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PREVENTION OF LONG-TERM EFFECTS OF STRESS.
An important component of crisis management is to set the stage for the prevention of the long-term effects of acute stress or crisis.
Factors that seem to determine the long-term impact of the stressful event include the nature of the
stressor (length, intensity, and quality); the patient’s past experience, that is, how he or she has previously managed stressful life events; the patient’s perception of the event; the physiological reactions that occur; and the person’s ability to cope with psychological and physiological reactions to the stress and subsequent illness behavior.
Dohrenwend and Dohrenwend (1981) have identified six processes or models that indicate how stressful life events might lead to adverse health changes.
Mechanisms of Stress Leading to Adverse Health Consequences:
Victimization: Intense acute or chronic stress, uncontrollable by the individual, has direct
adverse health effects.
Stress-strain: Psychophysiologic “strain” leads to adverse health effects.
Vulnerability: Preexisting personal dispositions and personal habits determine the effects of
stress on the individual.
Additive burden: Social situations and personal dispositions have independent effects.
Chronic burden: Acute transitory stresses have no effect on health. Rather, social and personal
dispositions are entirely responsible for adverse health effects.
Event proneness: Symptoms of adverse health predispose individuals to stressful life events,
which lead to health consequences. The first four mechanisms of stress listed in the table affect many individuals in crisis.
Victimization. Some stressful life events causing adverse health consequences may override any person’s coping capabilities.
For instance, extreme situations, such as combat, incarceration in a concentration camp, or psychological torture, and some severe stresses such as the unexpected death of a loved one, rape or violence—all situations over which an individual has little or no control—may directly cause adverse health changes, set in motion biological processes with pathophysiological consequences, or force changes in health
habits that increase risk for morbidity and mortality.
