A Handbook for the Study of Mental Health Social Contexts, Theories, and Systems

Social context defines not only the sources of stress, but also the social relationships within which stress is developed and mitigated. In addition to describing sources of stress and social support, the considerations of social context in Part II situate stress that accompanies social status (e.g., social class, gender, race, age) as well as role occupancy (e.g., spouse, worker). We begin with a review of the historical development of what is now referred to as the stress process model, originating with work of Leonard Pearlin. Aneshensel and Avison (2015) have provided an excellent overview of Pearlin's body of work, and Deborah Carr (2014) offers a very concise and readable overview of sociological research on stress in her book Worried Sick: How Stress Hurts Us and How to Bounce Back.

The sociological study of stress and social support has been dominant in mental health research since the 1960s. Thirty years of research has demonstrated a consistently positive relationship between life stress and psychological distress. In the 1970s, researchers modified the life stress model to take into account the important role that social support and other resources play in assisting individuals to cope with the stressful events in their lives. Intervening models, or coping theories, focus on how coping resources are mobilized after the stressful event, whereas distress-deterring models argue that coping resources (such as a supportive family) may actually reduce the likelihood of external stress occurring, or else can help alter the meaning of stress.

Because stress does not affect everyone the same way, researchers must also take into account vulnerability to stress. Vulnerability was originally conceived as a purely psychological concept; sociologists view it as a group concept as well. For example, membership in some social categories (minority status or gender) provides an individual with differential access to resources, as well as a different socialization experience which may structure one's reaction to both stress and illness, and consequently result in very different mental health experiences. Link and Phelan (1995) identify access to resources as a fundamental cause of disease because such access influences your exposure to various risk factors (for example, stress) and your ability to either avoid or cope with psychological distress.