Stress, Health and
Disease Reader
IBP 2019
Summary
,Chapter 1
The ins and outs of the mind’s effects on the body
● confusion about the definition of stress
➢ confusing ‘stressor’ with ‘stress response’
➢ the situation itself gets confused with the response to the situation
● Sapolsky’s working definitions:
○ stressor: anything in the outside world that knocks you out of homeostatic
balance
○ stress response: what your body does to reestablish the homeostasis
● BUT 2 ambiguities with definitions of stressors and stress responses:
○ External stimuli are not the only things
■ internal stimuli (e.g. pain, viruses) can be stressors as well
○ concept of homeostasis is argued to be incomplete and has now
allostasis
➢ the organism’s attempt to adapt to its internal state to changing
external and internal demands
● Stressor = every possible threat to the attainment of psychobiological goals
○ E.g. food and water, sleep, physical and social safety, sex, etc.
● Stress response = adaptive psychobiological reaction to a stressor
○ Provisional working definition: a stress response is a negative emotional
response, which is psychobiological in nature
How serious is the problem of stress, in terms of health effects?
● The World Health Organisation (WHO) referred to stress as a ‘worldwide
epidemic’
○ it’s mental burden, economic costs + risk for disease + premature death is
growing yearly
→ more than half of working days are lost because of illness due to
stress,
→ about 2⁄3 of all doctor visits are due to stress
● Nearly every disease seems to have a higher chance of occurrence when
organisms are chronically stressed
○ E.g cardiovascular disease, allergies, diabetes, arthritis
● “Subjective complaints” = somatic complaints/symptoms that have no medical
explanation
○ lower back pain, headaches, and chronic fatigue
○ often medically unexplained, but possible pathways from stress
, ● Most researched disease is cardiovascular disease (CVD)
○ high life stress → more than two-fold tisk for heart attacks
○ work stress → four-fold risk for cardiovascular diseases
○ conflicts in martial relationships → three-fold risk for recurrent heart
problems
○ death of loved one → six-fold risk for heart attacks
The routes from stress to disease
● There’s possible psychobiological routes of the stress response via intermediate
‘pathogenic’ states, to disease endpoints
● often forgotten major route = route via health behaviour
● indirect route: stress → unhealthy behaviors → disease
○ involves external factors
○ alternative indirect route:
■ stress → decrease in cognitive capacities → less able to inhibit
unhealthy behaviors → disease
● direct route: stress → psychobiological effects → disease
● Stress may co-determine mental problems
○ anxiety disorders, PTSD, etc.
→ can be seen as prolonged stress responses that have gone awry
● Mental problems in turn influence cognitive capacities as well as health
ffects on the psychobiological mediators
behaviours, and have direct e
● If you take the direct route in the diagram above, the diagram below applies.
● Direct Route:
Disease Reader
IBP 2019
Summary
,Chapter 1
The ins and outs of the mind’s effects on the body
● confusion about the definition of stress
➢ confusing ‘stressor’ with ‘stress response’
➢ the situation itself gets confused with the response to the situation
● Sapolsky’s working definitions:
○ stressor: anything in the outside world that knocks you out of homeostatic
balance
○ stress response: what your body does to reestablish the homeostasis
● BUT 2 ambiguities with definitions of stressors and stress responses:
○ External stimuli are not the only things
■ internal stimuli (e.g. pain, viruses) can be stressors as well
○ concept of homeostasis is argued to be incomplete and has now
allostasis
➢ the organism’s attempt to adapt to its internal state to changing
external and internal demands
● Stressor = every possible threat to the attainment of psychobiological goals
○ E.g. food and water, sleep, physical and social safety, sex, etc.
● Stress response = adaptive psychobiological reaction to a stressor
○ Provisional working definition: a stress response is a negative emotional
response, which is psychobiological in nature
How serious is the problem of stress, in terms of health effects?
● The World Health Organisation (WHO) referred to stress as a ‘worldwide
epidemic’
○ it’s mental burden, economic costs + risk for disease + premature death is
growing yearly
→ more than half of working days are lost because of illness due to
stress,
→ about 2⁄3 of all doctor visits are due to stress
● Nearly every disease seems to have a higher chance of occurrence when
organisms are chronically stressed
○ E.g cardiovascular disease, allergies, diabetes, arthritis
● “Subjective complaints” = somatic complaints/symptoms that have no medical
explanation
○ lower back pain, headaches, and chronic fatigue
○ often medically unexplained, but possible pathways from stress
, ● Most researched disease is cardiovascular disease (CVD)
○ high life stress → more than two-fold tisk for heart attacks
○ work stress → four-fold risk for cardiovascular diseases
○ conflicts in martial relationships → three-fold risk for recurrent heart
problems
○ death of loved one → six-fold risk for heart attacks
The routes from stress to disease
● There’s possible psychobiological routes of the stress response via intermediate
‘pathogenic’ states, to disease endpoints
● often forgotten major route = route via health behaviour
● indirect route: stress → unhealthy behaviors → disease
○ involves external factors
○ alternative indirect route:
■ stress → decrease in cognitive capacities → less able to inhibit
unhealthy behaviors → disease
● direct route: stress → psychobiological effects → disease
● Stress may co-determine mental problems
○ anxiety disorders, PTSD, etc.
→ can be seen as prolonged stress responses that have gone awry
● Mental problems in turn influence cognitive capacities as well as health
ffects on the psychobiological mediators
behaviours, and have direct e
● If you take the direct route in the diagram above, the diagram below applies.
● Direct Route:
