Stress and Illness

Stress, Health, and
Human Flourishing
by Jim Foley
© 2013 Worth
Module 32: Stress and Illness
Topics that hopefully won’t
become stressors
 Stress: a process of
perceiving and
responding to stressors
 Stressors:
 Catastrophes
 Life Changes
 Daily Hassles
 The stress response
system: General
Adaptation Syndrome
Stress and Susceptibility
to Disease:
 Psychoneuroimmunology
 Stress and Illness
 Stress in relation to
AIDS, cancer, and heart
 Personality Factors and
stress: Type A,
Health Psychology
 Emotions, as well as
personality, attitudes,
behaviors, and
responses to stress,
can have an impact on
our overall health.
 Health psychology
studies these impacts,
as part of the broader
field of behavioral
 Topics of study in
health psychology
 the phases of stress response
and adaptation
 how stress and health are
affected by
• appraisal of stressors
• severity of stressors
• personality types
• perceived control
• emotion or problem focus
• optimism
• social support
• exercise
• relaxation
• religious faith and
Stress: A Focus of Health Psychology
 Many people report being affected by “stress.”
 Some terms psychologists use to talk about stress:
 a stressor is an event or condition
which we view as threatening,
challenging, or overwhelming.
 Examples include poverty, an
explosion, a psychology test,
feeling cold, being in a plane,
and loud noises.
 appraisal refers to deciding whether
to view something as a stressor.
 stress reaction refers to any
emotional and physical responses to
the stressor such as rapid heartbeat,
elevated cortisol levels, and crying.
Stress refers to the
process of appraising
and responding to
events which we
consider threatening
or challenging.
Clarifying the Components of Stress
 Stress isn’t something
that happens to you; it’s a
process in which you
 The process includes the
stressor (event or
condition), cognitive
appraisal, body response,
and coping strategies.
 The advantage of
breaking “stress” into
these components is that
we can see options for
altering each of these
different factors.
What could this
person do to
reduce his level
of suffering from
Choosing How to View a Situation
Questions to ask yourself when facing a
possible stressor:
Is this a challenge, and will I tackle it?
Is it overwhelming, and will I give up?
There are few
conditions* that are
inherently and
universally stressful;
we can often choose
our appraisal and
our responses.
*extreme, chronic
physical threats or
challenges (such
as noise or
Beneficial and Harmful Stress Effects
A brief experience of stress can be beneficial:
 improving immune system response
 motivating action
 focusing priorities
 feeling engaged, energized, and satisfied
 providing challenges that encourage growth,
knowledge, and self-esteem
Extreme or prolonged stress, causes problems:
 mental and physical coping systems become
overwhelmed and defeated rather than strengthened
 immune functioning and other health factors decline
because of damage
The key factor is whether there is a
chance for recovery and healing.
There may be a spectrum of
levels of intensity and
persistence of stressors.
We can also see stressors as
falling into one of four*
 catastrophes.
 significant life changes.
 chronic daily hassles.
 low social status/power.
*the text focuses on the
first three.
Stressors refer to the events
and conditions that trigger
our stress response, because
they are perceived/ appraised
as overwhelmingly
challenging, threatening,
and/or harmful.
Catastrophic Events/Conditions
 Appraisal is not essential in a
catastrophic event. Most
people agree that the event is
harmful and overwhelming.
 Examples include earthquakes,
floods, hurricanes,
war/combat, and wildfires.
 It can be one single event or
chronic harmful conditions.
 Short-term effects include
increased heart attacks
on the day of the event.
 Long term effects include
depression, nightmares,
anxiety, and flashbacks.
 Bonding: both the trauma
and the recovery are
shared with others.
Major Life Events/Changes
 Even supposedly “happy” life changes, such as marriage,
starting college or a new job, or the birth or adoption of a
child, can bring increased challenge and stress.
 Change is often challenging.
 New roles, new priorities, and new tasks can put a strain on
our coping resources.
 The challenge, and the negative impact on health, increases
 the changes are painful, such as a death in family, loss of
job, or heart attack.
 the changes are in a cluster, and there are too many at once.
Chronic Daily Difficulties
Daily difficulties can be
caused by facing too many
tasks, too little time, and too
little control.
Daily difficulties can be
caused by the lack of social
power and freedom:
 being bullied
 living in poverty
 living under oppressive
political conditions
The Body’s Stress Response System
When encountering a sudden trauma or other stressor, our
body acts to increase our resistance to threat and harm.
Phase 1: The “fight or flight”
sympathetic nervous system
responds, reducing pain and
increasing the heart rate.
The core of the adrenal glands
produces norepinephrine and
epinephrine (adrenaline).
This system, identified by
Walter Cannon (1871-1945),
gives us energy to act.
Phase 2: The brain sends
signals to the outer part of the
adrenal glands to produce
cortisol and other stress
hormones. These focus us on
planning adaptive coping
strategies and resisting defeat
by the stressor.
Hans Selye (1907-1982)
indentified this extended
“resistance” phase of the
stress response, followed by:
Phase 3: Exhaustion.
General Adaptation Syndrome [GAS]
(Identified by Hans Selye):
Our stress response system defends, then fatigues.
Effects of Prolonged Stress
 The General Adaptation Syndrome
[GAS] works well for single
exposures to stress.
 Repeated and prolonged stress,
with too much Phase 3 time, leads
to various signs of physical
deterioration and premature aging:
 the production of new neurons
 neural circuits in the brain break
 DNA telomeres (chromosome
tips) shorten,  cells lose ability
to divide,  cells die,  tissue
stops regenerating,  early
aging and death
Female and Male Stress Response
 In response to a stressor such
as the death of a loved one,
women may “tend and
befriend”: nurture themselves
and others, and bond together.
 The bonding hormone
oxytocin may play a role in this
 Women show behavioral and
neurological signs of becoming
more empathetic under stress.
 Men under stress are more
likely to socially withdraw and
numb themselves with
 Men are also more likely to
become aggressive under
 In either case, men’s behavior
and brains show LESS
empathy and less tuning in to
others under stress.
Studying the Stress-Illness Relationship
 How does stress increase our
risk of disease?
 This is the subject of a new field
of study:
psychoneuroimmunology, the
study of how interacting
psychological, neural, and
endocrine processes affect
 Psychologists no longer use the
term “psychosomatic” because it
has come to mean an imagined
 We now refer to
psychophysiological illness, a
real illness caused in part by
psychological factors such as the
experience of stress.
How the
stress plays
a role:
Stress Increases
The Risk of Illness
Here we see psychoneuroimmunology in action:
 psychological factors, such as
appraisal, thoughts, and
 neurological factors, such as
brain signals engaging the
stress response system.
 immunology, such as stress
hormone exposure which
suppresses the immune
Brain signals
Hormonal action
Risk of illness
Psychoneuroimmunology Example:
The Impact of Stress on Catching a Cold
In a group
exposed to
germs, those
stress were
more likely to
catch a cold.
This tradeoff between
stress response and
immune response may
help our bodies focus
energy on managing
Stress, AIDS, and Cancer
AIDS = Acquired Immune
Deficiency Syndrome
Cancer: the stress link is
not as clear
 Because the stress response  Stress may weaken the
suppresses the immune
body’s defenses against
response, exposure to
the replication and
stress obviously worsens
spread of malignant cells.
the development of AIDS in
those exposed to HIV.
 Reducing stress slows the
progression of AIDS.
This does NOT mean that stress
causes cancer or AIDS.
Stress and Heart Disease
In coronary heart/artery disease, the
blood vessels that provide oxygen and
nutrients to the heart muscle itself
become clogged, narrowed, and closed.
Clogging of the coronary artery
Many factors contribute
to heart disease.
 Biological: genetic
predisposition to high
blood pressure and
high cholesterol
 Behavioral: smoking,
inactivity, and high-fat
 Psychological: chronic
stress, and personality
styles that worsen the
experience of stress
Type A PersonalityStressHeart Disease
 People with a type A
personality are impatient,
verbally aggressive, and
always pushing themselves
and others to achieve.
 People with a type B
personality are more
relaxed and go with the
 In one study, heart attacks
ONLY struck people with
Type A traits.
 Accomplishing goals is
healthy, but a compulsion
to always be working, with
little time spent “smelling
the flowers,” is not.
Also a problem: ANGER.
To reduce anger-related stress:
defuse anger with exercise,
talking, forgiveness, NOT
“letting it out” (catharsis) by
screaming, punching.
Pessimism and Heart Disease
It can be helpful
to realistically
negative events
that may happen,
and to plan how
to prevent or
cope with them.
Pessimism refers to the
assumption that
negative outcomes will
happen, and often facing
them by complaining
and/or giving up.
Men who are generally
pessimistic are more
likely to develop heart
disease within ten years
than optimists.
Depression and Heart Disease
 Why does depression
appear so often with
heart disease? Does one
cause the other?
 One possible answer is
that the two problems
are both caused by
chronic stress.
 There may be an
intervening variable:
excessive inflammation.
Health Consequences of Chronic Stress:
The Repeated Release of Stress Hormones
 The stress hormone cortisol
helps our bodies respond to
brief stress.
 Chronically high cortisol levels
damage the body.

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