Mapeamento de estressores e da severidade do estresse em adultos brasileiros por intermédio do stress and adversity inventory (Strain)

Abstract

The current global scenario can be a trigger to the rise of negative stress as well as physical and mental illness. There is a considerable amount of studies in the literature that seek to understand the impacts of stress on the mental and general health of individuals and communities. Research has recently begun to examine the genomic, genetic, and neural mechanisms that underlie inflammatory responses to social stress. Relatively little is known about biological processes that are influenced by stress, that linked with cognitive and affective processes can trigger depression. Many instruments to map stressors and stress levels have been developed in the world. However, none of them focuses on stressors occurring across the life span, mapping, instead, the last year, month or week. This lack of instrumental uniformity tends to characterize the data collection about stress in quite distinct ways and, in this sense, potentially less consubstantiatedly in a global evaluation perspective. The present thesis seeked to investigate how deeply the stress can affect health, as well as to search for studies on stress in order to get an overview of the potential impairments it can cause on the subject. Thus, this thesis has five studies presented in five sections. STUDY 1 presented in the first section, entitled "The Past, Present and Future of the Research on Stress", constitutes the first theoretical study of the thesis, which develops a historical review of the studies and personalities on the subject, analyzes the current research, and envisions the future of research about stress. In this section, we identify gaps in the international scenario regarding self-report measures of stress mapping, especially related to the lack of instruments aimed at mapping stressors and stress levels throughout the individuals' lives. SECTION 2 of this thesis presents the second study, which is entitled "Instruments for the Evaluation of Stress in the Brazilian Population: a Systematic Review". This study searched for instruments aimed at mapping stress in the Brazilian reality, specifically those with published studies that present indicators of scientific validity. Considering the limitations observed in the instruments available to access stress in Brazilians, which was consonant to the ten main problems detected at the international level regarding the measurements on stress, the third study was outlined. SECTION 3 presents an empirical study entitled "The Stress and Adversity Inventory for Adults (Adult STRAIN) in Brazilian Portuguese: An Overview and Initial Validation," which presents the Stress and Adversity Inventory (STRAIN) for adults as an alternative to mapping stress capable of filling the gaps identified in the first two articles of the thesis. STRAIN can access adversities throughout the life cycle of the individuals and shows richness in the presentation of results consonant with the complexity of the stress construct, being very useful for the identification of risk situations, with potential applicability in the contexts of public health, organizations and clinical practice. Thus, this is the first Brazilian study to link measures of life-threatening adversities throughout the individual's life and levels of severity of stress to health outcomes, representing an important and significant advance for research on stress in the national territory. In SECTION 4 of this thesis the fourth study was presented: "The Relationship between Subjective Social Status and Stress: How Does Inferior Feeling Affect Health?". This was the first Brazilian study, and one of the few international studies, that analyzed the relationships between Subjective Social Status, objective socioeconomic reality, longitudinal measures about stress, and health outcomes. In the study, we observe the potential impacts of feeling inferior, in an interpretative reading of the Subjective Social Status measure, for the mental health and sleep quality of the individuals, an aspect that establishes a focus on the relevance of contemplating this dimension of feeling inferior in clinical interventions that focus on treatment, prevention and health promotion. Thus, the present study, listed in this fourth section, warrants the relevance of studying mediators and moderators of health outcomes in their relationship with stressors mapped throughout the individuals' lives. Finally, in SECTION 5 of this thesis we present the "STRESStegy: Strategic Deck of Stress", a tool originally developed for psychoeducational work about stress, specially designed to train health professionals of all levels of attention to better assist patients in situations of stress amplification, as well as aiming to add tools to help professionals manage their own feelings of stress often related to the very nature of their work. The STRESStegy also acquires innovative contours, being the first pack with the psychoeducational proposal on the subject in Brazil.