Stress is most often seen as a biological problem.  It is true that the “stress response” is a biological response to environmental triggers.  In response to a stressor, the HPA axis is activated, resulting in the release of stress hormones – specifically, adrenaline and cortisol. The long-term release of these hormones is known to affect hippocampal development, cardiovascular fitness and even the length of our telomeres. However, a purely biological approach is an oversimplified explanation of stress in humans.  The cognitive approach argues that the way we think about stress can be a mediating factor in the effects of stress on our health.

The cognitive approach argues that stress can be mediated using the Transactional Model of stress. This model argues that it is the appraisal of the environmental stressor that leads to a stress response or not. In a classic experiment, Speisman allocated participants to one of three conditions.  All three groups would watch a circumcision ceremony, but with one of three soundtracks. The “trauma condition” had a soundtrack with emphasis on the mutilation and pain; the “intellectualization condition” had a soundtrack that gave a intellectual interpretation of the ceremony; the “denial condition” explained that the adolescents are willing and happy in the ceremony. Galvanic skin response and heart-rate – both measures of stress – were measured. The researchers found that the trauma condition had the highest stress response.   

Kelly McGonigal also argues that we can minimize the negative effects of stress by thinking differently about the problem.  She cites a Harvard study (Jamieson et al) in which participants were randomly allocated to one of two conditions.  In the first condition (the reappraisal condition), participants were instructed to think about their physiological arousal during a stressful task as helpful and empowering. In the control condition, they received no instructions about stress. After carrying out a stressful interview situation, their cardiovascular responses were measured.  The researchers found a more positive cardiovascular response in the “reappraisal condition.”

In both of these studies, it can be argued that the experiments are highly artificial and may not predict how the participants would act under normal conditions – that is, low ecological validity.  Although negative health effects of stress are linked to chronic stress, these studies only look at a single situation that will not have a long-term effect on an individual.  Jobin et al wanted to see if a “way of thinking” would influence how one copes with stress on a more regular basis. Jobin carried out a correlational study in which he found that pessimists tend to have higher baseline stress levels than optimists. He also found that on days when participants had higher than average stress, higher cortisol levels lasted longer in pessimists than in optimists. This shows a potential link between the way we perceive stress and the long-term effects on health.

There are several methodological limitations to the research.  First, when looking at research on stress, the way that stress is measured is always a concern.  Simply looking at galvanic skin response or heart rate is not an adequate measure of the stress response. Jobin’s study measured cortisol levels, which indicates that the HPA axis was actually activated.  In addition, Jobin also compared cortisol levels to baseline levels to account for individual difference. However, even in Jobin’s study, the focus is on acute stressors, rather than chronic stress. 

Another concern is that research is mostly carried out in Western countries with individualistic cultures.  It is likely that such cultures believe that they should be able to “control” stress and there may be a stronger sense of self-efficacy when it comes to managing stress.  Research in collectivistic cultures should test whether this same sense of control is evident. It is possible that collectivistic cultures may be more fatalistic in their approach to stressors and that encouraging a different approach to interpreting stress may not be as successful.

The implications of the cognitive approach are that we can to some extent control the physiological effects of stress by changing our cognition.  This has led to successful CBT treatment that can help people lower stress and anxiety.  However, long-term chronic stress – based on discrimination, war, refugee status, etc – may not be as easily managed by changing one’s cognition. In this case, it may be that the environmental stressors are so powerful that a positive mindset alone will not help to mitigate stress.  That being said, there is only limited research on how cognition may affect health in people in chronic stress conditions.

The cognitive approach argues that we are not destined to have poor health as a result of stressful life circumstances but that we have some control over our health.  The Transactional Model argues that cognition can be a mediating factor that either helps or hurts our health in stressful situations.