being eminently treatable, it remains largely under-recognised and, therefore, undertreated. The disorder is characterized by a fear of scrutiny by others, with sufferers experiencing excessive anxiety in social and performance situations. This excessive anxiety usually leads to avoidance behaviour that can severely affect normal daily living. With onset commonly occurring during childhood or adolescence, social anxiety disorder may disrupt normal patterns of development of social and personal relationships, often having a long-term impact on emotional stability in social or working life. If left untreated, the course of social anxiety disorder is frequently complicated with comorbid conditions, particularly major depression or substance abuse. This review assesses the size of the clinical problem by evaluating current and lifetime prevalence estimates, age of onset, risk factors and evolution of the clinical course; thereby providing the rationale for early recognition and prompt treatment.

Does Social Support Buffer Stress for College Women

Abstract: This study investigated whether specific functions of social support buffered the relationship between different types of stressful life events and anxiety and depression in 60 college women. Strong main effects for global, belonging, and self-esteem social support were obtained, indicating that these types of social support are generally beneficial to women. Evidence for a buffering effect was also present, particularly for self-esteem support among college women who had experienced coercive sexual events and interpersonal stressors. These results have important clinical implications since knowledge of when specific types of support are particularly beneficial could guide intervention efforts following major life events. Findings were also suggestive of the importance of attending not only to the positive aspects of support but to the potential for social relationships to produce rather than alleviate stress.

Treatment of Social Phobia in Adolescents: Cognitive Behavioral Programs Focused on Intervention and Prevention

Abstract: Social phobia is an exaggerated fear of a variety of social and performance situations due to the concern that one may become embarrassed or humiliated in front of others Such fear is considered "normal" to some degree, especially during the period of adolescence However, for a significant proportion of youth, social fear and social phobia become pathological conditions impacting upon functioning across a variety of life domains (friendships, academics, family functioning, vocational functioning) Youth with social phobia report greater feelings of depression, estrangement from others, hopelessness, and loneliness Moreover, research indicates that social phobia, if left untreated, can be a major pathway for more complex and destructive complications, such as suicidality and substance abuse This paper reviews the research in the area of social anxiety and social phobia in adolescents The phenomenology of the disorder, particularly within a developmental context, is presented Current data supporting the efficacy of a cognitive behavioral group treatment program for adolescents are presented, along with a presentation of a new program under development which is designed to target youth at risk of developing the disorder It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness (Dickens, 1859; 1981, p 1) Charles Dickens may well have been referring to the period of life termed adolescence when he penned the opening sentence of his novel A Tale of Two Cities Indeed, adolescence is typically considered a stressful period characterized by mood swings, conflict, and worry (Hall, 1904; Weiner, 1992) The benefits of increased independence, greater freedoms in socializing, reinforcement from social networks, and the initiating of dating often attenuate these stressful byproducts of adolescence A wealth of research exists within the fields of developmental psychology, developmental psychopathology, and clinical psychology focused on the adolescent years (see Dusek, 1996; Ingersoll, 1989; Weiner, 1992, for reviews) In brief, adolescence is a critical period of development involving physical, cognitive, and behavioral maturation that is mediated through the negotiation of various developmental tasks and challenges Among the most important developmental tasks for the adolescent are the development of emotional independence from the family, the establishment of long-term friendships and identification with a peer group, and the initial formation of long-term vocational goals (Albano, 1995; see also Havighurst, 1972; Johnson & Glass, 1989) SOCIAL ANXIETY IN ADOLESCENCE Adolescence is the period of development that uniquely corners the market on social anxiety Indeed, the typical adolescent is confronted with socialevaluative situations and demands on a daily basis, mainly in the form of school expectations such as taking exams and giving oral presentations, peer expectations and pressures, and scrutiny by parents and other authority figures Concerns regarding physical attributes and attractiveness, competence in social, athletic, and artistic pursuits, and transient worries focused on negative evaluation are common and expected during this time period For most adolescents, these social and evaluative concerns are indeed temporary and serve as a learning experience for the youth Such experience allows for the refinement of social and performance skills (eg, initiating conversations, public speaking), and various complex interpersonal and problem solving skills (eg, conflict resolution, relationship skills, assertiveness) Most adolescents progress through this period gaining mastery over developmental demands, with minimal disruption due to social anxiety concerns For some adolescents, however, high levels of social anxiety can exert a negative impact on their emotional and developmental well-being For example, research conducted by LaGreca and Lopez (1998) examined the relative impact of social anxiety on the interpersonal functioning of 250 high school students ranging in age from 15 to 18 years (M = 17 …

Sodium intake is increased by social stress and the Y chromosome and reduced by clonidine

Abstract: The objectives were to determine1) if female rats have higher Na intake than males and if social stress increases Na intake, 2) if the sympathetic nervous system (SNS) mediates the stress effects a...

The role of social and psychosocial factors in the development and course of cancer.

Abstract: This paper reviews studies dealing with the influence of social and psychosocial factors on the manifestation and course of cancer with special emphasis on breast cancer. Considerable social gradients are seen in the manifestation of malignant diseases. Most cancers (e.g. cervix, ovarian and lung cancer, malignancies of the upper respiratory and digestive organs) demonstrate a social gradient to the disadvantage of individuals from lower social ranks. In contrast, breast cancer is more prominent in middle and higher social groups. Evidence of the effects of social stress, especially concerning life-changing events, stems from retrospective and so-called limited prospective studies. With some exceptions, all these studies deal with breast cancer. In retrospective studies it was found that cancer patients report significantly more stressful experiences than do controls. In limited prospective studies the results are less straightforward, but suggest that severe loss events may be related to the manifestation of malignancies. Population studies found that patients from a lower social status had poorer chances of survival than did individuals from more privileged groups. This holds for most cancers including breast cancer. The few available studies dealing with stressful experiences and the recurrence of cancers are inconsistent, although sound methods have been applied. Nevertheless, the available evidence is no argument against performing more refined studies concerning the role of social factors in the onset and course of malignant diseases. These should provide an integration of psychological and biological perspectives.

Anxiolytic effects of repeated victory in male Wistar rats

Abstract: Recurring evidence suggests that social stress has anxiogenic-like effects in laboratory rodents. However, despite the fact that competitive situations are stressful, success in competitive situations reduces anxiety in humans. The aim of the present study was to investigate whether repeated experience of winning in aggressive encounters affects anxiety measures in laboratory rodents. Male rats were housed together with a female for 2 weeks. Cohabitation with females was necessary to induce high levels of aggressiveness in these animals. During the second week, half of the male rats were exposed daily for 30 min to an intruder of smaller size, and the other half remained undisturbed in their home cage. Group-housed male rats were also used as controls. Residents attacked and defeated intruders, who did not retaliate. After the fifth encounter, all animals were tested for anxiety on the elevated plus-maze. Repeated victory lowered anxiety measures considerably, despite the fact that aggressive encounters are stressful even for the victor. It is concluded that repeated victory has an anxiolytic action in male rats. The similarities with human data suggest that repeated winning in rats can be used as a laboratory model for success-induced changes in human anxiety. Aggr. Behav. 26:257–261, 2000. © 2000 Wiley-Liss, Inc.

[The effect of "social stress" during rat pregnancy on the anxiety level of the progeny].

Abstract: Anxiety and locomotion were studied in offsprings of female rats subjected to everyday stress (one a day being displaced into another cage with pregnant rats) during the 3d stage of pregnancy. At the age of 1 month, the prenatally stressed rats had higher anxiety and lower locomotion in comparison with control animals. At the age of 3 month, the prenatally stressed females did not significantly differ from the control in the level of anxiety and locomotion, while the males demonstrated lower ambulation than the control animals.

[Stress-induced anxiety and endogenous anxiogenic substances].

Abstract: Anxiety observed in animals subjected to stress was stated in relation to anxiety level and biological backgrounds of animals, changes in neurotransmitters and causal stressors. 1. Anxiety is thought to be a negative emotion caused by many kinds of stress such as restraint stress, SART (specific alternation of rhythm in temperature) stress (a repeated cold stress caused by environmental temperature), social stress, etc. 2. Emotional behavior in those stressed animals were attenuated by anxiolytics like diazepam, a benzodiazepine receptor agonist and buspirone, a serotonin (5-HT) 1A agonist. 3. Stressed rats had changed brain levels of a variety of neurotransmitters such as corticotropin-releasing factor (CRF), noradrenaline, 5-HT, dopamine, acetylcholine, histamine, cholecystokinin, etc. The percentage of time spent on the open arms of an elevated plus-maze apparatus decreased in those stressed animals. Abnormal elevated plus-maze behaviors were attenuated by diazepam, buspiron and a CRF antagonist. 4. Anxiety level differs according to the coping strategy of the recipients. Rats of different strain, sex, aging and/or family display different behaviors in elevated plus-maze. 5. Stress-induced anxiety-related behaviors were observed when levels of some neurotransmitters became unbalanced. Thus modulators of unbalanced brain substances are thought to have anxiolytic properties.

44 – Women, Stress, and Health

Abstract: This chapter examines the specific social-environmental stressors that women commonly encounter and the pathways through which these stressors affect women's health and well being. Stress is defined as a state of arousal resulting either from the presence of socio-environmental demands that tax the ordinary adaptive capacity of the individual or from the absence of the means to attain sought after ends. Epidemiologic research indicates that social groups differ in the extent to which they experience stress. These group differences in stress are a function of two key processes: differences in exposure to stress and differences in vulnerability to stress. Exposure to stress occurs when an individual encounters an objectively defined socio-environmental demand—also referred to as a stressor. Similar levels of stress exposure do not always have similar effects on health. Vulnerability to stress refers to the extent to which stress exposure results in the psychological and biological changes that undermine health and well being. Numerous studies identify the beneficial aspects of personal relationships for health and well being, but a growing body of evidence indicates that the negative dimensions of personal relationships—those that involve demands, strains, and conflict—have greater effects on physical and mental health than do the positive components.