Reevaluering af Stress som Differentieret Fænomen.

Heuch, Rasmus Bergqvist

4. semester

Psykologi, Kandidat

2017

2017-05-30

83 pages

Formålet med dette projekt er at studere fortidige og nutidige perspektiver på fænomenet stress, for at konceptualisere en differentieret definition. Teorier fra både markedsundersøgelser, biologiske eksperimenter, evolutionære teorier og selvrapporteringsundersøgelser undersøges, evalueres og syntetiseres til et fælles perspektiv, i overensstemmelse med Becks psykobiologiske model og pessimistisk videnskabelig realisme. Denne specifikke tilgang er en replikation af metoden fra et tidligere projekt, hvis formål var at undersøge forskellige biologiske og evolutionære teorier om depression, men henblik på at skabe en ny definition og diagnostiske guidelines. Dette viste en solid støtte for teorien om, at depression er et differentieret fænomen, hvorfor stress blev valgt til en lignende undersøgelse. Både stressor-specifikke og non-specifikke processer og reaktioner identificeres i relation til stress, og begge er medierede og modererede af kognition, emotion og sårbarhed som stammer fra en kombination af genetik og tidligere erfaringer. Stress konceptualiseres derfor som både den specifikke og den non-specifikke reaktion på opfattede stressorer, som er påvirket af individets genetiske sammensætning og tidligere livserfaringer. Stress er ikke altid negativt, og har flere positive fordele, afhængigt af sociale faktorer, tilgængelige ressourcer og opfattelsen af stressorer. Dette nye perspektiv på stress anbefales for al forskning, mens specifikke perspektiver foreslås for specifikke formål og anvendelser. Diagnostik vælges til en gennemgående undersøgelse, specifikt hvordan den nye konceptualisering af- og perspektiv på stress påvirker de nuværende diagnostiske guidelines beskrevet i den tiende udgave af International Classification of Diseases. Diagnostiske guidelines for angst redegøres for og sammenlignes med diagnostiske guidelines for depression, for at undersøge forskellige tilgange til kategorisering af mentale lidelser.

The aim of this project is to study past and present perspectives on the phenomenon of stress, in order to conceptualize a differentiated definition. Theories from both labour studies, biological experiments, evolutionary theories and self-report questionnaires are examined, evaluated and synthesized into a common ground perspective, in accordance with Beck’s psychobiological model and pessimistic, scientific realism. This specific approach is a replication of the method from a previous project, which aimed to examine different biological- and evolutionary theories of depression, with the intention of creating a new definition and diagnostic guidelines. This yielded strong support for a depression being a differentiated phenomenon, and hence stress was chosen for a similar examination. Both stressor-specific and non-specific processes and reactions are identified in relation to stress, each mediated and moderated by cognition, emotions and vulnerability stemming from a combination of genetics and past experiences. Thus, stress is conceptualized as the both the specific and non-specific reactions to perceived stressors, as influenced by the individual’s genetic makeup and previous life experiences. Stress in not inherently negative, and has several positive benefits, depending on social factors, available resources and perception of stressors. This new perspective on stress is recommended for all research, whilst specific perspectives are recommended for specific purposes and uses. Diagnostics is chosen for a thorough examination, specifically how the new conceptualization of- and perspective on stress influences the current diagnostic guidelines delineated in the tenth edition of the International Classification of Diseases. Diagnostic guidelines for anxiety is outlined and compared to diagnostic guidelines for depression, in order to examine different approaches to categorization of mental illnesses. Changes to the current categorization of stress-related mental illnesses are suggested, primarily concerning the focus on non-adaptive descriptions of stress and comorbidity to related illnesses. Due to the highly comorbid nature of stress, anxiety and depression, minor alterations are advised for both anxiety-related and depression-related mental illnesses. A new diagnosis is proposed for long-term stress without discretely identifiable life-changes as causation, and it is suggested that post-traumatic stress disorder is acknowledged as a phobic disorder with stress-related causation.

Stress ; Diagnostik ; Komorbiditet ; ICD-10 ; Eustress

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