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Each and everyday we come in contact with billions of germs. Each

germ is capable of bringing about illness. Although everyone comes
in contact with germs, not everyone becomes ill.
Some people come in contact with billions of germs and never
become ill. It's as if they are totally immune to contracting any type
of illness. Other people seem to become ill just at the mere thought of
germs. Its almost as if they are a magnet for illness.
Germs may be necessary in order for us to become ill, but are they
sufficient to make us ill? It is not only necessary for a germ to be
present; other factors are necessary in order for a person to become
What makes some people more susceptible to illness than others?
Several factors are related to the development of illness. Among the
factors related to the development of illness are stress, coping style,
and social support.

Everyday we are confronted with problems. When we are

confronted with a problem we must determine the seriousness of
the problem and determine whether or not we have the resources
(e.g., emotional resources) necessary in order to cope with
problem. If we believe that the problem is serious and we also
believe that we do not have the resources necessary to cope with
the problem, we will perceive ourselves as being under stress
(Cohen et. al., 1995).
Stress can be defined as a process in which environmental
demands strain an organisms adaptive capacity, resulting in both
psychological as well as biological changes that could place a
person at risk for illness


Things that cause us stress are called stressors. Many events can be thought of
as stressors. These include disasters, life crises, life changes, and daily hassles
Examples of stressors include: hurricanes, earthquakes, disease, divorce,
unemployment, marriage, and traffic jams. Stressors are things that interfere
with an important personal goal. The more important the goal is, the more stress
a person will feel when that goal is threatened
So for example, if it's important to a person to get to class on time, the person
will feel stress if he gets caught in traffic. The goal is to get to class on time and
the stressor is the traffic jam. The more important it is for the person to be on
time, the more stressful the traffic jam will be. So, a person is likely to feel more
stress on the day when an exam is given and there is a traffic jam, than he will
feel when no exam is given and there is a traffic jam.


The environmental stress perspective- emphasizes

assessment of environmental situations or experiences that
are objectively related to substantial adaptive demands
The psychological stress perspective- emphasizes
people's subjective evaluations of their ability to cope with
the demands presented to them by certain situations and
The biological stress perspective- emphasizes the
activation of certain physiological systems in the body that
have been shown time and time again to be regulated by
both psychologically and physically demanding conditions


However, while a certain amount of stress is normal, chronic

negative stress may be harmful to our health. Thomas Holmes
asserted that any and all change is stressful because it forces
individuals to adapt to new, unfamiliar circumstances
Holmes acknowledged that some changes require more of an
adjustment than other changes. Holmes believes that the
change resulting from both positive (e.g., marriage, promotion,
graduation) and negative (e.g., divorce, unemployment) life
events are stressful and may possibly do harm to an
individual's health.


When an individual is faced with stress, his body mobilizes for action in what is
called a fight or flight reaction (Rubin, Paplau, & Salovey, 1993). During a fight
or flight reaction, the heart rate increases, breathing is accelerated, and the
muscles tense up as if in preparation to throw something like a rock (fight) or to
run away (flight)
For example, when approached by a thief, you can either fight him or you can try
to run away from him. When an individual identifies a threat, activity in the
sympathetic nervous system rises and the adrenal glands release the hormones
epinephrine (or adrenaline) and norepinephrine into the blood stream. At the same
time, corticosteriod hormones which release fatty acids for energy, are released by
the adrenal glands
This nervous-system and hormonal activity causes digestion to stop, blood sugar
levels to increase, and the heart to pump more blood to the muscles (Rubin,
Paplau, & Salovey, 1993). All of these reactions are not unlike the physiological
aspects of strong emotions, like fear and anger


Spangler and Schieche (1998) examined the biobehavioral organization of

infants with various qualities of attachment. Quality of attachment
(security & disorganization), emotional expression, and adrenocortical
stress reactivity were investigated in 12-month-old infants observed during
Ainsworth's Strange Situation.
They found that securely attached infants did not show an adrenocortical
response. However, interestingly, adrenocortical activation during the
Strange Situation was found for the insecure-ambivalent group, but not for
the insecure-avoidant group.
Pruessner, Hellhammer, and Kirschbaum (1999) studied the effects of
burnout and perceived stress on early morning free cortisol levels after
awakening. They found that higher levels of perceived stress were related
to stronger increases in cortisol levels after awakening after a low dose
dexamethasone pre-treatment the previous night.


If stress persists after the initial fight or flight reaction,

the body's reaction enters a second stage. During this
stage, the activity of the sympathetic nervous system
declines and epinephrine secretion is lessened, but
corticosteriod secretion continues at above normal levels.
Finally, if the stress continues and the body is unable to
cope, there is likely to be breakdown of bodily resources
(Rubin, Paplau, & Salovey, 1993). It is in this stage that
there may be a reduction of the levels of epinephrine and
norepinephrine in the brain, a state related to depression .


Stressful life events are related to the risk of infected

individuals developing an illness. Traumatic stressful events
may trigger either behavioral or biological processes that
contribute to the onset of disease. Chronic stress has been
associated with increased reports of illness. Long-term
exposure to chronic stress may facilitate the development of
illness during exposure to stress.

Exposure to chronic stress may results in permanent or at the

very least long-term psychological, biological, or behavioral
responses that alter the progression of illness


Cohen et. al. (1998) found that those who had either a work
related or interpersonal chronic stressors (defined as stress
lasting one month or longer) had an increased risk of
developing colds compared to those who had no chronic
stressor. In addition, the longer the stress endured, the more
likely a person was to become ill.
Cohen, Doyle, and Skoner (1999) found that psychological
stress predicted a greater expression of illness and a greater
production of interleukin-6 in response to an upper respiratory
Finally, Zarski (1984) found no correlation between life
experiences and health status. However, life experiences were
significantly correlated with somatic symptoms and energy
level. Overall health status was highly correlated with somatic


In addition to stress, coping style is also related to the

development of illness. Coping has been defined as the
behavioral and cognitive efforts a person uses to manage
the demands of a stressful situation (Chang & Strunk,
1999). There are several methods of coping.


Feeling in Control as a Way of Coping. Both animals as well as

people cope better with a painful or threatening situation when they
can exercise some sort of control over the situation. For example,
suppose you are overweight and your doctor tells you that it is
because you have a genetic disorder. You have no control over your
situation. This may be very stressful for you. However, suppose now
that you are overweight but your doctor tells you that with diet and
exercise you can lose the weight. This situation may be less stressful
for you because you know that you can do something about your
weight. Just knowing that you can control your weight makes the
situation less stressful than if you were unable to control your weight.
Even when you can not control unpleasant events, they tend to be
less stressful if they are predictable, that is if you know they are
coming. So, knowing that traffic will be heavy on the 405 freeway at
8:00 am is less stressful than when traffic is heavy at 3:00 am
because you expect traffic to be heavy at 8:00 am but not at 3:00 am.


Optimism and Pessimism Coping Style. Some people seem

predisposed to believe that they can maintain control over
stressful situations. These people are said to have an optimistic
coping style (Rubin, Paplau, & Salovey, 1993). Other people
have a pessimistic coping style, they view the world as an
uncontrollable, unpredictable place in which they will never be
able to gain control over things that bother them (Rubin,
Paplau, & Salovey, 1993).
Approach and Avoidant Coping. Approach coping is when
the person focuses on both the sources of the stress as well as
the reactions to it (Chang & Strunk, 1999). Avoidant coping
means that the person neither focuses on the source of the
stress nor does the he focus on his reactions to stress (Chang &
Strunk, 1999).


Appraisal and Coping. A key component to people's reactions to stress is how

they appraise or think about a potentially stressful situation (Rubin, Paplau, &
Salovey, 1993). What may be stressful for one person may not be stressful for
another person. For example, one person may see going to college as a stressful
experience. He may be anxious about living away from home for the first time. He
may be worried about making new friends and doing well in school. Another
person may see going to college as the beginning of a new, fun adventure.
Primary and Secondary Appraisals. There are two types of appraisals, primary
and secondary. Primary appraisals refer to a set of cognitions regarding the
importance of a stressful situation for a person. Secondary appraisals are a set of
cognitions concerning an individual's resources for dealing effectively with
situation. Both appraisals affect a person's ability to cope and adjust to stressful
situations. Chang and Strunk (1999) examined the direct and indirect influences of
dysphoria (expressions of depressive symptoms) on primary and secondary
appraisals, coping, and psychological and physical adjustment. They found that
dysphoria was positively associated with primary appraisals, disengaged coping,
and physical symptoms.


Reappraisal as a Way of Coping. In order to cope effectively, it

usually helps to reappraise a situation as a challenge or an
opportunity rather than as a threat (Rubin, Paplau, & Salovey, 1993).
For example, suppose you are on your was to a very important
interview and you get stuck in traffic. You might think to yourself
that this is terrible, this is a very important interview. If you miss it
you won't get the job and you're life will be over. You should have
left earlier. You should have checked the traffic report before you


Social support can protect individuals from the effects of

stress on health. Fukunishi et. al. (1999) examined coping
with stress, including social support, dealing with illness,
and mood states among people not yet diagnosed as
having glucose tolerance abnormality. They found that
that poor utilization of social support was related to the
onset of glucose tolerance abnormality. It seems that
patients with glucose tolerance abnormality are unable to
adequately utilize social support to cope with stress, even
though they receive and perceive social support.


In conclusion, everyday we come in contact with billions of

germs. Each one is capable of making us ill. Some people are
more susceptible to illness than are others. Germs are
necessary but not a sufficient cause of illness. Other factors are
necessary in order for a person to become ill. Among the
factors related to the development of illness are stress, coping
style, and social support. Chronic negative stress increases our
chances of becoming ill. Coping style can decrease or increase
our risk of illness. Engaged coping can lead to a decrease in
illness; whereas, disengaged coping can lead to an increase in