Lecture 2025 02 26: Stress and Health
Schacter's definition of stressors is too negative, and ignore's Han's Selye's original definition.
from https://www.stress.org/what is stress?
The term “stress”, as it is currently used was coined by Hans Selye in 1936, who defined it as “the non
specific response of the body to any demand for change”. Selye had noted in numerous experiments
that laboratory animals subjected to acute but different noxious physical and emotional stimuli (blaring
light, deafening noise, extremes of heat or cold, perpetual frustration) all exhibited the same pathologic
changes of stomach ulcerations, shrinkage of lymphoid tissue and enlargement of the adrenals. He later
demonstrated that persistent stress could cause these animals to develop various diseases similar to
those seen in humans, such as heart attacks, stroke, kidney disease and rheumatoid arthritis.
In Selye's definition, falling into mad, romantic love can be defined as a stressor, a specific event that
places demands on a person, and can threaten their wellbeing. Just ask Shakespeare's 'Romeo and
Juliet'.
Chronic stressors fall into a different category, they are sources of stress that occur continuously or
repeatedly. Examples are: strained relationships; discrimination based on race, gender or sexual
orientation; bullying; overwork; money troubles. These are small stressors that may be easy to ignore if
they happen only occasionally, but can accumulate to what Selye categorizes as distress.
People who experience such daily hassles also report more psychological symptoms. (La Pierre et al.,
2012). and physical symptoms (Piazza et al., 2013).
Chronic stressors can also be linked to particular environments. For example, features of city life
noise, traffic, crowding, pollution, and even the threat of violenceprovide particularly insistent sources
of chronic stress. (Evan, 2006).
In one study of the influence of noise on children looked at the impact of attending schools under the
flight path to Heathrow Airport in London, England. Did the noise of more than 1250 jets flying
overhead each day have an influence on children's behavior? Compared with children from matched
control schools in lownoise areas, children going to school in the flight path reported higher levels of
noise annoyance and showed poorer reading comprehension. (Haines et al., 2001).
Stressors challenge you to do something. Glass & Singer, (1972) looked at the aftereffects of loud noise
on people who could not control it. Participants were asked to solve puzzles or proofread in a quiet
room, or in a room filled with loud noise. Glass & Singer found that bursts of such noise hurt
performance on the tasks after the noise was over. However, dramatic decline in performance was
prevented among participants who were told that during the noise period, they could stop the noise just
by pressing a button. They did not actually have this option, but access to the 'panic button' shielded
them from the detrimental effects of the noise.
Subsequent studies have found that lack of perceived control underlies other responses to stressors as
well, such as the stressful effects of crowding. (Evans & Stecker, 2004).Stressful Events
The terrorist attacks on the World Trade Center on September 11, 2011 were an enormous stressor that
had a lasting effect on many people, both physically and psychologically. People living close to the
World Trade Center (within 2.4 km) during 9/11 were found to have less grey matter in the amygdala,
hippocampus, insula, anterior cingulate, and medial prefrontal cortex relative to those living more than
322 km away during the attacks, suggesting this stressful event reduced the size of those parts of the
brain that play an important role in emotion, memory and decision making. (Ganzel et al., 2008)
People around the U.S. who had a stronger acute stress response to the events of 9/11 had a 53%
increase incidence of heart problems over the next 3 years. (Holman et al., 2008).
Fight-or-Flight Response
Walter Cannon coined this phrase to describe the body's response to any threatening stimulus; it is an
emotional and physiological reaction to an emergency that increases readiness for action. It is a
common response across species. It is a threestage physiological stress response that appears
regardless of the stressor that is encountered.
Brain activation in response to threat occurs in the hypothalamus, stimulating the nearby pituitary
gland, which in turn releases a hormone known as ACTH. ACTH travels through the bloodstream and
stimulates the adrenal glands atop the kidneys. In this cascading response of the HPA (hypothalamic
pituitaryadrenocortical) axis, the adrenal glands are stimulated to release hormones, including the
catecholamines (epinephrine and norepinephrine) which increase sympathetic nervous system
activation and therefore increase heart rate, blood pressure, and respiration rate. The increase
respiration and blood pressure make more oxygen available to the muscles to energize attack or intiate
escape. The adrenal glands also release cortisol , a hormone that increases the concentration of
glucose in the blood to make fuel available to the muscles.
The general adaptation syndrome (GAS)was termed by Hans Selye in the 1930s, when he undertook
a variety of experiments that looked at the physiological consequences of severe threats to wellbeing.
The three phases of the GAS are:
(1) Alarm phase, in which the body rapidly mobilizes its resources in response to threat. Energy is
required, and the body calls on its stored fat and muscle. The alarm phase is equivalent to Cannon's
fightorflight response;
(2) In the resistance phase, the body adapts to its high state of arousal as it tries to cope with the
stressor. Continuing to draw on resources of fat and muscle, it shuts down unnecessary processes, such
as digestion, growth, sex drive, menstruation, production of testosterone & sperm;
(3) In the exhaustion phase, the body's resistance collapses.
Many of the resistancephase defenses
create gradual damage as they operate, leading to costs for the body than can include susceptibility to
infection, tumor grouth, aging, irreversible organ damage, or death.People exposed to chronic stress, whether due to their relationships, job or something else, experience actual wear and tear on their bodies and increased aging.
What is the aging process? The cells in our bodies are constantly dividing, as part of this process, our
chromosomes are repeatedly copied so that our genetic information is carried into the new cells. The
process is facilitated by the presence of telomeres, To use an analogy, they are like the tape at the end
of your shoelaces that keeps the laces from fraying. Each time the cell divides, the telomeres become
slightly shorter. If they become too short, cells can no longer divide and this can lead to the
development of tumors and a range of diseases.
Our bodies fix this with an enzyme called telomerase,which rebuilds those telomeres at the end of our chromosomes. Ultimately, telomerase
cannot keep up telomere production at a sufficient pace, and over time cells lose their ability to divided.
This is the cause of aging and cell death This is not apoptosis, because it is not programmed cell death.
And where does this knowledge take us? You can read this on your own:
https://theconversation.com/endofageingandcancerscientistsunveilstructureoftheimmortality
enzymetelomerase95591
Social stressors can play an important role in the process of telomere maintenance. People exposed to
chronic stress have shorter telomere lengt and lower telomerase activity (Epel et. al, 2004). Laboratory
studies suggest tha cortisol can reduce the activity of telomerase, which in turn leads to shortened
telemere, causing a cascade effect in the form of accelerated aging and increased risk of a wide range of
diseases, including cancer, cardiovascular disease, diabetes, and depression (Blackburn & Epel, 2012).
Stress Effects On The Immune Response
The immune system is a complex that protects the body from bacteria, viruses, and other foreign
substances. The system includes white blood cells, such as lymphocytes (including T cells and B cells)
that produce antibodies that fight infection. Note: microglia are specialized lymphocytes.
Psychoneuroimmunology is the study of how the immune system responds to psychological variables,
such as the presence of stressors. Stressors can cause hormones like the glucocorticoids to flood the
brain, wearing down the immune system amd making it less effective.
Marucha, KiecoltGlaser, & Favagehi (1998) had medical student volunteers receive small wounds on
the roofs of their mouths. Researchers observed that thse wounds healed more slowly during exam
periods than during summer vacation.
In another study, healthy volunteers permitted researchers to swab the common cold virus in their
noses. (Cohen et al., 1998) Some people got colds and others did not, and stress helped account for the
difference. Volunteers who experienced constant stressors (lasting a month or longer) were especially
likely to suffer colds, in particular, those who had lost jobs, or were going through extended
interpersonal problems.Stress and Cardiovascular Health.
The main cause of coronary heart disease is atherosclerosis a gradual narrowing of the arteries that
occurs as fatty deposits, or plaque, build up on the inner walls of the arteries. Chronic stress can be a
major contributor (Kranz & McCeney, 2002). As a result of stressactivated arousal of the sympathetic
nervous system, blood pressure goes up and stays up, gradually damaging the blood vessels. The
damaged vessels accumulate plaque, increasing the likelihood of coronary heart disease. Everson et al.,
(1997) reported that Finnish men age 42 to 60 exhibited elevated blood pressure in response to stress,
and they reported that their work environment was especially stressful, showed progressive
atherosclerosis of a major artery in the neck during the 4year study.
Friedman & Rosenman (1974) interviewed and tested 3000 healthy middleaged men and then tracked
their subsequent cardiovascular health. They developed the concept of the Type A behavior pattern,
which is characterized by a tendency toward easily aroused hostility, impatience, a sense of time
urgency, and competitive acheivement strivings. The researchers found that of the 258 men who had
heart attacks in the 9 years following the interviews, over two thirds had been classified as Type A and
only one third had been classified as easygoing Type B.
Stress Interpretation
Psychological Reactions
The interpretation of a stimulus as distressful or eustressful (to use Selye's terms) is called primary
appraisal. (Lazarus & Folkman, 1984). The next step is secondary appraisal, determining whether the
stressor is something that you can handle or note; whether you have control over the event. (Lazarus &
Folkman, 1984). Our bodies react differently if the stressor is perceived as a threat (distress) or a
challenge (eustress). (Blascovich & Tamaka, 1996). Although both threats and challenges raise heart
rate, threast increase vascular reactivity such as the constriction of blood vessels, which can lead to
hight blood pressure. In one study. researchers found that even interactions as innocuous as
conversations can produce threat or challenge responses depending on the race of the conversation
partner. (Mendes et al., 2002).
Burnout
Burnout is a state of physical, emotional and mental exhaustion created by longterm involvement in an
emotionally demanding situation and accompanied by lowered performance and motivation. Burnout is
a particular problem in the helping professions (Maslach, Schaufelt & Leiter, 2001). Teachers, nurses,
clergy, doctors, dentists, psychologists, social workers, and police officers. This is likely because they
encounter emotional turmoil on the job, and can only work productively for a limited time. Symptoms
of burnout are: overwhelming exhaustion; a deep cynicism; detachment from one's work; a sense of
ineffectiveness; lack of accomplishment. (Maslach, 2003). Burnout also has physiological qualities.
Schacter has omitted this, and it needs to be addressed. It is known as adrenal fatigue.Adrenal Fatigue
is a stressrelated condition that results in symptoms like exhaustion, weakened immunity, sleep
disturbances, and food cravings. The adrenal glands and HPA (hypothalamic–pituitary–adrenal) axis
become depleted and dysregulated after a long period of emotional stress or chronic illness.
( https://adrenalfatiguesolution.com/adrenalfatiguesymptoms ).
Stress Management
Controlling one's thoughts is not easy, but it is possible to banish unpleasant thoughts from the mind.
This style of dealing with stress is known as repressive coping, or avoiding situations or thoughts that
are reminders of a stressor and maintaining an artificially positive viewpoint. (Barnier, Levin & Maher,
2004). When repressors suffer a heart attack, they are less likely than other people to report intrusive
thoughts of their heart problems. (Ginzburg, Solomon,& Bleich, 2002). Many victims of rape not only
avoid the place where the rape occurred, but may move away from their home or neighborhood. (Ellis,
1983). For some people, the avoidance of unpleasant thoughts and situations is so difficult that it can
turn into a grim preoccupation (Parker & McNally, 2008).
Rational coping is the process of facing a stressor and working to overcome it. It is the opposite of
repressive coping. It is a threestep process: acceptance of the reality of the stressor; exposure, or
attending to the stressor such as thinking about it and even seeking it out; understanding, working to
find the meaning of the stressor in your life. For example, using a technique called prolonged exposure
rape survivors relive the traumatic events in their imagination by recording a verbal account of the event
and then listening to the recording daily.
In one study, rape survivors were instructed to seek out objectively safe situations that caused them
anxiety or that they had avoided. This method produces significant reductions in anxiety and symptoms
of posttraumatic stress disorder compared to no therapy and compared to therapies that promote more
gradual and subtle forms of exposure. (Foa et al., 1999).
Reframing involves finding a new or creative way to think about a stressor that reduces its threat.
Stress inoculation training (SIT) is a reframing technique that helps people to cope with stressful
situations by developing positive ways to think about the situation. Subsequent research on SIT had
revealed that it can be useful, too, for helping people who have suffered prior traumatic events to
become more comfortable living with those events (Foa & Meadows, 1997). Pennebaker (1989)
reported that the physical health of university students improved after they spent a few hours writing
about selfdisclosure (one's deepest thoughts and feelings). They were then less likely to vist the
student health center, used less aspirin and acheived better grades. Engaging in such expressive writing
was found to improve immune function, whereas suppressing emotional topics weakend it (Petrie,
Booth, & Pennebaker, 1988).
Meditation is the practice of intentional contemplation. It appears to have positive psychological
effects (Holzel et al., 2011) Mindfulness meditation teaches one how to remain focused on, and
accepting of, immediate experience. Experienced meditators how deactivation in the default mode
network (which is associated with mind wandering). Even shortterm meditation training has been
shown to improve the connectivity between parts of the brain involved in conflict monitoring, cognitive
and emotional control , doing so by increased myelinization.(perhaps due to increased neuron firing)
Relaxation therapy is based on electromyography, used to measure subtle activity of muscles.
The most important ones (for psychology) are involved in subvocalization.
https://en.wikipedia.org/wiki/Subvocalization. This links back to meditation, which includes the
relaxation response, a condition of reduced muscle tension, cortical activity, heart rate, breathing, and
blood pressure. (Benson, 1990).
Aerobic Exercise
Aerobic exercise increases heart rate and oxygen uptake for a sustained period, and is associated with
psychological wellbeing. It actually does promote stress relief and happiness. One recent meta
analysis (a quantitative review of existing studies) compiled data from 90 studies including over 10,000
people with chronic illnesses who were randomly assigned to the aerobic exercise condition
experienced a significant reduction in depressive symptoms. (Herring et al., 2010). This appears also to
work for schizophrenia ((Gorczynski & Faulkner, 2011).
Situation Management
Social support is aid gained through interacting with others. To be socially disconnected is bad for
your health. Single individuals have an elevated risk of mortality from cardiovascular disease, cancer,
pneumonia and influenza, chronic obstructive pulmonary disease, liver disease and cirrhosis. (Johnson,
Backlund, et al., 2000). Good ongoing relationships can be as healthy as exercising and avoiding
smoking. (Umberson et al., 2006). Lonely people are more likely than others to be stressed and
depressed (Baumeister & Leary, 1995) and they can be more susceptible to illness because of lower
thannormal levels of immune functioning. (KiecoltGlaser et al., 1984).
Gender differences in social support have come to light partly because the flightorfight response to
stress may be largely a male reaction (Taylor, 2002). She suggested that the female response to stress is
to tend and befriend. Like men, women respond to stressors with sympathetic nervous system arousal
and the release of epinephrine and norepinephrine, but they also release oxytocin, a hormone secreted
by the pituitary gland in pregnant and nursing mothers. In the presence of estrogen, oxytocin triggers
social responses, a tendency to seek out social contacts, nurture others, create and maintain cooperative
groups.
Religious experiences Why do people who endorse religiosity or spirituality have better mental and
physical health? Some hypotheses: engagement in religious or spiritual practices, such as attendance at
weekly religious services, may lead to the development of strong and more extensive social networks,
which have wellknown health benefits. Following the recommendations of spiritual teachers with
respect to dietary restrictions, restraining from the use of recreational drugs and alcohol, and having a
more optimistic perspective on daily life events. All of these can lead to more positive healthy
outcomes. (Seeman, Dubin, & Seeman, 2003).
Humor There is a kernel of truth that humor can help us cope with stress. For example, humor can
reduce sensitivity to pain and distress, as researchers found when they subjected volunteers to an
overinflated blood pressure cuff. Participants were more tolerant of the pain during a laughterinducing
comedy audiotape than during a neutral tape or instructed relaxationl (Cogan et al., 1987)
Humor can reduce the time needed to calm down after a stressful event. Men viewing a hightly stressful
film about industrial accidents were asked to narate the film aloud, seriously or humorously.Both
groups reported tension while watching the film (increased skin conductance & heart rate, decreased
skin temperature) those looking for humor bounced back to normal arousal levels more quickly.
(Newman & Stone, 1996).
Sickness Response. Misery is part of the sickness response, a coordinated, adaptive set of reactions to
illness organized by the brain. (Watkins & Maier, 2005). Feeling sick makes you withdraw from activity
and lie still, conserving the energy for fighting the illness. Appetite loss is similarly helpful, as the
energy spent on digestion is conserved. Therefore, these behavioral changes are not random side effects,
but an evolutionary strategy. As we age, the sickness response becomes more prolonged. (Barrientos et
al., 2009).
The immune response to an infection begins with the activation of white blood cells that engulf
microbes and also release cytokines, proteins that circulate throughout the body and communicate with
other white blood cells, also communicating the sickness response to the brain. (Maier & Watkins,
1998). Cytokines do not enter the brain, instead they activate the vagus nerve that runs from the
intestines, stomach and chest to the brain, inducing the 'I am infected' message. (Goehler et al., 2000)
In humans, the connection between the sickness response, immune reaction, and stress is illustrated in
depression. In addition to fatigue and malaise, depressed people show signs characteristic of infection,
including high levels of cytokines circulating in the blood. (Maes, 1995).
When do we know we are sick? fMRI scans of brain activation in high and lowpain sensitive
individuals during painful stimulation show that the anterior cingulate cortex and the primary
somatosensory areas show greater activation in highpainsensitive individuals. (Coghill, McHaffie &
Yen, 2003)
Placebo effects fMRI scans reveal that some brain regions normally activated when when individuals
report pain in response to shocks are deactivated when those individuals are given a placebo analgesic
during the shock. The regions include the anterior cingulate cortex in the right medial view of the
brain, and the insula and thalamus in the ventral view of the brain (Wager et al., 2004). The effect is
most marked when the patient knows that a treatment is taking place.(StewartWilliams, 2004).
Knowledge effects can be remarkably specific, mirroring in detail what patients believe about the
nature of medicine, for example, that two pills work better than one, and that an injection is better than
a pill. (de Craen et al., 1999)
Somatic Symptom Disorders A psychosomatic illness is an interaction between mind and body that
can produce illness. A full-blown disorder occurs when a person with at least one bodily symptom
displays significant health-related anxiety, expresses disproportionate concerns about their symptoms,
and devotes excessive time and energy to their symptoms or health concerns.
Sick Role is a socially recognized set of rights and obligations linked with illness. (Parsons, 1975). The
sick role also incurs obligations: they cannot appear to enjoy the illness or reveal signs of wanting to be
sick and must also take care to pursue treatment to end this 'undesirable' condition. This becomes a
psychological disorder when it reaches the stage of malingering Because many symptoms of illness
cannot be faked (even facial expressions of pain are difficult to simulate) malingering is possible only
with a restricted number of illnesses. Malingering can be difficult to diagnose and treat, because, for
example, in the case of anorexia nervosa, the symptoms can be appear to be fake, but are not. (Feldman,
2004).
PatientPractitioner Interaction Physicians often err on the side of failing to acknowledge patient's
emotions, focusing instead on the technical issues of the case. (Suchman et al, 1997). This is
particularly unfortunate because a substantial number of patients who seek medical care do so for the
treatment of psychological and emotional problems. (Taylor, 1986).
Note: use these references for your midterm three long essay on Wit.
Compliance deterioration occurs: when the treatment must be frequent; inconvenient; painful; as the
number of treatments increases. (Miller & Rolnick, 2012).