5.3 Stress - Motivation, Emotion, and Stress

MCAT Behavioral Sciences Review - Kaplan Test Prep 2021–2022

5.3 Stress
Motivation, Emotion, and Stress


After Chapter 5.3, you will be able to:

· Distinguish between primary and secondary appraisals of stress

· Recall the three stages of general adaptation syndrome and the physiological changes associated with each stage

· Recognize common stressors and effective techniques for management of stress

In all aspects of life, at all times of day, we must make decisions, overcome challenges, and continue forward. While some of these decisions are small, others require planning and adaptation to new circumstances. Behavior of others and the perception of our surroundings affect our behavior and mental state, at times in a negative manner. It is our response to challenging events, be they physical, emotional, cognitive, or behavioral, that defines stress.


Cognitive appraisal is the subjective evaluation of a situation that induces stress. This process consists of two stages. Stage 1, or primary appraisal, is the initial evaluation of the environment and the associated threat. This appraisal can be identified as irrelevant, benign—positive, or stressful. If primary appraisal reveals a threat, stage 2 appraisal begins. Secondary appraisal is directed at evaluating whether the organism can cope with the stress. This appraisal involves the evaluation of three things: harm, or damage caused by the event; threat, or the potential for future damage caused by the event; and challenge, or the potential to overcome and possibly benefit from the event. Individuals who perceive themselves as having the ability to cope with the event experience less stress than those who don’t. In general, appraisal and stress level are personal, as individuals have different skills, abilities, and coping mechanisms. For example, while a spider might incite fear and stress in some, it would result in irrelevant appraisal in others. Some situations require ongoing monitoring through constant reappraisal, such as the perception of being followed.

MCAT Expertise

The MCAT will expect you to know the two stages of stress appraisal: primary and secondary. Primary appraisal is the initial examination, which results in the identification of the stress as irrelevant, benign—positive, or stressful. If identified as a threat, secondary appraisal is an evaluation of one’s ability to cope with the stress.


A stressor is a biological element, external condition, or event that leads to a stress response. The severity of stressors can range from minimal or irritating hassles, like temporarily lost keys, to catastrophic scenarios, such as an impending natural disaster. Common stressors include:

· Environmental factors: uncomfortable temperature, loud sounds, inclement weather

· Daily events: running late, losing items, unexpected occurrences

· Workplace or academic setting: assignments, hierarchical interactions, time management

· Social expectations: demands placed on oneself by society, family, and friends

· Chemical and biological stressors: diet, alcohol, drugs, viruses, allergies, medications, medical conditions

Stressors are classified as either causing distress or causing eustress. Distress occurs when a stressor is perceived as unpleasant (e.g., a threat), whereas eustress is the result of a positively-perceived stressor (e.g., a challenge). Eustress can include life events such as graduating from college, achieving a high score on the MCAT, getting married, or buying a house. While they are positive, any event requiring a person to change or adapt his or her lifestyle leads to stress. Stress level can be measured in “life change units” in a system called the social readjustment rating scale.

Stressors can also be psychological. Pressure, control, predictability, frustration, and conflict are all forms of psychological stress. Pressure is experienced when expectations or demands are put in place from external sources; this produces a feeling of urgency to complete tasks, perform actions, or display particular behaviors. The ability to control one’s surroundings typically reduces stress levels; the inability to control a situation or event increases stress. In a study of nursing home patients, it was observed that those who had the most control of their daily environment displayed more active, positive, and social behavior. Predictability also plays a role in stress levels. For example, firefighters and policemen who cannot predict their daily scenarios experience higher levels of stress on the job. Frustration, which occurs when attaining a goal or need is prevented, increases stress. These frustration stresses can be external, such as not getting a raise, or internal, such as a disability interfering with everyday life. Finally, conflict stresses arise from the need to make a choice. Approach—approach conflict refers to the need to choose between two desirable options. Avoidance—avoidance conflicts are choices between two negative options. Approach—avoidance conflicts deal with only one choice, goal, or event, but the outcome could have both positive and negative elements. For instance, while a job promotion might mean more money or status, it also comes with increased responsibility, potential for longer working hours, and increased pressure.


When subjected to stress, the body initially responds via the sympathetic nervous system. The “fight-or-flight” response initiates an increase in heart rate and decrease in digestion, with all available energy being reserved for reacting to the stressful event. The sequence of physiological responses developed by Hans Selye is called the general adaptation syndrome and consists of three distinct stages, as shown in Figure 5.10.

ImageFigure 5.10. Three Stages of Stress Response

First is alarm, or the initial reaction to a stressor and the activation of the sympathetic nervous system. Shortly thereafter, the hypothalamus stimulates the pituitary to secrete adrenocorticotropic hormone (ACTH). This hormone stimulates the adrenal glands to produce cortisol, which maintains the steady supply of blood sugar needed to respond to stressful events. The hypothalamus also activates the adrenal medulla, which secretes epinephrine and norepinephrine to activate the sympathetic nervous system. The next stage is resistance, in which the continuous release of hormones allows the sympathetic nervous system to remain engaged to fight the stressor. Last, a person will experience exhaustion when the body can no longer maintain an elevated response with sympathetic nervous system activity. At this point, individuals become more susceptible to illnesses and medical conditions (such as ulcers and high blood pressure), organ systems can begin to deteriorate (with effects including heart disease), and in extreme cases, death can result. Some of the positive and negative effects of stress are shown in Figure 5.11.

ImageFigure 5.11. Positive and Negative Effects of Stress


Beyond the effects on the human body, stress also takes a psychological toll on people who are unable to reduce their stress levels. On the emotional level, elevated stress can result in individuals feeling irritable, moody, tense, fearful, and helpless. They may also have difficulties with concentration and memory. Negative behavior responses to stress include withdrawing from others, difficulties at work or at school, substance use, aggression, and suicide. Additionally, chronic stress can lead to mental health disorders, such as anxiety and depression.


Strategies for coping with stress fall into two groups. Problem-focused strategies involve working to overcome a stressor, such as reaching out to family and friends for social support, confronting the issue head-on, and creating and following a plan of problem-solving actions. Emotionally focused strategies center on changing one’s feelings about a stressor. They include taking responsibility for the issue, engaging in self-control, distancing oneself from the issue, engaging in wishful thinking, and using positive reappraisal to focus on positive outcomes instead of the stressor. Some coping strategies are adaptive, and reduce stress in a healthy way. A stressed person could, for example, reach out to a loved one for help as a support-seeking coping strategy. However, coping strategies may also be maladaptive and include detrimental tactics, such as turning to drugs or alcohol.

Individuals can also engage in stress management to reduce their stress levels. Exercise is a powerful stress management tool that not only improves health and well-being, but also enhances mood. Exercise releases endorphins, opioid neuropeptides that act as “feel-good” neurotransmitters. Relaxation techniques, including meditation, diaphragmatic breathing, and progressive muscle relaxation have also been found to reduce stress. Additionally, studies have shown that engaging in a spiritual practice helps to manage stress.


Maladaptiveness is a key factor in determining whether a behavior should be considered a disorder. Maladaptive behaviors are discussed in more detail in Chapter 7 of MCAT Behavioral Sciences Review.

MCAT Expertise

Use these coping and stress management techniques to boost your performance (and mood) on Test Day!

MCAT Concept Check 5.3:

Before you move on, assess your understanding of the material with these questions.

1. What are the key features of primary and secondary cognitive appraisal of stress?

o Primary appraisal:

o Secondary appraisal:

2. What are the three stages of the general adaptation syndrome? What physiological changes are evident in each stage?


Physiological Changes

3. What are some common stressors? What are some effective techniques for managing stress?

o Common stressors:

o Stress management techniques: