s of stress: acute and chronic. Acute (or external) stressors include films, work overload, unexpected or uncontrollable noise, prestige or status loss, electric shock, uncontrollable situations, physical illness, surgery, threats to self-esteem, and traumatic experiences. Examples of chronic stressors include sleep deprivation, role strain and social isolation (Elliott and Eisdorfer, 1982). Chronic stress within an individual is often associated with negativity, and the observable physical manifestations include exhaustion, disease and even death (Rice, 1999). Individual differences in responding to stress are influenced by genetics, developmental and environmental influences, as well as being linked with one's own life experiences (McEwen and Stellar, 1993). However, stress does cause some common changes. Emotionally, stress can lead to feelings of depression, anxiety and anger (McEwen et al, 1993). Accordingly, on the basis of the above criteria, it is clear that stress has a direct correlation on health outcomes. In order to assess the interaction between stress, the immune system and health outcomes it is necessary to operationalise the contextual meaning associated with health in this instance. Stedman's medical dictionary (1961) defines disease as "an interruption or perversion of function of any of the organs and/or tissues or an abnormal state of the body as a whole" (cited Newberry, Jaikins-Madden and Gerstenberger, 1991, p. 23). Weiner (1977, p. 11), using Stedman's criteria, suggests "illness" is a synonym of disease and "health" as the absence of disease (cited Newberry et als., 1991). By contrast Schwartz (1984) has distinguished between the current state of the organism and its potential to resist disease. In his terminology, "wellness" refers to the current state and "health" refers to the potential to be well. Thus people can be diseased (low wellness) yet be healthy if they are exhibiting resistance to the pathology...
