In the British Medical Journal (1884) it was reported that bereaved persons are prone to infection.
Subjects were given nasal drops that contained a common cold virus or a placebo solution. Before the drops were administered, the subjects had been assessed for stress by a Questionnaire. 47% of those with high stress and 27% with low stress developed colds (Cohen et al., 1991).
Stress can affect health by:
Stress, behaviour, and illness
Following a divorce parents may have less time for the children-a situation described as "diminished parenting" (Wallerstein, 1983). The parents may not always prepare meals at regular times and bedtimes may also become irregular. Stress therefore affects behaviour, which, in turn, can impair health.
People who suffer from high levels of stress do can harmful thing to their bodies (Wiebe & McCallum, 1986). Whilst under stress people might consume a lot of alcohol, cigarettes, and coffee (Baer et al., 1987). People under stress also have a higher accident rate.
Stress, physiology, and illness.
High levels of job stress are associated with high blood pressure and abnormally enlarged hearts (Schnall et al, 1990). Monkeys that were relocated to a different living group would experience more stress because they would have to strive to regain their original status (Manuck et al., 1988). These monkeys compared with controls, which were not moved, were more likely to develop atherosclerosis (the growth of plaques, fatty patches, on artery walls).
Psychoneuroimmunology
This field studies the relationship between stress and the immune system. The nervous and endocrine systems send chemical messages in the form of neurotransmitters and hormones that increase or decrease immune function. Cells of the immune system produce chemicals such as the ACTH that feed information back to the brain. The brain needs to control the immune system and keep it in balance as too little immune activity leaves the individual open to infection and too much activity may produce autoimmune diseases (Buck, 1988).
Pessimism, depression and stress are related to impaired immune function (Kamen-Siegel et al., 1991). Caregiver spouses of alzheimer disease patients with matched control subjects had a lower immune function and reported more days of illness over the course of about a year (Kiecolt-Glaser et al., 1991).
The effect of a crisis can be long lasting. The immune system can be suppressed over an extended period of time. 256 healthy elderly individuals taking part in a longitudinal study were asked to contact researchers as soon as they experienced a major crisis. Fifteen subjects did. A month after the crisis, and again several months later, the researchers assessed the subjects cortisol and lymphocyte blood concentrations, recent diets, weights, and psychological distress. These measures were compared with compatible data taken before the crisis. It was found that lymphocyte concentrations, caloric intake, and body weight decreased, and cortisol concentrations and psychological distress increased, soon after the crisis. It took several months before the measures returned to the pre-crisis levels (Willis et al., 1987).
Immunosuppression can be conditioned. Rats were given saccharin-flavoured water to drink (which they like) and also got an injection of a drug that induces nausea. The strength of the saccharin-flavoured water was varied. Over several weeks the drug was not used but the animals continued to receive saccharin-flavoured water. Those rats that had received the stronger solutions in the conditioning trial tended to fall ill and die. It was thought that the nausea-inducing drug caused suppression of the immune function temporarily in the conditioning trial. The saccharin flavoured water became the conditioned stimulus that produced the conditioned response of suppressed immune function. It was this suppression of the immune function over a long period of time that caused the rats to become ill and die (Ader and Cohen, 1975).
Psychophysiological disorders
Psycho physiological disorders used to be called psycho somatic illnesses. The term refers to physical illnesses that are caused or aggravated by psychological factors, such as stress.
Ulcers and inflammatory bowel disease
Both of these cause pain and bleeding. Ulcers are found in the stomach and the duodenum or other sections of the small intestine. Inflammatory bowel disease, such as colitis, occurs in the colon or the small intestine. Ulcers are thought to be produced by excessive gastric juices eroding the lining of the stomach and duodenum when there is little or no food present. However ulcers have occurred in individuals with the very low levels of stomach acid (Weiss, 1984). A case study of a patient called Tom found that there was a direct relationship between emotional feelings brought about by stress, and the production of stomach acid and the reddening of the stomach lining. Researchers were able to directly observe these effects through an opening in his body that led correctly to his stomach. This was the only way Tom could feed himself (Wolf and Wolf, 1947).
Asthma
Asthma is a respiratory disorder in which inflammation and spasms obstruct the bronchial tubes and lead to difficulty breathing, accompanied by wheezing or coughing. It is common in children, particularly for boys. About three to 5% of the population suffers from asthma. Asthma attacks are caused by allergies, respiratory infections, and bio psychosocial arousal, such as from stress.
About one-third of children admitted to hospital because of their asthma were found to get better without any change in their medication. This might have been because they were allergic to the dust in their houses. To test for this, researchers vacuum cleaned the children's homes and spread the dust in the hospital wards. The children did not show any adverse reactions to the dust. It was concluded that psychological factors caused the asthma attacks (Long et al, 1958).
Chronic headache
There are two types of chronic headache: muscle contraction and migraine. Muscle contraction (or tension) headaches are caused by persistent contraction of the head and neck muscles, which is associated with stress. The pain is dull and steady and often feels like a tight band of pressure around the head.
Migraine headaches result from the constriction and dilatation of blood vessels inside and outside the skull. The pain begins on one side of the head near the temple, is sharp and throbbing, and last for hours or, sometimes, days. The classic migraine is preceded by an aura, a set of symptoms that signal an impending headache. These symptoms include sensory phenomena, such as seeing lines or shimmering in the visual field accompanied by dizziness and nausea.
After the age of ten, chronic headaches affect far more females than males. Headaches can occur after consuming such things as wine or chocolate. Everyday hassles play an important role in triggering headaches. However some headaches occur when there is no stress and sometimes a sufferer may be under stress and not be experiencing a headache.
Other disorders
Rheumatoid arthritis is a chronic and painful disease that produces inflammation and stiffness of the small joints, such as in the hands. Most patients are women. Dysmenorrhoea is characterised by painful menstruation, which may be accompanied by nausea, headache, and dizziness. Skin disorders, such as hives, eczema, and psoriasis, are characterised by the skin developing rashes or becoming dry and flaking or cracking. Stress appears to be involved in all of these.
Stress and cardiovascular disorders
Cardiovascular disorders include hypertension and CHD (chronic heart disease).
Hypertension
Determinants of hypertension include:
One problem with measuring BP is that some people become anxious when having their BP taken and thus produce a false diagnosis of hypertension (McGrady and Higgins, 1990).
Medical records for air traffic controllers and second-class airmen were studied. The air traffic controllers had higher blood pressure compared with the airmen. There was found a relationship between high blood pressure and the amount of air traffic the controllers handled. There was matching for age, as blood pressure increases with age (Cobb and Rose, 1973).
Crowding is stressful. Subjects from a crowded neighbourhood showed a greater increase in heart rate and blood pressure when performing a stressful task compared with subjects from a relatively un-crowded neighbourhood. Subjects were matched for age, gender, and family income (Fleming et al., 1987).
Black people in the United States tend to have higher blood pressures than whites. A study of blacks and whites in Detroit found the highest BP readings were from blacks living in high stress areas of the city. There were no difference between blacks and whites who lived in low stress areas (Harburg et al., 1973).
A study of occupational stressors among black men found that high blood pressure was associated with the subject worrying about their job security, or lack of job success or of being hindered in their chances of achieving job success owing to their colour (James et al., 1984).
Contrast with Hraba and Grant.Blood pressure and darkness of skin are correlated for black people of low socio-economic status, but not for blacks with higher income or education (Klag et al., 1991).
Hypertensive patients are more likely to be chronically hostile and resentful (Diamond, 1982). Most people experience higher blood pressure when they are angry or hostile. In families, interpersonal conflicts can be a major source of anger, which may lead to hypertension (Ewart, 1991). It is important to remember that there are several factors that contribute to hypertension.
Coronary heart disease
The incidence of heart disease is higher in technologically advanced countries (Susser et al., 1983). There are three possible reasons for this:
High work loads, job responsibility and job dissatisfaction are associated with coronary heart disease (Cottington and House, 1987).
Researchers carried out follow-up assessments over an eight-year period with patients who had recovered from their first heart attack. Those who did not have subsequent attacks tended to have no increase in life events during the study. Those who did have a reoccurrence did have an increase in life events (Theorell and Rahe, 1975).
There are several reasons why stress affects the heart:
Stress and cancer
There is a link between stress and cancer. Stress inhibits natural-killer (NK) cell activity, which helps to combat cancer cells.
Greer and Morris (1975) women who did not express their anger were more likely to prove positive in a biopsy test for cancer.
Greer et al (1979) - The greatest mortality amongst cancer sufferers is associated with groups who do not demonstrate a fighting spirit or do not use denial styles of coping.(See "Chronic" Document)
Cancer is when cells multiply and grow in an unrestrained manner.
Many studies of stress and cancer have used retrospective methods. These studies have suggested that there is a link between high stress levels and cancer. There are two main reasons why retrospective methods may be flawed:
Research with initially healthy subjects has found that people who experienced high levels of stress during the intervening years were more likely to develop cancer than those with less stress (Sklar & Anisman, 1981).
Studies with people already diagnosed with cancer found that patients who suffered relapses within a subsequent time period, such as a year, tended to have experienced more stressful life events or received less social support than those who did not have relapses (Rogentine et al., 1979).
Some studies have not being able to establish the link between stress and cancer (Watson & Ramirez, 1991). If stress plays a causal role in the development of cancer, it probably does so by impairing the immune systems ability to combat the disease and by increasing behavioural risk factors such as smoking cigarettes (Sarafino, 1994).
Notes from Canberra University
Stress Theories
Return to Gary Sturt's Home Page _