1. 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 Cardiovascular disorders Immune depression Immune depression www.psychlotron.org.uk

2. 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 www.psychlotron.org.uk

3. Heart Disease – Risk Factors Fixed Genetics Ethnicity Sex Age Variable High LDL cholesterol Hypertension Inactivity Obesity Diabetes High c-reactive protein www.psychlotron.org.uk

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

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

6. Stress & Heart Disease Kivimaki et al (2002) Highly stressed workers were 2x as likely to die from heart problems 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 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 Stress-prone individuals more likely to accumulate LDL ‘bad’ blood cholesterol www.psychlotron.org.uk

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