Constructing and Testing for Validation of Social Theory for Stress
Yang Tingzhong1,2,3, Zhang Weifang4,5, Peng Sihui6
1.Women’s Hospital School of Medicine Zhejiang University, Hangzhou 310006, China 2.Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou 310006, China 3.Injury Control Research Center, West Virginia University, Morgantown 26506, USA 4.Affiliated Hospital of Stomatology, Zhejiang University School of Medicine, Hangzhou 310006, China 5.Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou 310006, China 6.School of Medicine, Jinan University, Guangzhou 510632, China
Abstract Inspired by the concept of stress in physiology, the scientific concept of mental stress has been formulated in the fields of medicine and health sciences, and various explanatory models have been proposed during the evolution of the concept. Previous theoretical understandings of mental stress focused on biological and psychological aspects, ignoring the social origins of stress so that most of mental stress researches were limited in the laboratory and clinical aspects. The authors attempt to review the stress problem emanating from the social system, and put forward a new mental stress theory: the social theory for stress that focuses on the comprehensive understanding of the theory and develops a construct for testing of validation. The construct includes several key elements in mental stress system, social stressor, social stress response, and social management of stress, uncertainty stress, the latter being added based on the characteristics of the current society. The author argues that such a theory and the research enterprise must be based on a fundamental understanding of mental stress. Under this structural framework, the validity of the theory was examined respectively in different aspects using our prior research data.Social theory for stress attempts to understand stress from a sociological perspective, enabling us to have a deeper and more comprehensive understanding of mental stress. In the past, stress theory regarded mental stress as a biological and psychological phenomenon while social stress theory regarded mental stress as a social phenomenon. Social theory for stress emphasizes understanding dealings with mental stress from the social system. This stress system or process, from stressors, and stress responses to stress management, each sector is social. It follows that a key difference between a sociological approach and a biological and psychological approach is whether stress issues are conceptualized as social patterns or independently of what exists within the social system. Social theory for stress underscore that efforts should pay greater attention to use sociological approach to understand and effectively control excessive mental stress. It is worth noting that some previous researches regarded the so called “social stress theory” and “social theory of stress” as sociological theories, but they are only actually studies on social determinants of mental stress. This theory fundamentally breaks through the conventional recognition of mental stress and opens up a new perspective for research and applications. Compared with biological and psychological stress perspectives, the perspective of social theory for stress extends mental stress research from laboratory and clinical aspects to broader and more important aspects of the society, largely expanding its application scope. It not only makes individual level researches more dynamic, but also expands the scope of population researches..The results showed as follows (1) Social stressors significantly contribute to mental stress. We analyzed social stressors and mental stress among urban residents in the period of social transformation. Findings found that social transition stressor significantly contribute to high level stress (Health Risk Stress, HRS)，OR were 1.95 (95% CI: 1.78-2.15). Each type of the social stressor do significantly to HRS，OR was 1.50 (95% CI: 1.38-1.62) for changing and competing，1.50 (95% CI： 1.39-1.62) for unfair competing，and 1.96 (95% CI：1.78-2.16) for uncertainty. (2) Stress perceived from social stressors can be directly regarded as mental stress outcomes. We examined stress perceived from social stressors among urban residents: responses of “no stress”, “low stress”, “medium stress”, “high stress”, “very high stress” being coded as 1, 2, 3, 4, 5. The results showed that the average level of stress perceived by the respondents for social transformation was 2.28 (SD: 0.77). They were 2.47 (SD: 0.86), 2.38 (SD: 1.02), and 2.04 (SD: 0.85) in changing and competing, unfair competing, and uncertainty. Their perceived stress for each social transaction reached more than “medium stress”. (3) Mental stress is a function of social systems. We measured individual mental stress using the Chinese Perceived Stress Scale during SARS, then transformed it into a population tension index. Findings showed that High population tension is not conducive to their coping behavior against SARS infection. (4) Uncertain stress has a more negative effect on health than general stress. Our study showed that compared with study stress (OR=1.46, 95% CI: 1.17-1.82) and life stress (OR=1.34, 95% CI: 0.83-2.15), uncertainty stress (OR=2.20, 95% CI: 2.06-3.37) was more closely related to mental disorders among university students. We also examined the changing trends of uncertainty stress, and its impact on disease fear and prevention behaviors during the Chinese COVID-19 pandemic, using a prospective observational study. Results showed that uncertainty stress was positively associated with disease fear (β=0.450 46, SE=0.059 64, p<0.001), and negatively associated with self-efficacy (β=－0.669 8, SE=0.010 35, p<0.001), and prevention behaviors (β=－0.020 29, SE=0.008 76, p=0.021). The above results confirm that the construction that we built is reasonable.
Yang Tingzhong,Zhang Weifang,Peng Sihui. Constructing and Testing for Validation of Social Theory for Stress[J]. JOURNAL OF ZHEJIANG UNIVERSITY, 2022, 52(10): 61-68.
1 Selye H.， The Stress of Life， New York： McGraw-Hill， 1956. 2 Engel B. T.， “Stress is a noun！ no， a verb！ no， an adjective，” in Field T. M.， Mccabe P. M. & Schneiderman N. （eds.）， Stress and Coping， Baltimore： Lawrence Erlbaum Associates， 1985， pp. 3-12. 3 Holmes T. H. & Rahe R. H.， “The social readjustment rating scale，” Journal of Psychosomatic Research， Vol. 11， No. 2 （1967）， pp. 213-218. 4 Johnson J. H. & Sarason I. G.， “Moderator variables in life stress research，” https：//apps.dtic.mil/sti/pdfs/ADA066254.pdf， 2021-09-19. 5 Rahe R. H. & Arthur R. J.， “Life change and illness studies： past history and future directions，” Journal of Human Stress， Vol. ４， No. 1 （1978）， pp. 3-15. 6 Cannon W. B.， “New evidence for sympathetic control of some internal secretions，” American Journal of Psychiatry， Vol. 58， No. 4 （2006）， pp. 15-30. 7 Lazarus R. S. & Folkman S.， Stress， Appraisal， and Coping， New York： Springer Publishing Company， 1984. 8 杨廷忠： 《健康研究：社会行为理论与方法》，北京：人民卫生出版社，2018年。 9 Ho J. T. & Moscovitch D. A.， “The moderating effects of reported pre-pandemic social anxiety， symptom impairment， and current stressors on mental health and affiliative adjustment during the first wave of the COVID-19 pandemic，” Anxiety， Stress & Coping， Vol. 35， No. 1 （2022）， pp. 86-100. 10 Jiang S.， Zhang W. & Yang T. et al.， “Regional internet access and mental stress among university students： a representative nationwide study of China，” https：//www.frontiersin.org/articles/10.3389/fpubh.2022.845978/full， 2021-09-19. 11 Sun S.， Hoyt W. T. & Tarantino N. et al.， “Cultural context matters： testing the minority stress model among Chinese sexual minority men，” Journal of Counseling Psychology， Vol. 68， No. 5 （2021）， pp. 526-537. 12 Pearlin L. I.， “The sociological study of stress，” Journal of Health and Social Behavior， Vol. 30， No. 3 （1989）， pp. 241-256. 13 Pearlin L. I.， Menaghan E. G. & Lieberman M. A. et al.， “The stress process，” Journal of Health and Social Behavior， Vol. 22， No. 4 （1981）， pp. 337-356. 14 Horwitz A. V.， “The sociological study of mental illness，” in Aneshensel C. S.， Phelan J. C. & Bierman A. （eds.）， Handbook of the Sociology of Mental Health， New York： Springer， 1999， pp. 57-58. 15 Thoits P. A.， “Sociological approaches to mental illness，” in Horwitz A. V. & Scheid T. L. （eds.）， A Handbook for the Study of Mental Health： Social Contexts， Theories， and Systems， Cambridge： Cambridge University Press.， 1999， pp. 121-138. 16 Clark R.， Anderson N. B. & Clark V. R. et al.， “Racism as a stressor for African Americans： a biopsychosocial model，” American Psychologist， Vol. 54， No. 10 （1999）， pp. 805-816. 17 Aneshensel C. S.， “Social stress： theory and research，” Annual Review of Sociology， Vol. 18 （1992）， pp. 15-38. 18 Meyer I. H.， “Prejudice， social stress， and mental health in lesbian， gay， and bisexual populations： conceptual issues and research evidence，” Psychological Bulletin， Vol. 129， No. 5 （2003）， pp. 674-697. 19 Nurius P. S.， Uehara E. & Zatzick D. F.， “Intersection of stress， social disadvantage， and life course processes： reframing trauma and mental health，” American Journal of Psychiatric Rehabilitation， Vol. 16， No. 2 （2013）， pp. 91-114. 20 Lederbogen F.， Haddad L. & Meyer-Lindenberg A.， “Urban social stress—risk factor for mental disorders： the case of schizophrenia，” Environmental Pollution， Vol. 183 （2013）， pp. 2-6. 21 Turner R. J.， “Understanding health disparities： the relevance of the stress process model，” Society and Mental Health， Vol. 3， No. 3 （2013）， pp. 170-186. 22 Tobin C.， Erving C. L. & Barve A.， “Race and SES differences in psychosocial resources： implications for social stress theory，” Social Psychology Quarterly， Vol. 84， No. 4 （2020）， pp. 1-25. 23 Hofstede G.， Culture’s Consequences： International Differences in Work-Related Values， London： Sage Publications， 1980. 24 杨廷忠、黄晶晶、吴秀娟等： 《城市居民社会转型心理压力研究》，《中国行为医学科学》2007年第4期，第331-333页。 25 Wu D.， Yu L. & Yang T. et al.， “The impacts of uncertainty stress on mental disorders of Chinese college students： evidence from a nationwide study，” Frontiers in Psychology， Vol. 11 （2020）， pp. 243-252. 26 Peng S.， Yang X. Y. & Yang T. et al.， “Uncertainty stress， and its impact on disease fear and prevention behavior during the COVID-19 epidemic in China： a panel study，” American Journal of Health Behavior， Vol. 45， No. 2 （2021）， pp. 334-341. 27 Wu D.， Yang T. & Herold F. et al.， “Validation of the 4-Item and 10-Item uncertainty stress scale in a community-based sample of Chinese adults，” Psychology Research and Behavior Management， Vol. 15 （2022）， pp. 2803-2813. 28 Peng S.， Yang T. & Rockett I. R. H.， “Life stress and uncertainty stress： which is more associated with unintentional injury，” Psychology， Health & Medicine， Vol. 25， No. 6 （2020）， pp. 774-780. 29 Yang T.， Jiang S. & Yu L. et al.， “Life stress， uncertainty stress and self-reported illness： a representative nationwide study of Chinese students，” Journal of Public Health， Vol. 26， No. 2 （2018）， pp. 205-209. 30 Gratz K. L.， “Risk factors for and functions of deliberate self-harm： an empirical and conceptual review，” Clinical Psychology： Science and Practice， Vol. 10， No. 2 （2003）， pp. 192-205. 31 Jackson M.， Ramsden E. & Cantor D.， “Evaluating the role of Hans Selye in the modern history of stress，” in Cantor D. （ed.）， Stress， Shock， and Adaptation in the Twentieth Century， Rochester： University of Rochester Press， 2014， pp. 21-41. 32 杜本峰、黄振霄： 《生活事件与老年人抑郁倾向：累积效应、社会后果与影响机制》，《人口学刊》2020年第6期，第83-100页。 33 沈程峰、李欢欢、宋巍等： 《中学生应激性生活事件与自伤的关系：积极发展素质的调节作用》，《中国临床心理学杂志》2021年第3期，第483-488页。 34 杨杨、戚艳杰、陈旭等： 《父母养育方式和生活事件对儿童青少年情绪行为问题影响的调查》，《中华精神科杂志》2021年第5期，第374-380页。 35 Anderson K. F.， “Diagnosing discrimination： stress from perceived racism and the mental and physical health effects，” Sociological Inquiry， Vol. 83， No. 1 （2013）， pp. 55-81.
2022, Vol. 52 
