Affective Reactivity to Daily Stressors and Long-Term Risk of Reporting a Chronic Physical Health Condition



Daily stressors, such as an argument with a spouse or an impending deadline, are associated with short-term changes in physical health symptoms. Whether these minor hassles have long-term physical health ramifications, however, is largely unknown.


The current study examined whether exposure and reactivity to daily stressors is associated with long-term risk of reporting a chronic physical health condition.


Participants (N = 435) from the National Study of Daily Experiences completed a series of daily diary interviews between 1995 and 1996 and again 10 years later.


Greater affective (i.e., emotional) reactivity to daily stressors at time 1 was associated with an increased risk of reporting a chronic physical health condition at time 2.


Results indicate that how people respond to the daily stressors in their lives is predictive of future chronic health conditions.

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  1. 1.

    Centers for Disease Control and Prevention. Chronic disease overview: Costs of chronic disease. Available at Published 2009. Accessed October 10, 2011

  2. 2.

    Wu SY, Green A. Projection of chronic illness prevalence and cost inflation. Santa Monica: RAND Health; 2002.

    Google Scholar 

  3. 3.

    Porter ME. A strategy for health care reform—toward a value-based system. N Engl J Med. 2009; 361: 109-112. doi:10.1056/NEJMp0904131.

    PubMed  Article  CAS  Google Scholar 

  4. 4.

    Piazza JR, Charles ST, Almeida DM. Living with chronic health conditions: Age differences in affective well-being. J Gerontol Psychol Sci. 2007; 62(6): 313-321.

    Article  Google Scholar 

  5. 5.

    Schnittker J. When mental health becomes health: Age and the shifting meaning of self-evaluations of general health. Milbank Q. 2005; 83(3): 397-423.

    PubMed  Article  Google Scholar 

  6. 6.

    World Health Organization. Depression. Retrieved from Available 2009. Accessed August 19, 2011

  7. 7.

    Lindholm C, Burstrom B, Diderichsen F. Does chronic illness cause adverse social and economic consequences among Swedes? Scand J Public Health. 2001; 29(1): 63-70.

    PubMed  Article  CAS  Google Scholar 

  8. 8.

    Verbrugge LM, Patrick DL. Seven chronic conditions: Their impact on US adults’ activity levels and use of medical services. Am J Public Health. 1995; 85(2): 173-182.

    PubMed  Article  CAS  Google Scholar 

  9. 9.

    National Center for Chronic Disease Prevention and Health Promotion. The power of prevention: Chronic disease…the public health challenge of the 21st century. Available at Published 2007. Accessed October 10, 2011

  10. 10.

    Johns Hopkins University. Partnership for Solutions. Medical Expenditure Panel Survey. Available at Published 2001. Accessed October 20, 2011

  11. 11.

    Schniederman N, Ironson G, Siegal SD. Stress and health: Psychological, behavioral, and biological determinants. Annu Rev Clin Psychol. 2005; 1: 607-628.

    Article  Google Scholar 

  12. 12.

    Springer KW, Sheridan J, Kuo D, Carnes M. Long-term physical and mental health consequences of childhood physical abuse: Results from a large population-based sample of men and women. Child Abuse Negl. 2007; 32(5): 517-530. doi:10.1016/j.chiabu.2007.01.003.

    Article  Google Scholar 

  13. 13.

    Stroebe M, Schut H, Stroebe W. Health outcomes of bereavement. Lancet. 2007; 370(9603): 1960-1973.

    PubMed  Article  Google Scholar 

  14. 14.

    Almeida DM. Resilience and vulnerability to daily stressors assessed via diary methods. Curr Dir Psychol Sci. 2005; 14(2): 64-68.

    Article  Google Scholar 

  15. 15.

    Piazza JR, Almeida DM, Dmitrieva NO, Klein LC. Frontiers in the use of biomarkers of health in research on stress and aging. J Gerontol Psychol Soc Sci. 2010; 65(5): 513-525. doi:10.1093/geronb/gbq049.

    Article  Google Scholar 

  16. 16.

    Serido J, Almeida DM, Wethington E. Chronic stressors and daily hassles: Unique and interactive relationships with psychological distress. J Heal Soc Behav. 2004; 45: 17-33.

    Article  Google Scholar 

  17. 17.

    Dougall AL, Baum A. Stress, health, and illness. In: Kopec JA, Sayre EC, eds. Handbook of health psychology. Mahwah: Erlbaum; 2001: 321-337.

    Google Scholar 

  18. 18.

    Krantz DS, McCeney MK. Effects of psychological and social factors on organic disease: A critical assessment of research on coronary heart disease. Annu Rev Psychol. 2002; 53: 341-369.

    PubMed  Article  Google Scholar 

  19. 19.

    Holt-Lunstad J, Smith T, Layton JB. Social relationships and mortality risk: A meta-analytic review. PLoS Med. 2010; 7(7). doi:10.1371/journal.pmed.1000316. e1000316.

  20. 20.

    Almeida DM, Piazza JR, Stawski RS, Klein LC. The speedometer of life: stress, health, and aging. In: Schaie KW, Levey R, eds. The handbook of the psychology of aging. New York: Elsevier; 2011: 191-216.

    Google Scholar 

  21. 21.

    Zarski JJ. Hassles and health: a replication. Heal Psychol. 1984; 3(3): 243-251. doi:10.1037/0278-6133.3.3.243.

    Article  CAS  Google Scholar 

  22. 22.

    Zohar D. When things go wrong: the effect of daily work hassles on effort, exertion and negative mood. J Occup Organ Psychol. 1999; 72(3): 265-283. doi:10.1037/0021-9010.88.6.1082.

    Article  Google Scholar 

  23. 23.

    Charles ST, Almeida DM. Daily reports of symptoms and negative affect: Not all symptoms are the same. Psychol Heal. 2006; 21(1): 1-17. doi:10.1080/147683205001129239.

    Article  Google Scholar 

  24. 24.

    DeLongis A, Folkman S, Lazarus RS. The impact of daily stress on health and mood: Psychological and social resources as mediators. J Personal Soc Psychol. 1988; 54(3): 486-495.

    Article  CAS  Google Scholar 

  25. 25.

    Repetti RL. Short-term effects of occupational stressors on daily mood and health complaints. Heal Psychol. 1993; 12(2): 125-131. doi:10.1037/0278-6133.12.2.125.

    Article  CAS  Google Scholar 

  26. 26.

    Affleck G, Urrows S, Tennen H, Higgins P, Pav D, Aloisi R. A dual pathway model of daily stressor effects on rheumatoid arthritis. Ann Behav Med. 1997; 19(2): 161-170.

    PubMed  Article  CAS  Google Scholar 

  27. 27.

    Gil KM, Carson JW, Porter LS, Scipio C, Bediako SM, Orringer E. Daily mood and stress predict pain, health care use, and work activity in African American adults with sickle-cell disease. Heal Psychol. 2004; 23(3): 267-274. doi:10.1037/0278-6133.23.3.267.

    Article  Google Scholar 

  28. 28.

    Cathart S, Pritchard D. Daily hassles and pain sensitivity in chronic tension-type headache sufferers. Stress Heal. 2008; 24(2): 123-127. doi:10.1002/smi.1167.

    Article  Google Scholar 

  29. 29.

    Fifield J, McQuillan J, Armeli S, Tennen H, Reisine S, Affleck G. Chronic strain, daily work stress and pain among workers with rheumatoid arthritis: Does job stress make a bad day worse? Work Stress. 2004; 18(4): 275-291. doi:10.1080/02678370412331324996.

    Article  Google Scholar 

  30. 30.

    Verhoeven EWM, Kraaimaat FW, de Jong EMGJ, Schalkwijk J, van de Kerkhof PCM, Evers AWM. Individual differences in the effect of daily stressors on psoriasis: A prospective study. Br J Dermatol. 2009; 161(2): 295-299.

    PubMed  Article  CAS  Google Scholar 

  31. 31.

    Smyth J, Ockenfels MC, Porter L, Kirschbaum C, Hellhammer DH, Stone AA. Stressors and mood measured on a momentary basis are associated with salivary cortisol secretion. Psychoneuroendocrinology. 1998; 23(4): 353-370. doi:10.1016/S0306-4530(98)00008-0.

    PubMed  Article  CAS  Google Scholar 

  32. 32.

    Brosschot JF, Van Dijk E, Thayer JF. Daily worry is related to low heart rate variability during waking and the subsequent nocturnal sleep period. Int J Psychophysiol. 2007; 63(1): 39-47.

    PubMed  Article  Google Scholar 

  33. 33.

    Chandola T, Heraclides A, Kumari M. Psychophysiological biomarkers of workplace stressors. Neurosci Biobehav Rev. 2010; 35: 51-57.

    PubMed  Article  Google Scholar 

  34. 34.

    Richman LS, Pek J, Pascoe E, Bauer D. The effects of perceived discrimination on ambulatory blood pressure and affective responses to interpersonal stress modeled over 24 hours. Heal Psychol. 2010; 29(4): 403-411. doi:10.1037/a0019045.

    Article  Google Scholar 

  35. 35.

    Gouin J, Glaser R, Malarkey WB, Beversdorf D, Kiecolt-Glaser J. Chronic stress, daily stressors, and circulating inflammatory markers. Heal Psychol. 2011. doi:10.1037/a0025536.

  36. 36.

    McEwen BS. Stress, adaptation, and disease: Allostasis and allostatic load. Ann N Y Acad Sci. 1998; 840: 33-44. doi:10.1111/j.1749-6632.1998.tb09546.x.

    PubMed  Article  CAS  Google Scholar 

  37. 37.

    Ming EE, Adler GK, Kessler RC, et al. Cardiovascular reactivity to work stress predicts subsequent onset of hypertension: The air traffic controller health change study. Psychosom Med. 2004; 66: 459-465. doi:10.1097/01.psy.0000132872.71870.6d.

    PubMed  Article  Google Scholar 

  38. 38.

    Ross K, Martin T, Chen E, Miller GE. Social encounters in daily life and 2-year changes in metabolic risk factors in young women. Dev Psychopathol. 2011; 23: 897-906.

    PubMed  Article  Google Scholar 

  39. 39.

    Chida Y, Steptoe A. Greater cardiovascular responses to laboratory mental stress are associated with poor subsequent cardiovascular risk status: A meta-analysis of prospective evidence. Hypertension. 2010; 55(4): 1026-1032.

    PubMed  Article  CAS  Google Scholar 

  40. 40.

    Gee GC, Spencer MS, Chen J, Takeuchi D. A nationwide study of discrimination and chronic health conditions among Asian Americans. Am J Public Health. 2007; 97(7): 1275-1282. doi:10.2105/AJPH.2006.091827.

    PubMed  Article  Google Scholar 

  41. 41.

    Lazarus RS, Folkman S. Stress, appraisal and coping. New York: Springer; 1984.

    Google Scholar 

  42. 42.

    Cohen F, Lazarus RS. Coping and adaptation in health and illness. In: Mechanic D, ed. Handbook of health, health care, and the health professions. New York: Free Press; 1983: 608-635.

    Google Scholar 

  43. 43.

    Cohen S, Hamrick NMS, Rodriguez MS, Feldman PJ, Rabin BS, Manuck SB. The stability of and intercorrelations among cardiovascular, immune, endocrine, and psychological reactivity. Ann Behav Med. 2000; 22(3): 171-179. doi:10.1007/BF02895111.

    PubMed  Article  CAS  Google Scholar 

  44. 44.

    Watson D, Pennebaker JW. Health complaints, stress, and distress: Exploring the central role of negative affectivity. Psychol Rev. 1989; 96: 234-254. doi:10.1037/0033-295x.96.2.234.

    PubMed  Article  CAS  Google Scholar 

  45. 45.

    Costa PT, McCrae R. Neuroticism, somatic complaints, and disease: Is the bark worse than the bite. J Personal. 1987; 55: 299-316.

    Article  Google Scholar 

  46. 46.

    Charles ST, Gatz M, Kato K, Pedersen NL. Physical health twenty-five years later: The predictive ability of neuroticism. Heal Psychol. 2008; 27(1): 369-378. doi:10.1080/14768320500129239 OLD 51.

    Article  Google Scholar 

  47. 47.

    Martin L, Leff M, Calonge N, Garrett C, Nelson DE. Validation of self-reported chronic conditions and health services in a managed care population. Am J Prev Med. 2000; 18(3): 215-218. doi:10.1016/S0749-3797(99)00158-0.

    PubMed  Article  CAS  Google Scholar 

  48. 48.

    Bush TL, Miller SR, Golden AL, Hale WE. Self-report and medical record report agreement of selected conditions in the elderly. Am J Public Health. 1989; 79: 1554-1556.

    PubMed  Article  CAS  Google Scholar 

  49. 49.

    Brim OG, Ryff CD, Kessler RC. In: Brim OJ, Ryff CD, Kessler RC, eds. How healthy are we?: A national study of well-being at midlife. Chicago: Univ. of Chicago Press; 2004: 1-36.

    Google Scholar 

  50. 50.

    Radler B, Ryff C. Who participates? Accounting for longitudinal retention in the MIDUS national study of health and well-being. J Aging Health. 2010; 22: 307-331.

    PubMed  Article  Google Scholar 

  51. 51.

    Almeida DM, Horn M. Is daily life more stressful during middle adulthood? In: Brim OJ, Ryff CD, Kessler RC, eds. How healthy are we?: A national study of well-being at midlife. Chicago: Univ. of Chicago Press; 2004: 37-63.

    Google Scholar 

  52. 52.

    Almeida DM, McGonagle K, King H. Assessing daily stress processes in social surveys by combining stressor exposure and salivary cortisol. Biodemography Soc Biol. 2009; 55: 220-238.

    Article  Google Scholar 

  53. 53.

    Smyth JM, Stone AA. Ecological momentary assessment research in behavioral medicine. J Happiness. 2003; 4: 35-52.

    Article  Google Scholar 

  54. 54.

    Bem SL. Bem sex-role inventory manual. Palo Alto: Consulting Psychologists Press; 1981.

    Google Scholar 

  55. 55.

    Goldberg LR. The development of markers for the Big-Five factor structure. Psychol Assess. 1992; 4: 26-42.

    Article  Google Scholar 

  56. 56.

    Rossi AS. Caring and doing for others: Social responsibility in the domains of family, work, and community. Chicago: University of Chicago Press; 2001.

    Google Scholar 

  57. 57.

    Lachman ME, Weaver, SL. The Midlife Development Inventory (MIDI) Personality Scales: Scale construction and scoring. Technical report. 1997.

  58. 58.

    Almeida DM, Wethington E, Kessler RC. The daily inventory of stressful events: An interview-based approach for measuring daily stressors. Assessment. 2002; 9(1): 41-55.

    PubMed  Google Scholar 

  59. 59.

    Kessler RC, Andrews G, Colpe L, et al. Short screening scales to monitor population prevalences and trends in nonspecific psychological distress. Psychol Med. 2002; 32(6): 959-976. doi:10.1017/S0033291702006074.

    PubMed  Article  CAS  Google Scholar 

  60. 60.

    Radenbusch SW, Bryk AS. Hierarchical linear models: Applications and data analysis methods. 2nd ed. Newbury Park: Sage; 2002.

    Google Scholar 

  61. 61.

    Wilcox RR. Fundamentals of modern statistical methods: Substantially improving power and accuracy. New York: Springer; 2001.

    Google Scholar 

  62. 62.

    Zou GA. Modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004; 159(7): 702-706.

    PubMed  Article  Google Scholar 

  63. 63.

    Selye H. The stress of life. New York: Mcgraw-Hill; 1956.

    Google Scholar 

  64. 64.

    Holmes TH, Rahe RH. The social readjustment scale. J Psychosom Res. 1967; 11(2): 213-218. doi:10.1016/0022-3999(67)90010-4.

    PubMed  Article  CAS  Google Scholar 

  65. 65.

    Macleod J, Smith GD, Heslop P, Metcalfe C, Carroll D, Hart C. Psychological stress and cardiovascular disease: Empirical demonstration of bias in a prospective observational study of Scottish men. Br Med J. 2002; 324: 1247-1253.

    Article  Google Scholar 

  66. 66.

    Cohen S, Rodriguez MS. Pathways linking affective disturbances and physical disorders. Heal Psychol. 1995; 14(5): 374-380. doi:10.1037/0278-6133.14.5.374.

    Article  CAS  Google Scholar 

  67. 67.

    Jorm AF, Christensen H, Henderson S, Korten AE, Mackinnon AJ, Scott R. Neuroticism and self-reported health in an elderly community sample. Pers Individ Differ. 1993; 15: 515-521.

    Article  Google Scholar 

  68. 68.

    Charles ST, Gatz M, Kato K, Pedersen NL. Physical health twenty-five years later: The predictive ability of neuroticism. Heal Psychol. 2008; 27: 369-378.

    Article  Google Scholar 

  69. 69.

    Drossman DA, Creed FH, Olden KW, Svedlund J, Toner BB, Whitehead WE. Psychosocial aspects of the functional gastrointestinal disorders. Gut. 1999; 45: 1125-1130.

    Google Scholar 

  70. 70.

    Leserman J. Sexual abuse history: Prevalence, health effects, mediators, and psychological treatment. Psychosom Med. 2005; 67(6): 906-915. doi:10.1097/01.psy.0000188405.54425.20.

    PubMed  Article  Google Scholar 

  71. 71.

    Kendall-Tacket KA, Marshall R, Ness K. Chronic pain syndromes and violence against women. Women Therapy. 2003; 26(1–2): 45-56. doi:10.1300/J015v26n01_03.

    Article  Google Scholar 

  72. 72.

    Sachs-Ericsson N, Kendall-Tackett KA, Hernandez A. Childhood abuse and pain in the National Comorbidity Study. Child Abuse Negl. 2007; 31(5): 531-547.

    PubMed  Article  Google Scholar 

  73. 73.

    Davila GW, Bernier F, Franco J, Kopka SL. Bladder dysfunction in sexual abuse survivors. J Urol. 2003; 170: 476-479.

    PubMed  Article  Google Scholar 

  74. 74.

    Mayer EA. The neurobiology of stress and gastrointestinal disease. Gut. 2000; 47(6): 861-869.

    PubMed  Article  CAS  Google Scholar 

  75. 75.

    Ehlert U, Gaab J, Heinrichs M. Psychoneuroendocrinological contributions to the etiology of depression, posttraumtic stress disorder, and stress-related bodily disorders: the role of the hypothalamus-pituitary-adrenal axis. Biol Psychol. 2001; 57(1–3): 141-152. doi:10.1016/S0301-0511(01)00092-8.

    PubMed  Article  CAS  Google Scholar 

  76. 76.

    Peters KM, Kalinowski SE, Carrico DJ, Ibrahim IA, Diokno AC. Fact or fiction—is abuse prevalent in patients with interstitial cystitis? Results from a community survey and clinc population. J Urol. 2007; 178: 891-895.

    PubMed  Article  Google Scholar 

  77. 77.

    Talley NJ. Scope of the problem of functional digestive disorders. Eur J Surg. 1998; 582: 35-41.

    Google Scholar 

  78. 78.

    Alonso J, Petukhova M, Vilagut G, et al. Days out of role due to common physical and mental conditions: Results from the WHO World Mental Health Surveys. Molecular Psychiatry. 2010; 16(12): 1234-1246.

    PubMed  Article  Google Scholar 

  79. 79.

    Camilleri M, Dubois D, Couilie B, et al. Prevalence and socioeconomic impact of upper gastrointestinal disorders in the United States: Results of the US Upper Gastrointestinal Study. Clin Gastroenterol Hepatol. 2005; 3(6): 543-552. doi:10.1016/S1542-3565(05)00153-9.

    PubMed  Article  Google Scholar 

  80. 80.

    Fullerton S. Functional digestive disorders (FDD) in the year 2000—economic impact. Eur J Surg Oncol. 1998; 164(12): 62-64. doi:10.1080/11024159850191463.

    Google Scholar 

  81. 81.

    Becker N, Thomsen AB, Olsen AK, Sjogren P, Beck P, Eriksen J. Pain epidemiology and health related quality of life in chronic non-malignant pain patients referred to a Danish multidisciplinary pain center. Pain. 1997; 73(3): 393-400.

    PubMed  Article  CAS  Google Scholar 

  82. 82.

    Elder GH, Shanahan MJ, Clipp EC. Linking combat and physical health: The legacy of World War II in men’s lives. Am J Psychiatry. 1997; 154(3): 330-336.

    PubMed  Google Scholar 

  83. 83.

    Thakkar RR, McCane TR. The effects of daily stressors on physical health in women with and without a childhood history of sexual abuse. Child Abuse Negl. 2000; 24: 209-221.

    PubMed  Article  CAS  Google Scholar 

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The authors have no conflicts of interest to disclose.

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Corresponding author

Correspondence to Jennifer R. Piazza Ph.D..

Additional information

This work was supported by the National Institute of Health Grants awarded to David M. Almeida (P01 AG020166 and R01 AG019239) and Martin J. Slwinski (P01 AG03949).

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Piazza, J.R., Charles, S.T., Sliwinski, M.J. et al. Affective Reactivity to Daily Stressors and Long-Term Risk of Reporting a Chronic Physical Health Condition. ann. behav. med. 45, 110–120 (2013).

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  • Daily stressors
  • Stress
  • Chronic health conditions
  • Chronic illness
  • Reactivity