The ambiguous conceptualization of stress: stressor, stress response, and health outcomes

Stress is an umbrella term that lacks a universally agreed upon definition. The construct ambiguity of stress undermines theoretical integration, construct validity, and cumulative knowledge development. In our critical review, we trace the historical evolution of the stress construct, delineate sources of conceptual ambiguity, and evaluate whether the term stress itself is necessary for scientific exploration. We show that we do not need the term stress to describe the phenomena studied in stress research. However, the term ‘stress’ may still be useful to refer to a field of research and to integrate research findings. We demonstrate that phenomena related to stress can be described using more precise constructs: stressors, stress responses, and health outcomes. To facilitate conceptual clarity, we synthesize umbrella definitions for these constructs. Because such umbrella definitions remain necessarily broad, we emphasize that specifying the conceptualization and operationalization of the stressor, stress response, and health outcomes is indispensable for empirical rigor. To this end, we introduce the Stress Conceptualization Checklist for Empirical Studies (SuCCES), a structured reporting framework that guides researchers to describe the theory and conceptualization, specify which type of stressor, stress response and health outcome is studied, describe how they have arrived at their operationalization and differentiation between the stressor, stress response and health outcomes, and specify the context, time scale, life period, and assessment window of their stress measurement. This reporting standard aims to strengthen construct validity, improve measurement coherence, and promote cumulative progress in research on stress-related processes.