A common belief is that stress increases the risk of various outcomes for health, or rather for ill-health, particularly in the area of heart disease and strokes. There is also some belief of a link between stress and proneness to cancer. Apart from being very much dependent on the definition of stress, there are large individual differences in any such relationships. The idea of individual differences brings personality into consideration. The interesting question then becomes: what is the relationship between personality and health (or ill-health)?
Throughout the past 30 years, in the area of health, the major distinction to be made has been between Type A and Type B personalities. Type A people tend to be always pressured by time and to be irritable and aggressive. They are competitive and desperate to achieve. Type B people are the opposite; more relaxed and easy-going, less competitive and aggressive. According to the original researchers in this area, Type A behaviour is linked to a greater risk of heart disease.
There is a great deal of general evidence to support the relationship between Type-A personality and proneness to heart disorder. However, a problem is that this type of personality has many characteristics. Is the risk of heart disorder due to one, some or all of them? Again, the general evidence here suggests that the major factor is hostility. The hostile type of person seems to be at greater risk of heart disorder than those who are less hostile. This is particularly the case when the hostility is confrontational rather than the type characterised by constant worry or complaint.
Although there are proven links between Type A personality and risk of heart disorder, there remains much that is unknown about the link. For example, very little is known about any such relationship in women; the majority of the research has been with men. Furthermore, Type A men in white-collar jobs are more at risk of heart disease than men in blue-collar jobs. Also, there are clear links between Type A personality or behaviour and high rates of smoking and drinking, relatively unhealthy eating and even increased risk of accidents. The question then becomes, is there a direct link between Type A and risk of heart disease or is there a complex interrelationship between all of the factors involved?
A further factor that enters this complex equation is stress. Type A and Type B personalities react differently to stressful situations. Type A people react more rapidly and more forcefully to stressful stimuli than Type B people. They also tend to perceive any threat as more personal than Type Bs. It is also reasonable to surmise that Type A people tend to increase their likelihood of being in stressful situations. It is almost as if their personality style prompts them to seek out more stressful situations.
Although, as was seen in previous chapters, personality is reasonably settled, it is not set in stone. To some extent personality is modifiable and so it is with Type A behaviours. Generally, we can alter our perceptions and emotional reactions by working on our cognitions. So, someone who recognises Type A tendencies in himself or herself might set various life-style changes in place, ranging from taking more exercise and learning relaxation techniques to broadly changing typical reactions to stressful situations. An example might be learning to be relaxed when standing in a supermarket checkout queue behind someone who cannot find the correct money or who seems to have forgotten the pin number on their card. In this situation, the Type A person would be tense with frustration and impatience and even potentially hostile. The control of any such way of reacting can only be good for the immune system.
Another type of question that has been asked in recent years concerns the possibility of a personality type that is prone to cancer. At present, the general answer is that no link has been found. One suggestion has been that a so-called Type C personality might be linked with cancer. This is the sort of person who is prone to depression, feelings ofhelplessness and with a very flat sort of emotional reactivity. However, to date, the evidence does not support this suggestion.
Another way of looking at the links that have been proposed between personality and various diseases is that such specific links do not exist: rather there might be general disease-prone personality. These would be people who score highly on a number of characteristics such as anxiety, depression and anger. Related to this, there is some indication that attitudinal factors also have a part to play in proneness to disease. For example, people who have a pessimistic approach to accounting for the events of life tend throughout their middle years to be in a worse state of health than those who take an optimistic approach.
Linked to attitude or approach to life and the proneness to disease is what is sometimes referred to as general resilience. Part of this is based on a person's view of locus of control. This refers to whether or not a person perceives himself or herself to have control over possible negative outcomes in life. Perceived control has positive outcomes and perceived lack of control has negative outcomes, even including an effect on the immune system. People can also be divided into those who believe that they are in control of events generally in their lives and those who believe that most things happen due to circumstances outside them - referred to respectively as internal and external locus of control. Needless to say, those who have an internal locus of control would be expected to be less disease prone than those with an external locus.
Again, generally, resilient or hardy people have a strong internal locus of control. However, they also have a firm sense of what they are doing in life - a sense of purpose. They are the sort of people who rise to challenges, seeing anything that changes around them as an opportunity rather than a threat. If people are highly resilient, then the impact of stressful events on them is less and tends to be less likely to lead to illness.
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