Effectiveness of defenses: a significant predictor of cortisol excretion under stress

Although stress theories assert that psychological characteristics influence illness through their effects on physiological reactions to psychosocial stimuli, it has been difficult to demonstrate substantial associations to support this contention. Effectiveness of defense (ED) is a clinical assessment based on emotional reaction to stress, disruption of physiological and social functioning, and the ability to mobilize additional defenses to deal with acute, superimposed stress. By convention, high scores on these assessments define ineffective defenses. In 6 of 7 samples studied to date, a significant ED-cortisol correlation was obtained (combined significance, p less than 0.00006). The ED-cortisol correlation averaged r = 0.41 for the seven samples and evidence from two studies suggests that ED is particularly important during high stress. These findings indicate that ineffective defenses are associated with higher cortisol excretion and establish ED as a topic worthy of study in connection with psychosocial stress. Future research issues include determining the importance of individual components of the overall ED rating and ascertaining whether ED has other physiological correlates in addition to cortisol.