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The Effects of Stress

Most studies of stress have focused on the effects of severe or chronic stress on

various outcomes. There are important implications for health, with elevated stress

levels linked with higher risk for numerous diseases. The alarm reaction to stress is

usually associated with a decline in immune function. This makes individuals more

susceptible to infectious diseases (Zannino 1997 ). Studies of college students

(Jacobs et al. 1969 ) and prisoners (McClelland et al. 1982 ), among many others,

have shown increased incidence of respiratory illness in those under greater stress.

Much of the stress literature focuses on the effect of chronic stress on elevated

risk for non-infectious diseases, particularly cardiovascular disease. Using the

concept of allostasis, meaning“stability through change”(Sterling and Eyer 1988 ),

the idea of allostatic load was introduced by McEwen and others as a means to sum
the wear and tear on the body, with much of this wear due to stress (McEwen

2006 ). These studies of accumulated exposure to stress have examined the effects of

job strain (e.g., Karasek et al. 1981 ; Light et al. 1992 ; Kuper and Marmot 2003 ),

hassles (Twisk et al. 2000 ), life events (Kershaw et al. 2014 ), social isolation

(Steptoe and Kivimȁki 2013 ), acute exposure to highly stressful events (Dimsdale

2008 ), and adverse childhood experiences (Slopen et al. 2012 ), among many other

stressful circumstances, on risk for cardiovascular disease. Many other diseases

Table 7.3 Time course of responses to stress of selected measures

Measure Acute

or

chronic

Time to onset of

response (if

acute)

Variability of response if stress prolonged

Plasma

catecholamines

Acute Seconds Stable

Plasma cortisol Acute @ 10–30 min Decreases over time with extended stress in some

individuals

Urinary

catecholamines

Acute Hours Stable

Urinary

cortisol

Acute Hours Decreases over time with extended stress in some

individuals

Salivary

cortisol

Acute Minutes Decreases over time with extended stress in some

individuals

Hair cortisol Chronic N/A Stable

Immune

function

Chronic N/A Complex; some components up-regulated, others

down-regulated, with response changing over time

with extended stress

Hassles/“state”

instruments

Acute Hours to days Variable by day

Diary reports Acute Minutes Variable within minutes

Life events/

“trait”

instruments

Chronic N/A Stable over months

7 Stress Biomarkers as an Objective Window on Experience 127