Cognitive explanations of one health problem: Appraisals and stress

Travis DixonHealth Psychology

Stress can be caused by what's happening in the mind. This is how the cognitive approach explains stress.

The following content is adapted from our eBook Stress: A Student’s Guide for IB Health Psychology.

Stress is one health problem that students could explain for IB Psychology’s Paper Two. In this post we’ll look at the most common cognitive explanation of stress – cognitive appraisals.

Humans are different from other animals in that stress can be caused completely by our minds. This can occur through cognitive appraisals – the process of thinking about a potential stressor.  To use more academic language, a cognitive appraisal is the process of assessing the personal relevance of a stressor and one’s ability to cope with it. According to Lazarus and Folkman’s model of stress, there are two types of appraisals: primary appraisal and secondary appraisal.

Key term: Cognitive appraisal is “…the process of categorizing an encounter and its various facets with respect to its significance for well‐being.”[i]

Primary Appraisal

According to the Lazarus and Folkman’s theory, stress occurs when a stressor is appraised as threatening (could cause loss or harm) and there aren’t enough resources to cope.

During primary appraisal, a person perceives a stressor as (a) irrelevant, (b) harmless, (c) harmful, (d) threatening, or (e) challenging. If it’s irrelevant or harmless, it won’t cause stress. Something is stressful when it’s appraised as harmful, threatening, or challenging. A threat appraisal is if there’s an anticipation of harm or loss. A challenge appraisal means the person thinks there’s potential gains from the stressor.

Secondary Appraisal

Secondary appraisal is an assessment of one’s ability to cope with the stressor based on available resources. Resources can be physical (e.g. health, energy), social (e.g. friends and family support), psychological (e.g. intellect, self-esteem), or material (e.g. money). If something is primarily appraised as stressful (harmful, challenging, or threatening) and secondarily appraised as being too difficult to cope with, then the person will experience stress. This is why Lazarus’s full definition of stress is “…a relationship between the person and the environment that is appraised as personally significant (primary appraisal) and as taxing or exceeding resources for coping (secondary appraisal).”[ii]

Read More: “Key Study: Cognitive appraisals and the stress response (Lazarus, 1963).”

The Effects of Appraisals on Stress

Primary and secondary appraisals are part of Lazarus and Folkman’s theory. But cognitive appraisal can also mean other types of assessments. Let’s consider another basic type of stress appraisal: is stress bad for you? If you appraise stress as bad, it’s more likely to cause even worse stress and health problems. However, if you can think of stress as being beneficial, it suddenly becomes less harmful and might actually produce better health.

This has been shown in a number of studies, including Fischer et al.’s (2016) study on German university students. This study found that students who made negative appraisals of stress were more likely to end up with physical symptoms of ill-health.

Health problems could be caused by thinking that stress is bad for you.

Fischer et al.’s study shows how basic cognitive appraisals of stress as being harmful can affect stress levels and physical health. One explanation for Fischer’s results is that negative appraisals of stressors increase HPA axis activity leading to higher levels of cortisol. Over a prolonged period of time, this leads to many physical symptoms and health problems.

This process happens through the amygdala, the emotional center of the brain. Our amygdala detects threats in our environment and triggers the HPA axis. If you’re running through the forest and you see a snake, your amygdala will trigger your fight/flight response before you realize you’ve seen a snake. This is an evolutionary adaptation for survival because the amygdala activates the HPA axis so that stress hormones like cortisol and adrenaline are released. The release of stress hormones is why acute stress can be beneficial – they cause a quick release of energy into the bloodstream that energizes our muscles and our brain. Whatever threat we’re facing, we now have an increase in strength and brain power to deal with it.

However, the amygdala can also be activated in a top-down manner. This means we can activate our amygdala and HPA axis from the thoughts generated in our minds. Negative appraisals of stressors increase activity in the amygdala. This could be why Fischer’s participants had higher levels of stress and more health problems – their negative appraisals actually triggered physiological responses that over time caused physical symptoms.

The opposite is also true. We can reduce negative emotions and feelings of stress by changing our appraisals. How? This is covered in the lesson in the textbook on “Cognitive ReAppraisals.”


[i] Lazarus, R., & Folkman, S. (1984). Stress, Appraisal, and Coping. New York: Springer.

[ii] Folkman, S., & Lazarus, R. (1985). If it changes it must be a process: study of emotion and coping during three stages of a college examination. Journal of personality and social psychology, 48 1, 150-70 .

Fischer, S., Nater, U. M., & Laferton, J. A. (2016). Negative Stress Beliefs Predict Somatic Symptoms in Students Under Academic Stress. International journal of behavioral medicine23(6), 746–751.