PSYA2 – Stress Stress and Cardiovascular Disorders

BATs  Define: cardiovascular disorders (AO1)  Analyse and evaluate research on the relationship between stress and CVD (AO2)

Stress and Illness  Stress, on its own, does not make you ill  It may increase your risk of illness  Stress has been linked to: Cardiovascular disorders Immune depression

Stress and Illness Stress Direct biological effects e.g. physical strain, hormonal changes Maladaptive coping behaviour e.g. smoking, drinking alcohol Emotionally mediated effects on diet and activity level Increased Risk of Disease

Heart Disease – Risk Factors Fixed Genetics Ethnicity Sex Age Variable High LDL cholesterol Hypertension Inactivity Obesity Diabetes High c-reactive protein

Is there a relationship between prolonged exposure to stressors and the risk of cardiovascular disorders ? Evidence, suggests that acute and chronic stress may affect the Cardiovascular system (heart and circulatory system) as follows: Hypertension – high blood pressure Coronary Heart Disease (CHD) – caused by atherosclerosis angina and/or heart attack. Stroke – brain damage caused by disruption of blood supply to brain Of course the above are also affected by lifestyle, diet, smoking, alcohol e.t.c As cardiovascular disease is a major cause of death in the UK it is important to understand what causes it.

Stress may cause physical illness: Directly (as described in the GAS model) Indirectly- stressed individuals are more likely to smoke, drink e.t.c Direct Causes of Cardiovascular disorders Increased heart rate – may wear away lining of blood vessels Increases blood pressure damage to blood vessels Increased glucose levels clumps (plaque) blocking the blood vessels (atherosclerosis)

Stress & Heart Disease  Kivimaki et al (2002) Highly stressed workers were 2x as likely to die from heart problems  Sheps et al (2002) Stress-prone individuals with heart problems 3x more likely to die from heart attack  Steptoe et al (2005) Stress-prone individuals more likely to accumulate LDL ‘bad’ blood cholesterol

Other Research relating to stress and cardiovascular disorders.  Russek and Zohman (1958) – cardiovascular disorder and work related stress (chronic stress). Heart disease in medical professionals - Compared doctors with high stress jobs (GP’s and anaesthetists) with lower stress jobs (pathologists and dermatologists). Heart disease was greatest among GP’s (11.9%), lowest in dermatologists (3.2%) Supports view that stress linked to heart disease.  Does not show if link is direct or indirect.

Other Research relating to stress and cardiovascular disorders.  Rozanski et al (1999) - Cardiovascular disorders and individual differences. Suggested that sympathetic branch of ANS in some individuals is more reactive than others – hyperresonsive (respond to stress with higher increases in blood pressure and heart rate) more damage to cardiovascular system.

Stress & Heart Disease  Stress increases risk of cardiovascular disease – but is not a direct causal factor Effect is mediated by personality (stress prone-ness)  The mechanism is complex Direct effects and lifestyle-mediated ones are both likely to be important  Stress effects are clearest with pre-existing CHD If you have CHD stress will probably make it worse But we still don’t know if stress causes CHD initially

Match the key word with the definition Atherosclerosis CHD Hypertension Stroke CVD Cardio vascular disorder Brain damage caused by disruption of blood supply to brain High blood pressure Clumps (plaque) blocking the blood vessels Coronary heart disease

Personality and Stress  BATs  Describe the type A behaviour pattern. (A01)  Understand and evaluate research linking type A behaviour to stress and illness. (A02)  Describe the characteristics of hardiness Try out the questionnaire ‘What type are you?’

Although we each have a unique personality, we share some personality traits (characteristics) with others. Research has established that some personality characteristics make us more vulnerable to the negative effects of stress, while others makes us more resilient Stress Proneness

Stress & Heart Disease  Friedman & Rosenman (1974)  Assessed 3200 healthy American men.  Stress-prone individuals (Type As) were identified: Anger & hostility Competitiveness Time-urgency

Stress & Heart Disease  After 8½ years, men were reassessed 257 had developed CHD Of these, 70% were Type As  Association remained when smoking and other lifestyle factors were accounted for

Type A Personality Identified by Friedman and Rosenman in Typical Characteristics:  Aggressive – easily frustrated by efforts of others  Ambitious  Competitive drive – socially and at work  Chronic sense of time urgency Effects  Raised blood pressure and levels of stress hormones  More susceptible to CHD and cancer Type B = opposite of Type A

Type C (Cancer) Personality Typical Characteristics:  Suppress emotions – especially –ve ones.  Unassertive  Likeable – rarely argumentative, want to please others  Generally helpful to others Effects (Temoshok (1987)  Cope with stress in a way that ignores their own needs (even physical ones). Stresses suppressed.  Negative physiological consequences  More susceptible to cancer because more chronic stressors affect immune system and increase risk of cancer.

Type D (Depressed/distressed) Personality Typical Characteristics: Denollet et al 1996  Gloomy, Socially inept, Worriers  Cross between Eeyore and Marvin the Paranoid Android (Burne,1999) Effects:  Greater risk of heart attack.  Studied 300 male and female heart attack sufferers. Filled in questionnaire after 1 st attack. 10 years later Type D, 4x more likely to have another heart attack – ‘Distressed personality’ – associated with depression and social alienation

Over to you  Read p of Exploring Psychology  Choose a Celebrity that you think has an A type personality.  Justify why you think they have that Personality type (characteristics)  Use evidence from research to suggest why they are more likely to suffer stress related illness.