Culture and Social Relations in Stress
Dressier has carried out a range of empirical studies that examine the relationships among culture, stress, and disease to show the health effects of cultural factors such as beliefs and attitudes. "[R]isks and resistance resources are embedded in contexts of different social relationships . . . [and] how specific historical circumstances have generated specific configurations of stress, adaptation and disease" (Dressler, 1996, p. 253). Contextual factors and interpersonal dynamics alter the relationship between stress and disease through cultural effects on adaptive factors. The biopsychosocial model has considered the psychosocial mediation of stress apart from cultural meanings, community context, and broader sociohistorical trends. Dressler's research reveals that personal and cultural significance are crucial to the mediation effects.
Stress involves both risk factors, which are stressors, and social resources and relations, which facilitate resistance to those factors. Stress involves the individual's adaptation to the physical and social environment to produce a homeostatic balance. Inadequate resources for adaptation can disrupt physiological and emotional balance. Resistance resources are central to responses to stress. These resources include personal coping skills, social support, and a sense of social solidarity and perceptions of mutual group support (Dressler, 1996, p. 260).
Dressler cautions against a view of stress that emphasizes the individual's perception of stressful events. This mentalistic emphasis on perceptions contributes to neglect of the effects of the social environment. Individual perceptions and beliefs modify the impact of stress, but social conditions produce stress independent of perceptions. Stress interactions need to be conceptualized within ecological, person-environment, and systems perspectives that address adaptation as the effects of culture on stress and resistance processes. The need to assess subjective perceptions and the cultural significance of stress is illustrated in the variation across social and cultural groups in the effects of life events on depression, reflecting the importance of social context for well-being.
Contextual impacts on stress are illustrated in Dressler's cross-cultural studies of lifestyle incongruity, "defined as the degree to which lifestyle exceeds occupational class" (Dressler, 1996, p. 259). In examining socioeconomic status (SES) and disease risk among African Americans, Dressler and associates found a relationship to what he called "cultural consonance in lifestyle" (Dressler, Bindon, and Neggers, 1998). Disease risks are related to the degree to which individuals' behavior adheres to cultural models, as determined by cultural consensus analysis. Cultural consonance in lifestyle has a stronger association with hypertension than do the conventional SES measures. They
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