Research roundup: stress and physical health
Findings from APA’s annual Stress in America™ survey highlight the connection between prolonged stress and physical health, and suggest that the U.S. health care system is not meeting specific patient needs related to behavioral health that could aid in the prevention and management of chronic illness. This issue of Research Roundup addresses the correlation between stress and physical health in youth, adults and caregivers and provides practical implications for better meeting the needs of certain patient groups.
Keller, A., Litzelman, K., Wisk, L., Maddox, T., Cheng, R. E., Creswell, P., & Witt, W. P. (2012). Does the perception that stress affects health matter? The association with health and mortality. Health Psychology, 31(5), 677-684. doi: 10.1037/a0026743
This longitudinal study, consisting of more than 28,000 participants, examined how physical health is related to psychological distress. Participants were selected randomly from the Sample Adult Core (SAC) component of the National Health Interview Survey (NHIS).
This study explored the connections between amount of stress, the perception that stress affects health, and health and mortality outcomes. One third of participants reported that stress affected their health some or a lot. Over half reported experiencing a moderate or higher amount of stress in the past year. Higher levels of reported stress were linked to lower reported health status and more psychological distress. Also, those who perceived a connection between stress and health were more likely to report poorer health.
Stress and the perception that stress affects health did not independently predict mortality but in combination they did. Those who perceived stress impacting their health and reported “a lot” of stress had a 43 percent increase in risk of premature death.
Over half of the national sample reported experiencing a moderate or higher amount of stress in the past year. What is particularly interesting is the perception that stress impacts health appears to be linked to health status – both perception of one’s health and actual risk of premature death.
The study did not find a strong link between participant attempts to reduce stress and their health status, which suggests that individuals were either ineffective at doing so, or that perceptions of stress were more important than the level of stress. Psychologists may want to address stress using multiple strategies, including stress reduction, management of perceptions of stress and increasing positive healthy behaviors.
Gana, K., Bailey, N., Saada, Y., Joulain, M., Trouillet, R., Herve, C., & Alaphilippe, D. (2013). Relationship between life satisfaction and physical health in older adults: A longitudinal test of cross-lagged and simultaneous effects. Health Psychology, doi: 10.1037/a0031656
Some evidence suggests subjective well-being affects health, that health impacts subjective well-being, or that they are interrelated. This study used prospective data from 899 individuals ranging in age from 64 to 97 who had completed a series of assessments five separate times over an 8-year time span. For older adults, better physical health was linked to life satisfaction, suggesting positive mental well-being follows maintenance of physical health.
The data showed that poor health largely foreshadowed lower levels of life satisfaction; however, life satisfaction did not necessarily show the same relationship with status of health. While life satisfaction has been known to correlate with better health, this data suggests that the direction of the relationship is health status to life satisfaction, and life satisfaction does not predict physical health.
With the aging of the U.S. population, older adults are increasingly seen in psychological practice. Sometimes providers (as well as older adults) presume that decreased life satisfaction and poorer health are automatic aspects of aging. While a decline in abilities will occur with increasing age, efforts to sustain good health may be important for sustaining overall well-being.
Psychologists working with older adults may wish to not only address concerns individuals raise in regards to life satisfaction but to also encourage older adults to care for their physical health and to make efforts to increase their healthy behaviors in order to promote overall psychological well-being.
Raposa, E. B., Hammen, C. L., Brennan, P. A., O'Callaghan, F., & Najman, J. M. (2013). Early adversity and health outcomes in young adulthood: The role of ongoing stress. Health Psychology, No Pagination Specified. doi: 10.1037/a0032752
A community sample of 705 mother-child pairs was followed from child birth to age 20 years with data collection at regular intervals. Mothers’ reports of early adverse conditions from birth to age 5 were related to the presence of chronic disease in the child at age 15, depression from ages 15 to 20 and physical health at age 20.
Children who experienced early adversity had elevated risk for social and nonsocial stress at age 15, as well as depression between ages 15 and 20. Additionally, social and nonsocial stress both directly affected physical health at age 20 and also indirectly, through increased risk for depression.
Children exposed to early stressors and adversity are at increased risk for poorer outcomes later in life. Opportunities to provide support to young children and their parents through consultation in pediatric clinics, schools or other community settings may serve to prevent later depression and health problems. Helping families exposed to early adversity develop resilience may have long-term benefits.
Mausbach, B. T., Chattillion, E., Roepke, S. K., Ziegler, M. G., Milic, M., von Känel, R., Dimsdale, J. E., Mills, P. J., Patterson, T. L., Allison, M. A.; Ancoli-Israel, S., & Grant, I. (2012). A longitudinal analysis of the relations among stress, depressive symptoms, leisure satisfaction, and endothelial function in caregivers. Health Psychology, 31(4), 433-440.
Caregivers of individuals with Alzheimer’s disease face numerous stressors and challenges. One hundred sixteen caregivers were assessed three times at yearly intervals regarding stress, depressive symptoms, leisure satisfaction and endothelial function (measured by brachial artery flow-mediated dilation, or FMD).
Time and the number of years of caregiving were significant predictors of FMD, suggesting that FMD was worse the longer a participant was a caregiver (including prior to the start of the study). Additionally, increased FMD function was positively related to leisure satisfaction but negatively related to stress whereas depressive symptoms were not associated with FMD.
FMD is one indication of cardiovascular health yet also shows associations to stress and psychosocial functioning. Supporting caregivers in their role and facilitating their ability to care for their own health is beneficial for both caregiver and care recipient. Interventions that help caregivers increase pleasurable activities and positive relationships (some of the behavioral correlates of depression) may not only reduce stress but might also improve cardiovascular outcomes in caregivers.