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The Effects of Stress on Physical Illness

April 17, 2000



Research has shown a connection between stress and physical illness. Furthermore, who becomes ill under pressure may be regulated by other factors such as personality type. The purpose of this project was to determine if there is a relationship between stress and illness. Another motive for this project was to investigate whether or not correlations between illness, personality type, and/or stress is evident.

Twenty-one students in the Writing of Agriculture and Natural Resources class at the University of Florida were surveyed on their perceived level of stress and physical health. The questionnaire also analyzed their actual life stress level and level of extroversion. The questionnaire was evaluated and classified by personality types, health, and stress levels.

This study was expected to reveal that people who experience higher levels of stress would also experience higher rates of physical illness compared to people with lower levels of stress. The rates of illness in people who experience higher levels of stress may vary between perceived stress (how stressed one actually feels) and actual stress (as defined by specific life events). Specifically, people who report higher levels of perceived stress will experience higher rates of physical illness regardless of the number of actual stressful life events experienced (actual stress). In addition, personality types, such as people who are characteristically introverted (people who tend to keep to themselves) will tend to manifest signs of stress through physical symptoms more so than people who are characterized as extroverts (more social outgoing).

The results of my survey suggested that a correlation exists between stress and illness; and illnesses were exacerbated when the subjects indicated a characteristically introverted personality. There was further indication that subjects with an extroverted personality had signs of stress related illnesses. Overall, ninety-nine percent of the students who responded to the questionnaire revealed they had relatively high levels of stress and experienced various poor health frequently.


Stress and illness are no strangers to many. As many as 25 percent of the US population suffers from the negative effects of stress, and approximately 50 percent of all general medical patients are suffering from stress related problems (Everly, 1989). Several studies conducted confirm that stress is positively correlated with incidences of physical illness (DeVito, 1994). It is also becoming common knowledge that many physical diseases are either related to or can be exacerbated by excessive stress. Stress reduction is becoming a part of treatment and prevention of many diseases. Even insurance companies are paying for programs such as ones that reverse heart disease, which include learning stress reduction techniques .

Many studies have tried to link and explain the role of the immune system in the human stress response. The issue has even been given its own term, psychoneuroimmunology, meaning the study of the “direct causal relationship between stress and illness” (DeVito, 1994). For example, a study looking at wound repair in caregivers vs. non-caregivers found that caregivers, who were under significantly more stress than non caregivers, took an average of nine days longer to heal than non caregivers (Keicolt-Glaser, Marucha, Malarkey, Mercado, and Glaser, 1995). This study cited differences in the chemical immunological responses between the two groups.

There is no single recipe for managing stress, but utilizing fundamental coping mechanisms can help calm your mind. We cannot change who we are, our jobs, or families, but we can change our perceptions. The first step is to become more aware of the situation and environment. What causes your stress? How do you respond? By answering these questions, you can begin to modify your situation.

Some suggestions to reduce stress are to exercise; it strengthens the heart and lungs while bathing the brain in endorphins to reduce pain. You can also practice stress management techniques ranging from prayer, to biofeedback, to simple walks on the beach to feel inner peace. Relaxation techniques such as yoga, meditation, and investing in hobbies and leisure activities can do the same and more.

Literature Review

My review of the current literature indicated a link between stress and illness. However, it was unclear whether or not illness is more likely to be related to perceived stress, rather than actual life events which are considered stressful.

Personality may also factor in the relationship between stress and illness. Correlations between illness, personality type, and/or stress have been found. For example, the Type A personality has been associated with a higher incidence of heart disease. Neuroticism has also been linked to higher incidences of stress related illness (Hoffman, Levy-Shiff, and Malinski, 1996). An investigation published in the Journal of the American Medical Association found that a lack of diverse social contacts was correlated with greater risks of colds. This risk outweighed other factors such as smoking, low vitamin C intake or elevated stress hormones (“Harvard Health Letter”, 1998). People who are more likely to have social contact probably score higher on scales of extroversion, which indicate an outgoing, sociable personality. Studies of extroversion have shown that this trait may ameliorate the negative effects of stressful events (Hoffman, Levy-Shiff, and Malinski, 1996). Therefore, it is the opinion of this author that people who score higher on the aspect of extroversion will experience fewer physical ailments related to life stress than people who are less extroverted.

However, can it be said with certainty that everyone or even most people who experience severe stress can expect to fall victim to stress? The answer is not so cut and dry. Evidence suggests that other factors such as perception of the stressful event and personality type may also play a role in the stress-illness connection. Persons who perceive they are under more stress may react to it more strongly than persons who do not necessarily perceive the same situation stressful. The perception of stress is what causes the body to prepare for an emergency by producing certain hormones such as adrenaline, which has an effect on a broad rage body systems (DeVito, 1994). I


Students in the Writing for Agriculture and Natural Resources class were needed to complete a questionnaire to initiate this project. The survey examined 21 subjects of a variety of ages gathering specific information about the relationships between actual stress (as defined by life events that have occurred over the past year), perceived stress (how stressed you actually feel), physical illness, and the personality dimension of extroversion-introversion.

The survey began by asking demographic information such as age and sex. The next series of questions consisted of 11 personality-type questions to which the subjects were to respond with a yes/no answer. A total score of 11 points were possible. A high score indicated an extroverted personality, and a low score indicated an introverted personality. Subjects were to also indicate how stressed they perceived themselves as being in the past six months by choosing a number from a one to ten scale. An answer of ten would indicate extreme stress and therefore a high level of perceived stress. An answer of zero would indicate that the subject has experienced no stress over the past six months. Subjects answering the questionnaire were also asked how often they experience physical illness and how often they have had to miss work or school because of it.

After collecting, it was sorted, categorized, and analyzed to determine whether it supported the theory that stress causes illness.

The remainder of the information gathered for this project was in the form of both secondary and primary research – using the internet and the library.


Twelve females and nine males responded to the 30 questionnaires that were distributed. The level of extroversion was the dividing point for the comparative analysis. Of the students surveyed, 80 percent were characterized as having an extroverted personality.

Table 1 shows the results of the report including introversion-extroversion scale, a scale for all subjects responding to the survey, perceived stress, and total number of physical symptoms. The respondents were categorized into these groups according to the characteristics and answers given. More than half of all respondents experience high levels of perceived stress, actual stress, and physical illness. People who were categorized as introverts had a comparatively higher rate of stress and illness than those that are characterized as extroverts.

Table 1. Compares the % of individuals who have either a characteristically introverted or extroverted personality; with their levels of perceived and actual stress, and number pf physical symptoms of illness. Also shows % for all subjects surveyed.

Introversion Extroversion All Subjects

Perceived Stress 70% 35% 53%

Actual Stress 53% 49% 51%

Total Number of Physical Symptoms 69% 42% 56%


Statistical analysis supported the theory that stress causes illness. In addition, stress levels were higher in those people that indicated an introverted personality type. The study indicates a relationship between stress and illness, and that this relationship was strongest between how stressed one feels and illness. This held true for all subjects as a group.

The overall results of the questionnaire should be perceived with several uncertainties. One of the reasons for the uncertainties is the possibility that each subject did not answer each question as honestly as possible. For example, on each question of one of the surveys, a respondent circled the first answer of each question. Due to the formality of the questionnaire, the evidence provided by the subject would not be conclusive in any way. Another reason to view the results as doubtful is due to incomplete information. Two of the twenty-one individuals surveyed failed to complete crucial information on the questionnaire. These are just two vital scenarios that can cause misconceptions when reviewing the overall results and conclusions of this study.

Taking in account the stress levels of the individuals who responded to the survey, more than half do not find ways to relieve their stress. There does not appear to be in any one survey, a particular event that is causing stress related illnesses. As for all subjects, actual life stressors played a larger role in physical illness than how stressed one felt.

Although the group as a whole had factors that produced a relationship between stress and illness, people who displayed characteristics of an extroverted personality type had a weakened relationship between actual stress and illness. This group also had fewer physical symptoms of illness.

The group that was characterized as an introverted personality type scored the highest in all categories relating to stress and illness. They represented statistics that proved that they had cases of higher physical symptoms of illness, higher perceived stress levels and higher actual stress levels. This was not surprising considering all the literature that supports this conclusion.

In this study, the theory that stress causes illness proved to be correct. Of the 21 subjects surveyed, there proved to be an overall correlation between stress and physical illness. The relationship held stronger for those who are of an introverted personality type. Although the percentages were overall low for all categories, this was because not enough people responded to the study. The sample size was insufficient since 30 copies of the questionnaire were given out and only 21 responded. Even though these limitations are evident, the results still concluded that stress causes illness and is more evident in those people who are characterized as having an introverted personality type.

There are many ways to reduce stress, although it cannot be eliminated. Many individuals surveyed for this project did not take measures to reduce stress, such as an hour of relaxation, meditation, or exercise. Decreasing stress can help moderate the frequency and degree of illnesses that are generating from being highly stressed. All that is really needed to begin reducing stress is some quiet time for yourself – time to collect your thoughts and think about your well-being. Once you can find the time for stress-relief, the frequencies of illnesses can be decreased.


Can Stress Make You Sick? (1998, April). Harvard Health Letter, 23.

DeVito, P. (1994, July). The Immune System vs. Stress. USA Today Magazine, 123.

Hoffman, M. A., Levy-Shiff, R., & Malinski, D. (1996). Stress and Adjustment in the Transition to adolescence: Moderating Effects of Neuroticism and Extroversion. Journal of Youth and Adolescence 25, 161-175

Keicolt-Glaser, J. K., Marucha, P. T., Malarkey, W. B., Mercado, A. M., Glaser, R. (1995). Slowing of Wound Healing by Psychological Stress. The Lancet, 346.







Can Stress Make You Sick? (1998, April). Harvard Health Letter, 23.

DeVito, P. (1994, July). The Immune System vs. Stress. USA Today Magazine, 123.

Hoffman, M. A., Levy-Shiff, R., & Malinski, D. (1996). Stress and Adjustment in the Transition to adolescence: Moderating Effects of Neuroticism and Extroversion. Journal of Youth and Adolescence 25, 161-175

Keicolt-Glaser, J. K., Marucha, P. T., Malarkey, W. B., Mercado, A. M., Glaser, R. (1995). Slowing of Wound Healing by Psychological Stress. The Lancet, 346.





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