Difficulty: Intermediate | Prerequisites: Chapters 9-11 notes; basic understanding of cardiovascular anatomy and stress physiology.
This chapter covers four major chronic conditions through a health psychology lens: coronary heart disease (CHD), hypertension, stroke and Type 2 diabetes. The thread running through all four is the role of stress, social support and psychological factors in both the development and management of these conditions. There are important racial and gender disparities in each. If you are coming in cold, review the stress and coping material from earlier in the course, as well as Chapter 11's framework for adjusting to chronic disease.
CHD is caused by atherosclerosis and is linked to both chronic and acute stress. Women develop heart disease later but it is more dangerous for them. Hypertension disproportionately affects African American communities, with John Henryism offering one explanatory framework. Stroke outcomes depend on which side of the brain is damaged. Type 2 diabetes development is influenced by psychological factors including depression, low conscientiousness and job strain.
CHD (Coronary Heart Disease)
Illness caused by atherosclerosis (plaque build-up) or the narrowing of the coronary arteries. In simple terms, the arteries supplying blood to the heart become blocked or narrowed.
Atherosclerosis
The build-up of fatty deposits (plaques) inside artery walls, narrowing them and restricting blood flow.
Hypertension
High blood pressure. A major risk factor for heart disease and stroke.
John Henryism
A pattern of active, high-effort coping with psychosocial stressors that leads to greater cardiovascular reactivity to stress and less rapid recovery. Named after the folk legend of John Henry. In simple terms, working extremely hard to overcome barriers at the cost of physical health.
Aphasia
A communication disorder that can result from left-brain stroke damage. Affects the ability to produce or understand speech.
Type 2 Diabetes
A metabolic condition where the body does not use insulin properly. Development is influenced by both physiological and psychological factors.
CHD and stress:
Both chronic and acute stress are linked to CHD.
Stress contributes to the development of blood clots, which can trigger coronary events (heart attacks).
CHD and women:
There is less research on women and CHD compared to men.
Heart disease occurs later in women than in men.
When it does occur, it is more dangerous for women.
Stress management and social support:
People with low social support have higher risk for health problems, including CHD. Social isolation is itself a risk factor.
Hypertension is high blood pressure.
Racial disparities:
Hypertension is higher among African American communities, particularly those with lower SES.
This disparity is linked to structural and socioeconomic factors, not biology alone.
John Henryism:
A coping style characterised by prolonged, high-effort striving against barriers.
Results in greater cardiovascular reactivity to stress and less rapid recovery from stress.
Helps explain why sustained effortful coping in the face of systemic disadvantage can produce worse cardiovascular outcomes.
The cognitive effects of stroke depend on which side of the brain is damaged.
Right-brain damage:
Difficulty processing or using certain kinds of visual feedback.
Problems with depth perception.
May not be able to understand words they read.
Left-brain damage:
Communication disorders, most notably aphasia (difficulty producing or understanding speech).
Psychological factors in development:
Low conscientiousness
Job strain
Depression
All three are associated with increased risk of developing Type 2 diabetes.
Type 2 diabetes and stress:
People with Type 2 diabetes are particularly sensitive to the effects of stress. Stress can worsen blood glucose control and complicate disease management.
Students sometimes assume CHD affects men and women equally. Women develop heart disease later, but it is more dangerous when it does occur.
Students may think John Henryism is simply "working hard." It specifically refers to prolonged, high-effort coping against systemic barriers, and the cardiovascular cost of that sustained effort.
Students often assume stroke effects are uniform. The cognitive problems depend entirely on which hemisphere of the brain is damaged.
Know the mechanism linking stress to CHD (clot development triggering coronary events).
Know the gender differences in CHD (later onset in women, more dangerous).
Be able to explain John Henryism and its connection to hypertension in African American communities.
Know which cognitive problems map to right-brain vs. left-brain stroke damage.
Know the three psychological factors linked to Type 2 diabetes development (low conscientiousness, job strain, depression).
Understand why social support matters across all four conditions.
Fill in the blank: CHD is caused by ________ or the narrowing of the coronary arteries. (Atherosclerosis.)
True or False: Heart disease is less dangerous for women than for men. (False – it is more dangerous for women when it occurs.)
Fill in the blank: The concept of ________ describes greater cardiovascular reactivity to stress and less rapid recovery, linked to prolonged high-effort coping. (John Henryism.)
True or False: Left-brain stroke damage is associated with communication disorders like aphasia. (True.)
Fill in the blank: Three psychological factors linked to Type 2 diabetes development are low conscientiousness, job strain and ________. (Depression.)
Q: How does stress contribute to coronary heart disease?
A: Both chronic and acute stress are linked to CHD. Stress contributes to the development of blood clots, which can trigger coronary events such as heart attacks.
Q: What is John Henryism, and why is it relevant to hypertension in African American communities?
A: John Henryism is a coping style involving prolonged, high-effort striving against psychosocial barriers. It leads to greater cardiovascular reactivity to stress and slower recovery. It helps explain elevated hypertension rates in African American communities, particularly those with lower SES, where sustained effortful coping against systemic disadvantage takes a cardiovascular toll.
Q: What cognitive problems are associated with right-brain versus left-brain stroke damage?
A: Right-brain damage affects visual processing, depth perception and the ability to understand written words. Left-brain damage causes communication disorders, most notably aphasia.
Q: Name three psychological factors associated with the development of Type 2 diabetes.
A: Low conscientiousness, job strain and depression.
The stress mechanisms discussed here connect directly to the stress and coping frameworks covered earlier in the course. The social support findings tie back to Chapter 11's discussion of adjustment determinants. The racial disparities in hypertension and the gender disparities in CHD connect to the stereotyping and bias material in Chapter 9. The psychological factors in Type 2 diabetes (depression, conscientiousness) link to personality psychology and occupational health.
Coronary heart disease, CHD, atherosclerosis, stress and heart disease, women and CHD, gender differences cardiovascular, hypertension, high blood pressure, John Henryism, African American health, racial health disparities, cardiovascular reactivity, stroke, right brain damage, left brain damage, aphasia, visual processing, depth perception, Type 2 diabetes, T2D, depression and diabetes, conscientiousness, job strain, social support, PSY 320, health psychology, Michigan State University