Stress and Illness –
Overview
• What is the relationship between stress and
illness?
– Stress and changes in physiology
– Stress and changes in behaviour
• Moderating factors: e.g., coping, social
support, personality and control
• Stress: Portrait of a Killer, National Geo DVD
Stress and Illness –
Key point
If you repeatedly turn on the stress-response,
or if you cannot appropriately turn off the
stress-response at the end of a stressful
event, the stress-response can eventually
become as damaging as some stressors
themselves.
A large percentage of stress-related diseases
are disorders of excessive stress-response.
Robert Sapolsky – Why Zebras Don’t Get Ulcers
Psychophysiological model of
the stress response
Fig. 1. Negative emotionality in children with one of two brain-derived neurotrophic factor
(BDNF) genotypes—valine (val) homozygous or at least one methionine (met) allele—as a
function of the presence or absence of parental depression (n = 400).
Hayden E P et al. Psychological Science
2010;0956797610385357
Copyright © by Association for Psychological Science
Fig. 2. Negative emotionality in children with one of two brain-derived neurotrophic factor
(BDNF) genotypes—valine (val) homozygous or at least one methionine (met) allele—as a
function of the presence or absence of parental discord (n = 332).
Hayden E P et al. Psychological Science
2010;0956797610385357
Copyright © by Association for Psychological Science
Psychophysiological model of
the stress response
Psychophysiological model of
the stress response
This acute response is not typically problematic.
Chronically, however, it’s a different story…
Health Consequences of Chronic Stress
SAM   BP,
HR, epi)
HPA 
immunosuppression
Coronary Heart Disease
and Stress
• Rates of CHD is higher in those with high
stress jobs. Why?
– BP chronically elevated (wear and tear!)
– Epi  circulating platelets clump together
– Atherosclerosis (plaques)
• Kaplan’s research with monkeys (re: social
stress & unstable hierarchy -- low control)
Research study: “Overload in
Working Mothers”
• BCBS workers
• Measures:
– Urine samples (to look for metabolites of stress
hormones)
– Daily mood scale
• Results: feel stressed (esp w/ children at home)
– High stress (low perceived control + high demand)
– increased urinary neurohormones
Immunity
and Stress
T cell
Immune System Overview
Psychoneuroimmunology (PNI)
• Subfield of health psychology that
emphasizes the interaction of psychological,
neuroendocrine, and immunological
processes in stress and illness
PNI: From stressor to illness
• We differ as to the pattern and frequency of
stressors to which we are exposed
• These variations determine the magnitude and
frequency with which we turn on the stressresponse
• The magnitude and frequency of the stress
response regulate immune competence (e.g., via
glucocorticoids)
• Level of immune competence determines
susceptibility to disease
PNI Studies
• Immunosuppression has been linked to divorce,
bereavement, unemployment, exam periods,
occupational stress, and stressful bouts of exercise
– e.g., Life stress and exposure to cold viruses
• Wound studies (Kiecolt-Glaser)
• Animal studies show that tumor cells
grow more rapidly in animals exposed to electric
shock, loud noise, or other stressors
Sapolsky’s baboons
• High and Low Social Status
– High cortisol is associated with low social
status (instability and less controllability)
– Low status – Fewer lymphocytes and weak
immune system
Sapolsky’s baboons
Studies with dominant
male baboons suggest
that attitude
(“personality”) is a
more important
mediator of
physiology than rank
alone (i.e., just being
alpha male isn’t
necessarily good, if
one is high-strung
about it…)
Moderators of the stress-illness
relationship
Perception / Appraisal
Personality
Social Support
Control
Coping skills
How do these
relate to you?
What gets
you “stressed”
and why?
Moderators of the stress-illness
relationship: Perception
Many situations are not inherently stressful… depends
on appraisal:
Primary appraisal — determination of an
event’s meaning
Secondary appraisal — evaluation of one’s
ability to meet the demands of a challenging
event
Cognitive appraisals are extremely susceptible to one’s
current state of mood, health, motivation
Perception and stress
“I have had a great many
troubles in my life…
And most never happened…”
Mark Twain
Developing Coping Skills
Increasing social support
Time management
Emotion-focused coping or
problem-focused coping
Reducing the impact of the
stress reaction
Etc…