Are we all equally affected by stress? Who are the most at risk of stress-related diseases?
Our patterns of thinking and behaviour can influence how we perceive and cope with stress in our lives and therefore influence our long-term health outcomes. In this article, we'll explore the individual differences in stress and the implications for stress-related illness.
- We'll start by outlining the physical effects of stress.
- Next, we'll look at the theory behind the individual differences in stress response.
- Then, we'll look at the different reactions to stress individuals may experience.
- Moving along, we'll examine the long-term relationship between personality and stress: individual differences in the stress process.
- Finally, we'll explore individual and cultural differences in stress.
Fig. 1 - Even though stress can harm all of us, some people might be more at risk depending on their personality traits.
The Physical Effects of Stress
The negative health outcomes of stress are due to the physiological processes that the stress response involves. Two physiological responses are triggered in response to a stressor; these consist of the activation of:
- The Sympathomedullary pathway and,
- The Hypothalamic Pituitary Adrenal (HPA) Axis.
The sympathomedullary pathway puts us in the fight-or-flight state immediately after a threat is detected. The purpose is to prepare the body for intense physical activity, so we can run or fight the threat.
From an evolutionary perspective, this response is highly adaptive, and it allowed our ancestors to mobilise energy and survive when predators threatened their lives.
This response involves a release of adrenaline and noradrenaline, which increases breathing, heart rate, blood pressure and glucose concentration in the bloodstream to quickly deliver energy to our muscles.
Functions unrelated to fighting or fleeing from a predator, including digestion, immune and reproductive functions, are put on hold.
The HPA axis controls a slower and longer stress response, resulting in cortisol release.
Cortisol has similar effects to adrenaline but acts for longer. It increases the amount of glucose in the bloodstream and blood pressure and puts digestion, immune and reproductive functions on hold.
Prolonged stress can negatively affect us physically, leading to digestive problems, headaches or sleep problems in the short term.
Long-term exposure to stress can lead to autoimmune diseases, high blood pressure, metabolic issues, heart disease or even stroke.
Individual Differences in Stress Response
Researchers have observed that some people respond to stress differently than others. Early work in this domain was conducted by cardiologists Friedman and Rosenman, who investigated individual predisposition towards Coronary Heart Disease (CHD) in the 1960s. The researchers established two main personality types: A and B, with type A personality identified as predisposing people to greater CHD risk.
Kissen & Eyesneck (1962) also suggested Type C personality, which was further explored by Temoshok (1987) as part of her integrative model of traits related to cancer.
Below are three personality types with their associated behaviours.
Personality type | Characteristics |
Personality A | - Competitive and ambitious character, e.g. focused and determined, seeking advancement.
- Time pressure and impatience: physically and mentally active, multitasking, fast-talking, optimising time, less creative activities like hobbies.
- Hostile and aggressive: inflexible nature, easily irritable, short-tempered.
|
Personality B | - Non-competitive: not very goal-oriented, usually work at their own pace, fluctuating focus.
- Relaxed and calm: pursues one thing at a time, has a relaxed attitude, and celebrates successes but does not stress when they do not achieve goals.
- Flexible and patient nature: patient temperament, tolerant, flexible approach to people, suppresses emotions.
|
Personality C | - Motivated to achieve goals and passionate about accomplishing goals (Type A traits).
- A passive attitude: suppresses emotions, does not stress when one does not achieve goals and invests more effort in pleasing people (Type B).
- Have a tendency towards helplessness.
- Resistant to unwanted change.
|
The Different Reactions to Stress
People with Type A personalities might put a lot of pressure on themselves regarding work and success. They might work around the clock and feel like they are always running out of time; they prioritise work over other social activities or hobbies. They are likely to feel more threatened by change, get irritated quickly, and have a hostile or mistrustful attitude towards others.
Type B has a more flexible attitude to work, success and change. Work is not prioritised above all else for them, so it's not the end of the world for them if they don't reach their goals. Their attitude to others allows them to cultivate supportive relationships.
Type C's combine the passion and motivation of Type A without the urgency and hostility. They might feel helpless when faced with stressful situations, struggle to reach for support, suppress their emotions and focus on the needs of others instead of their needs.
Fig. 2 - Type A's are competitive and determined; they tend to have a hostile and mistrustful attitude towards others.
Personality and Stress: Individual Differences in the Stress Process
Early evidence suggests that type A personality is at a greater risk of developing Coronary Heart Disease when exposed to stress compared to type B personality. While type C personality was linked to a greater risk of cancer.
Individual Differences in Stress: Type A Personality Health Outcomes
Friedman and Rosenman (1974) examined the relationship between stress-related illness and personality types. They conducted a longitudinal study with 3200 male participants from San Francisco, aged 39 to 59. All participants were healthy at the beginning of the study.
Participants were categorised as Type A or B based on their behaviour during an interview. These interviews were designed to capture the trait of hostility associated with Type A's. Researchers performed scripted actions during the interview, such as interrupting the participant or being aggressive towards them.
When researchers followed up with participants after eight years, they found 257 participants suffered from coronary heart disease, 70% of whom were personality type A. High blood pressure and high cholesterol levels were more likely to be observed in type A than B.
The results might not be generalisable to women because of gender bias. Friedman and Rosenman (1974) conducted the study on a sample of only male participants.
Further research also pointed out that it might be hostility specifically which predicts CHD, rather than type A personality as a whole.
Dembroski et al. (1989) concluded that coronary heart disease was more likely to be predicted by the trait hostility in personality type A's.
Carmelli (1991) followed up with the participants of Friedman and Rosenman (1974) and found that participants with high hostility were more likely to die of coronary heart disease.
Individual Differences in Stress: Type C Personality Health Outcomes
Dattore et al. (1980) examined the relationship between personality types and stress-related illness. The participants included 200 retired army personnel who had served in the Vietnam War. They completed a questionnaire measuring depression symptoms and suppression of feelings.
At follow-up, 75 participants developed cancer. These participants showed fewer depression symptoms but greater repression of feelings.
To conclude, this study supports an association between Type C stress response (repression of feelings) and cancer.
However, much of the subsequent work on larger cohorts failed to support the association between Type C personality and cancer, e.g. Hansen et al. (2005).
Individual Differences in Stress: Hardiness in Psychology
So, traits like hostility and emotional suppression can increase one's risk of diseases, but are there any traits that protect people from negative health outcomes related to stress?
Kobasa and Maddi (1979) proposed the three C's associated with hardiness. These traits act as a defence system against the adverse effects of stress.
Hardiness is a group of traits that make people more resilient to stress and can reduce the risk of the negative health outcomes of stress.
Hardy people strive for growth in the face of difficult times and view stressful situations as a challenge to overcome a difficult situation rather than an obstacle.
Trait | Description |
Commitment | |
| Control | |
| Challenge | Hold the belief that one can gain knowledge through their struggles by leaving their comfort zone. See stressful events as an opportunity for growth. Have a positive outlook on life's challenges.
|
Fig. 3 - Hardiness can make people more resilient to the negative effects of stress.
Individual Differences in Stress: Kobasa and Maddi's (1979) Research Study
Kobasa et al. (1979) conducted a longitudinal study of 800 male American executives. They aimed to study the effects of stress on a sample of executives who face highly stressful events at work.
They used the SRRS (Social Readjustment Rating Scale) to measure stress levels and asked subjects about previous episodes of illness or disease.
Approximately 150 participants had high SRRS scores, indicating a history of high stress. Of these participants, 75 reported more illness, while 86 reported less illness.
Researchers followed up with participants after three months and administered personality tests, including a measure of hardiness.
These results suggest that hardiness could buffer the effects of stress in the low-illness group.
Just because there is a correlation between hardiness and better health outcomes, it doesn't mean one causes the other. Other variables like life experiences, parenting style, or social support may play a role.
Researchers suggested that people can learn hardiness through therapy and hardiness training that change people's outlook on stress and life's challenges. This is an example of practical applications of hardiness research.
However, the findings might not generalise to women, non-American samples and people from other socio-economic classes.
The study examined male American managers with privileged lifestyles, such as better salaries, vacations, and living conditions than the working class or unemployed.
Individual and Cultural Differences in Stress
Cultural differences can also influence the extent to which stress affects us. Firstly, across cultures, people are exposed to different types of stressors.
In the UK, the primary stressor for many is related to their job or relationship tensions. Political unrest, conflict, or lack of resources may be the primary stressors in other countries.
Depending on one's culture, we also perceive and appraise stressors differently.
A breakdown in the relationship with one's family or community may be much more stressful in some cultures than others.
Culture affects how we cope with stressors. In some cultures, individuals may rely on their social support or spirituality to cope with stress, while in others, independent and problem-oriented coping may be preferred.
Han et al. (2022) studied coping with stress in different cultures. They found that European Canadians opted for primary coping strategies (changing the stressful situation), while the Japanese endorsed both primary and secondary coping strategies (accepting the situation and adapting oneself).
Some evidence also points to the fact that some cultures are more prone to stress-related illness due to physiological factors. We see much higher levels of high blood pressure and coronary heart disease in African Americans than in European Americans. This could be both due to environmental and biological differences.
Individual Differences in Stress - Key takeaways
Long-term stress exposure can harm one's physical health and increase one's risk of life-threatening conditions.
Different personality types are associated with different stress responses.
Type A personality, identified by Friedman and Rosenman, is associated with a greater risk of developing Coronary Heart Disease in response to stress.
Type C personality was associated with a greater risk of developing cancer.
Hardiness is a group of traits that make people more resilient to stress and can reduce the risk of adverse health outcomes from stress.
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