Stress and Illness

1. Stress and Illness • Stress, on its own, does not make you ill • It may increase your risk of illness • Stress has been linked to: • Cardiovascular disorders • Immune depression www.psychlotron.org.uk

2. Increased Risk of Disease Stress and Illness Direct biological effects e.g. physical strain, hormonal changes Maladaptive coping behaviour e.g. smoking, drinking alcohol Stress Emotionally mediated effects on diet and activity level www.psychlotron.org.uk

3. Fixed Genetics Ethnicity Sex Age Variable High LDL cholesterol Hypertension Inactivity Obesity Diabetes High c-reactive protein Heart Disease – Risk Factors www.psychlotron.org.uk

4. Stress & Heart Disease • Friedman & Rosenman (1974) • Assessed 3200 healthy American men. • Stress-prone individuals (Type As) were identified: • Anger & hostility • Competitiveness • Time-urgency www.psychlotron.org.uk

5. Stress & Heart Disease • After 8½ years, men were reassessed • 257 had developed CHD • Of these, 70% were Type As • Association remained when smoking and other lifestyle factors were accounted for www.psychlotron.org.uk

6. Stress & Heart Disease • Kivimaki et al (2002) • Highly stressed workers were 2x as likely to die from heart problems • Sheps et al (2002) • Stress-prone individuals with heart problems 3x more likely to die from heart attack • Steptoe et al (2005) • Stress-prone individuals more likely to accumulate LDL ‘bad’ blood cholesterol www.psychlotron.org.uk

7. Stress & Heart Disease • Stress increases risk of cardiovascular disease – but is not a direct causal factor • Effect is mediated by personality (stress prone-ness) • The mechanism is complex • Direct effects and lifestyle-mediated ones are both likely to be important • Stress effects are clearest with pre-existing CHD • If you have CHD stress will probably make it worse • But we still don’t know if stress causes CHD initially www.psychlotron.org.uk