Personality, Health & Stress - Lecture Notes

Stress Management, Personality, and Health

Introduction to Stress and Personality

Stress is a common human experience. Individual responses to stress vary due to personality differences. Personality influences:

Likelihood of experiencing stressful situations.
Appraisal of events as stressful.
Selection of coping strategies.
Effectiveness of chosen coping strategies.

Defining Personality

Personality encompasses enduring characteristics and behaviors that define an individual's unique adjustment to life. This includes:

Major traits
Interests
Drives
Values
Self-concept
Abilities
Emotional patterns

Personality theories vary but agree that personality determines behavior.

Key Characteristics of Personality

Susceptible to environmental influences.
Influences behavior and reactions to others.
Consists of unique patterns of thoughts, behaviors, and emotions.
Consistent and flexible.

Trait Theory: The Big 5 (OCEAN)

The Big Five (OCEAN) model is a widely-accepted psychological model for understanding personality. It describes personality using five broad dimensions:

Openness: Creativity, curiosity, and willingness to try new things.
Conscientiousness: Self-discipline, organization, and goal-directed behavior.
Extraversion: Sociability, energy, and tendency to seek stimulation.
Agreeableness: Compassion, cooperation, and social harmony.
Neuroticism: Emotional stability and tendency toward negative emotions.

Typical Characteristics of Each Trait

Neuroticism: Worried, insecure, nervous.
Extraversion: Sociable, talkative, fun-loving.
Openness: Original, independent, creative.
Agreeableness: Good-natured, soft-hearted, trusting.
Conscientiousness: Careful, reliable, hardworking.

The Big Five as Spectrums

Traits exist on a spectrum rather than as fixed categories. Individuals fall somewhere along a continuum for each trait.

Example: Extraversion
- High Extraversion: Social, talkative, energetic.
- Low Extraversion (Introversion): Prefers solitude, reserved.
- Spectrum Example: Ambiverts enjoy socializing but also need alone time.

Coping with Stress & The Big-5 Trait Theory

Extraversion (E): Higher levels of extraversion are associated with problem-focused coping, support seeking, and reframing.
Openness (O): Higher levels of openness are associated with humor in coping and positive reappraisal. Individuals high in openness are more empathetic.
Neuroticism (N): High neuroticism is linked to negative emotions and maladaptive coping strategies like substance use, emotional outbursts, escape avoidance, self-blame, wishful thinking, hostile reactions, and interpersonal withdrawal.

Social Cognitive Theory (SCT)

Founded by Bandura, SCT explains personality as the dynamic interaction between:

Personal factors (thoughts, emotions, beliefs)
Behavior
Environment

Personality is shaped through learning, social influences, and self-perception. It is flexible and changes based on experiences, environment, and self-beliefs.

Self-Efficacy

Self-efficacy is a key concept in SCT, referring to a person’s belief in their ability to succeed in specific situations. It influences behavior, motivation, and emotions.

High self-efficacy leads to action, overcoming challenges, and positive personality traits.
Low self-efficacy leads to avoidance, anxiety, and negative personality patterns.

Self-Efficacy & Stress

Low self-efficacy is associated with vulnerability to stress, more psychological symptoms, and depression. High self-efficacy promotes a positive approach to coping strategies.

Problem-focused strategies are linked to less stress.
Higher self-efficacy is linked with problem-focused, active, and meaning-focused coping.
Lower self-efficacy is linked with emotion-focused strategies.

Health Psychology

Health psychology focuses on psychological, behavioral, and social factors influencing physical health and illness. It explores:

How people stay healthy
Why they become ill
How they respond to illness

It combines psychology and health sciences to understand the mind-body connection.

Key Concepts of Health Psychology

Prevention and Treatment of Illness
- Helping individuals manage chronic diseases through psychological strategies.
Identifying Causes of Health and Illness
- Studying how stress, personality, coping styles, and social support affect disease development and recovery.
Biopsychosocial Model
- Views health as an interaction between biological, psychological, and social factors.

Coronary Heart Disease (CHD) Epidemic

Late 1950s: CHD became the leading cause of death in the U.S.
Shift from infectious to lifestyle-related diseases.
Federal funding was allocated to investigate this “epidemic.”
Traditional risk factors: smoking, high blood pressure, cholesterol, inactivity, diabetes, obesity, and family history.

Introduction of Psychological Risk Factors

Cardiologists Meyer Friedman and Ray Rosenman (1964) discovered Type A personality.
Type A traits: impatience, competitiveness, aggressiveness, urgency.
Psychological traits can be as critical to heart health as physical risk factors.

Type A Personality

Type A Individuals Exhibit:

Time urgency
Polyphasia (multi-tasking)
Ultra-competitiveness (self-conscious, perceiving others as threats)
Rapid speech patterns (raising voices, using explosive words)
Manipulative control
Hyperaggressiveness and free-floating hostility (suppressed anger)

Relationship Explained: Type A Personality & CHD

Study: Tracked over 3,500 individuals for 8 years. Type A behavior predicted CHD more strongly than other risk factors.

Biologically, it heightened sympathetic nervous system activity, increased catecholamines (stress hormones), hypertension, and elevated cholesterol levels.
Hostile aggression is the most dangerous component of Type A behavior.

Studies

Link between hostility and coronary artery blockage.
A 4x greater CHD risk in those with high hostility scores.

Behavior Modification: Can Hostility Be Tamed?

Friedman et al. investigated the impact of counselling sessions on post-heart attack patients.

Findings showed a 44% reduction in Type A behavior.

Personality can't be completely changed, but hostility and anger can be managed!

Applications

Anger management training
Stress reduction techniques
Cognitive-behavioral therapy (CBT) approaches

Type D (Distressed) Personality

Research is shifting focus from Type A (aggression) to Type D (distressed) personality.

Psychocardiology or behavioral cardiology: relationship between emotional stress (anxiety and depression) and cardiac function.
Personality traits associated with anxiety and depression affect the course of heart disease.

Anger + Depression = Stress

Type D Personality Characteristics

The ‘‘distressed’’ personality subtype is characterized by:

Tendency to experience negative emotions (anger, hostility, depression, anxiety).
Inhibition of these emotions.
Avoidance of social interaction.
Report higher feelings of subjective stress during a stressor compared to non-Type D’s.
High scores on both Negative Affect (NA) and Social Inhibition (SI) were linked to disease morbidity and mortality.

Type D & Cardiovascular Disease

Type Ds have a $6\times$ increase in the likelihood of death from cardiac events and a $4\times$ increase in mortality 6-10 years following a cardiac event.
Type D is significantly associated with worse disease outcomes.

Potential Underlying Mechanisms

Type D has its effect through either psychophysiological or behavioral pathways.

Whitehead et al. (2007) found Type D personality showed significantly higher cortisol awakening responses.
Correlational link between Type D, stress, and the etiology of Coronary Heart Disease.

Codependent Personality Traits

Co-dependency: A stress-prone personality that increases the likelihood of perceived stress and ineffective coping.

Addictive in nature; based on the need to make others dependent to receive self- validation.

Predictive Factors

Codependent traits develop early in childhood in chaotic, unpredictable, or threatening environments. Children adopt codependent behaviors as survival skills to win approval and love.

Characteristics of Codependent Personality

Co-dependent individuals validate their own existence through the approval and manipulation of others.

Traits

Ardent approval seekers
Self-sacrificing martyrs
Perfectionists
Manipulators
Super-overachievers
Victims
Crisis managers
Feelings of inadequacy
Devoted loyalists
Reactionaries

Helpless – Hopeless Personality

It is a stress-prone personality based on low self-esteem. People with this personality have encountered repeated bouts of failure. Repeated failure becomes a learned response.

Seligman (1975) noted signatures of learned helplessness

Poor self-motivation
Cognitive distortion
Emotional dysfunction (chronic depression)

Helpless – Hopeless Personality: Locus of Control

These individuals perceive that their problems are beyond their resources and ultimately give up. The characteristic that best identifies the helpless–hopeless personality is having an external locus of control.

Locus of Control Types

Internal Locus of Control: Belief that outcomes are the result of one’s own efforts, decisions, or actions.
External Locus of Control: Belief that outcomes are influenced by outside forces such as fate, luck, chance, or powerful others.

Effects on Physical Health

A study examined whether hopelessness is an independent risk factor for early mortality.

Hopelessness Predicts Mortality: Hopelessness remained a strong predictor of death. Individuals with high levels of hopelessness were significantly more likely to die.
Cardiovascular Risk: Men with high hopelessness scores had over twice the risk of dying from ischemic heart disease.
Cancer Incidence: Hopelessness was also associated with a higher incidence of cancer.

Underlying Mechanisms

Psychological states like helplessness can contribute to disease development.

Stress Hormone Dysregulation: Learned helplessness activates the HPA axis, leading to chronic elevation of cortisol and other stress hormones.
Cardiovascular Reactivity: Helpless individuals show poor autonomic regulation, often resulting in elevated heart rate and blood pressure during stress.
Behavioral Pathways: Individuals with learned helplessness often engage in unhealthy behaviors.
Blunted Coping & Emotional Regulation: Learned helplessness impairs one's ability to cope effectively with stress and to regulate negative emotions.

Stress Resistant Personalities

These are the personalities that help when facing stress.

Resiliency: The Hardy Personality

Kobasa et al. found three specific personality traits that collectively acted as a buffer to stress and contributed to “hardy personality”.

Traits of the Hardy Personality

Commitment: Dedication to oneself, work, and family.
Control: A sense of personal control.
Challenge: The ability to see change and even problems as opportunities for growth.

Innate or Learned?

Although the hardy personality appears to be innate, the traits of commitment, control, and challenge can be learned as well!

Hardiness Study

In a study to determine the efficacy of teaching hardiness skills over an 8-week period, sixteen participants experiencing stress-related health problems were split into two groups.

The skills taught to the treatment group were:

Focusing or recognizing the body signals of stress
Reconstruction and reinterpretation of a stressor
Compensation, turning control of personal talents into abilities that foster strengths rather than triggering helplessness.

Sensation Seekers

Another personality identified as stress-resistant is called the sensation seeker or Type R (risk-taker) personality.

People who are attracted to “extreme” activities are better at coping with life events than those who avoid taking risks.

Intentional exposure to “approachable stress,” or sensation activities, make them calculate the risks involved. Sensation seekers think through their strategies rather than reacting impulsively.

Self-Esteem: The Bottom-Line Defense

Self-esteem: The sense of underpinning self-values, self-acceptance, and self- love; thought to be a powerful buffer against perceived threats.

Self-esteem has also been described as the harmony or discrepancy between actual self-image and ideal self-image.
Level of self-esteem appears to be a critical factor in how people respond to stress, regardless of personality type.

High vs. Low Self-Esteem

Low self-esteem is the common denominator in stress-prone personalities.
High self-esteem is a prerequisite for creating stress-resistant personalities.

Suggestions to Raise and Maintain Self-Esteem

Disarm the negative critic.
Give yourself positive reinforcements and affirmations.
Avoid “should haves.”
Focus on who you really are and your own identity.
Respect your own uniqueness without comparison to others.
Diversify your interests.
Create/find special places to recharge your energy and strengthen social bonds.