Stress Related Disorders Sourcebook, 6th Ed.

By Omnigraphics

Provides consumer health information about types of stress and the stress response, the physical and mental health effects of stress, along with facts about treatment for stress-related disorders, and stress management techniques for adults and children.

• Language: English
• Publisher: Omnigraphics
• Release date: Dec 1, 2021
• ISBN: 9780780819832

Book preview

Preface

About This Book

Stress levels are on the rise in our increasingly busy world. In a national survey, 24 percent of U.S. adults reported extreme stress, an increase from 18 percent just one year earlier. About one-third reported that their stress had increased over the past year; fewer than half as many said it had decreased. Prolonged stress adversely affects immune system function, worsening conditions such as chronic pain disorders, diabetes, and heart problems. Mental-health disorders, including depression, anxiety, and posttraumatic stress disorder (PTSD), are also linked to serious problems coping with stress. Mental illnesses are common in the United States. Nearly one in five U.S. adults live with a mental illness (51.5 million in 2019). Mental illnesses include many different conditions that vary in degree of severity, ranging from mild to moderate to severe. Additionally, based on diagnostic interview data from the National Comorbidity Survey Replication (NCS-R), an estimated 3.6 percent of U.S. adults had PTSD in the past year. As stress levels in adults rise, so do those in children and adolescents who struggle to cope with worries about family and school.

Stress-Related Disorders Sourcebook, Sixth Edition provides updated information about the origins and types of stress and describes physical- and mental-health disorders that may develop during and after stressful situations. Readers will learn about how stress worsens asthma, digestive disorders, infertility, and chronic pain. The book also discusses how stress contributes to mental-health problems, including depression, anxiety disorders, PTSD, and addiction to tobacco, alcohol, and drugs. Information about trauma, loss, and grief is presented, along with suggestions for managing stressful situations, such as aggressive driving, caregiver stress, economic hardship, and occupational stress. Tips on helping children and teens cope with stress are also offered. The book concludes with a glossary of related terms and a directory of organizations for people with stress-related disorders.

How to Use This Book

This book is divided into parts and chapters. Parts focus on broad areas of interest. Chapters are devoted to single topics within a part.

Part 1: Introduction to Stress and Stress-Related Disorders defines what stress is and gives a brief insight into the common signs and symptoms of stress, and the various factors that influence stress. Individual chapters also deal with how personality, fatigue, loneliness, adolescence, and aging are associated with stress.

Part 2: How Stress Affects the Body offers facts about how stress is associated with Alzheimer disease (AD), asthma, diabetes, stroke, erectile dysfunction (ED), gastrointestinal problems, headache, heart problems, infertility, weight issues, pain, pregnancy, skin problems, sleep disorders, and teeth grinding.

Part 3: How Stress Affects Mental Health discusses depression, anxiety disorders, adrenal insufficiency, disordered eating, obsessive-compulsive disorder (OCD), substance abuse, addiction, and other stress-related disorders that develop after trauma. Chapters include information about relationships and trauma, and traumatic stress in children and teens. An individual chapter deals exclusively with posttraumatic stress disorder (PTSD) in military personnel returning from the war zone.

Part 4: Treating Stress-Related Disorders includes chapters that deal with helping a family member handle stress, finding a therapist, and coping with traumatic stress reactions. It provides detailed information on the various treatment procedures such as psychotherapy, medications, complementary and alternative medicine (CAM), and counseling. An exclusive chapter deals with suicide prevention techniques.

Part 5: Stress Management covers the basics of preventing and managing stress, developing resilience, stress reduction techniques, healthy habits to combat stress, and handling stressful situations. It also discusses tips for coping with stress, stress management for children, teens, and families, and other stress management strategies.

Part 6: Additional Help and Information includes a glossary of stress-related terms and a directory of organizations for people with stress-related disorders.

Bibliographic Note

This volume contains documents and excerpts from publications issued by the following U.S. government agencies: Agency for Healthcare Research and Quality (AHRQ); Cancer Imaging Program (CIP); Centers for Disease Control and Prevention (CDC); Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); MedlinePlus; National Cancer Institute (NCI); National Digestive Diseases Information Clearinghouse (NDDIC); National Eye Institute (NEI); National Heart, Lung, and Blood Institute (NHLBI); National Institute of Biomedical Imaging and Bioengineering (NIBIB); National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); National Institute of Neurological Disorders and Stroke (NINDS); Office of Disease Prevention and Health Promotion (ODPHP); Office on Women’s Health (OWH); Surveillance, Epidemiology, and End Results (SEER) Program; U.S. Department of Veterans Affairs (VA); and U.S. Food and Drug Administration (FDA).

It also contains original material produced by Omnigraphics and reviewed by medical consultants.

About the Health Reference Series

The Health Reference Series is designed to provide basic medical information for patients, families, caregivers, and the general public. Each volume provides comprehensive coverage on a particular topic. This is especially important for people who may be dealing with a newly diagnosed disease or a chronic disorder in themselves or in a family member. People looking for preventive guidance, information about disease warning signs, medical statistics, and risk factors for health problems will also find answers to their questions in the Health Reference Series. The Series, however, is not intended to serve as a tool for diagnosing illness, in prescribing treatments, or as a substitute for the physician–patient relationship. All people concerned about medical symptoms or the possibility of disease are encouraged to seek professional care from an appropriate healthcare provider.

A Note about Spelling and Style

Health Reference Series editors use Stedman’s Medical Dictionary as an authority for questions related to the spelling of medical terms and The Chicago Manual of Style for questions related to grammatical structures, punctuation, and other editorial concerns. Consistent adherence is not always possible, however, because the individual volumes within the Series include many documents from a wide variety of different producers, and the editor’s primary goal is to present material from each source as accurately as is possible. This sometimes means that information in different chapters or sections may follow other guidelines and alternate spelling authorities. For example, occasionally a copyright holder may require that eponymous terms be shown in possessive forms (Crohn’s disease vs. Crohn disease) or that British spelling norms be retained (leukaemia vs. leukemia).

Medical Review

Omnigraphics contracts with a team of qualified, senior medical professionals who serve as medical consultants for the Health Reference Series. As necessary, medical consultants review reprinted and originally written material for currency and accuracy. Citations including the phrase Reviewed (month, year) indicate material reviewed by this team. Medical consultation services are provided to the Health Reference Series editors by:

Dr. Vijayalakshmi, MBBS, DGO, MD

Dr. Senthil Selvan, MBBS, DCH, MD

Dr. K. Sivanandham, MBBS, DCH, MS (Research), PhD

Health Reference Series Update Policy

The inaugural book in the Health Reference Series was the first edition of Cancer Sourcebook published in 1989. Since then, the Series has been enthusiastically received by librarians and in the medical community. In order to maintain the standard of providing high-quality health information for the layperson the editorial staff at Omnigraphics felt it was necessary to implement a policy of updating volumes when warranted.

Medical researchers have been making tremendous strides, and it is the purpose of the Health Reference Series to stay current with the most recent advances. Each decision to update a volume is made on an individual basis. Some of the considerations include how much new information is available and the feedback we receive from people who use the books. If there is a topic you would like to see added to the update list, or an area of medical concern you feel has not been adequately addressed, please write to:

Managing Editor

Health Reference Series

Omnigraphics

615 Griswold St., Ste. 520

Detroit, MI 48226

Part 1 | Introduction to Stress and Stress-Related Disorders

Chapter 1 | Stress: An Overview

What Is Stress?

Stress is how your body reacts to certain situations, such as sudden danger or long-lasting challenge. During stressful events, your body releases chemicals called hormones, such as adrenaline. Adrenaline gives you a burst of energy that helps you cope and respond to stress. For example, one kind of stress is the jolt you may feel when a car pulls out in front of you. This jolt of adrenaline helps you quickly hit the brakes to avoid an accident.

Stress can range from mild and short-term to more extreme and long-lasting. Chronic (long-lasting) stress can affect your mental and physical health.

What Are Some Symptoms of Stress?

Stress affects everyone differently. Some ways that chronic or long-term stress affects women include:

Pain, including back pain

Acne and other skin problems, such as rashes or hives

Headaches

Upset stomach

Feeling like you have no control

Forgetfulness

Lack of energy

Lack of focus

Overeating or not eating enough

Being easily angered

Trouble sleeping

Drug and alcohol misuse

Loss of interest in things you once enjoyed

Less interest in sex than usual

What Causes Stress

People can feel stress from many different things. Examples of common causes of short-term stress include:

Getting stuck in traffic or missing the bus

An argument with your spouse or partner

Money problems

A deadline at work

Examples of common causes of long-term stress include:

Poverty and financial worries. Depression is more common in women whose families live below the federal poverty line. Women in poverty who care for children or other family members, as well as themselves, may experience more severe stress.

Discrimination. All women are at risk for discrimination, such as gender discrimination at work. Some women experience discrimination based on their race, ethnicity, or sexual orientation. Stressful events, such as learning a new culture (for those new to the United States) or experiencing discrimination, put women at higher risk for depression or anxiety.

Traumatic events. Experiencing trauma, such as being in an accident or disaster or going through emotional, physical, or sexual assault or abuse as a child or an adult, may put you at higher risk of depression and other disorders. Women are more likely than men to experience certain types of violence, such as sexual violence, that are more likely to cause mental-health conditions, such as posttraumatic stress disorder (PTSD).

Ongoing, low-level stress can be hard to notice, but it can also lead to serious health problems. If you need help managing stress, talk to a doctor, nurse, or mental-health professional.

What Can You Do to Help Manage Your Stress?

Everyone has to deal with stress at some point in their lives. You can take steps to help handle stress in a positive way.

Take deep breaths. This forces you to breathe slower and helps your muscles relax. The extra oxygen sends a message to your brain to calm and relax the body.

Stretch. Stretching can also help relax your muscles and make you feel less tense.

Write out your thoughts. Keeping a journal or simply writing down the things you are thankful for can help you handle stress.

Take time for yourself. It could be listening to music, reading a good book, or going to a movie.

Meditate. Studies show that meditation, a set time of stillness to focus the mind on a positive or neutral thought, can help lower stress. In addition to traditional medical treatments, meditation also may help improve anxiety, some menopause symptoms, and side effects from cancer treatments and may lower blood pressure. Meditation is generally safe for everyone, and free meditation guides are widely available online.

Get enough sleep. Most adults need seven to nine hours of sleep a night to feel rested.

Eat right. Caffeine or high-sugar snack foods give you jolts of energy that wear off quickly. Instead, eat foods with B vitamins, such as bananas, fish, avocados, chicken, and dark green, leafy vegetables. Studies show that B vitamins can help relieve stress by regulating nerves and brain cells. You can also take a vitamin B supplement if your doctor or nurse says it is ok.

Get moving. Physical activity can relax your muscles and improve your mood. Physical activity also may help relieve symptoms of depression and anxiety. Physical activity boosts the levels of feel-good chemicals in your body called endorphins. Endorphins can help improve your mood.

Try not to deal with stress in unhealthy ways. This includes drinking too much alcohol, using drugs, smoking, or overeating. These coping mechanisms may help you feel better in the moment but can add to your stress levels in the long term. Try substituting healthier ways to cope, such as spending time with friends and family, exercising, or finding a new hobby.

Talk to friends or family members. They might help you see your problems in new ways and suggest solutions. Or, just being able to talk to a family member or friend about a source of stress may help you feel better.

Get help from a professional if you need it. Your doctor or nurse may suggest counseling or prescribe medicines, such as antidepressants or sleep aids. You can also find a therapist in your area using the mental-health services locator. If important relationships with family or friends are a source of stress, a counselor can help you learn new emotional and relationship skills.

Get organized. Being disorganized is a sign of stress, but it can also cause stress. To-do lists help organize both your work and home life. Figure out what is most important to do at home and at work and do those things first.

Help others. Volunteering in your community can help you make new friends and feel good about helping others.

Not All Stress Is Bad

In a dangerous situation, stress signals the body to prepare to face a threat or flee to safety. In these situations, your pulse quickens, you breathe faster, your muscles tense, and your brain uses more oxygen and increases activity – all functions aimed at survival and in response to stress. In non-life-threatening situations, stress can motivate people, such as when they need to take a test or interview for a new job.

Long-Term Stress Can Harm Your Health

Coping with the impact of chronic stress can be challenging. Because the source of long-term stress is more constant than acute stress, the body never receives a clear signal to return to normal functioning. With chronic stress, those same lifesaving reactions in the body can disturb the immune, digestive, cardiovascular, sleep, and reproductive systems. Some people may experience mainly digestive symptoms, while others may have headaches, sleeplessness, sadness, anger, or irritability.

Over time, continued strain on your body from stress may contribute to serious health problems, such as heart disease, high blood pressure (HBP), diabetes, and other illnesses, including mental disorders such as depression or anxiety.

_____________

This chapter contains text excerpted from the following sources: Text beginning with the heading What Is Stress? is excerpted from Stress and Your Health, Office on Women’s Health (OWH), U.S. Department of Health and Human Services (HHS), March 14, 2019; Text beginning with the heading Not All Stress Is Bad is excerpted from 5 Things You Should Know about Stress, National Institute of Mental Health (NIMH), November 12, 2019.

Chapter 2 | Life Events and Types of Stress

All animals have a stress response, and it can be life-saving. But, chronic stress can cause both physical and mental harm.

There are at least three different types of stress:

Routine stress related to the pressures of work, family, and other daily responsibilities

Stress brought about by a sudden negative change, such as losing a job, divorce, or illness

Traumatic stress, which happens when you are in danger of being seriously hurt or killed. Examples include a major accident, war, assault, or a natural disaster. This type of stress can cause posttraumatic stress disorder (PTSD).

Different people may feel stress in different ways. Some people experience digestive symptoms. Others may have headaches, sleeplessness, depressed mood, anger, and irritability. People under chronic stress get more frequent and severe viral infections, such as the flu or common cold. Vaccines, such as the flu shot, are less effective for them.

Some people cope with stress more effectively than others. It is important to know your limits when it comes to stress, so you can avoid more serious health effects.

Early Life Adverse Experiences and Epigenetics

Stress is a condition of the mind and a factor in the expression of disease that differs among individuals and reflects not only major life events but also the conflicts and pressures of daily life that elevate physiological systems so as to cause a cumulative chronic stress burden on brain and body. This burden reflects not only the impact of life experiences, but also of genetic variations; individual health-related behaviors such as diet, exercise, sleep patterns, and substance abuse; and epigenetic modifications in development and throughout life that set life-long patterns of behavior and physiological reactivity through both biological embedding and cumulative change.

Epigenetics is the now popular way to describe gene x environment interactions via molecular mechanisms that do not change the genetic code but rather activate, repress, and modulate expression of the code. Indeed, epigenetics denies the notion that biology is destiny and opens new opportunities for collaboration between the biological and behavioral, and social sciences.

Acting epigenetically, hormones associated with stress protect the body in the short term and promote adaptation (allostasis), but in the long run, the burden of chronic stress causes changes in the brain and body that lead to cumulative change – such as accumulation of body fat (allostatic load) – or diseases, such as diabetes or cardiovascular disease (CVD) (allostatic overload). Brain circuits are plastic and appear to be continuously remodeled by stress, as well as by other experiences, so as to change the balance between anxiety and self-regulatory behaviors, including mood control and impulsivity, memory, and decision-making. Such changes may have adaptive value in danger, but their persistence and lack of reversibility in brains that are not resilient can be maladaptive.

Besides developmental influences associated with parent-infant interactions and the quality of early experiences, the most potent of stressors that influence adult life are those arising from the family, neighborhood, workplace, and exposure to local, national, and international events in the media that can affect both brain and body health and progression toward a variety of diseases. Social ordering in human society is associated with gradients of disease, with an increasing frequency of mortality and morbidity along a gradient of decreasing income and education socioeconomic status (SES).

Although the causes of these gradients of health are very complex, they likely reflect, with increasing frequency going down the SES ladder, the cumulative burden of coping with limited resources, toxic and otherwise stressful living environments, and negative life events, as well as differences in health-related behaviors (aka lifestyle) that result in chronic activation of physiological systems involved in adaptation leading to allostatic overload.

Thus, the behavioral and social sciences have increasingly important roles in the evolution of our knowledge about brain-body interactions over the life course in the area known now as social neuroscience. Because of the multiple levels of interaction from the physical and social environment down to individual health behaviors and the impact of all of these upon the physiology of the body and internal workings of the brain, interventions must occur at multiple levels. Indeed, what happens at each stage of development, with particular potency early in life, has influences upon the trajectory that brain and body development take as the life course unfolds.

Early life events related to maternal care in animals, as well as parental care in humans, play a powerful role in later mental and physical health, as demonstrated by the adverse childhood experiences (ACEs) studies. Animal models have contributed enormously to our understanding of how the brain and body are affected, starting with the neonatal handling studies of Levine and Denenberg and the work of Meaney and Syzf. Epigenetic, transgenerational effects transmitted by maternal care are central to these findings. Besides the amount of maternal care, the consistency over time of that care and the exposure to novelty are also very important, not only in rodents but also in monkey models.

Prenatal stress impairs hippocampal development in rats, as does stress in adolescence. Abusive maternal care in rodents and the surprising attachment shown by infant rats to their abusive mothers appear to involve an immature amygdala, activation of which by glucocorticoids causes an aversive conditioning response to emerge. Maternal anxiety in the variable foraging demand (VFD) model in rhesus monkeys leads to chronic anxiety in the offspring, as well as signs of metabolic syndrome.

In studies of ACE in human populations, there are reports of increased inflammatory tone, not only in children, but also in young adults related to early life abuse, which includes family instability, use of chronic harsh language, and physical and sexual abuse. Chaos in the home is associated with development of poor self-regulatory behaviors, as well as obesity. It should be noted that the ACE study was carried out in a middle-income population, highlighting that poverty is not the only source of early life stressors.

Nevertheless, low SES does increase the likelihood of stressors in the home and neighborhood, including toxic chemical agents such as lead and air pollution. Without a determination of exact causes, it has been reported that low SES children are more likely than other children to be deficient in language skills and self-regulatory behaviors and also in certain types of memory that are likely to be reflections of impaired development of perisylvian gyrus language centers, prefrontal cortical systems, and temporal lobe memory systems. Low SES and family poverty are reported to correlate with smaller hippocampal volumes, overall smaller gray matter volume, and impaired development in children of reduced prefrontal control of amygdala activity resulting in impaired self-regulatory behavior. Neglect is associated with impaired white matter development and integrity. Lower subjective SES, an important index of objective SES, is associated with reduction in prefrontal cortical gray matter.

Moreover, individuals reared in a lower SES environment tend to show greater amygdala reactivity to angry and sad faces, which, may be a predisposing factor for early cardiovascular disease that is known to be more prevalent at lower SES levels. Finally, depression is often associated with low SES, and children of depressed mothers, followed longitudinally, have shown increased amygdala volume, while hippocampal volume was not affected.

Yet, on the positive side, there are the reactive or context-sensitive alleles that, in nurturing environments, lead to beneficial outcomes and even better outcomes compared to less reactive alleles, even though those same alleles can enhance adverse outcomes in a stressful early-life environment. Regarding adverse outcomes and good and bad environments, allostatic processes are adjusted via epigenetic influences to optimize the individual’s adaptation to, and resulting fitness for, a particular environment, whether more or less threatening or nurturing. Yet, there are trade-offs in terms of physical and mental health that, on the one hand, may increase the likelihood of passing on one’s genes by improving coping with adversity and enhancing mental health and overall reproductive success, but on the other hand, may impair later health, for example by eating of comfort foods.

Moreover, when an individual faces a new challenge, there is the question of resilience in terms of the ability to show experience-related adaptation, for example, when an individual from a safe environment is placed into a dangerous one or vice versa. This brings up the question of plasticity, particularly in brain architecture that is so fundamental to brain and body health, and there is both old and new evidence that glucocorticoids, often thought of in a negative sense in relation to stress effects, play an important role in the ability of the brain to adapt to new challenges and possibly also to remediate deficits associated with stress over the life course.

Significant Adversity and Resilience

Resilience is the common response to major life stressors, showing that this is largely due to data analytic and measurement choices. To do so, researchers used existing longitudinal data from the German Socio-Economic Panel Study (SOEP), an ongoing survey initiated in 1984, and annually assesses participants over a wide range of measures. The outcome measure of interest was life satisfaction and the major life stressors examined were spousal loss, divorce, and unemployment.

From the review of the literature that has utilized growth mixture modeling (GMM) to study resilience, it was noticed that two methodological assumptions were commonly held, but never thoroughly tested: homogeneity of variance across trajectories and slope variances set to zero. The first assumption implies that the amount of within-group variability is the same between trajectories. By contrast, researchers allowed for the fact that resilient individuals, as a group, are more stable, whereas those in the other groups, show more variability.

Furthermore, by estimating the slope variances to zero, prior analyses assumed that all individuals in the particular trajectory show the same rate of change in the outcome of interest. Researchers allowed for the possibility that some individuals may take longer to recover, whereas others may recover more quickly (for e.g., three years versus one year to return back to normalcy).

What researchers found when they relaxed these methodological assumptions was unexpected and surprising. Removing the restrictive assumptions applied in previous studies dramatically changed the proportion of people who were resilient. Rates of resilience in the face of unemployment were reported to be 81 percent. With the restrictive assumptions removed and having applied specifications of the model that are more in line with conceptual assumptions, the rates were much lower, around 48 percent. Focusing on divorce, using the same methodological assumptions as before, 85 percent were considered resilient, whereas when the restrictive assumptions were removed, 36 percent were likely to belong to the resilient trajectory. Lastly, for spousal loss, 75 percent were deemed resilient using the same methodological assumptions as before, whereas when the restrictive assumptions were removed, 47 percent were likely to be resilient.

Removing Restrictive Assumptions and Changes in Proportion of Resilience

Given the widespread use of GMM in the examination of resilience to major life stressors, researchers believe that there are important extensions of our findings. The most pressing direction researchers were focusing on is examining the multidimensionality of resilience. Most studies, overwhelmingly, have solely included one outcome, making it difficult to ascertain whether resilience is across the board. Put differently, if most individuals are found to be resilient in the well-being domain, does this transfer to other areas of life, such as health, sleep disturbances, or substance use? Researchers tested this in a study where they examined resilience to spousal loss in five outcomes. They found that resilient trajectories largely differed across outcomes, with 66 percent, 19 percent, 26 percent, 37 percent, and 29 percent showing a resilient trajectory in life satisfaction, negative affect, positive affect, general health, and physical functioning, respectively

When considering the multidimensional nature of resilience across five key outcomes, only eight percent of bereaved individuals were deemed resilient across all outcomes, whereas 20 percent did not show a resilient trajectory in all five outcomes examined. This multidimensional approach permits for studying cross-domain variability and allows for determining whether resilience in specific outcomes co-exist with declines in others.

The findings have important implications not just for science, but for public policy. Sweeping scientific claims that most people are resilient carry the dangers of blaming the victims and more seriously, suggest that external interventions are not necessary to help people hit by traumatic events. Researchers believe that the findings are caused to reconsider the commonness of resilience to major life stressors and that instead, most individuals are deeply affected, but are able to recover over time. For both empirical and conceptual reasons, it is unwise for scientists to make any definitive statements about the commonness of resilience in the face of major life stressors because as we have shown, it depends on data analytic choices and the outcomes examined.

_____________

This chapter contains text excerpted from the following sources: Text in this chapter begins with excerpts from Stress, MedlinePlus, National Institutes of Health (NIH), August 9, 2016. Reviewed November 2021; Text under the heading Early Life Adverse Experiences and Epigenetics is excerpted from Population Health: Behavioral and Social Science Insights, Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services (HHS), July 2015. Reviewed November 2021; Text beginning with the heading Significant Adversity and Resilience is excerpted from Resilience to Major Life Stressors: Conceptual and Methodological Considerations, Office of Behavioral and Social Sciences Research (OBSSR), National Institutes of Health (NIH), July 19, 2016. Reviewed November 2021.

Chapter 3 | Factors That Influence Response to Stress

Chapter Contents

Section 3.1—Personality and Stress

Section 3.2—Gender Differences in Stress Response

Section 3.3—Chronic Stress and Loneliness Affect Health

Section 3.4—Stress and Fatigue

Section 3.5—Media Coverage Linked to Stress

Section 3.6—Adrenal Insufficiency and Stress

Section 3.1 | Personality and Stress

Personality and Stress, © 2016 Omnigraphics. Reviewed November 2021.

The stress response, sometimes known as the fight-or-flight response, mobilizes the body’s reserves to overcome a perceived threat. It evolved to protect people from danger and is considered essential to survival. When confronted with a stressful situation, the body increases its production of the chemicals cortisol, adrenaline, and noradrenaline. These chemicals trigger a faster heart rate, rapid breathing, muscle tension, and alertness. At the same time, the chemicals slow down nonessential body functions, such as the digestive and immune systems.

Stress can broadly be classified as physiological or psychological. Physiological stress refers to the adaptive mechanisms the body uses to respond to physical challenges, such as a broken bone or exposure to extreme cold. Psychological stress, on the other hand, refers to a disparity between an external stressor and the person’s mental, emotional, or social resources. Examples might include feelings of anxiety about an upcoming test or worry about meeting a work deadline.

Even though the sources of psychological stress may not be life threatening, the body responds to them in much the same way as it responds to physiological stressors. These responses, while designed to protect the body, can actually have harmful effects on both physical and mental health when they recur frequently over prolonged periods of time. Chronic stress has been linked to a multitude of health conditions, including depression, digestive problems, fatigue, headaches, heart disease, high blood pressure (HBP), insomnia, muscle aches, and obesity.

Personality Types

The response to stress is a complex and highly personalized mechanism involving many interrelated biological, psychological, and social factors. Studies have shown that an individual’s personality – as determined by inherited characteristics, life experiences, and cognitive predispositions – strongly influences how they interpret and deal with stressful situations. People who demonstrate certain personality traits, such as resilience and adaptability, tend to respond better to adversity and be less susceptible to stress.

Researchers have developed the Five Factor Model as a way to classify different personality types. The Big Five personality characteristics in this model include:

Openness to new experiences, as opposed to closed-mindedness

Conscientiousness, as opposed to disorganization

Extraversion, as opposed to introversion

Agreeableness, as opposed to disagreeableness

Neuroticism, as opposed to emotional stability

Although age, gender, intellect, and other factors can influence a person’s sensitivity to stressors, studies have shown that personality type is an important factor in determining an individual’s reaction to stress. In fact, personality traits can help explain how some people can handle huge amounts of stress for long periods of time, while others may feel overwhelmed when faced with small amounts of stress on a temporary basis.

An individual’s personality influences every stage of the stress response, from evaluating whether or not a situation is stressful to choosing coping methods. In general, individuals with strong scores in extraversion tend to be optimistic and develop good problem-solving and coping strategies. They can reappraise potentially stressful situations in a positive way – for instance, as a challenge and an opportunity for growth and personal development – and effectively seek social support to help them deal with the stressor. On the other hand, individuals with strong scores in neuroticism tend to be pessimistic. They can become overwhelmed by potentially stressful situations, which can take a toll on their life satisfaction and physical health.

Type A and Type B Behavior

The theory of type A behavior was developed in the 1950s by American cardiologist Meyer Friedman, who noticed a link between a certain personality type and the risk of heart disease. His 1974 book on the theory opened up a new field of research that looked beyond the well-known risk factors of diet and cholesterol and examined the mind–body connection to heart disease. The term type A personality soon became a national buzzword to refer to high-stress personalities who tended to be driven, impatient, and competitive. This personality type was considered to be in opposition to Type B personalities, who tended to be calm, steady, relaxed, and less vulnerable to stress.

Type A personalities are believed to have an overactive sympathetic nervous system pathway. This pathway is responsible for stimulating the fight-or-flight response, which is associated with increased secretions of the emergency hormones that elevate the heart and respiratory rates and may contribute to hypertension and heart disease. In Type B personalities, the parasympathetic nervous system pathway is dominant. This pathway is associated with a lower metabolic rate and the release of feel-good neurotransmitters such as endorphin, melatonin, and serotonin.

Critics argue, however, that human behavior is too complex to be categorized within the narrow parameters outlined by Friedman. Modern-day psychologists generally refrain from drawing a clear distinction between the two extreme personality types, preferring to regard them as points on a continuum. In addition, some psychologists argue that personality and experiences do not necessarily condition people to respond to stress in a certain way. Instead, they claim that people can learn to manage stress effectively through training programs that help them build self-confidence, develop problem-solving skills, and face the everyday challenges of life in a more positive manner.

Reference

McLeod, Saul. Type A Personality, Simply Psychology, 2011.

Section 3.2 | Gender Differences in Stress Response

Gender Differences in Stress Response, © 2016 Omnigraphics. Reviewed November 2021.

It has long been recognized that men and women react differently to stress. Researchers have noted, for example, that women have a higher incidence of stress-related illnesses such as posttraumatic stress disorder (PTSD), depression, and anxiety than men.

Scientists believe that such differences may have a biological basis. A 2010 study on the brains of rats – which have the same basic neural structure as those of humans – found that females were more sensitive to a certain stress hormone than males, and also less able to adapt to high levels of it. In addition, a 2012 study on humans found that men’s and women’s brains processed stress differently and suggested that a single gene may be responsible for this gender variation.

Gender Differences in the Brain’s Response to Stress

The 2010 study focused on corticotropin releasing factor (CRF), a hormone released by the hypothalamus region of the brain in response to stress. CRF acts as a neurotransmitter, helping to carry signals between brain cells. In response to a stressor, CRF binds to receptors on cells in the locus coeruleus (LC), a cluster of neurons in the brainstem. The CRF signals the neurons to secrete norepinephrine and cortisol, the main hormones responsible for mobilizing the body’s energy reserves and producing the fight-or-flight stress response.

In the presence of these hormones, the nervous system goes into a state of hyperarousal, which is characterized by a faster heart rate, rapid breathing, muscle tension, and alertness. Although hyperarousal is a natural part of the body’s stress response, research has shown that long-term and excessive activation of the CRF receptors can lead to stress-related disorders, such as anxiety and PTSD.

In the study of rats, scientists observed that the stress signaling system was more responsive in females than in males, so the receptors in the female brains bound more tightly to CRF. Moreover, the CRF receptors remained activated much longer in response to stress in the female brains, thereby prolonging their exposure to CRF. The male brains, on the other hand, quickly adapted to the higher levels of stress hormones by reducing the number of receptors through a process called internalization, thus limiting their exposure to CRF.

Researchers believe that these gender differences in the stress response may help explain why women have a higher incidence of stress-related mood and anxiety disorders than men. Although the biological mechanism may be different in humans than in animals, the possibility that gender may influence CRF exposure has clinical and therapeutic implications for many psychiatric disorders.

Gender Differences in the Behavioral Response to Stress

In the twenty-first century, many psychologists have begun to question the longstanding belief that humans universally exhibit the fight-or-flight response to stress. A growing number have argued that while this response is common for men, women are more likely to exhibit a tend-and-befriend response. Instead of preparing to fight back or run away when faced with danger, many women demonstrate affiliative social behavior – either by seeking social support to deal with the situation or by trying to defuse the situation through relationship-building.

Research has found that in addition