Whetten David A., Cameron Kim S. Developing management skills
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MANAGING PERSONAL STRESS CHAPTER 2 107
______ ______ 9. I encourage others to generate recommended solutions, not just questions, when
they come to me with problems or issues.
______ ______ 10. I strive to redefine problems as opportunities for improvement.
TIME MANAGEMENT ASSESSMENT
In responding to the statements below, fill in each blank with the number from the rating
scale that indicates the frequency with which you do each activity. Assess your behavior
as it is, not as you would like it to be. How useful this instrument will be to you depends
on your ability to accurately assess your own behavior.
Please note that the first section of the instrument can be completed by anyone. The
second section applies primarily to individuals currently serving in a managerial position.
Turn to the end of the chapter to find the scoring key and an interpretation of your
scores.
Rating Scale
0 Never
1 Seldom
2 Sometimes
3 Usually
4 Always
Section I
______ 1. I read selectively, skimming the material until I find what is important, then high-
lighting it.
______ 2. I make a list of tasks to accomplish each day.
______ 3. I keep everything in its proper place at work.
______ 4. I prioritize the tasks I have to do according to their importance and urgency.
______ 5. I concentrate on only one important task at a time, but I do multiple trivial tasks at
once (such as signing letters while talking on the phone).
______ 6. I make a list of short five- or ten-minute tasks to do.
______ 7. I divide large projects into smaller, separate stages.
______ 8. I identify which 20 percent of my tasks will produce 80 percent of the results.
______ 9. I do the most important tasks at my best time during the day.
______ 10. I have some time during each day when I can work uninterrupted.
______ 11. I don’t procrastinate. I do today what needs to be done.
______ 12. I keep track of the use of my time with devices such as a time log.
______ 13. I set deadlines for myself.
______ 14. I do something productive whenever I am waiting.
______ 15. I do redundant “busy work” at one set time during the day.
______ 16. I finish at least one thing every day.
______ 17. I schedule some time during the day for personal time alone (for planning, meditation,
prayer, exercise).
______ 18. I allow myself to worry about things only at one particular time during the day, not
all the time.
______ 19. I have clearly defined long-term objectives toward which I am working.
______ 20. I continually try to find little ways to use my time more efficiently.
108 CHAPTER 2 MANAGING PERSONAL STRESS
Section II
______ 1. I hold routine meetings at the end of the day.
______ 2. I hold all short meetings standing up.
______ 3. I set a time limit at the outset of each meeting.
______ 4. I cancel scheduled meetings that are not necessary.
______ 5. I have a written agenda for every meeting.
______ 6. I stick to the agenda and reach closure on each item.
______ 7. I ensure that someone is assigned to take minutes and to watch the time in every
meeting.
______ 8. I start all meetings on time.
______ 9. I have minutes of meetings prepared promptly after the meeting and see that follow-
up occurs promptly.
______ 10. When subordinates come to me with a problem, I ask them to suggest solutions.
______ 11. I meet visitors to my office outside the office or in the doorway.
______ 12. I go to subordinates’ offices when feasible so that I can control when I leave.
______ 13. I leave at least one-fourth of my day free from meetings and appointments I can’t
control.
______ 14. I have someone else who can answer my calls and greet visitors at least some of
the time.
______ 15. I have one place where I can work uninterrupted.
______ 16. I do something definite with every piece of paper I handle.
______ 17. I keep my workplace clear of all materials except those I am working on.
______ 18. I delegate tasks.
______ 19. I specify the amount of personal initiative I want others to take when I assign them
a task.
______ 20. I am willing to let others get the credit for tasks they accomplish.
TYPE A PERSONALITY INVENTORY
Rate the extent to which each of the following statements is typical of you most of the
time. Focus on your general way of behaving and feeling. There are no right or wrong
answers. When you have finished, turn to the end of the chapter to find the scoring key
and an interpretation of your scores.
Rating Scale
3 The statement is very typical of me.
2 The statement is somewhat typical of me.
1 The statement is not at all typical of me.
_______ 1. My greatest satisfaction comes from doing things better than others.
_______ 2. I tend to bring the theme of a conversation around to things I’m interested in.
_______ 3. In conversations, I frequently clench my fist, bang on the table, or pound one fist
into the palm of another for emphasis.
_______ 4. I move, walk, and eat rapidly.
MANAGING PERSONAL STRESS CHAPTER 2 109
_______ 5. I feel as though I can accomplish more than others.
_______ 6. I feel guilty when I relax or do nothing for several hours or days.
_______ 7. It doesn’t take much to get me to argue.
_______ 8. I feel impatient with the rate at which most events take place.
_______ 9. Having more than others is important to me.
_______ 10. One aspect of my life (e.g., work, family care, school) dominates all others.
_______ 11. I frequently regret not being able to control my temper.
_______ 12. I hurry the speech of others by saying “Uh huh,” “Yes, yes,” or by finishing their
sentences for them.
_______ 13. People who avoid competition have low self-confidence.
_______ 14. To do something well, you have to concentrate on it alone and screen out all distrac-
tions.
_______ 15. I feel others’ mistakes and errors cause me needless aggravation.
_______ 16. I find it intolerable to watch others perform tasks I know I can do faster.
_______ 17. Getting ahead in my job is a major personal goal.
_______ 18. I simply don’t have enough time to lead a well-balanced life.
_______ 19. I take out my frustration with my own imperfections on others.
_______ 20. I frequently try to do two or more things simultaneously.
_______ 21. When I encounter a competitive person, I feel a need to challenge him or her.
_______ 22. I tend to fill up my spare time with thoughts and activities related to my work (or
school or family care).
_______ 23. I am frequently upset by the unfairness of life.
_______ 24. I find it anguishing to wait in line.
SOURCE: Tolerance of Ambiguity Scale, S. Budner (1962), “Intolerance of Ambiguity as a Personality Variable,”
from Journal of Personality, 30: 29–50. Reprinted with the permission of Blackwell Publishing, Ltd.
SOCIAL READJUSTMENT RATING SCALE*
Circle any of the following you have experienced in the past year. Using the weightings at
the left, total up your score.
Mean Life
Value Event
87 1. Death of spouse/mate
79 2. Death of a close family member
78 3. Major injury/illness to self
76 4. Detention in jail or other institution
72 5. Major injury/illness to a close family member
71 6. Foreclosure on loan/mortgage
71 7. Divorce
70 8. Being a victim of crime
69 9. Being a victim of police brutality
*This assessment is not available online.
110 CHAPTER 2 MANAGING PERSONAL STRESS
69 10. Infidelity
69 11. Experiencing domestic violence/sexual abuse
66 12. Separation or reconciliation with spouse/mate
64 13. Being fired/laid-off/unemployed
62 14. Experiencing financial problems/difficulties
61 15. Death of a close friend
59 16. Surviving a disaster
59 17. Becoming a single parent
56 18. Assuming responsibility for sick or elderly loved one
56 19. Loss of or major reduction in health insurance/benefits
56 20. Self/close family member being arrested for violating the law
53 21. Major disagreement over child support/custody/visitation
53 22. Experiencing/involved in an auto accident
53 23. Being disciplined at work/demoted
51 24. Dealing with unwanted pregnancy
50 25. Adult child moving in with parent/parent moving in with adult child
49 26. Child develops behavior or learning problem
48 27. Experienced employment discrimination/sexual harassment
47 28. Attempting to modify addictive behavior of self
46 29. Discovering/attempting to modify addictive behavior of close family member
45 30. Employer reorganization/downsizing
44 31. Dealing with infertility/miscarriage
43 32. Getting married/remarried
43 33. Changing employers/careers
42 34. Failure to obtain/qualify for a mortgage
41 35. Pregnancy of self/spouse/mate
39 36. Experiencing discrimination/harassment outside the workplace
39 37. Release from jail
38 38. Spouse/mate begins/ceases work outside the home
37 39. Major disagreement with boss/coworker
35 40. Change in residence
34 41. Finding appropriate child care/day care
33 42. Experiencing a large unexpected monetary gain
33 43. Changing positions (transfer, promotion)
33 44. Gaining a new family member
32 45. Changing work responsibilities
30 46. Child leaving home
30 47. Obtaining a home mortgage
30 48. Obtaining a major loan other than home mortgage
MANAGING PERSONAL STRESS CHAPTER 2 111
28 49. Retirement
26 50. Beginning/ceasing formal education
22 51. Receiving a ticket for violating the law
Total of Circled Items: _________
SOURCE: Social Readjustment Rating Scale, Hobson, Charles Jo, Joseph Kaen, Jane Szotek, Carol
M. Nethercutt, James W. Tiedmann and Susan Wojnarowicz (1998), “Stressful Life Events:
A Revision and Update of the Social Readjustment Rating Scale,” International Journal of
Stress Management, 5: 1–23.
SOURCES OF PERSONAL STRESS
1 Identify the factors that produce the most stress for you right now. What is it that creates
feelings of stress in your life?
Source of Stress Rating
2 Now give each of those stressors above a rating from 1 to 100 on the basis of how powerful
each is in producing stress. Refer to the Social Readjustment Rating Scale for relative
weightings of stressors. A rating of 100, for example, might be associated with the death of
a spouse or child, while a rating of 10 might be associated with the overly slow driver in
front of you.
3 Use these specific sources of stress as targets as you discuss and practice the stress
management principles presented in the rest of the chapter.
Improving the Management
of Stress and Time
Managing stress and time is one of the most crucial, yet
neglected, management skills in a competent manager’s
repertoire. Here is why: The National Institute for
Occupational Safety and the American Psychological
Association estimate that the growing problem of stress
on the job siphons off more than $500 billion from the
nation’s economy. Almost half of all adults suffer adverse
health effects due to stress; the percentage of workers
feeling “highly stressed” more than doubled from 1985
to 1990 and doubled again in the 1990s. In one survey,
37 percent of workers reported that their stress level at
work increased last year, while less than 10 percent say
their stress level decreased. Between 75 and 90 percent
of all visits to primary care physicians are for stress-
related complaints or disorders. An estimated one
million workers are absent on an average working day
because of stress-related complaints, and approximately
550,000,000 workdays are lost each year due to stress.
In one major corporation, more than 60 percent of
absences were found to be stress related, and in the
United States as a whole, about 40 percent of worker
turnover is due to job stress. Between 60 and 80 percent
of industrial accidents are attributable to stress, and
worker compensation claims have skyrocketed in the
last two decades, with more than 90 percent of the law-
suits successful. It is estimated that businesses in the
United States alone will spend more than $12 billion on
stress management training and products this year
(American Institute of Stress, 2000). Name any other
single factor that has such a devastating and costly effect
on workers, managers, and organizations.
A review of the chapters in a recent medical book
on stress illustrates the wide-ranging and devastating
effects of stress: stress and the cardiovascular system,
stress and the respiratory system, stress and the endo-
crine system, stress and the gastrointestinal tract,
stress and the female reproductive system, stress and
reproductive hormones, stress and male reproductive
functioning, stress and immunodepression, stress and
neurological disorders, stress and addiction, stress
and malignancy, stress and immune functions with
HIV-1, stress and dental pathology, stress and pain, and
stress and anxiety disorders (Hubbard & Workman,
1998). Almost no part of life or health is immune from
the effects of stress.
As an illustration of the debilitating effects of job-
related stress, consider the following story reported by
the Associated Press.
Baltimore (AP) The job was getting to the
ambulance attendant. He felt disturbed by the
recurring tragedy, isolated by the long shifts.
His marriage was in trouble. He was drinking
too much.
One night it all blew up.
He rode in back that night. His partner
drove. Their first call was for a man whose leg
had been cut off by a train. His screaming and
agony were horrifying, but the second call was
worse. It was a child-beating. As the attendant
treated the youngster’s bruised body and
snapped bones, he thought of his own child.
His fury grew.
Immediately after leaving the child at the
hospital, the attendants were sent out to help a
heart attack victim seen lying in a street. When
they arrived, however, they found not a cardiac
patient but a drunk—a wino passed out. As they
lifted the man into the ambulance, their frustra-
tion and anger came to a head. They decided to
give the wino a ride he would remember.
The ambulance vaulted over railroad
tracks at high speed. The driver took the cor-
ners as fast as he could, flinging the wino
from side to side in the back. To the atten-
dants, it was a joke.
Suddenly, the wino began having a real
heart attack. The attendant in back leaned
over the wino and started shouting. “Die, you
sucker!” he yelled. “Die!”
He watched as the wino shuddered. He
watched as the wino died. By the time they
reached the hospital, they had their stories
straight. Dead on arrival, they said. Nothing
they could do.
The attendant, who must remain anony-
mous, talked about that night at a recent
counseling session on “professional burnout”—
a growing problem in high-stress jobs.
112
CHAPTER 2 MANAGING PERSONAL STRESS
SKILL
LEARNING
MANAGING PERSONAL STRESS CHAPTER 2 113
As this story graphically illustrates, stress can pro-
duce devastating effects. Personal consequences can
range from inability to concentrate, anxiety, and depres-
sion to stomach disorders, low resistance to illness, and
heart disease. For organizations, consequences range
from absenteeism and job dissatisfaction to high accident
and turnover rates.
THE ROLE OF MANAGEMENT
Amazingly, a 25-year study of employee surveys
revealed that incompetent management is the largest
cause of workplace stress! Three out of four surveys
listed employee relationships with immediate supervi-
sors as the worst aspect of the job. Moreover, research in
psychology has found that stress not only affects work-
ers negatively, but it also produces less visible (though
equally detrimental) consequences for managers them-
selves (Auerbach, 1998; Staw, Sandelands, & Dutton,
1981; Weick, 1993b). For example, when managers
experience stress, they tend to:
❏ Selectively perceive information and see only
that which confirms their previous biases
❏ Become very intolerant of ambiguity and
demanding of right answers
❏ Fixate on a single approach to a problem
❏ Overestimate how fast time is passing (hence,
they often feel rushed)
❏ Adopt a short-term perspective or crisis mentality
and cease to consider long-term implications
❏ Have less ability to make fine distinctions in
problems, so that complexity and nuances are
missed
❏ Consult and listen to others less
❏ Rely on old habits to cope with current situations
❏ Have less ability to generate creative thoughts
and unique solutions to problems
Thus, not only do the results of stress negatively
affect employees in the workplace, but they also drasti-
cally impede effective management behaviors such as
listening, making good decisions, solving problems effec-
tively, planning, and generating new ideas. Developing
the skill of managing stress, therefore, can have signifi-
cant payoffs. The ability to deal appropriately with stress
not only enhances individual self-development but can
also have an enormous bottom-line impact on entire
organizations.
Unfortunately, most of the scientific literature on
stress focuses on its consequences. Too little examines
how to cope effectively with stress, and even less
addresses how to prevent stress (Hepburn, McLoughlin,
& Barling, 1997). We begin our discussion by present-
ing a framework for understanding stress and learning
how to cope with it. This model explains the major
types of stressors faced by managers, the primary reac-
tions to stress, and the reasons some people experi-
ence more negative reactions than others do. The last
section presents principles for managing and adapting
to stress, along with specific examples and behavioral
guidelines.
Major Elements of Stress
One way to understand the dynamics of stress is to
think of it as the product of a “force field” (Lewin,
1951). Kurt Lewin suggested that all individuals and
organizations exist in an environment filled with rein-
forcing or opposing forces (i.e., stresses). These forces
act to stimulate or inhibit the performance desired by
the individual. As illustrated in Figure 2.1, a person’s
level of performance in an organization results from fac-
tors that may either complement or contradict one
another. Certain forces drive or motivate changes in
behavior, while other forces restrain or block those
changes.
According to Lewin’s theory, the forces affecting
individuals are normally balanced in the force field. The
strength of the driving forces is exactly matched by
the strength of the restraining forces. (In the figure,
longer arrows indicate stronger forces.) Performance
changes when the forces become imbalanced. That is, if
the driving forces become stronger than the restraining
forces, or more numerous or enduring, change occurs.
Conversely, if restraining forces become stronger or
more numerous than driving forces, change occurs in
the opposite direction.
Feelings of stress are a product of certain stressors
inside or outside the individual. These stressors can be
thought of as driving forces in the model. That is, they
exert pressure on the individual to change present levels
of performance physiologically, psychologically, and
interpersonally. Unrestrained, those forces can lead to
pathological results (e.g., anxiety, heart disease, and
mental breakdown). However, most people have devel-
oped a certain amount of resiliency or restraining forces
to counter stressors and inhibit pathological results.
These restraining forces include behavior patterns, psy-
chological characteristics, and supportive social relation-
ships. Strong restraining forces lead to low heart rates,
good interpersonal relationships, emotional stability, and
114 CHAPTER 2 MANAGING PERSONAL STRESS
effective stress management. An absence of restraining
forces leads to the reverse.
Of course, stress produces positive as well as neg-
ative effects. In the absence of any stress, people feel
completely bored and lack any inclination to act. Even
when high levels of stress are experienced, equilibrium
can be restored quickly if there is sufficient resiliency.
In the case of the ambulance driver, for example, mul-
tiple stressors overpowered the available restraining
forces and burnout occurred. Before reaching such an
extreme state, however, individuals typically progress
through three stages of reactions: an alarm stage, a
resistance stage, and an exhaustion stage (Auerbach,
1998; Cooper, 1998; Selye, 1976).
REACTIONS TO STRESS
The alarm stage is characterized by acute increases in
anxiety or fear if the stressor is a threat, or by increases
in sorrow or depression if the stressor is a loss. A feeling
of shock or confusion may result if the stressor is partic-
ularly acute. Physiologically, the individual’s energy
resources are mobilized and heart rate, blood pressure,
and alertness increase. These reactions are largely self-
correcting if the stressor is of brief duration. However, if
it continues, the individual enters the resistance
stage, in which defense mechanisms predominate and
the body begins to store up excess energy.
Five types of defense mechanisms are typical of most
people who experience extended levels of stress. The first
is aggression, which involves attacking the stressor
directly. It may also involve attacking oneself, other
people, or even objects (e.g., whacking the computer). A
second is regression, which is the adoption of a behavior
pattern or response that was successful at some earlier
time (e.g., responding in childish ways). A third defense
mechanism, repression, involves denial of the stressor,
forgetting, or redefining the stressor (e.g., deciding that it
isn’t so scary after all). Withdrawal is a fourth defense
mechanism, and it may take both psychological and phys-
ical forms. Individuals may engage in fantasy, inattention,
or purposive forgetting, or they may actually escape from
the situation itself. A fifth defense mechanism is fixation,
which is persisting in a response regardless of its effective-
ness (e.g., repeatedly and rapidly redialing a telephone
number when it is busy).
If these defense mechanisms reduce a person’s
feeling of stress, negative effects such as high blood
pressure, anxiety, or mental disorders are never experi-
enced. The primary evidence that prolonged stress has
occurred may simply be an increase in psychological
defensiveness. However, when stress is so pronounced
as to overwhelm defenses or so enduring as to outlast
available energy for defensiveness, exhaustion may
result, producing pathological consequences.
While each reaction stage may be experienced as
temporarily uncomfortable, the exhaustion stage is the
most dangerous one. When stressors overpower or out-
last the resiliency capacities of individuals, or their ability
to defend against them, chronic stress is experienced and
negative personal and organizational consequences gen-
erally follow. Such pathological consequences may mani-
fest physiologically (e.g., heart disease), psychologically
(e.g., severe depression), or interpersonally (e.g., dissolu-
tion of relationships). These changes result from the
damage done to an individual for which there was no
defense (e.g., psychotic reactions among prisoners of
war), from an inability to defend continuously against a
stressor (e.g., becoming exhausted), from an overreac-
tion (e.g., an ulcer produced by excessive secretion of
Figure 2.1 Model of Force Field Analysis
Current Level of Functioning
Driving force A
Driving force B
Driving force C
Driving force D
Restraining force A
Restraining force B
Restraining force C
Restraining force D
MANAGING PERSONAL STRESS CHAPTER 2 115
Figure 2.2 A General Model of Stress
body chemicals), or from lack of self-awareness so that
stress is completely unacknowledged.
Figure 2.2 identifies the major categories of stres-
sors (driving forces) that managers experience, as well
as the major attributes of resiliency (restraining forces)
that inhibit the negative effects of stress. Each of these
forces is discussed in some detail in this chapter, so
that it will become clear how to identify stressors, how
to eliminate them, how to develop more resiliency,
and how to cope with stress on a temporary basis.
COPING WITH STRESS
Individuals vary in the extent to which stressors lead to
pathologies and dysfunctions. Some people are labeled
“hot reactors,” meaning they have a predisposition to
experience extremely negative reactions to stress (Adler &
Hillhouse, 1996; Eliot & Breo, 1984). For others, stress is
experienced more favorably. Their physical condition,
personality characteristics, and social support mech-
anisms mediate the effects of stress and produce
resiliency, or the capacity to cope effectively with stress.
In effect, resiliency serves as a form of inoculation against
the effects of stress. It eliminates exhaustion. This helps
explain why some athletes do better in “the big game,”
while others do worse. Some managers appear to be bril-
liant strategists when the stakes are high; others fold
under the pressure.
An elaboration of the differences in dispositions
toward stress reactions comes from a set of studies in
which hot reactors were more likely to be women (men
reacted more quickly to stress, but more factors pro-
duced stress in women); individuals with low self-
esteem and who viewed themselves as less attractive;
and children who had been neglected, fearful, or in
chaotic or broken homes (Adler, 1999). Physician Frank
Trieber reported: “If you come from a family that’s
somehow chaotic, unstable, not cohesive, harboring
grudges, very early on, it’s associated later with greater
blood pressure reactivity to various types of stress.”
In managing stress, using a particular hierarchy of
approaches has been found to be most effective (Kahn &
Byosiere, 1992; Lehrer, 1996). First, the best way to
manage stress is to eliminate or minimize stressors with
EXPERIENCING STRESS
MANAGING STRESS
• Anticipatory
• Encounter
• Time
• Situational
• Physiological
• Psychological
• Physical
• Psychological
• Social
Enactive Strategies
Purpose
Eliminate
stressors
Permanent
Enactive
Long time
Develop resiliency
strategies
Long term
Proactive
Moderate time
Learn temporary
coping mechanisms
Short term
Reactive
Immediate
Effects
Approach
Time
Required
Proactive Strategies Reactive Strategies
Stressors Reactions
Resiliency
116 CHAPTER 2 MANAGING PERSONAL STRESS
Figure 2.3 Some Physiological Effects of Stress
enactive strategies. These create, or enact, a new
environment for the individual that does not contain the
stressors. The second most effective approach is for indi-
viduals to enhance their overall capacity to handle stress
by increasing their personal resiliency. These are called
proactive strategies and are designed to initiate action
that resists the negative effects of stress. Finally, devel-
oping short-term techniques for coping with stressors is
necessary when an immediate response is required.
These are reactive strategies; they are applied as on-
the-spot remedies to reduce temporarily the effects of
stress.
To understand why this hierarchy of stress manage-
ment techniques is recommended, consider the physio-
logical processes that occur when stress is encountered.
Experiencing a stressor is like stepping on the accelera-
tor pedal of an automobile: the engine “revs up.” Within
seconds, the body prepares for exertion by having blood
pressure and heart rate rise substantially. The liver pours
out glucose and calls up fat reserves to be processed into
triglycerides for energy. The circulatory system diverts
blood from nonessential functions, such as digestion, to
the brain and muscles. The body’s intent is to extinguish
the stress by either “fight or flight.” However, if the
stressor is not eliminated as a result of these physiologi-
cal responses, the elevated blood pressure begins to take
its toll on arteries. Moreover, because the excess fat and
glucose don’t get metabolized right away, they stay in
the blood vessels. Heart disease, stroke, and diabetes are
common consequences. If the stress continues, minutes
later a second, less severe physiological response occurs.
The hypothalamus signals the pituitary to produce a
substance called ACTH. This substance stimulates the
adrenal cortex to produce a set of hormones known as
glucocorticoids. The action of ACTH serves to stimulate
a part of the brain vital to memory and learning, but
an excess actually can be toxic. That’s why impaired
memory and lower levels of cognition occur under con-
ditions of high stress. People actually get dumber! These
same glucocorticoids also suppress parts of the immune
system, so chronic stress leaves people more vulnerable
to infections. Figure 2.3 summarizes these physiological
consequences.
Individuals are better off if they can eliminate
harmful stressors and the potentially negative effects of
frequent, potent stress reactions. However, because
most individuals do not have complete control over
their environments or their circumstances, they can sel-
dom eliminate all harmful stressors. Their next-best
alternative, therefore, is to develop a greater capacity to
withstand the negative effects of stress and to mobilize
the energy generated by stressors. Developing personal
resiliency that helps the body return to normal levels of
activity more quickly—or that directs the “revved up
engine” in a productive direction—is the next best
strategy to eliminating the stressors altogether.
SOURCE: American Institute of Stress (2000), http://www.stress.org/problem.htm.
Immune Response
People who care for spouses
with dementia didn’t
respond to a flu vaccine as
well as a control group.
People with Full Response*
100
80
60
40
20
0
%
0–70 70+ ALL
Age in years
Caregiver
Control
Coronary Disease
Men who said they were
highly stressed were more
likely to have heart attacks
and strokes.
Heart-Disease Incidence
†
10
8
6
4
2
0
%
135791113
Years in study
High-
stress
group
Low-
stress
group
1 month
3 months
Viral Infection
The chances of catching a
cold increased the longer
people experience work or
interpersonal stress.
Relative Risk of a Cold
5
4
3
2
1
0
No
stress
Work Inter-
personal
*
Percent with a fourfold antibody resistance.
†
Cumulative annual incidence.
Sources: “Chronic stress alters the immune response to influenza virus vaccine in older adults.”
“Self-perceived psychological stress and incidence of coronary artery disease in middle-aged men.”
“Types of stressors that increase susceptibility to the common cold in healthy adults.”