Chapter 14

Stress is defined as circumstances that threaten or are perceived to threaten one’s well-being, taxing coping abilities. While people often associate stress with major disasters like hurricanes or wildfires, everyday hassles—such as commuting, waiting in line, or misplacing a phone—can also be significant stressors. Research suggests that these minor stressors can accumulate and negatively impact mental and physical health, contributing to anxiety and depression. The perception of stress varies between individuals, depending on how they interpret and appraise events.

Stress is subjective and depends on individual perception. Lazarus and Folkman’s cognitive appraisal model explains how people assess stress through primary appraisal (determining if an event is irrelevant, non-threatening, or stressful) and secondary appraisal (evaluating coping resources). This process is dynamic and influenced by personality traits like anxiety and neuroticism.

Stressful events can be classified into acute (short-term, with a clear endpoint) and chronic (long-term, with no definite resolution). Additionally, stress can arise from four major sources:

1. Frustration – When goals are blocked (e.g., traffic delays, relationship issues).

2. Conflict – Struggles between incompatible motivations, categorized as approach-approach, avoidance-avoidance, or approach-avoidance conflicts.

3. Change – Adjustments to life circumstances, even positive ones.

4. Pressure – Expectations to perform or conform.

While major stressors like disasters are impactful, minor daily hassles can accumulate and significantly affect mental and physical health.

Conflict arises when individuals face choices between competing motivations. Psychologists classify conflicts into three types:

1. Approach-Approach Conflict – Choosing between two desirable options, such as playing tennis or racquetball. This type is the least stressful since either choice is positive.

2. Avoidance-Avoidance Conflict – Choosing between two undesirable options, such as taking a degrading job or remaining unemployed. This type is highly stressful as both outcomes are negative.

3. Approach-Avoidance Conflict – A single choice has both positive and negative aspects, like accepting a promotion that requires relocating to an undesirable city. This type often leads to indecision and vacillation.

Additionally, life changes, whether positive or negative, can be significant sources of stress. Holmes and Rahe’s Social Readjustment Rating Scale (SRRS) measures stress levels based on life events requiring adaptation, reinforcing that change itself is a key stressor.

The Social Readjustment Rating Scale (SRRS) has been widely used in stress research, with findings linking higher scores to increased vulnerability to physical and psychological health problems. However, critics argue that the SRRS does not exclusively measure change, as it includes various stressful experiences, particularly negative ones, suggesting that change itself is not inherently stressful.

Another major source of stress is pressure, which arises from expectations to perform tasks efficiently or conform to societal standards. Time constraints, work demands, and self-imposed perfectionism contribute to stress. Research indicates that younger generations feel increased external and internal pressures, leading to heightened self-criticism.

Responding to Stress in Depth

Stress responses are multidimensional, involving emotional, physiological, and behavioral reactions. The way people experience and manage stress can have a profound impact on their mental and physical health.

1. Emotional Responses to Stress

Stressful events trigger various emotional reactions, which can persist long after the event has passed. These emotions fall into three common categories:

(a) Annoyance, Anger, and Rage

• Arises when people face frustrating or uncontrollable situations (e.g., traffic jams, long lines, unfair treatment).

• If prolonged, anger can lead to chronic stress and negative health effects like high blood pressure.

(b) Apprehension, Anxiety, and Fear

• Often linked to uncertainty and threats to well-being (e.g., worrying about job security, upcoming exams).

• Chronic anxiety is associated with sleep problems, weakened immune function, and burnout.

(c) Dejection, Sadness, and Grief

• Occurs after significant loss or failure (e.g., death of a loved one, breakup, losing a job).

• Long-term sadness can lead to depression and emotional exhaustion.

Even though stress often triggers negative emotions, research shows that people also experience positive emotions during stressful times. Feelings of gratitude, hope, and resilience can emerge, helping individuals cope better.

2. Physiological Responses to Stress

Stress activates the body's fight-or-flight response, which prepares a person to react to perceived threats. This involves:

(a) The General Adaptation Syndrome (Selye, 1976)

Selye proposed that the body goes through three stages when responding to stress:

1. Alarm Stage: Immediate activation of the sympathetic nervous system, releasing stress hormones like adrenaline and cortisol.

   • Symptoms: Increased heart rate, rapid breathing, muscle tension.

2. Resistance Stage: If stress continues, the body adapts and remains alert, but energy resources start to deplete.

   • Symptoms: Irritability, difficulty concentrating, sleep disturbances.

3. Exhaustion Stage: If stress is prolonged, the body's resources are depleted, leading to physical and mental breakdown.

   • Symptoms: Weakened immune system, fatigue, increased risk of illness (e.g., heart disease, ulcers).

3. Behavioral Responses to Stress

People react to stress in different ways, which can either help them cope effectively or lead to maladaptive behaviors.

Adaptive Coping Strategies (Healthy Responses)

• Problem-focused coping: Directly addressing the source of stress (e.g., making a study plan for exams).

• Emotion-focused coping: Managing emotional distress (e.g., talking to a friend, mindfulness exercises).

• Seeking social support: Connecting with loved ones or professionals for guidance.

Maladaptive Coping Strategies (Unhealthy Responses)

• Avoidance or denial: Ignoring problems instead of addressing them.

• Substance abuse: Using drugs, alcohol, or overeating as an escape.

• Aggression: Lashing out at others due to frustration.

Recognizing these responses helps individuals develop better stress-management techniques and improve overall well-being.

Summary: Emotional Responses and Stress

1. Expressing Emotions & Coping

   • Putting emotions into words reduces stress impact and lowers reliance on maladaptive coping (e.g., substance use, aggression).

   • Recognizing and communicating emotions helps individuals manage stress better.

2. Positive Emotions During Stress

   • Despite stress, people experience gratitude, hope, and love, which support resilience.

   • Positive emotions enhance the immune system, protect against heart disease, and contribute to longevity.

   • Studies suggest that individuals who express more positivity tend to live longer.

3. Effects of Emotional Arousal

   • Emotions serve as signals, like physical pain, prompting necessary action.

   • High emotional arousal can impair attention, memory, and decision-making.

   • The inverted-U hypothesis suggests moderate arousal improves performance, but excessive arousal hinders it.

1. Emotional Arousal and Performance

• Emotional arousal affects task performance in an inverted-U pattern (Figure 14.5).

• Optimal level of arousal depends on task complexity:

  • Simple tasks: Higher arousal improves performance.

  • Complex tasks: Lower arousal is better for optimal performance.

• Too much arousal can reduce efficiency and impair decision-making.

2. Physiological Responses to Stress

• Stress triggers physiological changes, including activation of the fight-or-flight response.

• Walter Cannon (1932) introduced the fight-or-flight response, which is a reaction to perceived threats:

  • Mobilizes the autonomic nervous system (ANS).

  • Prepares the body to either fight (attack) or flight (escape).

  • Controlled by the sympathetic division of the ANS, affecting blood vessels, muscles, and glands.

3. Positive Emotions and Longevity

• Research suggests positive emotions can enhance health and longevity.

• Study on Major League Baseball players (Figure 14.4):

  • Players with full smiles in photos lived longer than those with partial or no smiles.

• Another study found that autobiographies with more positive words were linked to longer life spans.

Key Takeaways

• Emotional and physiological responses to stress are complex.

• Moderate arousal improves performance, but too much impairs it.

• The fight-or-flight response helps react to threats but can cause stress-related health problems.

• Positive emotions may promote better health and longer life.

1. Fight-or-Flight Response (Walter Cannon, 1932)

• Walter Cannon was one of the first to describe the fight-or-flight response, a physiological reaction to threats controlled by the autonomic nervous system (ANS).

• When faced with danger, the sympathetic nervous system is activated, leading to:

  • Increased heart rate and breathing rate

  • Dilated pupils for better vision

  • Redirected blood flow from digestion to muscles

  • Release of adrenaline and cortisol to provide energy

• Cannon studied this response in animals (e.g., cats confronted by dogs) and noted immediate physiological changes.

• This response was highly adaptive in early human evolution, helping individuals survive threats like predators.

Modern Implications

• In today's world, humans rarely face life-threatening dangers, but their bodies still react to stress the same way (e.g., exams, deadlines, social conflicts).

• Chronic activation of this system can lead to health problems, including high blood pressure, heart disease, and anxiety disorders.

2. Tend-and-Befriend Response (Taylor et al., 2000)

• Unlike men, who are more likely to engage in fight-or-flight, women often respond to stress with tend-and-befriend behaviors:

  • Tend: Caring for and protecting offspring during stressful situations.

  • Befriend: Seeking social support to cope with stress.

• This response is influenced by hormonal differences, particularly oxytocin, known as the "cuddle hormone."

  • Oxytocin promotes bonding between mothers and children and increases during stress.

  • It encourages trust, cooperation, and social bonding.

• This response is thought to have evolved because women traditionally played a central role in child-rearing, making fleeing or fighting a less viable option.

Modern Implications

• Women tend to have stronger social networks and use them as a coping strategy for stress.

• Oxytocin may have protective effects against stress-related illnesses.

• Social support has been linked to better health outcomes and lower stress levels in both men and women.

3. General Adaptation Syndrome (Hans Selye, 1936, 1956, 1982)

• Hans Selye, a Canadian researcher, developed the General Adaptation Syndrome (GAS) model, showing that the body reacts to all stressors in a similar way.

• He identified three stages of the stress response:

Stage 1: Alarm Reaction

• The body detects a stressor and enters a state of shock before activating the fight-or-flight response.

• Physiological changes include:

  • Increased adrenaline and cortisol release

  • Higher heart rate and blood pressure

  • Heightened alertness and energy levels

Stage 2: Resistance

• The body tries to adapt to the stressor while maintaining high physiological arousal.

• If the stressor continues, the body may adjust to function at a new normal, but:

  • Energy reserves are being used up

  • The immune system becomes weaker, increasing vulnerability to illness

  • Memory, focus, and emotional regulation can be impaired

Stage 3: Exhaustion

• If stress persists for too long, the body loses its ability to cope.

• Symptoms of exhaustion include:

  • Physical burnout (chronic fatigue, illness, weakened immune system)

  • Mental and emotional exhaustion (depression, anxiety, irritability)

  • Increased risk of serious health conditions (heart disease, high blood pressure)

4. The Impact of Chronic Stress

• When stress becomes chronic, it can lead to:

  • Weakened immune system, making people more prone to infections

  • Increased risk of heart disease, due to prolonged high blood pressure

  • Mental health issues, including anxiety, depression, and burnout

• Chronic stress is common in modern society, often due to work, finances, social pressures, or personal responsibilities.

Key Takeaways

• Fight-or-flight helps the body respond to threats but can be harmful when activated too frequently.

• Tend-and-befriend is a stress response more common in women, involving social bonding and nurturing behavior.

• Hans Selye’s General Adaptation Syndrome (GAS) explains how the body responds to prolonged stress in three stages: alarm, resistance, and exhaustion.

• Chronic stress can have serious physical and mental health consequences, making stress management crucial.

Detailed Summary of Brain-Body Pathways and Stress Effects

Diseases of Adaptation (Hans Selye, 1956)

• Hans Selye initially believed that prolonged stress led to hormonal exhaustion.

• However, research now shows that chronic over-activation of the stress response damages various organ systems (Sapolsky, 2007).

• These stress-induced conditions are referred to as "diseases of adaptation" (McCarty, 2016), including:

  • High blood pressure

  • Heart disease

  • Weakened immune function

  • Digestive disorders

  • Anxiety and depression

Brain-Body Pathways in the Stress Response

When the brain detects stress, it activates two major pathways that signal the endocrine system (Dallman et al., 2007; Stowell et al., 2013).

Pathway 1: Autonomic Nervous System (ANS) → Adrenal Medulla → Catecholamines

• The hypothalamus activates the sympathetic division of the ANS, which then stimulates the adrenal medulla (inner part of the adrenal glands).

• The adrenal medulla releases catecholamines (adrenaline and noradrenaline) into the bloodstream.

• These hormones trigger fight-or-flight responses, such as:

  • Increased heart rate and blood pressure

  • Enhanced blood flow to muscles and brain

  • Increased oxygen intake for better alertness

  • Dilated pupils for better vision

  • Suppressed digestion to conserve energy

Pathway 2: Hypothalamus → Pituitary Gland → Adrenal Cortex → Corticosteroids

• The hypothalamus signals the pituitary gland, which releases ACTH (adrenocorticotropic hormone).

• ACTH stimulates the adrenal cortex (outer layer of adrenal glands) to produce corticosteroids.

• Corticosteroids:

  • Increase energy availability by breaking down fats and proteins.

  • Reduce inflammation in case of injury.

Effects of Chronic Stress on the Brain

1. Neurogenesis Suppression

   • Stress can inhibit neurogenesis (the formation of new neurons), especially in the hippocampus (Lucassen et al., 2017).

   • Reduced neurogenesis is linked to depression (Anacker, 2014).

2. Structural & Functional Brain Changes

   • Prolonged stress alters neural circuits, making individuals more vulnerable to:

     • Psychological disorders (e.g., anxiety, depression)

     • Cognitive decline (memory and learning deficits)

     • Physical illnesses (heart disease, metabolic issues)

   • Stress-induced brain changes involve neural and glial networks (Diwadkar, 2016).

3. Hormonal Imbalance & Mental Health

   • Chronic cortisol elevation affects brain areas like the hippocampus, impairing memory and emotional regulation.

   • These changes increase susceptibility to mental health disorders (Czeh & Fuchs, 2016; McEwen, 2016).

Key Takeaways

• Stress activates two brain-body pathways:

  • Autonomic Nervous System (ANS) → Fight-or-flight response

  • Endocrine System (HPA Axis) → Corticosteroid release

• Chronic stress damages the brain and body, leading to:

  • Cardiovascular diseases

  • Suppressed immune function

  • Memory and cognitive impairments

  • Increased risk of anxiety and depression

• Managing stress (exercise, meditation, social support) can help protect brain function and overall health.

Detailed Summary of Stress, Brain Structures, and Coping Mechanisms

Brain Structures Involved in Stress Regulation

Research suggests that stress affects key brain regions responsible for processing and regulating our stress responses (Gianaros & Wagner, 2015).

1. The Amygdala (Threat Processing & Emotional Regulation)

• The amygdala is crucial for detecting threats and triggering emotional responses.

• Chronic stress leads to an overactive amygdala, causing exaggerated responses to perceived threats (Mah et al., 2016).

• This hyperactivity can result in increased anxiety, fear responses, and emotional instability.

2. The Hippocampus (Memory & Stress Regulation)

• The hippocampus plays a role in memory formation and stress regulation.

• Prolonged exposure to stress hormones (cortisol) can cause hippocampal shrinkage, leading to:

  • Memory impairments

  • Difficulty distinguishing real threats from non-threatening situations

  • Increased vulnerability to depression

3. The Prefrontal Cortex (Rational Thinking & Self-Control)

• The prefrontal cortex (PFC) regulates decision-making, impulse control, and emotional responses.

• Chronic stress weakens the PFC, making it harder to:

  • Control emotional reactions

  • Regulate impulses (e.g., stress eating, substance use)

  • Make rational, long-term decisions

Coping Mechanisms: Adaptive vs. Maladaptive Responses

Coping refers to active efforts to manage stress. These responses can be adaptive (healthy) or maladaptive (harmful) (Folkman, 2010).

1. Learned Helplessness: Giving Up & Resignation

• Some individuals passively accept stressors rather than trying to overcome them.

• This response is called learned helplessness (Seligman, 1974, 1992), which occurs when people believe they have no control over stressful events.

• Effects of learned helplessness:

  • Increased risk of depression (Maier & Seligman, 2016)

  • Reduced motivation to take action

  • Feelings of hopelessness and resignation

✅ Adaptive Alternative: Goal Adjustment

• Studies show that disengaging from unattainable goals can reduce stress and improve mental health (Wrosch et al., 2012).

• People who adjust their goals report lower stress hormone levels and better overall health (Wrosch, 2011).

2. Blaming Oneself: Catastrophic Thinking

• Some individuals respond to stress by engaging in excessive self-blame and negative self-talk.

• Catastrophic thinking (Ellis, 1973, 1987) occurs when people:

  • Overestimate the severity of problems

  • Believe negative outcomes are inevitable

  • Dwell on personal shortcomings

• Self-blame contributes to:

  • Increased emotional distress

  • Heightened anxiety and depression (Beck, 1976, 1987)

✅ Adaptive Alternative: Self-Compassion & Cognitive Restructuring

• Recognizing mistakes without excessive self-criticism leads to better emotional resilience.

• Cognitive restructuring (changing negative thought patterns) helps reduce stress and anxiety.

3. Indulging Oneself: Stress-Induced Impulsivity

• Stress can lead to impulse control issues, resulting in unhealthy coping behaviors such as:

  • Overeating (Araiza & Lobel, 2018)

  • Smoking & substance abuse (Siegel et al., 2017; Aarstad-Martin & Boyraz, 2017)

  • Compulsive shopping (Ruvio et al., 2014)

  • Gambling addiction (Mishra & Meadows, 2017)

✅ Adaptive Alternative: Healthy Stress Management Techniques

• Exercise, mindfulness, and social support can help manage stress without engaging in self-destructive behaviors.

• Research institutions, such as the Alberta Gambling Research Institute, are investigating ways to prevent and address stress-induced gambling.

Key Takeaways

• Chronic stress affects key brain regions (amygdala, hippocampus, prefrontal cortex), increasing the risk of anxiety, depression, and impulsivity.

• Maladaptive coping strategies (learned helplessness, self-blame, indulgence) worsen stress-related outcomes.

• Adaptive coping strategies (goal adjustment, self-compassion, stress management) help improve mental health and resilience.

Summary of Coping Strategies: Maladaptive vs. Constructive Approaches

1. Indulging Oneself: Internet Addiction & Problematic Behaviors

• Stress can lead to self-indulgence as a coping mechanism, including:

  • Gambling (Ruvio et al., 2014; Mishra & Meadows, 2017)

  • Substance abuse (Siegel et al., 2017; Aarstad-Martin & Boyraz, 2017)

  • Compulsive shopping

  • Excessive internet use (Kimberly Young, 2009, 2013)

Internet Addiction: A Growing Issue

• Internet addiction includes:

  • Excessive gaming

  • Preoccupation with sexual content

  • Obsessive socializing (social media, texting, etc.) (Weinstein et al., 2014)

• Symptoms of Internet Addiction:

  1. Spending excessive time online

  2. Experiencing anger, anxiety, or depression when restricted from online activities

  3. An escalating need for better equipment & faster connections

  1. Negative consequences (e.g., academic decline, social isolation, conflicts)

• Global Prevalence:

  • A meta-analysis of 31 countries found an average prevalence of 6% (Cheng & Li, 2014).

  • Stress is a major contributing factor (Chen et al., 2014; Tang et al., 2014).

  • Internet addiction is linked to anxiety, depression, and substance use (Ho et al., 2014).

✅ Adaptive Alternative: Mindful Technology Use & Healthy Distractions

• Setting screen time limits & digital detoxes

• Engaging in offline activities (exercise, hobbies, socializing in person)

2. Defensive Coping: Avoidance & Self-Deception

• Defensive coping refers to unconscious psychological strategies used to shield oneself from stress-related emotions (Vaillant, 1994).

• These strategies are based on Freud’s concept of defense mechanisms and involve distorting reality (Cramer, 2008).

Why Defensive Coping is Maladaptive

• It avoids rather than resolves problems.

• Wishful thinking and avoidance lead to prolonged stress and emotional distress.

• Self-deception can sometimes offer temporary relief but is not a long-term solution (Grant et al., 2013).

✅ Adaptive Alternative: Problem-Solving & Emotional Regulation

• Facing stressors directly rather than avoiding them.

• Practicing self-awareness to recognize emotional responses.

3. Constructive Coping: Healthier Stress Management

• Constructive coping refers to healthful and proactive efforts to deal with stress.

• While no strategy guarantees success, constructive coping increases resilience and well-being (Bonanno & Burton, 2013).

Key Features of Constructive Coping

1. Direct Problem-Solving Approach

   • Task-oriented and action-based

   • Evaluates realistic options instead of avoiding the problem

2. Realistic Self-Appraisals

   • Recognizing both strengths & limitations

   • Avoiding extreme negativity while maintaining self-awareness

3. Emotional Regulation

   • Learning to recognize & manage emotions effectively

   • Reducing emotional reactivity to stressors

✅ Examples of Constructive Coping:

• Cognitive restructuring (challenging negative thoughts)

• Mindfulness & relaxation techniques

• Seeking social support

• Exercise & healthy lifestyle habits

Key Takeaways

• Maladaptive coping (e.g., internet addiction, self-indulgence, defensive mechanisms) can worsen stress.

• Constructive coping involves problem-solving, realistic thinking, and emotional regulation.

• Practicing healthy stress management strategies leads to better resilience and mental well-being.

The Effects of Stress on Psychological Functioning

Stress is an unavoidable part of life, with both positive and negative effects. While moderate stress can be motivating, excessive or prolonged stress can lead to psychological and physical health issues.

Burnout: A Consequence of Chronic Stress

Burnout is a state of physical and emotional exhaustion, cynicism, and reduced self-efficacy that develops due to prolonged stress, particularly in the workplace or academic settings.

Key Components of Burnout (Maslach & Leiter, 1997, 2007):

1. Exhaustion – Chronic fatigue, weakness, and low energy.

2. Cynicism – Negative attitudes towards work, oneself, and life.

3. Reduced Self-Efficacy – Decreased sense of competence, leading to feelings of hopelessness.

Causes of Burnout

Research suggests multiple workplace and academic factors contribute to burnout:

• Excessive workload & long hours (Statistics Canada, 2003)

• Lack of control over tasks and outcomes (Maslach & Leiter, 2005)

• Poor interpersonal relationships at work

• Lack of recognition for efforts

• Job insecurity & financial stress

Consequences of Burnout

Burnout affects both individuals and organizations, leading to:

• Physical illnesses

• Depression & anxiety

• Increased absenteeism & job turnover

• Reduced productivity & performance

Burnout in Students

Burnout is not limited to professionals—it is also on the rise among students (Dyrbye et al., 2010; Portoghese et al., 2018).

• Students struggle to balance academics, work, and social life.

• Burnout leads to reduced coping abilities, poor academic performance, and low self-efficacy (Schaufeli et al., 2002; Moneta, 2011).

✅ Preventing Burnout:

• Time management & setting boundaries

• Seeking social support

• Practicing stress-reducing activities (e.g., exercise, mindfulness, hobbies)

• Prioritizing self-care & rest

The Effects of Stress: Burnout & PTSD

Stress can have profound effects on mental and physical health. When stress is prolonged or severe, it can lead to burnout and post-traumatic stress disorder (PTSD)—two significant psychological conditions that impact various populations.

Burnout and Its Consequences

Burnout is a state of chronic physical and emotional exhaustion, cynicism, and reduced self-efficacy, commonly caused by prolonged stress at work or school (Maslach & Leiter, 1997).

Key Effects of Burnout

🔹 Increased risk of mental health issues, including depression, anxiety, and suicidal ideation (Dyrbye et al., 2008).

🔹 Higher risk for physical illnesses, such as memory loss, heart disease, ulcers, asthma, migraines, and arthritis (Crompton, 2011).

🔹 Reduced academic/work performance and increased absenteeism.

Burnout is a global issue, affecting workers and students in many cultures (Schaufeli et al., 2009).

Post-Traumatic Stress Disorder (PTSD)

PTSD is a serious psychological disorder that develops after exposure to extreme stress or trauma. It was first widely recognized after the Vietnam War, when many returning veterans struggled with lingering psychological issues (Schlenger et al., 1992).

Who Is at Risk?

🔹 Military veterans – An estimated 10% of war-zone veterans experience PTSD (Government of Canada, 2017).

🔹 First responders (police, paramedics, firefighters) – A national study found that 44.5% of frontline workers in Canada reported symptoms of serious mental illness, including PTSD, depression, and anxiety (Carleton et al., 2017).

🔹 Victims of trauma, including sexual assault survivors, accident survivors, and individuals exposed to natural disasters (Galea et al., 2005).

Barriers to Seeking Help

Many individuals with PTSD, especially those in law enforcement, hesitate to seek help due to stigma and workplace culture (Mason, 2008; Regehr & Bober, 2005).

✅ Raising awareness and improving mental health support for at-risk populations is crucial to reducing PTSD’s long-term effects.

The Effects of Stress on Physical & Mental Health

Stress is not just a mental burden—it can also have serious long-term effects on physical health, increasing the risk of chronic diseases such as heart disease. Research has shown that severe trauma can even affect future generations, highlighting the intergenerational impact of stress.

Intergenerational Trauma & PTSD

Studies suggest that trauma experienced by one generation can lead to psychological and physiological changes in their descendants.

Key Findings:

🔹 Fort McMurray Wildfire (2016): 60% of evacuees experienced PTSD symptoms three months later, and 20% suffered from depression, anxiety, and trauma-related insomnia (Belleville et al., 2017).

🔹 9/11 & Holocaust Survivors: Pregnant women who witnessed 9/11 or lived through the Holocaust had children with smaller head sizes, thinner cortexes, and lower cortisol levels, making them more susceptible to PTSD (Bowers & Yehuda, 2016).

🔹 Indigenous Communities in Canada: The lasting impact of residential schools on Indigenous families may mirror these findings.

Stress & Physical Health

Chronic stress can weaken the immune system and increase the risk of disease. A Canadian health report identified stress as a key factor linking poverty, poor living conditions, and illness (Mikkonen & Raphael, 2010).

Heart Disease & Stress

🔹 Coronary Heart Disease (CHD) is the leading cause of death in North America, accounting for 90% of heart-related fatalities.

🔹 Common risk factors: Smoking, poor diet, lack of exercise, high cholesterol, high blood pressure.

🔹 Inflammation is now seen as a major contributor to CHD and heart attacks (Christodoulidis et al., 2014).

Personality, Hostility, & Heart Disease

🔹 Type A Personality: Competitive, impatient, time-conscious, and prone to stress.

🔹 Type B Personality: Relaxed, easygoing, less prone to stress-related illness.

🔹 Hostility & Heart Attacks: Studies suggest that anger & hostility (rather than all Type A traits) are strongly linked to heart disease (Betensky et al., 2012).

📌 **One study of 13,000 participants found that those with an "angry temperament" had nearly 3× more heart attacks than those with a calmer disposition (Williams et al., 2000).

Key Takeaway:

Managing stress is essential not only for mental well-being but also for preventing serious physical health issues. Would you like strategies for coping with stress more effectively? 😊

Stress, Anger, and Heart Disease

Stress and emotional reactions, particularly anger and depression, significantly increase the risk of heart disease.

Anger & Coronary Events

🔹 Study by Williams et al. (2000):

• Moderate anger → 36% increase in coronary events.

• High anger → Nearly 3× higher risk of coronary disease.
  🔹 Frequent conflict with family, friends, or neighbors can double or triple the risk of death from heart disease (Lund et al., 2014).

Anger & Immediate Heart Risks

🔹 Within 2 hours of an outburst of anger:

• 5× increase in heart attack risk.

• 3× increase in stroke risk (Mostofsky et al., 2014).
  🔹 In extreme cases, the risk of a heart attack can spike 8.5× higher after an episode of intense anger (Buckley et al., 2015).

Depression & Heart Disease

🔹 Depression and heart disease are closely linked, but which causes which?

🔹 Earlier belief: Heart disease causes depression.

🔹 New research: Depression itself may cause heart disease (Gustad et al., 2014).

Key Study:

🔹 Study of 20,000 participants (Surtees et al., 2008):

• Depressed individuals were 2.7× more likely to die of heart disease.

• Their depression preceded their heart disease, proving it wasn’t just a reaction to illness.

🔹 Overall, depression doubles the risk of heart disease (Halaris, 2013).

Takeaways:

🔹 Managing stress, anger, and depression is crucial for heart health.

🔹 Frequent anger and outbursts can significantly increase cardiovascular risk.

🔹 Depression is not just a mental health issue—it’s a physical health risk too.

Stress, Immune Function, and Illness

Stress affects both mental and physical health, weakening the immune system and increasing vulnerability to various diseases.

Stress & Immune System Suppression

🔹 The immune system protects the body from bacteria, viruses, and other harmful substances.

🔹 Chronic stress weakens the immune response, making people more susceptible to infections and diseases.

Key Studies:

🔹 Kiecolt-Glaser et al. (1984):

• Medical students had weakened immune function during final exams compared to a month before.
  🔹 Marsland et al. (2012):

• Highly stressed individuals were more likely to catch the common cold when exposed to respiratory viruses.

🔹 Other stressors that impair immune function:

• Loneliness (Jaremka et al., 2013a)

• Depression (Fagundes et al., 2013)

• Marital problems (Jaremka et al., 2013b)

• Feeling low in social status (Derry et al., 2013)

Stress & Chronic Inflammation

🔹 Long-term stress can lead to chronic inflammation, a key factor in many diseases (Cohen et al., 2012).

🔹 Chronic inflammation is linked to:

• Heart disease

• Diabetes

• Arthritis

• Osteoporosis

• Respiratory diseases

• Alzheimer’s disease

• Certain cancers (Liu et al., 2017)

Health Conditions Linked to Stress

Is Stress the Cause of Illness?

🔹 Most research is correlational, meaning stress is linked to illness but not necessarily the direct cause.

🔹 A third factor, such as personality, could influence both stress levels and health.

🔹 However, the strong connection between stress, immune function, and inflammation suggests it plays a major role in disease development.

Takeaways:

🔹 Managing stress is key to maintaining a strong immune system.

🔹 Long-term stress increases the risk of chronic inflammation and serious health conditions.

🔹 Reducing stress through mindfulness, exercise, and social support may help prevent disease.

Stress, Personality, and Coping Mechanisms

Stress affects people differently, and several factors moderate its impact on mental and physical health.

Personality & Stress Perception

🔹 Certain personality traits influence how people experience and respond to stress.

🔹 Neuroticism:

• Individuals high in neuroticism may perceive more events as stressful.

• They may also be more sensitive to unpleasant physical symptoms, increasing the perceived link between stress and illness (Espejo et al., 2011).

🔹 Key Study Findings:

• Research shows that stress and illness are moderately correlated, with correlation values typically in the 0.20s to 0.30s (Schwarzer & Luszczynska, 2013).

• However, stress is just one factor in a complex network of influences, including genetics, lifestyle, nutrition, medical care, and social support.

Factors That Help People Cope with Stress

Some individuals handle stress better than others due to moderator variables, such as:

✅ Social Support

✅ Optimism

✅ Conscientiousness

1. Social Support: A Buffer Against Stress

🔹 Definition: Emotional and practical assistance from friends, family, and community.

🔹 Key Benefits:

• Enhances immune function (Stowell et al., 2013).

• Reduces stress reactions and helps with coping (Pietromonaco & Collins, 2017).

• Frequent hugs were linked to lower susceptibility to illness (Cohen et al., 2015).

🔹 Social Isolation & Health Risks:

• Loneliness is linked to weakened immune responses (Pressman et al., 2005).

• Social isolation increases the risk of poor health and early death (Cacioppo et al., 2015; Holt-Lunstad et al., 2015).

• Good relationships, especially with a spouse, improve health and life expectancy (Robles et al., 2014).

📌 Meta-Analysis: A review of 148 studies found that strong social support increases survival chances by 50% (Holt-Lunstad et al., 2010).

2. Optimism: A Positive Outlook on Life

🔹 Optimists tend to:

• Interpret stressors as challenges rather than threats.

• Use problem-focused coping strategies, which reduce stress impact.

• Have better physical health outcomes, including stronger immune function and lower risk of heart disease.

3. Conscientiousness: The Power of Self-Discipline

🔹 Highly conscientious people:

• Are more organized, responsible, and proactive in managing stress.

• Tend to engage in healthier behaviors (e.g., regular exercise, healthy diet, avoiding risky behaviors).

• Have lower stress levels and better overall health.

Takeaways

✅ Stress does not directly cause illness but contributes to health risks.

✅ Personality traits (e.g., neuroticism) influence stress perception and health outcomes.

✅ Social support is a powerful buffer, reducing stress and improving immune function.

✅ Optimism and conscientiousness help individuals cope with stress in healthier ways.

Social Support, Self-Esteem, and Cultural Differences

Social support is a critical factor in mental and physical well-being, but not everyone experiences or seeks support in the same way.

Self-Esteem and Social Support

🔹 People with low self-esteem (LSE) may struggle with receiving support, even when they need it the most.

🔹 Research by Marigold et al. (2014, 2019) suggests that those with LSE:

• Crave validation and support but often reject positive feedback due to self-doubt.

• May act in ways that alienate potential supporters, making it harder for them to receive help.

• Respond better to support that acknowledges their negative thoughts and feelings rather than just positive reframing.

📌 Key Takeaway: When supporting someone with low self-esteem, instead of just telling them to “stay positive,” it may be more effective to validate their struggles while still offering encouragement.

Cultural Differences in Social Support

🔹 Western (e.g., American) cultures prefer explicit social support, which includes:

• Verbal encouragement and direct problem-solving help.

• Expressing emotions openly with friends and family.

🔹 Eastern (e.g., Asian) cultures often prefer implicit social support, which means:

• Feeling supported simply by being around loved ones, even without talking about their problems.

• Avoiding burdening others with personal stress.

📌 Key Study: Taylor et al. (2007) found that while Asians benefit from social support, they tend to avoid direct expressions of it, preferring instead to draw comfort from their social groups in non-verbal ways.

Community and Well-Being

🔹 A strong sense of community is linked to better health (Shields, 2008):

• Over 80% of those with strong community ties reported good mental health.

• Over two-thirds reported good physical health.

🔹 Even small interactions with acquaintances (e.g., chatting with a barista or store clerk) boost mood and well-being (Sandstrom & Dunn, 2014).

📌 Key Takeaway: Even superficial social interactions can make a difference in our daily happiness and mental health.

Optimism and Health

🔹 Optimism is a general expectation that positive outcomes will occur.

🔹 Studies show that optimism is linked to:

• Better physical health (Scheier et al., 2012).

• Stronger immune function (Segerstrom & Sephton, 2010).

• Improved cardiovascular health (Hernandez et al., 2015).

• Increased longevity (Peterson et al., 1998).

📌 Why is optimism beneficial?

• Optimists engage in problem-focused coping instead of avoidance.

• They are more likely to seek and maintain social support.

• The optimism-health link is consistent across cultures (Gallagher et al., 2013).

Conscientiousness and Longevity

🔹 Conscientiousness, one of the Big Five personality traits, is also linked to better health and longevity (Friedman, 2011; Kern et al., 2014).

📌 Why does conscientiousness promote a longer life?

• Fewer unhealthy habits: Less likely to smoke, drink excessively, or take risks.

• Better coping strategies: More likely to deal with stress constructively.

• Better medical adherence: More likely to follow doctors' advice.

• Higher SES (socioeconomic status): Often leads to better jobs, income, and healthcare access.

📊 Health Disparities and Socioeconomic Status (SES)

• Mortality rates are 2-3 times higher among the poor (Phelan et al., 2010).

• Higher SES individuals tend to have better nutrition, more exercise, and less stress.

Hardiness: Resisting the Effects of Stress

🔹 Hardiness is a personality trait that helps people cope with stress effectively.

🔹 First studied by Kobasa (1979) in business executives who thrived under stress.

🔹 Hardiness consists of three key traits (Lambert & Lambert, 1999):

1. Commitment – Viewing work/life as meaningful and engaging.

2. Control – Believing in one's ability to influence outcomes.

3. Challenge – Seeing stress as an opportunity for growth.

📌 Example of Hardiness: Malala Yousafzai’s resilience in fighting for girls' education despite extreme adversity.

Optimism and Health

🔹 Optimism is a general expectation that positive outcomes will occur.

🔹 Studies show that optimism is linked to:

• Better physical health (Scheier et al., 2012).

• Stronger immune function (Segerstrom & Sephton, 2010).

• Improved cardiovascular health (Hernandez et al., 2015).

• Increased longevity (Peterson et al., 1998).

📌 Why is optimism beneficial?

• Optimists engage in problem-focused coping instead of avoidance.

• They are more likely to seek and maintain social support.

• The optimism-health link is consistent across cultures (Gallagher et al., 2013).

Conscientiousness and Longevity

🔹 Conscientiousness, one of the Big Five personality traits, is also linked to better health and longevity (Friedman, 2011; Kern et al., 2014).

📌 Why does conscientiousness promote a longer life?

• Fewer unhealthy habits: Less likely to smoke, drink excessively, or take risks.

• Better coping strategies: More likely to deal with stress constructively.

• Better medical adherence: More likely to follow doctors' advice.

• Higher SES (socioeconomic status): Often leads to better jobs, income, and healthcare access.

📊 Health Disparities and Socioeconomic Status (SES)

• Mortality rates are 2-3 times higher among the poor (Phelan et al., 2010).

• Higher SES individuals tend to have better nutrition, more exercise, and less stress.

Hardiness: Resisting the Effects of Stress

🔹 Hardiness is a personality trait that helps people cope with stress effectively.

🔹 First studied by Kobasa (1979) in business executives who thrived under stress.

🔹 Hardiness consists of three key traits (Lambert & Lambert, 1999):

1. Commitment – Viewing work/life as meaningful and engaging.

2. Control – Believing in one's ability to influence outcomes.

3. Challenge – Seeing stress as an opportunity for growth.

📌 Example of Hardiness: Malala Yousafzai’s resilience in fighting for girls' education despite extreme adversity.

The Positive Effects of Stress & Resilience

Malala Yousafzai: A Case of Hardiness and Resilience

🔹 Malala Yousafzai, a Pakistani human rights activist, exemplifies hardiness through her unwavering commitment to education.

🔹 Despite being shot in 2012 for advocating girls’ education, she recovered and continued her activism.

🔹 Honors and Recognition:

• 2014 Nobel Peace Prize (youngest recipient).

• Honorary Citizen of Canada (2017) (youngest to receive this honor).

📌 Hardiness Traits Displayed by Malala:

• Commitment: Passionate about education rights.

• Control: Continued activism despite threats.

• Challenge: Transformed adversity into motivation for global change.

Can Stress Have Positive Effects?

🔹 Contrary to the common belief that stress is purely harmful, research suggests it can foster personal growth and resilience (Folkman & Moskowitz, 2000).

🔹 The rise of positive psychology (Seligman, 2003) has led to studies on resilience, showing that many people recover and even thrive after adversity (Bonanno et al., 2012).

📌 How Can Stress Lead to Personal Growth?

• Encourages self-improvement and new skills development.

• Helps people re-evaluate priorities and gain insights.

• Builds mental toughness and adaptability.

💡 Post-Traumatic Growth (PTG):

• Coined by Tedeschi & Calhoun (2004).

• Describes positive psychological change after adversity.

• Studies show many people with major health issues report personal growth (Lechner et al., 2009).

📊 Moderate Stress & Resilience

• Seery (2011, 2013) found that people with intermediate levels of adversity had:

  • Better mental health than those with little or extreme adversity.

  • Greater resilience when facing new stressors.

🔹 Conclusion: Some stress is necessary for resilience—too little may leave people unprepared, while too much can be overwhelming.

Social Support and Well-Being

Social connections are crucial for well-being, but individuals with low self-esteem (LSE) struggle to accept support, often distorting positive feedback and alienating their supporters (Marigold et al., 2007, 2010). Research suggests that instead of simply offering positive encouragement, validating LSE individuals' feelings may be more effective (Marigold et al., 2014). Cultural differences also shape support preferences: Westerners favor explicit support (direct help and comfort), while Asians prefer implicit support (spending time with close others without discussing problems) (Taylor et al., 2007).

Social Ties and Health

A strong sense of community belonging is linked to better physical and mental health (Shields, 2008). Even weak social ties (e.g., interactions with acquaintances or strangers) positively impact well-being (Sandstrom & Dunn, 2014).

Personality Traits and Health

Certain personality traits contribute to resilience and longevity:

• Optimism leads to better coping, social support, and physical health (Scheier et al., 2012).

• Conscientiousness reduces risky behaviors and improves stress management, adherence to medical advice, and socioeconomic success (Friedman, 2011).

• Hardiness (commitment, control, and challenge) helps individuals endure stress effectively, as seen in Malala Yousafzai’s activism (Kobasa, 1979).

Positive Effects of Stress

Though stress is often viewed negatively, it can promote resilience and personal growth (Calhoun & Tedeschi, 2008). Moderate stress levels help individuals develop coping skills, with research showing that intermediate adversity is linked to the best mental health outcomes (Seery, 2011). This concept, called post-traumatic growth, suggests that overcoming difficulties can lead to personal development.

Health-Compromising Behaviors

Many university students engage in unhealthy behaviors, such as poor diet, lack of exercise, and binge drinking (Kwan et al., 2013). However, smoking, drug use, and marijuana consumption are less prevalent. Smoking, though declining in high-income countries like Canada, remains a leading cause of premature death, reducing life expectancy by 10-14 years (Schmitz & DeLaune, 2005). It also increases risks for cancer, cardiovascular disease, and lung conditions, and is considered a gateway drug to substances like cocaine (Levine et al., 2011).

Social Support and Well-Being

People with low self-esteem (LSE) struggle to accept support and may distort positive feedback, often alienating their supporters (Marigold et al., 2007, 2010). Research suggests that validating their feelings rather than offering excessive encouragement is more effective (Marigold et al., 2014). Cultural differences also influence support preferences: Westerners favor explicit support (direct help), while Asians prefer implicit support (being around close others without discussing problems) (Taylor et al., 2007).

Social Ties and Health

Strong community belonging is linked to better physical and mental health (Shields, 2008). Even weak social ties (interactions with acquaintances or strangers) positively impact well-being (Sandstrom & Dunn, 2014).

Personality Traits and Health

• Optimism improves coping and health outcomes (Scheier et al., 2012).

• Conscientiousness reduces risky behaviors and enhances stress management (Friedman, 2011).

• Hardiness (commitment, control, and challenge) fosters resilience, as seen in Malala Yousafzai’s activism (Kobasa, 1979).

Positive Effects of Stress

While often viewed negatively, stress can promote resilience and personal growth (Calhoun & Tedeschi, 2008). Research shows that moderate stress levels help people develop coping skills, with those facing intermediate adversity demonstrating the best mental health outcomes (Seery, 2011). This concept, called post-traumatic growth, highlights how overcoming difficulties leads to personal development.

Health-Compromising Behaviors

Many university students engage in unhealthy behaviors, such as poor diet, lack of exercise, and binge drinking (Kwan et al., 2013). However, smoking, drug use, and marijuana consumption are less common.

Smoking and Its Risks

• Smoking remains a leading cause of premature death, reducing life expectancy by 10-14 years (Schmitz & DeLaune, 2005).

• It increases the risk of lung cancer, heart disease, and other serious conditions (Thun et al., 2000).

• Second-hand smoke is also deadly, causing 1.2 million premature deaths annually (WHO, 2019).

• Many smokers underestimate their personal risk, making quitting difficult (Ayanian & Cleary, 1999).

Quitting Smoking and Vaping

• Health benefits of quitting begin immediately (Kenfield et al., 2008).

• Success rates for quitting smoking are low (~25%), and relapse is common (Scharf et al., 2016).

• E-cigarettes contain less nicotine but still pose risks, especially for adolescents, who often misunderstand their nicotine content (Vincent et al., 2019). Research suggests that vaping can lead to traditional smoking (Klein, 2018).

Lack of Exercise and Health Risks

• Sedentary behavior (e.g., excessive TV watching) is linked to poor health and obesity (Statistics Canada, 2008).

• Regular exercise reduces the risk of cancer, obesity, high blood pressure, and mental health issues (Colley et al., 2011; Rhodes et al., 2017).

Exercise and Health Benefits

• Regular exercise is linked to increased longevity and can be as effective as medications for managing conditions like diabetes (Public Health Agency of Canada, 2017).

• The World Health Organization (WHO) recommends 150 minutes per week of moderate-to-vigorous physical activity for adults, but few Canadians meet this standard (Statistics Canada, 2017).

• Physical activity levels have declined sharply, especially among children, with most accumulating only 14 minutes of activity after school (Picard, 2011).

• Screen time is increasing, with Canadian kids spending up to eight hours per day on screens, leading to obesity and cognitive development issues (Statistics Canada, 2016; Active Healthy Kids Canada, 2018).

Why Exercise Increases Longevity

1. Enhances cardiovascular fitness, reducing the risk of heart disease (Lanier et al., 2016).

2. Prevents obesity-related diseases such as diabetes and respiratory issues (Jakicic & Rogers, 2018).

3. Reduces chronic inflammation, which contributes to various diseases (Allen, 2015).

4. Acts as a buffer against stress, reducing its physiological impact (Edenfield & Blumenthal, 2011).

5. Preserves brain function, slowing cognitive decline and dementia (Prakash et al., 2015; Basso & Suzuki, 2017).

6. Improves mood and cognitive performance, even after a single workout (Basso & Suzuki, 2017).

Alcohol and Drug Use

• Moderate alcohol consumption may have some cardiovascular benefits (Ogunmoroti et al., 2018).

• Heavy drinking and binge drinking, however, significantly increase health risks (Sher et al., 2011).

Alcohol and Drug Use

• Binge drinking is common among 60% of Canadian university students and poses severe health risks, including alcohol poisoning and death (Kwan et al., 2013; Seitz et al., 2017).

• Recreational drug use can be fatal due to overdoses and impairment-related accidents. Long-term drug use increases the risk of infectious diseases, cardiovascular and liver diseases, cancer, and neurological disorders.

• Alcohol, despite being legal, causes the greatest physical harm at the population level.

Risky Sexual Behavior and HIV/AIDS

• Intoxication leads to poor decision-making, increasing the likelihood of unprotected sex and exposure to HIV/AIDS (MacDonald et al., 1996).

• HIV/AIDS statistics:

  • Canada has seen a 25.5% increase in HIV infections since 2014 (Haddad et al., 2019).

  • Global rates remain high, especially in Africa (Kharsany & Karim, 2016).

• Preventive strategies:

  • Fewer sexual partners and consistent condom use lower infection risk.

  • Pre-exposure prophylaxis (PrEP) offers protection to high-risk individuals, though concerns exist about its impact on attitudes toward safe sex (Chu & Bositis, 2017).

• Psychological factors also influence risky sexual behavior, including beliefs about a just world affecting condom use (Choma et al., 2012).

Themes in Stress and Health

• Health is influenced by multiple factors, including genetics, stress, behaviors, personality, and social environment.

• Stress contributes to illness but has a modest overall impact compared to other health determinants.

Psychological Perspectives on Stress and Health

• Multifactorial Causation: Stress is one of many factors that affect health. Other contributors include genetics, behavior, social support, and physiological responses.

• Subjectivity of Experience: The way people perceive stress is more important than the stressor itself. A situation may be stressful for one person but motivating for another.

• Personal Stress Appraisals Matter: How individuals interpret stress influences its impact on health. Many stress management strategies focus on changing one's perspective to reduce stress.

Personal Application: Improving Coping and Stress Management

Key Strategies for Stress Management

1. Reappraisal: Rational Thinking (Albert Ellis's Approach)

   • People react emotionally based on their thoughts, not just the stressful event itself.

   • Catastrophic thinking (exaggerating problems) leads to distress.

   • Solution: Identify and dispute irrational beliefs (e.g., “I must always be perfect”) to develop healthier thought patterns.

2. Using Humour to Reduce Stress

   • Humour acts as a buffer against stress and enhances resilience.

   • Research shows that people who use humour at work or in daily life experience lower stress and better performance.

Relaxation and Mindfulness-Based Stress Reduction (MBSR)

Key Techniques for Managing Stress:

1. Relaxation Techniques

   • Helps reduce emotional turmoil and physiological arousal.

   • Harvard cardiologist Herbert Benson emphasized the relaxation response, where activities like meditation, music, prayer, or warm baths can significantly lower stress.

   • Techniques include:

     • Progressive Relaxation (Jacobson, 1938)

     • Autogenic Training (Schultz & Luthe, 1959)

     • Relaxation Response Training (Benson & Klipper, 2000)

2. Mindfulness-Based Stress Reduction (MBSR)

   • Developed by Jon Kabat-Zinn (1995), focusing on nonjudgmental awareness of thoughts and surroundings.

   • Involves meditation, yoga, and body scans.

   • Research shows MBSR reduces stress and improves mental health (Khoury et al., 2015).

Minimizing Physiological Vulnerability: The Role of Exercise

Why Exercise Matters for Stress Management

• Regular physical activity reduces stress-related wear and tear on the body.

• Research suggests even moderate exercise lowers the risk of disease and increases longevity (Gremeaux et al., 2012).

• A well-known study (Blair et al., 1989) showed higher fitness levels are linked to lower mortality rates (Figure 14.18).

Tips for Starting and Sticking to Exercise

1. Choose an activity you enjoy – You'll be more likely to stick with it.

2. Start small and gradually increase intensity – Avoid burnout or discouragement.

3. Make it social – Exercising with friends can increase motivation.

4. Incorporate movement into daily life – Take stairs, walk more, stretch at work.