Studies Show It's Possible To Control
How You React To Stress
Redford Williams, MD and
Virginia Williams, PhD
The following is an excerpt from the book In Control
by Redford Williams, MD, and Virginia Williams, PhD Published
by Rodale; February 2006;$24.95US/$33.95CAN; 1-59486-256-7
Copyright © 2006 Redford Williams, MD, and Virginia Williams.
PhD Studies Show It's Possible To Control How You React
Beginning in the early 1980s, several randomized clinical
trials of behavioral strategies targeted certain psychological
and social risk factors in people with heart disease or cancer.
By chance assignment, some subjects were taught the strategies,
while others were put in a control group and didn't learn
the strategies. Randomized clinical trials are considered
the gold standard when it comes to proving that new treatments
-- whether new drugs or behavioral approaches -- are effective
in treating or preventing disease. These early studies found
some amazing results.
Copyright © 2006 Redford Williams,
MD, and Virginia Williams, PhD
People with malignant melanoma (a type of skin cancer) who
received training in coping sills to handle stress slashed
their recurrence rate by 50 percent and their death rate by
an astonishing 70 percent. Heart attack patients who received
training that reduced both hostility and depression cut their
risk of recurring heart attacks or death in half. Other heart
patients who were trained to use coping skills to reduce stress
cut their risk of having subsequent heart attacks or needing
bypass surgery or angioplasty by more than 50 percent. One
of our corporate clients found that training decreased bad
stuff, such as depression and hostility, and increased good
stuff, such as social support and self-esteem, among employees.
These results were obtained in what might be described as
"open label trials" of our program (in other words, there
was no randomized control group). Now there have been two
carefully conducted randomized clinical trials of patients
with heart disease that document these benefits more rigorously.
In the first, psychologist Karina Davidson, PhD, and her student
Yori Gidron at Dalhousie University in Halifax, Nova Scotia,
randomly assigned heart attack patients to groups that received
either the usual care or training to reduce hostility, which
was based on an earlier version of our 8-week program. At
the end of eight training sessions, those in the hostility-reduction
group showed significant decreases in both hostility and blood
pressure compared with those who received the usual care.
More important, when the researchers followed up with the
patients after 2 months, they found that both hostility and
blood pressure levels had decreased even further in those
receiving hostility-reduction training, while levels had drifted
up slightly in those receiving the usual care. After 6 months,
those who had received hostility-reduction training had been
hospitalized again for an average of only about 1/2 day, compared
with 2.5 days for the usual-care group.
A more recent randomized clinical trial was conducted by psychologist
George Bishop, PhD, at the National University of Singapore
and the National Heart Centre there. In that study, people
who had undergone coronary bypass surgery were randomly assigned
to either the usual care or to our coping skills workshop.
Because we trained Dr. Bishop and his colleagues to deliver
the workshop, the training was provided to the patients in
Singapore just as it is in the United States, with some adaptations
for Far Eastern culture. (For example, instead of practicing
assertion toward someone who has distressed you, you would
have a friend or relative act as an intermediary, thereby
ensuring that no one would lose face.)
As first presented at the Annual Scientific Sessions of the
American Heart Association in Chicago in November 2002, Dr.
Bishop's study both confirmed and extended the results obtained
by Dr. Davidson and Gidron. When tested 3 months after the
workshops were completed, the patients who received training
were better off on several fronts than those who received
the usual care. For example:
They experienced less psychosocial bad stuff: lower scores
on depression (a 60 percent decrease), anger (18 percent),
and perceived stress (18 percent). They experienced less biological
bad stuff: lower resting heart rate (a 9 percent decrease)
and reduced reactivity of blood pressure (56 percent) and
heart rate (65 percent) when angered. They experienced more
psychosocial good stuff: higher scores for satisfaction with
social support (a 14 percent increase) and satisfaction with
life (13 percent). These results provide direct evidence that
training in coping skills can really change not only people's
ability to improve their emotional lives but also their physical
prognoses and prospects for future health.
Redford Williams, MD, is director of the Behavioral
Medicine Research Center, professor of psychology, professor
of psychiatry, and professor of medicine at the Duke University
Medical Center. He has served as president of the American
Psychosomatic Society, Society of Behavioral Medicine, and
Academy of Behavioral Medicine Research, and he is president-elect
of the International Society of Behavioral Medicine.
Virginia Williams, PhD, is the president of William
Lifeskills, Inc., in Durham, North Carolina, and has organized
and led workshops teaching the In Control process to thousands
of individuals, corporations, and government agencies around
the world. The Williamses also coauthored Anger Kills, a bestseller,
and Lifeskills. They live outside of Durham, North Carolina.
For more informaiton, visit: www.williamslifeskills.com/
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