Stress and Illness

PSYCHOPHYSIOLOGICAL DISORDERS

If the reactions that compose the stress response are chronic or if they frequently exceed normal ranges, they can lead to cumulative wear and tear on the body, in much the same way that running your air conditioner on full blast all summer will eventually cause wear and tear on it. For example, the high blood pressure that a person under considerable job strain experiences might eventually take a toll on his heart and set the stage for a heart attack or heart failure. Also, someone exposed to high levels of the stress hormone cortisol might become vulnerable to infection or disease because of weakened immune system functioning (McEwen, 1998).

Robert Sapolsky, a noted Stanford University neurobiologist and professor, has for over 30 years conducted extensive research on stress, its impact on our bodies, and how psychological tumult can escalate stress—even in baboons. Here are two videos featuring Dr. Sapolsky: one is regarding killer stress and the other is an excellent in-depth documentary from National Geographic.

Physical disorders or diseases whose symptoms are brought about or worsened by stress and emotional factors are called psychophysiological disorders. The physical symptoms of psychophysiological disorders are real and they can be produced or exacerbated by psychological factors (hence the psycho and physiological in psychophysiological). A list of frequently encountered psychophysiological disorders is provided in Table.

Type of Psychophysiological Disorder Examples
Cardiovascular hypertension, coronary heart disease
Gastrointestinal irritable bowel syndrome
Respiratory asthma, allergy
Musculoskeletal low back pain, tension headaches
Skin acne, eczema, psoriasis
Types of Psychophysiological Disorders (adapted from Everly & Lating, 2002)

In addition to stress itself, emotional upset and certain stressful personality traits have been proposed as potential contributors to ill health. Franz Alexander (1950), an early-20th-century psychoanalyst and physician, once postulated that various diseases are caused by specific unconscious conflicts. For example, he linked hypertension to repressed anger, asthma to separation anxiety, and ulcers to an unconscious desire to “remain in the dependent infantile situation—to be loved and cared for” (Alexander, 1950, p. 102). Although hypertension does appear to be linked to anger (as you will learn below), Alexander’s assertions have not been supported by research. Years later, Friedman and Booth-Kewley (1987), after statistically reviewing 101 studies examining the link between personality and illness, proposed the existence of disease-prone personality characteristics, including depression, anger/hostility, and anxiety. Indeed, a study of over 61,000 Norwegians identified depression as a risk factor for all major disease-related causes of death (Mykletun et al., 2007). In addition, neuroticism—a personality trait that reflects how anxious, moody, and sad one is—has been identified as a risk factor for chronic health problems and mortality (Ploubidis & Grundy, 2009).

Below, we discuss two kinds of psychophysiological disorders about which a great deal is known: cardiovascular disorders and asthma. First, however, it is necessary to turn our attention to a discussion of the immune system—one of the major pathways through which stress and emotional factors can lead to illness and disease.

2 of 12