Research reveals relationship between people’s response to stress and cholesterol levels

Stress is an inescapable part of our lives. From exposure to major traumatic events like the Asian tsunami, to minor hassles like negotiating our way through rush hour traffic on Sukhumvit, dealing with the stress of life is the name of the game.

Taken individually, most stressful events might seem rather harmless and inconsequential. Few would think twice about the health consequences of routine annoyances we all have to contend with on a daily basis; the difficult coworker, the reckless motorcycle driver, running out of money before we run out of month. Nevertheless, there is gathering evidence that even minor stressful events can have an important impact upon health.

Stress, for example, has been shown to increase heart rate, lower resistance to the common cold, and increase some indicators of tissue inflammation. Now it appears that stress can also increase cholesterol levels, at least for some people. New evidence for the link between stress and cholesterol was published in the November issue of Health Psychology, published by the American Psychological Association.

Cholesterol is a fat-like compound that is found in many foods, in the bloodstream, and in cells of the body. Our bodies produce cholesterol, and we take in additional amounts in many of the foods that we eat. Cholesterol is necessary for several essential body functions.

The word “cholesterol,” of course, has some negative connotations for many of us. We hear talk of “good” and “bad” cholesterol. Bad cholesterol refers to low-density lipoprotein (LDL), which can deposit on artery walls, dangerously reducing, or possibly blocking the flow of blood. Good cholesterol refers to high-density lipoprotein (HDL), which is thought to provide protection against artery blockage.

When your doctor tests you for cholesterol he is measuring the amount of cholesterol circulating in your blood. Most of the cholesterol detected, about 85%, is produced by the body. The rest comes from what you eat and drink. Because high levels of total cholesterol, low levels of HDL (“good cholesterol”), high levels of LDL (“bad cholesterol”), and undesirable ratios among these factors place a person at risk for developing coronary heart disease, it is important to understand the variables that affect cholesterol levels.

Researchers Andrew Steptoe and Lena Brydon of University College London exposed 199 healthy middle-aged men and women to moderately stressful tasks in a laboratory setting. Before and after their exposure to stress, subjects’ cardiovascular, inflammatory and hemostatic functions were examined. Results showed that averages for total cholesterol, LDL, and HDL levels increased following the stressful behavioral tasks. Individuals, however, varied considerably in their level of increase in cholesterol, some showing more dramatic increases than others.

Three years later, these subjects’ cholesterol levels were again measured. As expected, cholesterol levels had increased with the passage of time. Surprisingly, those who had responded greatest to the laboratory stress showed significantly greater increases in cholesterol than those who had responded least. These changes were unrelated to baseline cholesterol levels, or to such factors as gender, age, body mass, smoking, and alcohol consumption.

The researchers speculated that the stress responses they observed in the lab were indicative of the way these people responded to everyday stresses. Those who showed the largest cholesterol increases might be expected to respond more dramatically to daily challenges of life. As those experiences accumulate they could result in an increase in fasting cholesterol years later.

It is quite interesting that individual differences in people’s response to stress would be associated with increases in cholesterol levels three years later. Although the stress responses in this study were not exceedingly large, techniques like these could provide a means of identifying those whose response to stress might be a risk factor for developing coronary heart disease. Such individuals could then be offered early interventions to help maintain their cholesterol levels within a healthy range. It also reinforces the notion that psychological interventions designed for stress management could help those who respond unhealthily to stress to learn more adaptive ways of handling the inevitable hassles and annoyances of everyday life.

December 1 is World AIDS Day

Stop me if you’ve heard this one.

While strolling along a California beach, a psychologist stumbles upon an antique lamp. He picks it up, rubs it, and out of a plume of smoke, there appears a genie.

The genie says, “Because you have released me, out of gratitude, I will grant you one wish.”

The psychologist thinks for a moment, and then replies, "I've always wanted to go to Hawaii, but I hate to fly, and I get seasick on ships. Would you build me a bridge to Hawaii so that I can drive there to visit?"

The genie grimaces and says, "Are you kidding? Think of the logistics! How would the supports ever reach the bottom of the Pacific Ocean? Think of the concrete, the steel, the shipping hazards. I’m sorry, but I can’t do that. Please think of another wish."

“OK,” says the psychologist. “Forget about the bridge. Just answer some questions concerning my patients. Why do some of my patients continue to smoke cigarettes and eat in ways that severely compromise their health? Why do they engage in risky behavior and maintain unhealthy lifestyles, knowing that they significantly increase their chance of resulting disability, illness, or premature death?”

Why do some of my patients do such things as sexually abuse their children, physically assault their wives, cheat, lie, and steal? In short, why do my patients think, act, and feel the way they do?

The genie thinks for a moment. Then with a sigh, he replies, “That bridge you wanted; would you prefer two lanes or four?”

Perhaps nowhere is the mystery of human behavior more puzzling than in the unfolding of the HIV/AIDS pandemic. Here, we have a life-threatening illness for which we have no cure or medical vaccine. It is preventable, yet for the past twenty years it has continued to spread worldwide. There is no end in sight.

The statistics are hard to fathom. Over 5 million people were newly infected with HIV in 2004. That amounts to about 570 infections per hour. Particularly worrying is the fact that over half of all new HIV infections worldwide are now appearing in young people between the ages of 15 and 24. Each day 6,000 young people are diagnosed with AIDS.

Over 20 million people have died of AIDS complications since the beginning of the epidemic. Each illness and death affects countless others, resulting in financial hardship, families without a breadwinner, children without parents, intensely personal loss, and heartache.

Early in the pandemic, Thailand distinguished itself by providing a model for successfully fighting the disease. Then Prime Minister Anand Panyarachun, Senator Mechai Viravaidya, and other courageous Thai leaders are generally credited with stabilizing, and then reversing an alarming trend in new HIV infections.

One key element of Thailand’s effective response to HIV/AIDS was to initiate a massive public education campaign. A 100% condom program was launched with the support of the Kingdom’s existing health infrastructure. Rather than attempting to suppress Thailand’s commercial sex industry, authorities wisely chose to aggressively promote condom use among sex workers and their clients. After reaching a peak of 143,000 new HIV infections in 1991, the number fell steadily to about 21,000 in 2003.

Despite these early successes, there are worrying signs on the horizon. The United Nations Development Program has reported that HIV continues to spread among diverse groups within Thai society, posing new challenges for detection and prevention efforts. About 600,000 people nationwide are now living with HIV, and they require care and support. HIV/AIDS is a major killer among young adults.

Experts warn that prevention efforts have not kept pace with the rapid changes that have occurred in the epidemic. Public concern has diminished, as AIDS spending has failed to keep up with the growing threat. Public education and awareness campaigns are on the decline. Today we hear more about the threat of a bird flu epidemic, which has yet to materialize in human populations, than we do about HIV/AIDS.

Like many modern health problems, HIV infection is produced by certain modifiable behavior. The most common method of transmission is through unprotected sexual intercourse with a partner who is HIV+. Another way is by sharing needles or other contaminated injection or skin-piercing equipment with others who are HIV+.

HIV can also be transmitted through blood and blood products, for example, through infected blood transfusions. An infected mother can also transmit the virus to her child in the womb or during delivery, and through breastfeeding. In all of these cases, transmission can be easily prevented. Through effective prevention we could eradicate the disease within a generation.

If we know how to prevent HIV infections, why does the epidemic continue to grow? Why are certain groups of people so poorly informed about the risks and methods of avoiding HIV infection? Why do educators resist making comprehensive sex education an urgent priority? Why do knowledgeable individuals nevertheless engage in risky behavior? Why do we place a stigma upon those who are living with HIV? Why do we permit discrimination against such people?

It would seem that finding solutions to these issues would be considerably less problematic than building a bridge from California to Hawaii, whether two lanes or four.

Crisis in France: Understanding violent behavior by groups

At the time of this writing, violence continues to erupt in nearly 300 cities and towns across France.

Destructive rioting that originated on October 27 in Paris's suburbs has spread, recently turning deadly, as a 60 year-old man was reported killed. Thousands of cars have been torched during more than two weeks of nightly violence; two churches and three schools were firebombed, according to news reports. Even police, attempting to quell the violence, have come under fire, leaving thirty-six officers wounded, two seriously.

The sudden, widespread appearance of mob violence like this raises some interesting questions about human behavior. Why would so many people suddenly resort to such extreme, destructive behavior? What forces are at work in episodes like this?

The general wisdom that has emerged in news commentary relates these ugly incidents to frustration experienced by ethnic minorities over poverty, racial discrimination, high rates of unemployment, their low status in French society, and related injustices. The violence was reportedly triggered by the accidental electrocution of two teens as they attempted to elude police. It subsequently seemed fueled by the unfortunate comments of France's Interior Minister, who characterized the rioting immigrant youths as “rabble.”

While frustration over long-festering injustices might seem to be a reasonable factor leading to this explosion of anger fueled violence, is it sufficient to account for the extreme behavior exhibited by the members of these mobs? What light might psychological research shed upon these troubling events?

Psychologists have demonstrated that groups have a set of dynamics that do not exist when people are acting individually. Do you recall the feelings you experienced as a member of a crowd at a sporting event, a music concert, or a political rally? Perhaps you felt a sense of excitement and power, a sense that you were a part of something bigger than yourself. Members of groups have been shown to be aroused, meaning that they are more physically activated, excited, primed and ready for action.

Researchers have also theorized that a person generally feels less personal responsibility as a member of a group, than as an individual. For example, a person is less likely to offer assistance if he encounters an emergency situation as a member of a group, than if he witnesses the same emergency while alone. In addition, a person seems capable of performing acts as a member of a group that he or she might never even consider performing as an individual. It’s as if responsibility for behavior becomes diffuse within a group situation.

Like the rioting in France, episodes of looting, police brutality, rioting at sport events, military massacres of civilians, and lynchings are actions that are performed almost exclusively by groups. It would be difficult to imagine these activities being performed by individuals. Psychologists Leon Festinger, Albert Pepitone, and Theodore Newton coined the term, “deindividuation” to describe a process whereby people lose a sense of their own identity, adopting instead, the norms of behavior of the group which make these activities possible.

Deindividuation occurs most easily when certain conditions are in place. The size of the group is one important factor. Vandalism performed by a large group hides the vandalism of an individual. Participants become faceless in a rioting mob. Darkness serves the same purpose, hiding the identities of the individuals performing the violent acts. It is noteworthy that the rioting in France occurred predominantly or exclusively at night and in groups. Larger crowds are capable of greater atrocities because they afford greater anonymity to their members.

Psychologist Philip Zimbardo hypothesized that crowded cities create conditions of anonymity for the inhabitants, permitting antisocial acts to more easily occur. To test his hypothesis, he abandoned two cars with their hoods left open. One car was left on a busy New York City street, and the other in Palo Alto, a comparatively smaller city. As predicted, the New York vehicle was quickly and repeatedly vandalized; a total of 23 times over three days. By contrast, the car abandoned in Palo Alto was never touched, except when a passerby stopped to lower the hood when it started to rain.

There is no doubt that the violent behavior by crowds of people is a complex phenomenon with multiple causes or influences. The apparently longstanding injustices suffered by ethnic minorities in France must certainly be considered an important factor leading to their decision to participate in these violent acts. There is, however, more involved than injustice.

The French, after all, do not have a monopoly on injustice, and rioting is not a common response to such conditions. Further, it is not unheard of for groups to choose to respond to injustice using nonviolent means. Psychologists and other social scientists are actively exploring issues like these. Perhaps as we advance our understanding of group behavior, we will develop means of reducing the potential for violent and destructive acts like those we are witnessing today in France.

Can we trust our intuitions?

A reader writes, “Years ago I ‘felt’ something was wrong with my sister. I kept trying to call her with no response. At the time I was working on a very busy switchboard and had contacts all over the place, so I rang the local exchange in the town where she was living. Two hours later I had my sister on the phone, telling me her house had burned down around the time I had tried to call her. Luckily everyone managed to get out. It was a very freaky feeling.”

Have you ever felt that you knew something without the use of reasoning or detailed analysis? Perhaps you had a hunch, a piece of knowledge for which you could not account. Are you guided by “gut instincts?” Are there advantages to heeding your intuitions?

Some peak performance gurus advocate intuitive decision making. They suggest turning off the analytical mind, and tuning into the “right brain,” a hidden source of wisdom useful for making important decisions. Is this a valid claim? Is there a reason to trust our intuition?

There is plenty of evidence that we are routinely guided or influenced by automatic or unconscious mental processes, and that these processes can serve us well. When we respond emotionally to situations, for example, we usually do so without extensive deliberative thought or analysis. If experiencing a sense of uneasiness in unfamiliar and dangerous surroundings motivates you to move quickly to a place of safety, that feeling might be considered wise or adaptive.

Irrational or disturbed emotional reactions, however, are often maladaptive. Those who refuse to board an airliner out of fear, but seem unconcerned about using earthbound automobile transportation are ignoring statistics which demonstrate the far greater danger associated with automobile travel.

There are other types of mental processes that occur outside of our awareness. If there is a task that you perform with great regularity and expertise, you probably perform it efficiently with very little conscious thought or effort, seemingly intuitively.

For many of us, driving a car is one such over-learned skill. Having driven daily for many years, we are able to do it more or less automatically, without much effortful thought. We can sing along with the radio, talk on a cell phone, converse with passengers, and even eat a snack while navigating mindlessly and more or less flawlessly through rush hour traffic.

Some people will insist following an event that, “I intuitively knew it all along.” Social psychologists have researched this hindsight judgment and found it to be notoriously error prone. Similarly, people like the above reader, occasionally report experiencing a premonition, unexplained knowledge of events which later occur, or are shown to have occurred. Some people are passionately confident in the validity of premonitions, based upon remarkable experiences like this one.

A scientific explanation of premonitions usually goes like this: A premonition that is confirmed by subsequent events tends to be remembered, while premonitions of events that fail to occur are typically forgotten. The result is that people experiencing premonitions tend to overestimate the reliability of these random experiences, leaving them with a false impression of extrasensory perception.

Psychologist David Dunning and his colleagues were interested in this feeling of overconfidence we have in decisions we make. They allowed students to interview people about their backgrounds, hobbies, interests, and whatever else they wished. Following each interview, the students were asked to predict how the interviewee would respond to 20 two-choice questions.

The students guessed correctly 63% of the time, 13% better than chance; however they felt 75% confident of the accuracy of their predictions. Studies like this have led theorists to conclude that we are biased toward overestimating the accuracy of our judgments and decisions. Could this help explain the confidence of some in the validity of their intuitions?

Human decision making is an interesting area of psychological investigation. I suppose that being human means that we are bound to make errors in our judgments. Nevertheless, as we learn more about the ways in which human decisions go awry, we might likewise sharpen our ability to think critically, possibly improving the precision of our decision making processes.