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Envisia Learning
3435 Ocean Park Blvd, Suite 203
Santa Monica, CA 90405
Phone: (310) 450-8397
Fax: (310) 450-0548
http://www.envisialearning.com

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  as a

generic term for the whole area of
problems that includes the stimuli
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themselves and the various intervening
processes. t defines a large, complex,
amorphous, interdisciplinary area of
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r Epinephrine (Ep also known as adrenaline) an
norepinephrine (NEp) activate/arouse us during stress
r mmediate response to stressor (within seconds)

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r èeleases stored energy (glucose/fatty acids) to deal with

emergencies via glucocorticoids (e.g., cortisol)
r Slower onset following stressor (within minutes)

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0Fight or Flight´ activation of the

lam autonomic nervous system (e.g., heart
rate, blood pressure, cortisol, etc.)

mmune suppression reaction, release

 
a of endorphins and growth hormone

Exhaustion phase contributing towards

a

 stress related illness and exacerbation
of medical conditions

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r A team of researchers headed by Shelley Taylor, a psychologist
at the University of California, Los Angeles, reviewed over 1,000
human and animal stress response studies
r Men and women also react with a 0tend-and-befriend´ approach
in the face of work and life stress
r Females respond to stressful situations by protecting themselves
and their young through nurturing behaviors--the "tend" part of
the model--and forming alliances with a larger social group,
particularly among women--the "befriend" part of the model
r Males, in contrast, show less of a tendency toward tending and
befriending, sticking more to the fight-or-flight response

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r Sickness and disease are not the same

r Stressors do not make you sick
r Stressors make you more likely to get
diseases that make you sick
r Chronic stress exacerbates pre-existing
conditions, rather than, causing disease
directly
r There exists substantial individual variability in
response to disease

  


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Problems Associated with Chronic Stress

r Cardiovascular (e.g., arteriosclerosis)
r Digestion (e.g., ulcers, decreased nutrient
absorption)
r Bone (e.g., osteoporosis, stunted growth)
r Glucose (e.g., late onset diabetes)

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r Acute (e.g., final exams, sleep deprivation)

and chronic (e.g., bereavement, marital
conflict, care giving) stressors are significantly
associated with immunosuppression in over
30 years of research

r Negative appraisal, realistic acceptance,

suppression of negative/trauma related
thoughts and pessimism appear to directly
contribute adversely to immune function

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Overall, the evidence suggests a signifcant

association between repressive coping and
immunosuppression, cardiovascular reactivity and
elevated blood pressure
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r A recent meta-analysis examined the relationship

between psychosocial factors and breast cancer
r Average effect sizes were calculated from 46 studies
for 8 major categories
r The average woman in the breast cancer group
generally used a repressive coping style to a greater
extent than did 65% of the women in the control group

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r ndividuals high in defensiveness reported

significantly higher social support compared to
others
r Some limited evidence of a 0super repressor´
were observed in this study (high
defensiveness, low anxiety, high optimism)
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r Self-manager differences in performance

ratings were studied in relation to the ratee¶s
personality scores for 204 managers
r nflated self ratings (relative to those of his/her
manager) were significantly associated with
higher achievement, high social confidence,
high social desirability and low anxiety

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r 84 students predicted how their best friends

would respond to various inconsiderate
behaviors on their part compared to their
friends reactions
r èepressor¶s predictions were significantly less
negative than their friends and, unlike
nonrepressors, showed no association with
their friends responses (i.e., low social
awareness about their inconsiderate behaviors)
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r 1 in every 5 people

r Blood pressure shoots up under pressure

r High in cynical mistrust, hostility and anger

r Untreated, hot reactors are subject to heart

disease, stroke and sudden cardiovascular
death

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r Experience illness or symptoms following
stressful events or a
 the stress is over --
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r Happens when shifting gears from a state of

high activation to one of low activation

r s frequently experienced after a stressful

project is completed, on or after weekends,
holidays, vacations, or after retirement

 
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r Perceive less work/life stress

r Practice daily health habits
r Possess strong social support
r èeact less frequently with Type A
response to stress
r Possess a hardy outlook and optimistic
explanatory style of work and life events
r Utilize health enhancing coping
strategies and behaviors
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r Genetic 30%
r Social Circumstances 15%
r Environment 5%
r Medical Care 10%
r Behavior/Lifestyle 40%

McGinnis et al., 2001

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S: 25%
abandon new behaviors after 15 weeks; 60%
make the same resolution the next year
r ]
 SS: 95% of those who lose
weight regain it back within 2 years
r S 
: Only 13-14% are abstinent 6 to
12 months after quitting
r   : 90% of those treated have a
drink within 3 months; 50% return to pre-
drinking levels within a year

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r StressScan quickly identifies individual characteristics

that protect against or contribute to stress related
illness
r This validated instrument based on over 15 years of
research measures 15 psychosocial risk factors
including perceived stress, lifestyle management
behaviors, social support, Type A behavior, cognitive
hardiness, coping style and psychological well being
r n addition, two validity scales measure inconsistent
responding and responding bias
r Norms are based on ethnically diverse sample of 1,111
men and women, ages 20 to 68 from diverse working
environments


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r StressScan is available online or scored by hand in just

15 to 20 minutes
r The StressScan report summarizes important health
risk alerts and health resources for each individual
r StressScan has established reliability and validity
based on over 15 years of research
r StressScan is ideal for coaches who are dealing with
work pressure, stress and family balance issues
r StressScan makes an excellent health risk appraisal
within organizational settings (as part of executive
coaching, wellness, stress management and health
promotion programs)
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 is made up of 5
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my life.´ A response in the scored direction for
any of these items suggests that the
respondent may be presenting him/herself in
an unusual light. The
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 is
the number of these items for which the scored
response has been given. Scores higher than 2
may suggest a careless or unusual response
bias to completing the S
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r Measures of work and life stress are modestly associated with physical
illness, job burnout and psychological distress þ
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r A 2004 survey by Consulting Tools USA revealed that 40% of all

employees report they 0disagreed´ or 0strongly disagreed´ with the
statement 0the amount of pressure and stress on my job is reasonable
and rarely excessive´
r èeduction in perceived work and life stress have been found to be
associated with immune enhancement þ"#
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r ndividual stress-management interventions generally are effective in
reducing negative individual health outcomes, but do not consistently
affect outcomes such as absenteeism, turnover, accidents, health care
costs, productivity or job satisfaction unless additional organizational
interventions occur þ"#
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r Global Health Habits

r Exercise/Physical Activity

r Sleep/èest

r Eating/Nutrition

r Prevention

r Substance Use (alcohol, smoking)

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r Physical activity affects many aspects of health including
protection against premature mortality, CHD, hypertension,
cancer, depression and anxiety

r Despite established benefits of regular exercise, more than

60% of adults in the US and UK are sedentary or
insufficiently active

r The US American College of Sports Medicine recommends

a level of physical activity of 30 minutes on 5 or more
days/week or intense activity of 30-60 minutes at least 3
days/week for protective health benefits

r Lack of exercise has been shown to be an independent risk

factor for heart disease (risk of inactivity ranges from 1.5 to
2.4, an increase in risk comparable with that observed for
high cholesterol, HBP or cigarette smoking)
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r Sleep is a 24-hour circadian rhythm
r èEM and NèEM sleep
r Sleep disorders:
nsomnia
Excessive daytime sleepiness (e.g., sleep apnea, narcolepsy)
Circadian rhythm disorders (e.g., delayed phase, shift work, jet lag)
r There are many causes of sleep deprivation. Some include: 1) Not allowing
enough time for sleep; 2) sleep disorders; 3) excessive worry ; 4) depression;
repeated awakenings from noise; 5) shift work, working at night and travel
across time zones; 6) medications; and 7) medical illness causing pain, difficulty
in breathing, etc.
r Even a small loss of sleep can decrease waking performance and alertness.
èesearch indicates that, for most people, one night with 2 hours less sleep than
is usually required is sufficient to affect subsequent waking performance and
alertness significantly
r Popular sleep treatments that might be helpful for sleep problems (e.g.,
insomnia) include exercise, mental/physical relaxation, light therapy, melatonin,
valerian and new generation sleep aids

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r Approximately 61% of American adults are overweight

r Healthy eating and nutrition involves the following eight
components: 1) high monsaturated fats found in many
nuts and olive oils and low saturated fats found in most
meat/dairy products; 2) moderate alcohol consumption;
3) high consumption of vegetables; 4) high
consumption of cereals, grains and fiber; 5) high
consumption of fruits; 6) high consumption of legumes;
7) low consumption of meat; and 8) low consumption of
dairy products
r From a long term health perspective, it appears more
important to increase the number of healthy foods
regularly consumed than to just reduce the number of
less healthy foods regularly consumed

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r The use of aspirin has been shown to

have a cardiovascular health benefit
r Some recent studies suggest that
moderate use of alcohol several times a
week may have some limited protective
effects on the cardiovascular system

r ap/ 
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, when used,
reduced the risk of fatal injury to front-seat
passenger car occupants by 45 percent
and the risk of moderate-to-critical injury
by 50 percent

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r Moderate alcohol consumption is associated

with cardiovascular health benefits

r The lowest mortality occurs in those who

consume one or two drinks per day
r Demonstrated reduction in current and future
coronary heart disease (CHD) with moderate
consumption of alcohol
r About 50% of the protective effect of alcohol is
mediated through increased levels of HDL
cholesterol
r Higher levels of alcohol consumption have been
conclusively linked to more serious illnesses,
accidents and adverse health outcomes

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r Smoking in adults has declined in the US
from 53% in 1966 to 23% in 2001

r Cigarette smoking is a major risk factor for

CHD (30% of approximately 170,000 of all
coronary deaths are directly attributed to
smoking)

r Smokers risk of heart attack is twice that of

non-smokers

r Lower stress consistently contributes to one¶s

ability to successfully maintain cessation in
both the short and long-term

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r Cross sectional and prospective studies have consistently
shown that social support can significantly reduce the
severity of stress and psychological experience of it
r Epidemiological research has established that low social
support is associated with both mortality and morbidity
r Types of social support
r Emotional
r nformational
r nstrumental
r Sources of social support, perceived availability, utility and
overall satisfaction are associated with health and well-being
in the face of work and life stressors
r Positive changes in social support have been found to
influence coping behaviors and immune function þ"#
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r Commonly associated with hard driving,

competitive, achievement striving,
impatient, hostile, energetic, fast paced and
time urgent behaviors

r The toxic components of Type A Behavior

appear to be yalm

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r èesearch shows a relationship between

reduction of Type A Behaviors and CHD

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r oiew change as a allg, rather than a threat

r Are 
mm

, rather than alienated, with their activities a
work and home
r Possess a more 
al, rather than external, locus of
control
r Possess an
p
m
 explanatory style by appraising bad
events as relatively external, unstable and specific
r èeport greater self-esteem, self-efficacy and lower
neuroticism (core self-evaluations) associated with
increased job satisfaction and job performance
r Hardy individuals who experience stress report significantly
less illness, job burnout, and psychological distress

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r Positive Appraisal
r Negative Appraisal
r Threat Minimization
r Problem-Focused Coping
n two separate longitudinal studies, high
scores on the Threat Minimization coping
style and exercise significantly predicted
lower levels of self-reported physical illness
and absenteeism þ"#
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r èeligion is a very important part of the lives

of approximately 67% of the American
public
r 96% of the American public believe in God
r 42% attend religious services regularly
r nterest in spiritual growth is increasing
with 82% expressing such interest in 1998
compared to only 58% in 1994
Powell et al., 2003
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1. Service attendance protects against death  a  
2. èeligion/spirituality protects against heart disease S
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3. Deeply religious people are protected against death 

4. èeligion/spirituality protects against disability 

5. èeligion/spirituality slows cancer 

6. People who use religion to cope live longer

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8. èeligion/spirituality impedes recovery from illness S

m
9. Being prayed for improves physical recovery from S
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illness

Powell et al., 2003, American Psychologist, 58, 36-52

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Meditation Stretching
Breathing Progressive
Exercises èelaxation
oisualization Yoga
Self-Hypnosis Massage

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1. Choose a quiet environment that is not too brightly lit. Allow
yourself 5 minutes at first and gradually work up to 20
minutes.
2. Sit upright with your spine erect«.feet should be flat on the
ground with your hands resting in your lap. Close your eyes
and keep your body still.
3. Start with some deep breathing: inhale and exhale deeply,
letting all your breath out. Pause, then inhale letting the
breath flow naturally using your abdomen muscles.
4. Now allow your breathing to become natural and slow«.as
you exhale count 0one.´ Continue counting, each time you
exhale. f thoughts enter your mind and your forget to count,
simply notice and dismiss the thoughts. Do the same with
sounds and bodily sensations²simply notice and dismiss
them.
5. f you wish to time yourself, use a non-ticking timer«]hen
you are done, rock, gently back and forth before slowly getting
up. Practice at least once daily.
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Picture a scene in which you are perfectly relaxed«..
Perhaps you are lying at the beach on a warm breezy
day«.Continue to visualize this scene, noticing the
warmth of the sun on your body, feeling more relaxed,
while your breathing becomes slow and rhythmic.

You feel the warmth of the sun on your arms, legs,

and face«.how it totally relaxes and soothes all of
your muscles«you actually can feel beads of
perspiration form and your fingers and hands swell
slightly as you continue to slow down your breathing
and feel relaxed and calm«..Focus on the sounds of
the waves crashing at the beach and feel the slight
breeze of the wind on your face as you continue
feeling calm, comfortable and very relaxed«slowly
open your eyes«.Practice this visualization when you
experience stress and anxiety.
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Organizational
Stressors

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r A 2001 Kaiser Family Foundation survey found employees

with single insurance coverage are now paying 27% more
on average than last year
r The US Health Care Financing Administration forecasts for
2005 suggest a dollar increase of 57% from 2002 to 2005
r èelatively progressive companies pay 80 times more in
diagnosis and treatment than for employee preventative
maintenance health programs
r Solid evidence suggests that 50% to 70% of all diseases
are associated with modifiable health risks and potentially
preventable

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r A recent review of over 13 studies indicates an

average benefit to cost ratio of $3.48 in reduced
health care costs and $5.82 in lower
absenteeism per dollar invested (Aldana, 2001)

r Combined health enhancement programs

focusing on lifestyle management change have
been shown to yield a $3 to $6 return on
investment for each dollar invested in 2 to 5
years (Pelletier, 2001)

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r More and more people in the

workforce are putting emphasis on
amly as an important priority

r Over 70% of workers 



think
there is a healthy balance between
work and family

r ncreasingly employees are exploring

new careers because of the inability
to manage work and family stressors

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r 70% of employees¶ perception of the

organizational climate is associated with
the emotional intelligence of the leader
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r Poorly managed workgroups are an

average of 51%  productive and
44% profitable than well managed
groups

r 80% of turnover is directly related to

unsatisfactory relationships with one¶s
boss

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r èesults of two company wide employee

engagement surveys were analyzed for all
corporate staff for a large food service corporation
for 2002 and 2004
r Employees rated leadership and management
practices using a benchmarked 8-item Leadership
Effectiveness ndex (alpha .91)
r Employees were asked additional questions about
retention (intention to leave in 12 months), job
satisfaction and perceptions of stress

Nowack, K. (2005). V




 

    
  



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r Companies with poor
morale have an
unscheduled absence rate 



of 3.2% compared to 1.5%

for companies reporting á
 

0good´ or 0very good´ 

morale  
 

 
r Only 35% of unscheduled  
absences are due to actual 



illness


r Estimates are that

employee absenteeism
costs about $660 per
employee CCH Unscheduled Absence Study 2005

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r Positive mood of the team leader

promotes worker productivity and
retention

r Team members tend to share

moods, whether positive or
negative, with more positive
moods associated with increased
performance

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Participative management
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r Nowack, K. (2000). Occupational stress management: Effective or not? n P. Schnall, K. Belkie, P.
Landensbergis, & D. Baker (Eds.). Occupational Medicine: State of the Art èeviews, Hanley and Belfus,
nc., Philadelphia, PA., ool 15, No. 1, pp. 231-233.
r Greene, è. and Nowack, K. (1996) Stress, hardiness and absenteeism: èesults of a 3-year longitudinal
study. ]ork and Stress, 9, 448-462.
r Nowack, K. M. (1994). Psychosocial predictors of health, job satisfaction and absenteeism: èesults of
two prospective studies. Paper presented at the 1994 American Psychological Association National
Convention, Los Angeles, CA.
r Nowack, K. and Pentkowski, A. (1994). Lifestyle habits, substance use, and predictors of job burnout.
]ork and Stress, 8, 19-35.
r Schwartz, G.E., Schwartz, . ., Nowack, K.M., & Eichling, P.S. (1992). Changes in perceived stress and
social support over time are related to changes in immune function. University of Arizona and Canyon
èanch. Unpublished manuscript.
r Nowack, K. M. (1991). Psychosocial predictors of physical health status. ]ork and Stress, 5, 117-131.
r Nowack, K. M. (1990). nitial development and validation of a stress and health risk factor instrument.
ournal of Health Promotion, 4, 173-180.
r Nowack, K. M. (1989). Coping style, cognitive hardiness, & health status. ournal of Behavioral
Medicine, 12, 145-158.

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