Chronic Illness in the Modern World
The leading causes of mortality and morbidity in the Western world, since the beginning of the twentieth century, are no longer infectious diseases, but chronic illnesses including diseases of the heart, cerebrovascular diseases, cancer, chronic obstructive pulmonary diseases and diabetes, which develop slowly over an extended period of time and tend to affect people across the lifespan disrupting their quality of life. It is estimated that one in five employees experience high levels of stress and £3.7 billion is lost, in terms of production, each year as a result.
Stress and stress-related diseases, as Vollrath points out, are the health scourge of modern times and are one of the reasons why health psychology, the purpose of which is to explain the psychological factors which give rise to the health compromising behaviours which contribute to the aetiology of such illnesses with a view to preventing them, has been one of the fastest growing disciplines in psychology since the 1980s.
If stress is chronic, in the sense that it is ongoing and longer lasting than acute stress, it can lead to longer term disturbance of the behavioural and biological processes contributing to disease development. Hans Selyes research in 1956 &1976 suggested that physical reactions to stress involve three phases which he termed the general adaptation syndrome: the alarm reaction, similar to the fight-or-flight syndrome which involves change in heart rate, respiration and perspiration as the body attempts to regulate its temperature; resistance, which occurs when stressors persist and the body works hard to produce the physical changes needed to cope with them including the release of adrenaline, noradrenaline and cortisol; and exhaustion, which occurs when resources have been depleted and organ systems that were weak in the first place, or heavily involved in the resistance process, become associated with wear and tear.
Research by Kiecolt-Glaser et al. who are particularly at risk of experiencing chronic stress responses, have found an increased vulnerability to disease as a result of immune changes. Similarly, Steptoe et al, found higher levels of peri-natal mortality, childhood accidents, diabetes and CHD and cancers among those in lower socioeconomic groups, where chronic stress is more common.
Stress & Cancer Progression
Although caution is advised where drawing conclusions from studies into the relationship between stress and coping and cancer progression, due to mixed evidence, some human studies, such as that by Rosch in 1996, do show that stress influences tumour cell mutation by slowing down the cell repair process as a potential result of hormonal activation and the release of glucocorticoids or the production of lymphocytes. A study by Palesh et al, of women who had metastatic or recurrent breast cancer tumours, also found that those who had reported traumatic life events, experienced a significantly shorter disease-free intervals.
Preventative & Treatment Interventions
While multiple variables are involved in the onset of chronic illness, stress, if not a contributing factor, certainly has an exacerbating effect. As such, health psychology interventions which reduce the impact of stressors and help individuals to cope with stressors are of key importance in both preventing the onset of chronic illness and encouraging treatment adherence and as a means of supplementing pharmacotherapy treatments with a view to promoting more positive health outcomes for those who have already been diagnosed.