This paper reviews the currently popular definitions and theoretical arguments of the so-called "stress" perspective with the purpose of integrating this material into one general paradigm. The literature has been concerned primarily with two parallel processes which purport to account for the individual's coping and adaptive behavior, one characterized by the interplay of internal, psychological forces, and the other by external, environmenml factors. These rwo general processes have been integrated in this paper by expanding upon the general models presented by Dohrenwend ( 7 ) to include imporcant feedback processes. It is argued that adaptation to stress is a dynamic process and that the failure to adapt is often the result of a continuing process of past failures by the organism effectively to cope with less severe stressful stimuli, each failure feeding back to affect future attempts to cope with new environmental demands. The implications of the approach presented in this paper for future empirical investigation are discussed. Definitional PreliminariesThe concept of stress has received considerable attention in recent years from both a conceptual and research as evidenced by two relatively recent conferences devoted exclusively to the subject ( 2 , 19). Although stress research has been prolific, one is struck when reviewing the stress literature by the lack of continuity of basic theoretical and operational constructs (19). Dispersed throughout the literature are bits and pieces of a potentially coherent model, but in few studies is there an attempt to develop a truly specific and dynamic stress-response model. Notable among exceptions to this are the researches of Kahn and his colleagues (16) concerning role conflict and ambiguity as sources of organizationally induced stress; the conceptual formulation of Dohrenwend ( 7 ) emphasizing the role of various types of internal and external mediating factors in the stress adjustment process, the subsequent work applying the same model to an investigation of mental disorder (8) ; and the research of Mechanic (20, 21) of students taking Ph.D. qualifying examinations and the stress-adaptation process which that event triggered. Although these models are notable in their attempts to identify salient elements of the stress-response process they all tend to lack a certain degree of dynamism in that important feedback mechanisms are often left vague and unspecified ( 7 ) . Further, the various definitions of stress employed in these and other studies have tended to em-'Special thanks are given to Walter Buckley for his valuable comments on an earlier version of this paper.
Cal i f o r n i a . The peroxidase test, although a sensitive and precise methodTo investigate the maternal-fetal transfer o f Cephamandole f o r determining the unbound b i l i r u b i n concentration i n serum from (CMD) and i t s d i s t r i b u t i o n i n the fetus, we administered a single jaundiced neonates, has been reported t o be inaccurate due t o er-1000 mg 1 .M. dose t o 35 pregnant women (14-1 trimester, 21-11 r o r s from sample d i l u t i o n as well as oxidation o f albumin-bound trimester) 25 minutes t o 17 hours p r i o r t o therapeutic abortion b i l i r u b i n . These potential errors were investigated i n serum and and s t e r i l i z a t i o n by hysterectomy. CMD concentration was assayed defatted albumin solutions. A decrease i n the peroxidase-determicrobiologically i n maternal serum, myometrium, f e t a l tissues mined apparent unbound b i l i r u b i n concentration (AUBC) w i t h i n -(placenta, brain, lung, l i v e r , kidney) and f e t a l f l u i d s creasing serum d i l u t i o n was found i n b i l irubin-enriched umbil i c a l (amniotic, CSF, u r i n e and serum). Maternal serum h a l f -l i f e was cord sera as well as sera from jaundiced infants, but was less 2.4 hours while peak serum concentration was 19 uglml a t 1 hour marked i n bilirubin-enriched defatted albumin solutions. The d iand 1.5 uglml a t 8 hours. Mean Fetal serum CMD concentrations l u t i o n a l decrease i n AUBC d i d n o t appear t o be due t o slow oxidawere 25% o f maternal serum a t 1 hour, 30% a t 2 hours, 44% a t 4 t i o n o f albumin-bound b i l i r u b i n . Instead, the b i l irubin-a1 bumin hours and equal a t 9.5 hours. There was no detectable CMD complex was found t o have a much low r d i sociation r a t e constant (<0.8 u g h 1 o r gm) l e v e l i n f e t a l : b r a i n (19 samples) and CSF i n serum (K-1 + SO = 3.3 t 0.2 x l O -~~e c -f )~t h a n i n defatted a l -(21 samples), l i v e r (28 samples), lung (16 samples), u r i n e ( 6 bumin solution? (K-l + SD = 1.7 + 0.6 x 10-sec-1 ) , causing the samples), amniotic f l u i d (29 samples). Of 10 f e t a l kidneys, dissociation o f the complex t o be r a t e -l i m i t i n g when serum i s anonly 2-11 trimester (13 and 19 weeks' G.A.) had detectable alyzed a t the c u r r e n t l y infections. SERUM FREE TOCOPHEROL LEVELS I N PREMATURE INFANTS INDIVIDUAL DIFFERENCES IN ARYL HYDROCARBON HYDROXYLASE (PI) RECEIVING TOTAL PARENTERAL ALIMENTATION (TPN a l l y d e f i c i e n t i n Vitamin E (V-E) l e d t o the recommendation o fCleveland, Ohio. supplementing V-E during the f i r s t 2 mos. f o r PI less than 15009.AHH activity was measured in cultured AFC obtained from paHowever, exact V-E requirements f o r PI have not been documented.tients undergoing amniocentesis for advanced maternal age. Enzyme The t a b l e shows the predicted l e v e l (mgldl) o f V-E on PI ( n = 10) activity in cell homogenates was measured spectrofluorimetrically who were receiving TPN only without l i p i d source. The TPN conby the conversion of 3,4-benzpyrene to...
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