Psychological

influence on becoming
ill- Stress &
Dispositional
influences
BY : SHAHANAS VADAKKAYIL
Dispositional
influences
 contents

01 Optimism and pessimism 02 Type A behaviour pattern

03 Hostility and anger

04 Negative mood

05 Emotional inhibition 06 Religious belief/spirituality

 Dispositional influences

• A great deal of research has focused on • Different personality characteristics have

the role of personality and dispositional been investigated to see whether certain
influences in the stress process. characteristics lead a person to be more
vulnerable (or resistant) to different
stressors.
 01
Optimism and
pessimism
 Pessimism
 Pessimistic individuals tend to view  consists of three dimensions:
future outcomes negatively, which
has been linked to negative health 1. internality (it’s all my fault) versus
outcomes, particularly disease externality (it’s not me)
progression.
2. stability (it will last forever) versus instability
(this will soon pass)
 A 'pessimistic explanatory style' is a
cognitive personality trait that 3. globality (everything will be affected) versus
indicates how individuals attribute specificity (everything else will be okay).
causes to life events.
 Optimism

 Optimists have been

found to adjust better
 Over the longer term
to life transitions than
experiencing less
pessimists, partially
stress may influence
because they perceive
physical health.
greater social support
and reinterpret events
or issues in a positive
manner, and therefore
experience less stress.
 Pessimistic individuals tend to have poorer physical health and higher
mortality rates over thirty years compared to more optimistic
individuals.
 02

Type A behaviour
pattern
 Type A behaviour pattern
 The Type A Behavior Pattern (TABP)
was developed to identify
psychological risk factors for coronary
heart disease (CHD).
 Two cardiologists, Friedman and
Rosenman, developed the TABP based
on their clinical experience with
patients.
 They noticed that their heart patients had
similar characteristics, such as
competitiveness, achievement orientation, a
strong sense of time urgency, impatience and
easily aroused hostility.
 All of these attributes became part of the
TABP. The construct is typified by the view of
the high achieving business man who is
aggressively struggling to achieve more and
more in less time.
 Western Collaborative Group Study
● The Western Collaborative Group
Study was the first large, long-term
study investigating TABP and
CHD.
● It involved 3,154 men, mostly
white, non-manual workers, aged
between 39 and 59 years.
● At the start of the study each
participant took part in a structured
interview to assess Type A
behaviour. None of the men had
CHD at the beginning of the study.
● In the following eight and a half years, men with
TABP had an increased incidence of CHD
compared to their more laid back counterparts
(type Bs). These results were astonishing and
impressive. Even when other risk factors were
controlled for (e.g. parental history of heart
disease, high blood pressure, lipids, high
cholesterol, diabetes, cigarette smoking, lack of
education, lack of exercise), Type As were twice
as likely to have developed CHD and to have
died from CHD than Type Bs.
● Yet relative risk tells us nothing about
causality: the risk of developing CHD
in this study was twice as high for
Type As as Type Bs, but not all Type
As developed heart disease.
● Early research on TABP was criticized
for its focus on men and high-status
positions, revealing that men funding
large-scale projects had traditional risk
factors for CHD. Later studies with both
male and female participants showed
inconsistent results.
 Limitation

● Many studies have limitations due to
the assessment method used, which
often used Type A questionnaire
measures instead of structured
interviews, which did not capture
specific aspects of TABP.
● The link between Type A and CHD
may be specific to a specific group or
behavior, and not all Type A
components increase CHD risk.
Negative emotions, particularly
hostility, are identified as key TABP-
related factors.
● The inconsistent results, and the inconsistency between findings
that rates of CHD are actually higher in people of lower SES (than
in the middle-class, ambitious and striving businessman), led
Carroll (1992) to conclude that it may be more beneficial to talk
about Type A environments rather than Type A individuals.
 03
Hostility and
anger
 Hostility and anger

 Hostility has been defined as a general  Anger refers to an unpleasant

trait involving ‘a devaluation of the emotion which varies in intensity
worth and motives of others, an from mild irritation to rage.
expectation that others are likely
sources of wrongdoing, a relational
view of being in opposition toward
others, and a desire to inflict harm or
see others harmed’
 Recent evidence suggests that anger and hostility are linked to higher rates of
coronary heart disease (CHD), including increased incidence, clinical events
like heart attacks and angina.

 Evidence for the effects of anger and hostility on other diseases, such as cancer,
is not so well established.
 Meta-analysis

● A meta-analysis of 45 studies found that ● The impact of anger and hostility is

hostility is an independent risk factor for comparable to the size of other risk
chronic heart disease (CHD). factors like smoking and
hypertension.
● The impact of hostility and anger on ● High hostility individuals often
cardiovascular health is not fully exhibit poorer immune function after
understood, but large cardiovascular disclosing personal information,
system responses, especially to possibly due to the perceived threat
interpersonal stress, may be of such disclosure, compared to
significant. those with low hostility.
Consedine and colleagues argue that we need to be cautious about the hostility–
disease findings for a number of reasons:

 First, there are a substantial  Second, Research on hostility's effects on

health is limited, focusing on white,
number of null findings.
middle- and upper-class men. Some
studies show hostility affects health
outcomes in both genders, while others
show inverse relationships in women.
● Third, Consedine and colleagues suggest gender differences in
emotional experience and expression may explain inconsistent
findings, with anxiety potentially playing a key role for women
and hostility for men.
 04
Negative mood
● Negative affect, characterized by
negative moods, has been linked to
both subjective and objective health
outcomes, particularly in relation to
symptoms of respiratory illness.
● Experiencing negative mood has been
● Depression and depressed mood have been
associated with recovery from and mortality
rates after a MI, as well as with the onset of
new cardiac events. Some evidence also
exists showing that depression is related to
how quickly the HIV virus progresses.
related to poorer immune function
compared to experiencing positive mood,
and across a number of studies
psychological distress is associated with the
down-regulation of immunity.
 STUDY
● Scheier and Bridges have conceptually
integrated numerous findings indicating
negative moods and emotions are linked
to poorer health outcomes.
● The assumption is that people's behavior
is typically goal-directed, and that goals
provide meaning to our actions and lives.
● However, when people are thwarted
in achieving their goals, they can
either disengage and give up or may
feel depressed, which may lead to a
more generally negative outlook.
Becoming ill can disrupt attainment
of goals, and may lead to negative
emotions, which in turn may have an
adverse effect on progression or
recovery from the illness.
 05
Emotional
inhibition
● The 1970s concept of a cancer-prone
personality, which suggests individuals
who suppress their emotions and are
not forthcoming in any emotional sense
are more likely to develop cancer, is
widely accepted as harmful to health.
● Sontag (1991) argued that such
labelling had no basis in fact, and that
the victim blaming actually did more
harm than good to people who became
ill. Some evidence shows that emotional
suppression is associated with increased
incidence of cancer.
 Extensive meta-analytic review

● Garssen (2004) found no psychological ● Researchers have also been investigating

factor has been proven to influence cancer whether suppressing emotions is bad for
development, with helplessness and health more generally.
repression being the most promising
constructs, despite no convincing evidence
of any psychological influence on cancer
development.
● The largest body of evidence on this
matter has come from Pennebaker
and colleagues.
● Researchers have studied the potential
health benefits of disclosing traumatic
experiences, arguing that inhibiting
emotions is difficult as it impairs
information processing and prevents
individuals from assimilation of events
due to holding back major thoughts and
feelings.
● A typical study would involve
university students who were asked to
come to a psychology laboratory and to
sit on their own for about an hour and
write about a particular topic.
● Participants had to attend and write on
● In the experimental group, participants
were asked to write about a traumatic
experience that they had not discussed
with anybody previously.
● In the control group, participants were
asked to write about mundane topics,
such as what they had done that morning
or the previous day.
three consecutive days. Following this,
self-report health measures were taken at
various points during the next three to six
months, and visits to the university
medical centre were recorded (with the
informed consent of the participants).
 Results

● Results generally show that ● Researchers have also found differences in

participants who wrote about a
traumatic experience showed fewer
physical health problems and fewer
visits to the medical centre over the
following months than the control
group.
immune functioning between participants who
disclosed traumatic events and those who did
not suggesting that inhibiting strong emotions
may influence disease via immune processes .
● Disclosure plays a crucial role in physiological
and health outcomes by enabling individuals to
understand, comprehend, and stop avoiding
events, thus enhancing their overall well-being.
 Cochrane review
● A Cochrane review of 61 studies found
that the impact of emotional disclosure
interventions on physical health was not
conclusive, and no evidence was found
for the influence of emotional disclosure
on objectively assessed health center
visits, despite a rigorous and well-
developed review method.
● The review identifies several issues in this
field, such as small sample sizes, poor
reporting, and insufficient evidence of a
mechanism for physical health benefits,
indicating that the current evidence does
not adequately demonstrate the
effectiveness of this emotional disclosure
intervention.
 06
Religious belief
or
Spirituality
● Recent years have seen a renewed interest in the
impact of spiritual or religious factors on physical
health outcomes, with evidence linking religious
beliefs and church attendance to improved physical
health and lower mortality rates.
 Reviewed studies

● Seeman and colleagues have ● The review found a positive correlation

reviewed studies on the between religious beliefs and
physiological processes influencing physiological processes related to health
the relationship between religious and disease, specifically cardiovascular
belief and health, highlighting that system, neuroendocrine, and immune
recent advancements in study functioning.
designs and methodologies provide
more definitive conclusions.
● Seeman and colleagues emphasized the ● Oman and Thoresen (2002) provide a
need for enhanced methodologies in this comprehensive overview of the various
field and a greater emphasis on ways in which religion can impact
spirituality beyond just meditation. physical health.
 Reference

● Lyons, A.C., & Chamberlain, K. (2006). Health Psychology. Cambridge University

Press