Stress and Health

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Using a holistic approach to discuss how stress can affect health as well as ways of
managing stress.
This first half of this paper will define stress and look at the holistic effects stress has on
biological, social and psychological aspects of health. The second part will focus on coping
strategies using holistic approach to managing stress. Harington (2013) describes how stress
is experience by everyone at some point, however how people deal with it differs greatly
from individual to individual. This shows the complexity of this subject and how when
coping with stress an individualised approach would be beneficial.
The HSE (2015) showed that stress and anxiety account for the majority of absences from
work and that in 2014/15, 23.3 million days where lost due to work related ill health, these
figures show the burden stress can have on society.
The vast amount of definitions of stress throughout the literature can show how everyone
interprets stress differently. The Labour Relations Commission (2007) Believed that stress is
an individual’s feeling of inability to “bridge the gap” with what is expected from them that
leads to a pattern of social, physiological and psychological dysfunctions or complaints. This
definition is a good place to start but stress can also come from something the person has
thought up or imagined Carlson et al (2006) states that a stressor can be real or imagined
and can provoke an emotional and behavioural response. keil (2004) describes stress as
something that must be manage therefore a negative concept. Although these definitions of
stress are relatively complex stress is a widely used term in modern day society which
Montoro et al (2009) believe makes stress so hard to define. As well as understanding what
stress is it is also important to look at the meaning of the term ‘holistic’. Collinge (1996)

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states that the term holistic means ‘whole’ so when looking at the holistic care of an
individual it is important to look at the persons physical, social, mental and spiritual health.
Anisman (2014) believes there is three types of stressors systemic, Psychogenic and
neurogenic. Systemic stressors do not need any conscious decision making and take place
within the body an example of this would be the immune response on an infection.
Psychogenic and neurogenic require conscious decision making and thought an example of
these would be exam stress. In a meta-analytic review Ortqvist and Wincent (2008) state
that stress effects different people in different ways and will causes ill health if it is
unmanageable, having a good understanding of stress is important if we are to manage or
recognise symptoms. Biologically there are seen to be three predicted stages the body uses
to respond to stress which were originally stated by Selye (Cited in McVicar, 2014) as
“general adaptation syndrome”. He explains that the process starts with the ‘Alarm stage’,
this initiates the activation of the hypothalamus which tells the pituitary glands to release
glucocorticoids which is one of the hormones of the stress response. In response adrenalin
and cortisol are released by the adrenal glands(sapolsky, Romero & Munch, 2000;
Segerstrom & Miller, 2004). This will lead to an increase of cardiac output, an increase in
breathing rate and a higher blood glucose levels to boost energy. Once the initial reaction
has taken place the second stage which is the resistance stage is initiated this is when the
body tries to resist or adapt to the stressor keeping a level of alertness. During this stage the
adrenal cortex continue to release glucocorticoids to help the body react to the stressor
until it is resolved or until the body can no longer cope. The final stage is the exhaustion
stage when the stressor has lead to the individual becoming depleted of energy. This
process was useful when humans had to defend against wild animals however this response
can take place under an imagined stressor which is not always so useful. Biological

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processes that are seen to support Psychological and physiological well-being have been
referred to as ‘allostasis’ (McEwen, 2007). When trying to understand the stress response it
Is important to look at the brains role more in-depth. McEwen (2008) states that the brain is
the dominant organ in the stress response and governs what is stressful and what is not.
Moreover he states that the brain also comes under attack from stress as chronic stressors
will change the brain both chemically and structurally. Kinto (2015) states that the HPA axis,
cortisol and adrenaline are crucial in the adaptive response to stressors. He describes these
stressors can be either internal or external and states that the systems involved in stress
response has strong control over the hippocampus. Stress can make changes to the
hippocampus that may effects and individual’s mood, ability to make rational decisions and
can even effect memory and behaviour. In acute stress, if the situation is uncontrollable it
will amplify the levels of cortisol secreted in humans ( Dickernson & Kemeny, 2004). Cortisol
is as steroidal hormone that is secreted during the normal response to any stress, it is
released by the adrenal cortex and is important for the normal metabolism of
carbohydrates. (The Oxford Dictionary of Nursing, 2014). However If the ardrino-cortical and
sympathetic systems are over aroused over long term it can cause damage to arteries and
organs (McEwan, 2009). Neil Schneiderman, Gail Ironson and D. Siegel (2005) identified
that a severe stress response in healthy individuals of a young age characteristically do not
inflict any danger to health. However, if the threat is constant the long term effects of the
stressor can have a negative impact on health, especially in older individuals. MaMahon et
al (2003) states that neglect, sexual, physical and emotional abuse as well as violence are
the most commonly studied stressors in children and adolescence. There has also been
studies into exposure to war and terrorism during childhood that found the majority of
children exposed to war develop significant psychological morbidity which include both

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post-traumatic stress disorder and depressive symptoms (Shaw, 2003). Shaw (2003) also
suggests that exposure to chronic stressors during the developmental years has lasting
neurobiological effects and can increase the risk of mood disorders, anxiety, structural
changes in the central nervous System and even early death.
One of the reasons stress may especially effect older people is discussed by McFarlance
(2010), he brings to light the potential stress has in exacerbating existing medical problems
and believes that stress plays an important role in more than half of the presenting medical
problems in modern medicine such as myocardial infarction, stroke, Irritable bowel
syndrome and flu. Neil Schneiderman et al (2005) recognised that the persistence, nature
and number of stressors experienced, how susceptible the individual is to stress and their
learnt coping strategies will all determine the effects stress will have on their. Keller et al
(2012) produced a study in the U.S. that looked at data from the 1998 National Interview
Survey and the National Death mortality data of 2006. The study found that 33.7% of
186million U.S. adults believed that stress affected their health a lot or to some extent. They
concluded that individuals who believed stress affects their health and who reported high
amount of stress had increased risk of premature death. It was also first acknowledged by
cohen & Kessler (1995) that’s stressful events, anxiety and depression have an impact on
the pathogenesis of disease. This shows that how when an individual is stressed they can
show signs and symptoms of cold and flu, looking rundown and exhausted.
Depression has also been linked to stressful life events (Hammen, 2005). In 2003 Kendler,
Hettema, butera, Gardner and Prescot, identified that life stresses such as the loss of a loved
one, Increasing debt and being socially isolated have been seen to forecast the onset of
depression. Van Praag (2004) stated that roughly 20% to 25% of people who had

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experienced a major stressful event would go on to develop depression therefore showing
the impact stress and have on an individual’s psychological health. In a meta-analysis Burk,
Davis, Otte & Mohr (2005) found that people who were clinically depressed and them who
were not depressed had similar levels of cortisol before a stressful event, however, the
subjects who were clinically depressed had greater levels of cortisol during the recovery
period (25 minutes after a stressful event). McFarlane (2010) mentions that long term
chronic stress or traumatic events at work may lead to psychological problems and may
even lead to psychosis. Which can result in long absence from work, having a negative
impact on one’s financial situation and family life. This situation would make levels of
cortisol increase hugely which in return will have a negative effect on a range of
psychological and biological processes such as the metabolism of carbohydrates, fats and
proteins as well as the inflammatory response (Cohen, Janicki-deverts & Miller, 2007).
Unfortunately higher levels of stress has also been related to suicide attempts, Ramberg
(2015) states that post-traumatic stress disorder is a well-established risk factor of suicidal
thoughts and behaviours. Along with the psychological impacts stress has on health
Sanafino & smith (2014) describe the psycho-physiological impacts stress has on an
individual and state that disorders such as asthma, inflammatory bowel, headaches and
tacacardia are all a product of stress.
Stress has also been related to the development of autoimmune diseases such as multiple
sclerosis (Harbuz et al, 2003). As stress has been seen to cause inflammation, stress can
affect the cardiovascular system, Ross (1999) states that the immune system responds to
vascular injury as it would atherosclerosis, immune cells migrate to the affected area that
can eventually lead to a clot. This explains why stress is a factor in the onset of myocardial
infarction. In a study conducted by Cruze et al (2015) they look for the first time at the

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effects chronic social stress has on the cardiovascular system in adolescence. They observed
that adolescence where vulnerable to the cardiovascular effects of stress caused by chronic
social isolation. They state that previous work doesn’t provide detailed enough evidence on
the effects of stress on the cardiovascular system caused by social determinants. Steptone &
Kivimaki (2012) stated that, epidemiologically, chronic stress forecasts the occurrence of
Coronary Heart Disease (CHD). They continue by supporting the evidence that in patients
with CHD, acute psychological stress is directly linked to the induction myocardial death and
that if the stress is long term it can increase the risk of myocardial infarction, cardiac arrest
shortness of breath and death. Razzoli et al (2009) reported that when rats are exposed to
repeated stress, a short time later they show signs of defensive behaviours, an inability to
feel pleasure from normally pleasurable activity’s and weight gain. After 3 weeks the rats
where still showing the same behavioural adaptations as well as a decrease in general
activity, social avoidance and depressive like behaviours. This shows the vast amount of
unwanted changes stress can cause on not just rats but most biological organisms.
Stress can affect many other biological systems such as the digestive system. Qin et al
(2014) state that Irritable bowel syndrome is a stress related disorder and suggest that if
individuals are to reduce their symptoms it is important that they manage stress effectively..
D’mello (2012) stated that stress related conditions are the second most reported issue of ill
health, health professionals reporting the highest levels of stress. It is because of this the
Health Service Executive (2007) believe that the factors of stress need to be taken seriously
by employers as stress is related to absenteeism, low staff morale and human error.
Because of the effects stress has on employees the National Institute for Health and Care
Excellence (2009) issued guidelines for employers in supporting mental wellbeing. Malone
(2004) states that chronic stress on an individual can lead them to develop sleep disorders,

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eating disorders and has a direct correlation to alcohol abuse and has been linked to drug
abuse. All of these factors can contribute to increased absences from work or school and
even job loss or exclusion from school. Hardy et al (1997) states that if high levels of stress
in work and an increasing work demands are not addressed then it may result in an
individual becoming ‘burnt out’. Thoits (2010) States that when a person possesses high
levels of self-esteem, social support and mastery then the effects stress has on an
individual’s health is reduced. It is there for important to look at ways of coping with stress
to improve health.
With the extensive amount of health complications directly or indirectly brought on by
stress it shows how important stress management and coping strategies are in preventing ill
health. The methods of coping that will be looked at are Pharmaceutical, Progressive Muscle
Relaxation, Cognitive Behavioural Therapy, Mindfulness-Based Stress Reduction as well as
the effects of Exercise.
As discussed above as well as healthy methods of dealing with stress people can turn to
drugs and alcohol as a way of coping (Malone, 2004). Alderbridge-Gerry et al (2011)
conducted a study using daily diary’s to evaluate the correlation between coping and
alcohol consumption. They found that people who use avoidance techniques and the use of
social support where the subjects that were associated with increased alcohol consumption.
However Corbin et al (2013) states that although stress has been implicated as an important
motivation for alcohol consumption research has not directly identified a relation between
drinking outcomes due to stress. A review undertook by Sinha (2008) collected evidence
from preclinical, clinical, and population studies and found that highly stressful situations
and chronic stress increase addiction vulnerability both in relapsing addicts and new

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addictions. She stated that this is due to individuals using drugs as a coping strategy for
stressors that are emotionally distressing, uncontrollable and unpredictable. As well as
negative coping strategies there are a number of positive ones that can be used to reduce
stress.
Mindfullnes based stress reduction is one of the most researched coping strategies for
stress and is now part of NICE clinical guidelines 23 (2004; amended 2007) for the treatment
of anxiety and depression. The Mindful-Based Stress Reduction technique implies that a
greater appreciation and awareness of the present will provide a more accurate perception,
will reduce emotional upset and will improve energy and an individual’s ability to cope with
stress (Chiesa & Serretti, 2010). Greeson et al (2015) believe that if systematic mindfulness-
based stress reduction is done correctly it can effect areas of the brain that are involved in
regulating attention, awareness and emotion. As well as Mindfulness-based stress reduction
a similar alternative called Mindfulness-based cognitive therapy can be used for stress
reduction, it comprises of therapy based exercises that look at how an individual is thinking
and how that can directly impact on how they are feeling (Fennell, Sumbundu & Perczel,
2015). In a systematic review and meta-analysis Gu et al (2015) state that the evidence for
mindfulness has shown a positive correlation between the development of mindfulness
based stress reduction and mindfulness based cognitive therapy skills and an increased
likely hood of an individual to accept stressful experiences. They state that after developing
an acceptance of stressful situations it leads to a reduced biological, psychological and social
response to stress.
Another way of dealing with stress could be through the use of pharmacology, however
Kreidler (2002) looks at the effects of pharmacology on post-traumatic stress and suggests

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that the literature on the use pharmacology for treatment in individuals effected by
childhood trauma is inconsistent and believes it is important for researchers and health
professional to be aware of any advance. Anthierens et al (2010) identified that there are
three different groups of GP’s when it comes to willingness to prescribe the drug
benzodiazepines to reduce stress. The first group which made up 39% of the subjects had no
concerns in prescribing benzodiazepines for the treatment of stress. The next group which
made up 17% of the GP’s studied where aware of the problems associated with
benzodiazepines but they didn’t believe it was their role to use non-pharmacological
methods to treat stress. The third group was 44% of subjects were reluctant to prescribe
benzodiazepines but stated there where barriers stopping them using non-pharmacological
methods. This shows the need for GP’s to be aware of the non-pharmacological stress
management techniques and the barriers they believe stop them from using them need to
be broken.
When it comes to exercise and stress reduction it is widely agreed by the lay person that
exercise can help reduce stress however a study by Ho et al (2014) showed that resistance
exercise did not bring about any substantial change to the amount of cortisol or adrenaline
released during a response to mentally changing tasks. In contrast Heaney et al (2011)
looked at Ten women that had exercise dependence and 10 women who did not (as
controls).They measured salivary cortisol and physical activity during and after a ten minute
long mental arithmetic stress test. The women who were exercise dependent showed a
decreased cardiac reaction to the stress test as well as a lower level of salivary cortisol 10,
20 and 30 minutes after the stress test. Although this study’s results where promising the
size of the cohorts involved. Vancampfort et al (2011) back up this argument looking at
patients with schizophrenia, they show that they can reduce levels of stress and anxiety by

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taking part in aerobic exercise or yoga taking their own preference into account. Collins et al
(2009) studied rats and found that improved ability to cope with stress was shown in
exercised rats seems. They go on to suggest that when the exercised rat where subjected to
a stressor they showed to have increased cognitive capabilities showing they had a more
productive and affective response to the stressor.
Cognitive behavioural therapy works for the reduction of stress by teaching individuals to
replace negative thoughts about stress and how the view stress. These thoughts can be
irrational and counter factual and Cognitive behavioural therapy look at replacing them with
beneficial ones Hunnot (2010). In patients that respond to treatments there have been
documented nurobiological changes related to cognitive behavioural therapy that show it
can modify dysfunctional neural activity, Porto (2009). In a study conducted by Granath
(2006) Psychological measurments (Quality of life, anger, exhaustion and self-rated stress)
as well as physiological measurements (blood pressure, heart rate, salavory cortisol and
urinary catecholamines) where took from subjects before and after undertaking 10 sessions
of cognitive behavioural therapy. They found that the subjects showed significant
improvements in most of the measurements including salivary cortisol used as a
measurement for reaction to stressful stimuli.
In a systematic review that looked at studied published from May 2011 to May 2013
Sharma (2014) found that 12 of the 17 studies they looked at had reported positive
psychological and physiological changes to stress by using Yoga as a management
technique. He states that although some of the studies showed inconsistencies the results
where promising and recommends more research should be done into the effects of Yoga in
reducing stress. Pascoe & Bauer (2015) write that there is evidence that yoga has the

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ability to enhance mood due to its inhibitory effects on physiological stress, their study
found that the 25 randomised control studies they looked at provided solid preliminary
evidence that if yoga is practiced properly it can lead to better regulation of the HPA the
systematic nervous system, which is accompanied by a decrease in symptoms of depression
and anxiety. Riley & Park (2015) state that for a while now Yoga has been shown to have
positive effects on reducing stress and state that there is an increasing confidence in
medical professionals to recommend yoga for a variety of mental and physical problems
that are exacerbated or caused by stress. They state that as well as health professionals
having greater confidence in recommending Yoga it is also positive to see that there is a
growing amount of research being done.
Another less researched means of stress reduction was studied by lineman et al (2015).
They looked at music as a means for reducing stress when used daily. They looked at fifty
five healthy university students and found that music can be considered as a means of
reducing stress. They suggest that if music is being listened to for relaxation effects it will
reduce stress by affecting the physiological stress systems of the body. Bradt et al (2013)
conducted a systematic review that found that listening to music has a beneficial effect on
people suffering from chronic heart disease because of its stress reducing propertied. They
also found that as well as reducing stress it can also effect have a positive effect on blood
pressure, heart rate respiratory rate, quality of sleep and pain.
From the references used in this paper it is apparent that stress has a major negative impact
on a person’s bio-psycho-social health. Stress whether it be imagined or real has been
shown to be managed with self-help or help form a rained professional. It is apparent that
more work needs to be done to promote the use of stress reduction techniques by health

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professionals instead of medication when it is not needed. It is promising to see the growing
amount of research into techniques such as Mindfulness Based Stress Reduction, Cognitive
Behavioural Therapy and Yoga but more research could be done into the effects of music on
stress. These methods should be promoted before an individual turns to alcohol or even
drug use as a coping and avoidance strategy, as well as being good for health this could also
have the potential to save the National Health Service a considerable amount of money.

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Reference List
Aldridge-Gerry, A. A., Roesch, S. C., Villodas, F., McCabe, C., Leung, Q. K., & Da Costa, M.
(2011). Daily stress and alcohol consumption: modelling between-person and within-
person ethnic variation in coping behaviour. Journal of Studies on Alcohol and Drugs,
72(1), 125-134.
Anisman, H.(2014). An introduction to stress & health. Los Angeles, CA: SAGE.
Anthierens, S., Pasteels, I., Habraken, H., Steinberg, P., Declercq, T., & Christiaens, T. (2010).
Barriers to nonpharmacologic treatments for stress, anxiety, and insomnia: family
physicians' attitudes toward benzodiazepine prescribing. Canadian Family Physician,
56(11), 398-406.
Bradt, J., Dileo, C., & Potvin, N. (2013). Music for stress and anxiety reduction in coronary
heart disease patients. Cochrane Database of Systematic Reviews, 12, CD006577.
doi: 10.1002/14651858.CD006577.pub3
Burke, H. M., Davis, M. C., Otte, C., & Mohr, D. C. (2005). Depression and cortisol responses
to psychological stress: a meta-analysis. Psychoneuroendocrinology, 30(9), 846-856.
doi: 10.1016/j.psyneuen.2005.02.010
Carboni, L., Piubelli, C., Pozzato, C., Astner, H., Arban, R., Righetti, P. G., Domenici, E. (2006).
Proteomic analysis of rat hippocampus after repeated psychosocial stress.
Neuroscience, 137(4), 1237-1246. doi: 10.1016/j.neuroscience.2005.10.045
Carlson, J.G., Burke, R., Ronald, J. (2006) Introduction to stress. International journal of
stress management,13(4), 395-8
Chiesa, A., & Serretti, A. (2010). A systematic review of neurobiological and clinical features
of mindfulness meditations. Psychological Medicine, 40(8), 1239-1252. doi:
10.1017/S0033291709991747
Cohen, S., Janicki-Deverts, D., & Miller, G. E. (2007). Psychological stress and disease. Journal
of the American Medical Association 298(14), 1685-1687. doi:
10.1001/jama.298.14.1685
Cohen, S., Kessler, R. C., & Underwood Gordon, L. (Eds.) (1995). Measuring stress: A guide
for health and social scientists. New York: Oxford.
Collinge, W. (1996). The American Holistic Health Association Complete Guide to Alternative
Medicine. Warner Books, New York.
Cruz, F. C., Duarte, J. O., Leao, R. M., Hummel, L. F., Planeta, C. S., & Crestani, C. C. (2015).
Adolescent vulnerability to cardiovascular consequences of chronic social stress:
Immediate and long-term effects of social isolation during adolescence.
Developmental Neurobiology. doi: 10.1002/dneu.22297

of 18
D’mello, S. (2011). Stress: the global economic downturn has taken its toll on employees:
whats the impact for organizations. Retrieved from http://tinyurl.com/n3glfl5
Donovan, R. O., Doody, O., & Lyons, R. (2013). The effect of stress on health and its
implications for nursing. British Journal of Nursing, 22(16), 969-970, 972-963. doi:
10.12968/bjon.2013.22.16.969
Fennell, M., Sumbundu, A., & Perczel, J. (2015). [Mindfulness-based cognitive therapy].
Psychiatry Hungary, 30(1), 100-103.
Granath, J., Ingvarsson, S., von Thiele, U., & Lundberg, U. (2006). Stress management: a
randomized study of cognitive behavioural therapy and yoga. Cognitive Behavioural
Therapy, 35(1), 3-10. doi: 10.1080/16506070500401292
Greeson, J. M., Smoski, M. J., Suarez, E. C., Brantley, J. G., Ekblad, A. G., Lynch, T. R., &
Wolever, R. Q. (2015). Decreased symptoms of depression after mindfulness-based
stress reduction: potential moderating effects of religiosity, spirituality, trait
mindfulness, sex, and age. Journal of Alternative and Complementary Medicine,
21(3), 166-174. doi: 10.1089/acm.2014.0285
Gu, J., Strauss, C., Bond, R., & Cavanagh, K. (2015). How do mindfulness-based cognitive
therapy and mindfulness-based stress reduction improve mental health and
wellbeing? A systematic review and meta-analysis of mediation studies. Clinical
Psychology Review, 37, 1-12. doi: 10.1016/j.cpr.2015.01.006
Hammen, C. (2005). Stress and depression. Annual Review of Clinical Psychology, 1, 293-319.
doi: 10.1146/annurev.clinpsy.1.102803.143938
Harbuz, M. S., Chover-Gonzalez, A. J., & Jessop, D. S. (2003). Hypothalamo-pituitary-adrenal
axis and chronic immune activation. Annals of the New York Academy of Sciences,
992, 99-106.
Hardy, G. E., Shapiro, D. A., & Borrill, C. S. (1997). Fatigue in the workforce of National
Health Service Trusts: levels of symptomatology and links with minor psychiatric
disorder, demographic, occupational and work role factors. Journal of Psychosomatic
Research, 43(1), 83-92.
Harrington, R.(2013). Stress, health and well-being: Thriving in the 21st century. Belmont,
CA: Cengage Learning.
Health and Safety Executive. (2016).Working Days Lost. Retrieved from
http://www.hse.gov.uk/statistics/dayslost.htm
Health Service Executive. (2007). HSE to exceed target levels for 2007 despite budgetary
pressure. Retrieved from
http://www.hse.ie/eng/services/news/media/pressrel/newsarchive/2007_Archive/S
eptember_2007/HSE_to_exceed_target_service_levels_for_2007_despite_budgetar
y_pressures.html

of 18
Heaney, J. L., Ginty, A. T., Carroll, D., & Phillips, A. C. (2011). Preliminary evidence that
exercise dependence is associated with blunted cardiac and cortisol reactions to
acute psychological stress. International Journal of Psychophysiology, 79(2), 323-329.
doi: 10.1016/j.ijpsycho.2010.11.010
Helman, C. (2001). Culture, Health and Illness. Butterworth-Heinemann, Oxford.
Ho, J. Y., Kraemer, W. J., Volek, J. S., Vingren, J. L., Fragala, M. S., Flanagan, S. D., . . . Maresh,
C. M. (2014). Effects of resistance exercise on the HPA axis response to psychological
stress during short-term smoking abstinence in men. Addictive Behaviour, 39(3), 695-
698. doi: 10.1016/j.addbeh.2013.10.027
Hunot, V., Moore, T. H., Caldwell, D., Davies, P., Jones, H., Furukawa, T. A., . . . Churchill, R.
(2010). Cognitive behavioural therapies versus treatment as usual for depression.
Cochrane Database Systematic reviews (9). doi: 10.1002/14651858.CD008699
Keil, R. M. (2004). Coping and stress: a conceptual analysis. Journal of Advanced Nursing,
45(6), 659-665.
Keller, A., Litzelman, K., Wisk, L. E., Maddox, T., Cheng, E. R., Creswell, P. D., & Witt, W. P.
(2012). Does the perception that stress affects health matter? The association with
health and mortality. Health Psychology, 31(5), 677-684. doi: 10.1037/a0026743
Kino, T. (2015). Stress, glucocorticoid hormones, and hippocampal neural progenitor cells:
implications to mood disorders. Frontiers in Physiology, 6, 230. doi:
10.3389/fphys.2015.00230
Labour Relations Commission. (2007). Labour Relations Commision: Annual report 2007.
Retrieved from
http://www.workplacerelations.ie/en/Publications_Forms/Guide_on_Work-
related_Stress.pdf.
Lambiase, M. J., Dorn, J., & Roemmich, J. N. (2012). Metabolic and cardiovascular
adjustments during psychological stress and carotid artery intima-media thickness in
youth. Physiology & Behavior, 105(5), 1140-1147. doi:
10.1016/j.physbeh.2011.12.012
Lazarus, R. S., Folkman, S (1984). Stress appraisal and coping. New York: Springer
Linnemann, A., Ditzen, B., Strahler, J., Doerr, J. M., & Nater, U. M. (2015). Music listening as
a means of stress reduction in daily life. Psychoneuroendocrinology, 60, 82-90. doi:
10.1016/j.psyneuen.2015.06.008
Malone, S. (2004) Surviving stress: A guide for Managers and Employees. Oak Tree Press,
Cork.
Marmot, M. G. (2003). Understanding social inequalities in health. Perspectives in Biology
and Medicine, 46(3), S9-23.

of 18
McEwen, B. S. (2007). Physiology and neurobiology of stress and adaptation: central role of
the brain. Physiological Reviews, 87(3), 873-904. doi: 10.1152/physrev.00041.2006
McEwen, B. S. (2008). Central effects of stress hormones in health and disease:
Understanding the protective and damaging effects of stress and stress mediators.
European Journal of Pharmacology, 583(2-3), 174-185. doi:
10.1016/j.ejphar.2007.11.071
McEwen, B. S. (2009). The brain is the central organ of stress and adaptation. Neuroimage,
47(3), 911-913. doi: 10.1016/j.neuroimage.2009.05.071
McFerran, T. (2014). A Dictionary of Nursing. Oxford,UK: Oxford University Press.
McMahon, S. D., Grant, K. E., Compas, B. E., Thurm, A. E., & Ey, S. (2003). Stress and
psychopathology in children and adolescents: is there evidence of specificity?
Journal of Child Psychology and Psychiatry, 44(1), 107-133.
McVicar, A., Ravalier, J. M., & Greenwood, C. (2014). Biology of stress revisited: intracellular
mechanisms and the conceptualization of stress. Stress Health, 30(4), 272-279. doi:
10.1002/smi.2508
Montoro, J., Mullol, J., Jáuregui, I., Dávila, I., Ferrer, M., Bartra, J., … Valero, A. (2009). Stress
and allergy. Journal of Investigational Allergology and Clinical Immunology, 19(Suppl
1), 40-47. Retrieved from http://www.jiaci.org
National Institute of Health and Care Excellence. (2004; amended 2007). Depression in
adults: The treatment and management of depression in adults. NICE guideline 23.
Retrieved from https://www.nice.org.uk/guidance/cg90
National Institute of Health and Care Excellence. (2009). promoting mental wellbeing
through productive and healthy working conditions: Guidance for employers. NICE
public health guidance 22. Retrieved from http://tinyurl.com/l2e3dor
Ortqvist, D., Wincent, J. (2008). Prominent consequences of role stress: a metaanalytic
review. International Journal of Stress Management, 13(4), 399-422
Pascoe, M. C., & Bauer, I. E. (2015). A systematic review of randomised control trials on the
effects of yoga on stress measures and mood. Journal of Psychiatric Research, 68,
270-282. doi: 10.1016/j.jpsychires.2015.07.013
Porto, P. R., Oliveira, L., Mari, J., Volchan, E., Figueira, I., & Ventura, P. (2009). Does cognitive
behavioral therapy change the brain? A systematic review of neuroimaging in
anxiety disorders. Journal of Neuropsychiatry and Clinical Neuroscience, 21(2), 114-
125. doi: 10.1176/appi.neuropsych.21.2.114
Qin, H. Y., Cheng, C. W., Tang, X. D., & Bian, Z. X. (2014). Impact of psychological stress on
irritable bowel syndrome. World Journal of Gastroenterology, 20(39), 14126-14131.
doi: 10.3748/wjg.v20.i39.14126

of 18
Ramberg, M., Stanley, B., Ystgaard, M., & Mehlum, L. (2015). Depressed suicide attempters
with posttraumatic stress disorder. Archives of Suicide Research, 19(1), 48-59. doi:
10.1080/13811118.2014.915777
Razzoli, M., Carboni, L., & Arban, R. (2009). Alterations of behavioral and endocrinological
reactivity induced by 3 brief social defeats in rats: relevance to human
psychopathology. Psychoneuroendocrinology, 34(9), 1405-1416. doi:
10.1016/j.psyneuen.2009.04.018
Riley, K. E., & Park, C. L. (2015). How does yoga reduce stress? A systematic review of
mechanisms of change and guide to future inquiry. Health Psychology Review, 1-18.
doi: 10.1080/17437199.2014.981778
Ross, R. (1999). Atherosclerosis--an inflammatory disease. The New England Journal of
Medicine, 340(2), 115-126. doi: 10.1056/NEJM199901143400207
Sapolsky, R. M., Romero, L. M., & Munck, A. U. (2000). How do glucocorticoids influence
stress responses? Integrating permissive, suppressive, stimulatory, and preparative
actions. Endocrine Reviews, 21(1), 55-89. doi: 10.1210/edrv.21.1.0389
Sarafino, E. P., & Smith, T. W.(2014). Health psychology: Biopsychosocial interactions. (8th
ed.). Hoboken, NJ: John Wiley & Sons.
Schneiderman, N., Ironson, G., & Siegel, S. D. (2005). Stress and health: psychological,
behavioral, and biological determinants. Annual Review of Clinical Psychology, 1,
607-628. doi: 10.1146/annurev.clinpsy.1.102803.144141
Segerstrom, S. C., & Miller, G. E. (2004). Psychological stress and the human immune
system: a meta-analytic study of 30 years of inquiry. Psychological Bulletin, 130(4),
601-630. doi: 10.1037/0033-2909.130.4.601
Sharma, M. (2014). Yoga as an alternative and complementary approach for stress
management: a systematic review. Journal of Evidenced Based Complementary and
Alternative Medicine, 19(1), 59-67. doi: 10.1177/2156587213503344
Shaw, J. A. (2003). Children exposed to war/terrorism. Clinical Child and Family Psychology
Review, 6(4), 237-246.
Sinha, R. (2008). Chronic stress, drug use, and vulnerability to addiction. Annals of the New
York Academy of Sciences, 1141, 105-130. doi: 10.1196/annals.1441.030
Steptoe, A., & Kivimaki, M. (2012). Stress and cardiovascular disease. Nature Reviews
Cardiology, 9(6), 360-370. doi: 10.1038/nrcardio.2012.45
Thoits, P. A. (2010). Stress and health: major findings and policy implications. Journal of
Health and Social Behavior, 51, S41-53. doi: 10.1177/0022146510383499.
van Praag, H. M. (2004). Can stress cause depression? Progress in Neuro-
Psychopharmacology & Biological Psychiatry, 28(5), 891-907. doi:
10.1016/j.pnpbp.2004.05.031

of 18
Vancampfort, D., De Hert, M., Knapen, J., Wampers, M., Demunter, H., Deckx, S., . . . Probst,
M. (2011). State anxiety, psychological stress and positive well-being responses to
yoga and aerobic exercise in people with schizophrenia: a pilot study. Disability
Rehabilitation, 33(8), 684-689. doi: 10.3109/09638288.2010.509458
von Kanel, R. (2012). Psychosocial stress and cardiovascular risk: current opinion. Swiss
Medical Weekly 142, w13502. doi: 10.4414/smw.2012.13502

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