“…As several investigators have recently suggested, a more productive approach to the study of psychosocial factors and diseases such as hypertension is to use a multidimensional approach in which known risk factors such as family history of the disease, cardiophysiologic characteristics, diet, and life style are included in the design along with the more elusive psychosocial variables (Lazarus, 1978;Stahl, Grim, Donald, & Niekirk, 1975). Harrell (1980) and Schwartz, Shapiro, Redmond, Ferguson, Ragland, and Weiss (1979) go a step further and recommend that experimental stresses be used rather than self-reports of phenomenal life stresses. Regardles of the type of stressors studied, it is important that studies of the contribution of stress in disease take into account the interplay of the following four factors: (a) individual, ethnic, and social class differences in appraisal and responses to stress (Askenasy, Dohrenwend, B. P., Dohrenwend, B. D., 1977;Goldstein, 1973); (b) interpersonal interaction factors such as personal stress-coping styles (Lazarus, 1974;Diamond, 1982), and the availability and use of social supports (Cobb, 1976;Dean & Lin, 1977;Billings & Moos, 1981); (c) physical-environmental variables such as socioecologic stress levels in the living environment (Harburg, Erfurt, Hauenstein, Chape, Schull, & Schork, 1973;Kosa, Antonovsky, & Zola, 1969); and, (d) larger societal and sociopsychological variables, such as the status-related effects of ethnicity and social class on stress exposure and stress-related health risks (Dohrenwend, B. P., & Dohrenwend, B. S., 1970;Myers, 1982).…”