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There is general consensus in the strategy literature that successful firms alter strategy to address changes in their environments and enact more favourable conditions. Studies of organizational change suggest that this adjustment is not always made in a timely manner. Different beliefs about cause and effect have been established as a plausible explanation for differential responses to environmental change. This exploratory study of six pharmaceutical firms suggests more specifically that multiple concepts associated with environmental changes must be directly linked to organizational performance before new strategies are initiated. The results emphasize the importance of stress as a precursor to strategic response and have implications for the way we conceptualize `response' when referring to significant changes in strategy.