Historically, scholars (Cannon,1953; Donavon 1985; Selye, 1950) have emphasized stress in terms of physical aspects alone, maintaining that stress is something that happens to the body causing the body to react through a series of biochemical processes. While this perspective has been fruitful in forming a comprehensive understanding of the physiological response of individuals, it ignores the active role humans play in shaping the stress response. In some instances, such as severe temperature exposure or sleep deprivation, this model is useful. Yet, humans are not just biological entities they are also cultural beings and "actors both manipulate their culture and are constrained by it" (Ortner, 1990: 63).

Stress, on the contrary, is the product of a complex interaction between culture and biology in which individuals’ experiences are positioned. In psychosocial stress the physical response must be triggered by a threatening stimulus first (Cannon, 1953). The stimuli, which trigger the physiological response, are culturally constructed. Therefore, the significance of meaning attached to the stress evokes the response, not the stressor itself. Furthermore, humans adapt in two ways, through biology and through culture (Marks, 1995). If culture constitutes the manner in which people cognize the world and the way people cognize the world is created from experience (D’Andrade, 1995), it becomes crucial to understand how belief systems, composed of categories, either help or hinder individuals’ adaptability. Thus, the purpose of this paper is to assess how belief systems influence stressful experiences. It is hypothesized that belief systems that allow for flexibility are adaptive while belief systems that are rigid are maladaptive. In constructing any comprehensive model of stress, it is necessary to amalgamate cultural and biological approaches (Dressler, 1995). This paper will begin by looking at the physiology of stress, then consider how meaning influences stressful experiences, and finish by presenting a model for understanding psychosocial stress.

The Physiological Process of Stress

Biologically, the stress process is a reaction to a stressor. The stress process is the body’s attempt to counter-act the adverse effects of the stressor in order to bring the body back to homeostatic state (Bridges, 1982). A normal state of homeostasis is the internal balance created between an individual’s inner, biological condition regardless of external, environmental stimuli (Bridges, 1982). The aim of a homeostatic state is to maintain an organism’s internal constancy (Cannon, 1953). Homeostasis is disrupted when the body deviates too much from the normal functioning level. While homeostasis usually refers to experiences of physical stress, however, it can also be applied to the experience of psychological stress as well. For example, sweating is a response to heat stress. Perspiration is the body’s attempt to cool itself realigning it back to its normal temperature. However, the experience of being hot can also be psychological stressful. Stress is a process composed of three parts: definition of stimuli, an attempt to adapt to the stressor, and the outcome of the attempt. The stressor must first be perceived as a threat before any physiological reaction occurs. The body attempts to cope with an environmental stressor. The body either resists the stressor, resulting in prolonged or chronic stress, or adjusts to the stressor, realigning the body back to a homeostatic state.

Physiological reactions to stress induce a series of biochemical changes. A stress response is activates three physiological systems: the sympathetic system, the parasympathetic system, and the endocrine system, none of which functions independently of the others (Donovan, 1985; Selye, 1950, 1956; Toates, 1995). The sympathetic system can be thought of as the active response whereas the parasympathetic system can be thought of as a conservative one. The sympathetic system primarily prepares the body for action by dilating pupils, directing more blood to the muscles and brain, increasing the heartbeat, elevating blood sugar, and by inactivating the intestinal tract (Selye, 1950, 1978; Toates, 1995). The parasympathetic system, on the other hand, constricts pupils, decreases blood pressure and heart rate, increases salivary production along with acid, pepsinogen, mucus and gastrin secretions to aid in digestion, and relaxes the colon and bladder to expel waste (Donovan, 1985). The endocrine system provides hormones that activate chemical reactions within and between the various systems and organs. Parasympathetic systemic response is associated with manifestations of states of extreme fear, diarrhea, urinary incontinence and fainting (Toates, 1995) whereas sympathetic outcome is strongly associated with cardiovascular disease (Toates, 1995). Ordinarily, the sympathetic system dominates the stress response in humans (Selye, 1956). The stress response is non-specific, meaning that it is not targeted at any specific locus, but instead is a general response involving the whole body. (Selye, 1950). However, certain organs and systems play more vital functions than others do.

Selye (1950, 1978) provides the following description. The kidney functions to regulate blood pressure through the endocrine substances of renin, a kidney enzyme, and angiotensin. Together renin and angiotensin are known as renal pressor substances. Renin acts on the adrenal cortex, the outer part of adrenals (two endocrine glands situated above the kidneys), stimulating the secretion of aldosterone, a pro-inflammatory corticoid, also resulting in raised blood pressure. Simultaneously, the hypothalamus sends a corticotrophin releasing factor to the pituitary gland, a kind of endocrine gland located in the skull, requiring the secretion of the adrenocorticotrophic hormone (ATCH). ACTH, in turn, stimulates the adrenal cortex resulting in the manufacturing of glucocorticoids. Corticoid hormones also include glucocorticoids, or anti-inflammatory hormones, and mineralocorticoids, or pro-inflammatory hormones. Corticoids are hormonal substances that either inhibit or excite inflammation. If inflammation is inhibited, it hinders the inflammatory defense reaction that guards against the injurious agent; if inflammation is bolstered it affects mineral metabolism thereby influencing available energy and tissue production. Glucocorticoids are a type of hormone that restrains extreme defense reactions. The glucocorticoids inhibit the thymicolymphatic organs and lymphoid and eosinophils cells (white blood cells), reducing immunity and allergic reactions. Pro-inflammatory corticoids also consist of adrenocortical hormones, also called mineralocorticoids due to their effect on mineral metabolism, which withholds sodium and causes an excretion of potassium. For the most part, mineralocorticoids stimulate defense reaction. The glucocorticoids also play a role in the mobilization of energy via the production of glucose used in defense of the stressor. In addition, glucocorticoids react on the kidney.

If the kidney over-produces renal pressor substances the renal arteries become partially constricted, and blood pressure is raised. With an overdose of corticoids a kidney disease could develop over time, called nephrosclerosis. However, if the kidneys manufacture too little renal pressor substances, blood pressure also elevates. Kidney blood vessels are constricted through chemical reactions of the hormones causing and increase in the production of renal pressor substances. Consequently, blood vessels in the entire body constrict and apply resistance against the heart resulting in raised blood pressure. This effect is significant if fluid retention increases vascular fillings. Coincidentally, a hardening, rigidity and inflammation of the arterial walls occurs throughout the body, contributing to the development of arteritis or arteriosclerosis, a condition ensuing from prolonged stress. Angiotension, in turn, acts again on the adrenal cortex increasing the secretion of mineralocorticoids. This cycle over time eventually leads to hypertension.

The thyroid, an endocrine gland located in the neck that regulates general metabolism (Selye, 1978: 473), is affected during the stress process via corticoids that stimulate the metabolism of body tissue. Thyrotropin is a hormone released by the pituitary that stimulates the release of thyroxin by the thyroid gland. The thyroid produces a hormone called thryotrophine. Thyrotrophine hormones are important because they are the most concentrated accelerators of chemical reaction in the body; namely, they stimulate metabolic reactions in general. Metabolism is important because it involves the transformation of food into tissue and energy needed for the stress response.

The liver is also a key component in comprehending the physiological stress process. It is involved with most biochemical reactions resulting from stress. It regulates the concentrations of sugar, protein and lipids in the bloodstream that are mobilized for energy. Additionally, it can also counter-balance the effects of high corticoid levels produced by the adrenals by dissolving any surplus. The liver can also address toxic pollutants through the stimulation of catatoxic hormones.

Both the endocrine system and the central nervous system, which includes the sympathetic and parasympathetic systems, coordinate the non-specific physiological response to stress. The central nervous system is composed of the brain, the spinal cord, the brain stem, and the thalamus. Two hormones relevant to the stress process are produced in the sympathetic nervous system, adrenalines and acetylcholines. Several responses are regulated through the relationship of these two chemicals. Nervous stimuli cause the production of adrenalines. Adrenalines are produced through two mechanisms, (1) the adrenal medulla, the inner part of the adrenals (two endocrine glands located just above the kidneys), which secretes adrenalines directly into the bloodstream, and (2) through nerve secretion, which are confined to affecting specific tissue areas.

In summary, physiological response to a stressor involves a drop in blood eosinophils (white blood cells) with increased corticoid and adrenaline (a hormone) production, physiologic signs of nervous tension or exhaustion, raised blood pressure, rapid heart beat, sweating, and gastrointestinal disturbances (Selye, 1978). The sympathetic nervous system prepares the body for ‘flight or fright’ (Cannon, 1953) increasing cardiac output and vasodilation of the arterioles (Veith in Toates, 1995). Adrenaline is released into the bloodstream and metabolism accelerated causing an increased supply of glucose to the muscles (Toates, 1995) preparing the body for action. The brain releases corticotrophin releasing factor activating the sympathetic system, raising adrenaline levels (Toates, 1995). The emotional state of fear or anger triggers the sympathetic response process (Cannon, 1955).

Selye (1950) has mapped the organic response to stress as a three-stage process, termed the general adaptation syndrome. The first stage in the process is the alarm stage, followed by the stage of resistance. Completing the process is the last stage, the stage of exhaustion. In each of these stages a series of biochemical reactions occurs in response to stress, as explained above. In psychosocial stress research, the sympathetic system predominates most research concern since it is provoked by emotional responses, namely fear and anger (Cannon, 1953). Emotional response, a psychological state, is most critical in the alarm stage because individuals decide what stimuli are stressful or not. The subsequent stages of resistance and exhaustion are spurred only after the perception of the stimulus has been perceived as threatening. However, the definition of a threatening stimulus is culturally determined.

Blood pressure is a reliable means of measuring stress response in individuals (Selye 1950). Blood pressure signifies an increase in heart rate in conjunction to an excess discharge of adrenaline by the adrenal medulla, for example, and is associated with prevalent diseases such as hypertension and cardiovascular disease. Moreover, as Dressler (1995) notes, the meaning of blood pressure measurement is not context dependant, a prevailing benefit in cultural studies of blood pressure levels. "What makes cross-cultural variability in blood pressure interesting is precisely that we know...the same phenomenon is being assessed. We can then begin to investigate the different reasons for that variability" (Dressler, 1995: 29).

Studies and Results

Keil et. al. (1977) demonstrated the association of social class and age to hypertension and high blood pressure undercutting the genetic argument for high rates of hypertension and blood pressure in blacks. The study compared the rates of hypertension between two groups in Charleston, South Carolina. One group consisted of low social class, male Blacks and the second group consisted of high social class, male Blacks. Hypertension rates were initially taken in 1960 and compared with a follow-up study in 1974. Men in the low social class group were categorized as laborers, service workers, operative or semi-skilled workers and had education levels of one year of high school or less. Men in the high class group were mostly craftsmen, foremen, clerical, managerial, and professional workers with educational levels ranging from high school to college degrees.

Overwhelmingly, the incidence rate of hypertension was noticeably more significant (p<.01) in males of the low social class than in males of the high social class group. The rate of hypertension in the first group was 21.0 per 1,000 men per year while the incidence rate for the second group was 5.5 per 1,000 men per year. The incidence of hypertension was 3.8 times higher in lower than upper class Blacks. Blood pressure was also taken to indicate levels of stress. Again, the average blood pressure levels in the lower class group were considerably higher than levels in the upper class group. Systolic pressure averaged 8 mm Hg and diastolic pressure 5 mm Hg higher in the lower class group as compared with upper class group. The risk of becoming hypertensive was three to four times greater for males belonging to the lower social class than males belonging to the higher social class. See table 1.1 for a review of this study’s and other study’s findings.

Keil et. al.’s (1977) findings attest to the strong impact that social context has on individuals experiencing psychosocial stress, as other researchers have demonstrated (Bindon et. al, 1997; Dressler and Bindon, 1997). The lower class group had overwhelmingly higher rates of blood pressure and hypertension after skin color was controlled for, indicating they experienced more stress than black males in the upper class group. Since these levels were only found in the lower class group, it can be reasonably concluded that a determinant factor of hypertension rates and high blood pressure levels are related to class context and is not due to genetic factors. Keil et. al. (1977), however, did not consider other factors that could contribute to these high levels of hypertension incidence, such as salt intake. Regardless, these variables could be associated with class lifestyle as unhealthy diets high in salt content are often associated with lower class available food choices. Most importantly, this study undermines the genetic argument that hypertension and high blood pressure are largely biologically based to show that experience within a class group can contribute to elevated levels.

Harburg et. al. (1973) also found context to be a contributing factor to elevated blood pressure and high incidence of hypertension. They conducted a study in Detroit to assess variations in blood pressure levels between Blacks and Whites in differing communities. They postulated that individuals living in high stress neighborhoods would have had a higher mean blood pressure than those individuals residing in low stress environment. Extensive use of census tracts was used to determine the high and low stress areas. Tracts were rank ordered according to their ‘stress score’, which depended on economic deprivation, residential instability, family instability, crime and density of the neighborhood as well as an ‘instability score’. To qualify for a high stress area, communities had to exhibit both an upper variation for the instability measure and a low range for the socioeconomic measure. Low stress areas were determined by having both a low instability level in concert with varied levels of socioeconomic class.

The sample consisted of 252 black males, 240 white males, 256 black females, and 252 white females. To qualify respondents had to live in one of the four study areas, be either Black or White, be between the age of 25-60, be married and living with a spouse, and have other relatives residing in the area. Blood pressure was measured systematically by well-trained nurses. Blood pressure levels were checked at the beginning of the interview as well as 5-10 later and, again, approximately10 minutes later. The mean systolic, the average diastolic, clinical categorical systolic, and clinical categorical diastolic were analyzed. Clinical categorical systolic readings were based from (1) under 119 mm Hg labeled low normal, (2) 120-139 mm Hg regarded as normal, (3) 140-159 mm Hg catalogued as borderline hypertensive, and (4) 160+ mm Hg indexed as hypertensive. Clinical categorical diastolic readings were measured by (1) less than 83 mm Hg qualifying as a low normal reading, (2) 84-89 mm Hg grouped as normal, (3) 90-94 mm Hg regarded as borderline, and (4) 95+ mm Hg or hypertensive. They hypothesized the mean blood pressure for Blacks would exceed the mean blood pressure of Whites, indicating higher levels of stress.

It was shown that Blacks males in high stress areas had a greater systolic average, approximately 130 mm Hg, than Black males residing in low stress areas, who had a systolic mean of about 127 mm Hg (statistically insignificant). Black males living in high stress communities also showed a higher mean of diastolic readings, averaging 86 mm Hg, as compared to Black males in low stress environments, with a mean reading of 83 mm Hg (p<.01). Overall, white males exhibited little variation in both systolic and diastolic blood pressure readings for either high or low stress environments. For females, Black women in high stress areas showed the highest systolic reading, with a mean of 129 mm Hg, as well as diastolic readings, with an average of 82 mm Hg. In contrast, white females showed a considerably lower average with the largest differentiation being in systolic blood pressure levels between females in high stress environments, with a mean of 124 mm Hg, and females residing in low stress areas, with an average of approximately 120 mm Hg.

In general, blood pressure levels were highest for Black males in high stress environments of all social groups. Unlike the Keil et. al study (1977), Harburg et. al. (1973) examined the role age and weight played in this borderline hypertensive and hypertensive group of men. Elevated blood pressure readings were significantly superior in males’ 25-39 years of age and especially in males in this age category living in high stress areas regardless of weight. As Harburg et. al. indicate, high stress Black males had 2.5 times above the rate of borderline hypertension or outright hypertension than Black males living in low stress communities.

The data compiled from this study (Harburg et. al., 1973), indicate that environmental context does play a substantial role in the experience of stress. Individuals in high stress areas had significantly elevated levels of blood pressure and hypertension than individuals in low stress environments. Nonetheless, other factors, such as race and age, also influence on blood pressure levels extensively. Again, however, the age correlation to blood pressure found in this study does not necessarily imply a genetic link. Henry and Cassel (1969) suggested the rise in both blood pressure and age could be indicative of a psychosocial process instead of a genetic process. In this case, however, the blood pressure levels are correlated with young blacks. But the implication remains the same, in that, there is something about the experience of certain age groups, in this context 25-39 year olds, that is socially and psychologically stressful. This study would have greatly benefited if the research design included a qualitative component to examine explicitly why younger black males experienced such high stress levels. The qualitative aspect could have clearly delineated between the influence of genetic factors and lifestyle habits, i.e. diet and exercise, and experience as the primary contributor to high blood pressure levels.

Blood pressure did vary according to environmental conditions in addition to the combination of variables that reflect social status, i.e. sex, race, and class. In all, Blacks, especially young blacks, exhibited the greatest mean blood pressure level and hypertension incidence than any other group. These findings suggest that not only is class context an influencing factor but race is as well. The findings also attest to the fact that blood pressure and hypertension is not solely a genetic disorder since Blacks in low stress areas and Blacks in high stress areas did not display the same level of incidence. Moreover, these findings signify that experience of daily, psychosocial stress affects blood pressure levels and hypertension rates. Therefore, context is a significant contributor to the experience of stress and health outcome. However, context is not the only influencing factor on psychosocial stress.

The common underpinning of a stressful event is the lack of control experienced by individuals whereby coping mechanisms either completely falter or inadequately account for that particular event (Karasek, 1982; Kasl and Cobb, 1970). Karasek et. al. (1982:31) after an extensive literature review on endocrine, metabolic and cardiovascular activities during the stress response. They concluded that the determinant environmental factor is the degree of control an individual has in coping with the stressor: stress accompanied by low control leads to strain, whereas stress coupled with high control leads to regeneration. Degree of control is determined by the coping strategy used when an individual encounters a stressor. If they are able to employ a moderating strategy they have a high degree of control; if they are unable to use such a strategy they have a low degree of control.

Kasl and Cobb (1970) traced blood pressure levels as men underwent the loss of a job, unemployment, probationary reemployment, and stable employment in a new job. Blood pressure levels were significantly higher in men anticipating the loss of a job and unemployment than blood pressure levels for men who had stable employment. They tracked men who were anticipating the loss of a job and unemployment and took their diastolic and systolic blood pressures then compared these readings after the men found stability in new jobs. The mean drop in diastolic blood pressure was 3.06 mmHg (p<.00001). The mean drop for systolic blood pressure was 5.32 mmHg (p<.0001). Furthermore, men who reported that life got back to normal relatively quickly showed a significant drop in blood pressure (size of drop of diastolic blood pressure was 6 mmHg; p<.001). Men whose blood pressure levels remained elevated over time reported experiencing unemployment more severely, reported prolonged subjective stress, exhibited less ego resilience, and showed little improvement in self-esteem or reduction of irritation. They conclude that " . . . some of our psychological variables dealing with perception of future and optimism about it, point to an almost permanently damaging effect of the job loss experience" (1970:36).

The coping mechanisms for understanding and responding to an event lay in the cognitive categories of an individual’s belief system (Ortner, 1990). Categories of a belief system are culturally defined and formed from observations of external reality (D’Andrade, 1995; Ortner, 1990). Observations continuously reshape the belief system so that the belief system can explain all that is observed (D’Andrade, 1995; Ortner, 1990). Hence, cognitive categories give individuals a model for interpreting stressful behavior or events as well as prescribing appropriate behavior in reacting to that stressor (D’Andrade, 1995; Ortner, 1990). If an individual cannot understand an occurrence through the employment of a belief system, chaos ensues.

James (1994) alludes to the consequence of chaos. He hypothesized individuals using prolonged, high-effort coping strategies to psychosocial stressors, defined as chronic financial strain, job insecurity, subtle social insults about race and class, will have increased heart rate, systolic blood pressure, and incidence of hypertension than individuals using low-effort coping strategies to combat psychosocial environmental stress. He compared blood pressure levels and the prevalence of hypertension taken from blacks and whites living in a rural county in North Carolina. He postulated that Blacks would exhibit a higher Blood pressure mean and rate of hypertension due to a higher level of psychosocial stress, given their subordinate social position within the social context of American culture.

James divided coping strategies into high-effort and low-effort categories, which were measured by a 12-item scale. Questions were composed of a series of statements centering on the effects of mental and physical stamina, whether the individual felt a strong commitment to hard work, and whether the individual exhibited a strong determination to succeed. An individual scored high if they scored above the mean for their ethnic group and scored low if their score fell below the mean of their ethnic group. Socioeconomic status was determined by level of occupation in conjunction with level of education. Each variable was measured for individuals in each ethnic group. Means were determined on the basis of socioeconomic status and coping strategies in White and Black groups. By measuring blood pressure rates and prevalence of hypertension of individuals using different coping strategies he contrasts the groups by socioeconomic statuses in order to gauge the degree of psychosocial stress.

Both groups were limited by age, 21-50 years old. The white group was comprised of skilled, blue collar and lower to middle white collar workers. Unskilled and semi-skilled workers constituted the black group. The high socioeconomic status group of blacks had high school degrees while the low socioeconomic status group had only some high school education. Blood pressure rates for the high socioeconomic status group of blacks was 78.1 mmHg while blood pressure levels for low socioeconomic status blacks was 80.4 mmHg (p<.06). When blood pressure levels were compared by socioeconomic status, for blacks as class levels rose, blood pressure decreased and as class level declined, blood pressure levels increased. No significant difference between class and blood pressure was found in the White group. Blacks in the high socioeconomic group had a lower mean diastolic pressure in contrast to blacks who low socioeconomic Blacks, with a significant difference being 2.3 mm Hg.

The difference in blood pressure becomes more apparent when socioeconomic status is related to high-effort coping strategies verses low-effort coping strategies. Blood pressure levels increased for individuals, regardless of socioeconomic status, who scored high on the coping strategy indicator but was markedly significant for individuals who employed high-effort coping strategies that were also of low socioeconomic status. Blacks who had low-effort coping strategies and low socioeconomic status had a mean diastolic blood pressure of 79.3 mm Hg in comparison to Blacks who used a low-effort strategy but were in the high socioeconomic group had a mean of 78.3 mm Hg, a difference of 1.0 mm Hg. More importantly, Blacks using the high-effort strategy varied more significantly in terms of socioeconomic status. Black with a high-effort coping system and a low socioeconomic strategy has a mean blood pressure of 81.4 mm Hg. Blacks using the same type of strategy but were of high socioeconomic status had a mean blood pressure of 77.6 mm Hg, a discrepancy of 3.8 mm Hg (see table 1.2 for summary).

James’ study (1994) also indicates that incidence of hypertension and blood pressure levels is associated with the effect of coping strategies. Blacks who engaged in a low-effort coping strategy possessed a relatively insignificant difference in diastolic blood pressure levels between the two socioeconomic groups. Differences in hypertension prevalence by socioeconomic status was insignificant for Blacks using a low-effort strategy (25% for low SES group, 23.4% for high SES group). However, for Blacks using a high-effort coping strategy, hypertension prevalence was three times greater for Blacks in the lower socioeconomic group (31.4%) than those in the high socioeconomic group (11.5%). So there is a higher rate of hypertension in the groups employing high-effort strategies than in the group using low-effort strategies, although there is a difference associated with class. These findings suggest that blood pressure level varies according to class differences, in which race is a factor, but more substantially by coping strategy.

It can be concluded from James (1994) findings that the Blacks that used high-effort coping strategies but remained in the lower class experienced a discrepancy between their position in the world, coupled with the social beliefs used to legitimize their position, and their belief of where they should be. High-effort coping strategies suggest individuals are actively trying to cope with the stress of their experience. People only cope with something when that something is considered stressful. Furthermore, because they attempted to cope with psychosocial stress aggressively also suggests there is something about their lifestyle that does not correspond with their belief system. If they are experiencing psychosocial stress, the treatment they are receiving socially and the accompanying message their self worth could be conflicting with their own beliefs that say this treatment is unjustified. Take for example, an older black person and a younger black person in the lower class strata. An older person may be able to dismiss discriminatory treatment because they are not bothered by what others think of them. Their belief system may regard such treatment is due to the ignorance of the other party and thus they are not stressed. The older person has used a low-effort coping strategy. A young black, on the other hand, may find others opinion particularly disturbing. They may feel the need to react to such treatment aggressively by, for example, confronting that person or continuously thinking about that experience and being bothered by it. The young person has used a high-effort coping strategy, their emotions remain elevated. Regardless, it can be argued, they cognitively and emotionally associate different meanings of their experience attributed by the larger social context, which contributes to an elevated blood pressure level and an increased susceptibility to incidence of hypertension.

Balshem (1988) also found control to be a key issue in psychosocial stress response. By looking at the relationship between clerical workers and their bosses, she maintains workers’ stress levels elevate as bosses become more undemocratic and unsupportive by not allowing personal autonomy in decision-making and by providing little respect for their workers’ contributions. Balshem calculated perceived stress and support by a correlation matrix, each by three measures. Perceived stress consisted of the subjective job stress rating, the number of somatic complaints and reported satisfaction with work. Support measures included support from a supervisor, from coworkers, and from family and friends. The most significant outcomes (p<.001) were between stress measures and measures of support from a supervisor or coworkers (see table 1.3). Consequently, clerical workers felt "taken for granted" as they are repeatedly overlooked due to their subservient position. Additionally, their lack of control was considered stressful as one woman explained "we do not get to make the decisions yet we have to deal with them" (Balshem,1988: 364). Another woman explained that lack of structure and attention to detail in the office " . . . leaves everything chaotic" (Balshem 1998: 364). Clearly, clerical workers experience a similar kind of stress as lower class Black, as a result of the lack of control legitimized by their subordinate social positions.

"Human knowledge is carefully preserved and passed from one generation to another" (D’Andrade 1995:xiv) thereby implying humans are marked by a need for continuity in life. People need to be able to predict outcomes to a degree. A belief system allows for this (D’Andrade 1995; Ortner, 1990). Without a framework for ordering experience the individual becomes stressed. When a belief system fails to make sense of an event or there is inconsistency between the belief system and an event individual scramble for devices that can rationalize the situation. This may mean modifying an already existing belief system. Nonetheless, if individuals cannot constitute an event into a belief system smoothly then chaos is inevitable. Since humans are patterned beings, and patterns produce order, chaos is stressful, and ultimately the event becomes stressful. If the chaos remains unordered for a prolonged period of time then chronic stress develops. Hence, the ability to adapt or cope effectively in a world where complete control over the homeostasis of an individual’s world is impossible, the key to successful adaptation is the degree of flexibility within a belief system. A belief system must allow individuals to recognize, respond, and possibly cognitively reorganize categories to adapt to stress effectively.

The interaction between culture and biology thus calls for the creation of a model (see figure 1.1) that accounts for both. The process begins with an external stress, external in the sense that the stressor is novel to the population. These could be macro-level forces that are beyond the control of the local level and individual, such as social status or culture change. The external stressor acts on the cultural belief system. The belief system established by group consensus gives meaning to the experience and guides behavior (Ortner, 1990). Two avenues become apparent at this point. The belief system can immediately account for the stressor allowing the individual to remain in a homeostatic state, which is adaptive since detrimental health outcomes are averted.

In the second avenue, the belief system cannot account for the stressor and meaning attributed to the stressor is viewed as threatening. If the belief system is flexible, in which the individual has control in interpreting and reacting to stressors, the belief system can modify its cosmology to account for the stressor giving individuals a behavioral guide for low-effort coping strategies. Individuals and the group then return to homeostatic state. The malleable belief system is thus adaptive. However, if the stressor is perceived as a threat a second route can occur. If the belief system is not flexible, giving individuals no choice for interpreting experience or choosing coping strategies, chaos occurs, ultimately forcing the individual to adopt a high-effort coping strategy. If the belief system continues to be rigid for a prolonged period of time and stress levels remain elevated, then biological disorders such as high blood pressure and hypertension transpire, constituting maladaptation.

Conclusion

Any approach to studying psychosocial stress must incorporate both cultural elements and biological aspects (Dressler, 1995). The cultural aspect, however, must not stop at the inclusion of context but must broaden to include how systems of meaning are composed and operate. Systems of meaning within contextual frameworks must also be examined to accurately gage how mechanisms of a belief system interact with biology. Through several studies (Balshem, 1988; Harburg et. al., 1973; James et. al., 1996; James, 1994; Karasek et. al., 1982; Kasl and Cobb, 1970; and Keil et. al., 1977), this paper has illustrated the need for incorporating belief systems along with contextual data. These studies have alluded to this point but have not directly dealt with the specific components of belief systems, as suggested. Purposed here is a biocultural model for understanding psychosocial stress that needs to be tested and probably modified by analysis of contemporary culture groups before it should be considered legitimate.

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