Introduction

The notion of life events adversely affecting health is deeply embedded in popular consciousness. However among theorists there have been interesting variations. Some early thinkers pursued general theories involving homeostasis, viewing disease in terms of ‘illness as a whole’. The best known were Cannon's (1932) fight–flight reaction and Selye's (1956) general adaptation syndrome. These detailed a number of biological responses to environmental demands, presenting them as an orchestrated pattern, almost regardless of the specific nature of these demands. These generalized patterns included responses which were easy to measure in early psychological laboratories, such as heart rate or sweating, and this may partly have accounted for the interest shown in this model of illness. Others pursued theories involving more specificity, believing that particular disorders arise from specific circumstances. During the 1950s this was accepted by followers of Franz Alexander and the school of psychosomatic medicine. Another example was Flanders Dunbar's influential set of ideas that specific personality types were more vulnerable to certain illnesses (Dunbar, 1954). The specificity considered nearly always involved the person's underlying attitude rather than the specific way the environment impinged in the form of a life event. However more recent research has suggested the value of examining the latter in relation to particular health outcomes and this chapter aims to convey this perspective (see also ‘Personality and health’ and ‘Stress and health’).

Life events, difficulties and meaning

One important difference between various perspectives on stress involves what may be called their conceptual level of stress analysis.