Stress, illness, and illness behavior.

This paper examines adaptation as a transactive process involving the skills and capacities of individuals and their supporting groups on the one hand, and the types of challenges they face on the other. Many difficulties in understanding stress processes in illness result from the confusion between illness and illness behavior. It is argued that the medical record is as much a history of the individual's behavior and social selection processes as it is a reflection of levels of physical health. Various examples are discussed, illustrating how medical records can be misleading in research examining the relationship between stress and illness, and how influences attributed to stress may be the result of illness behavior. The paper concludes by examining alternative conceptual models for studying the relationships between life challenges, illness behavior and illness.