Key Study: Stress beliefs and health problems (Fischer et al., 2016)

Travis DixonHealth Psychology, Key Studies

Health problems could be caused by thinking that stress is bad for you.

The following information is adapted from our eBook: IB Health Psychology – A Revision Guide.

Why do people develop physical health problems? One answer could be based on stress beliefs – if you think stress is bad you might be more likely to have health problems. This was one finding from the following study. 

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Stress is correlated with a number of physical and mental health problems, including heart attacks and depression. These problems could occur because of different beliefs about stress.  Some people believe that stress is bad for them and causes problems, whereas others think stress is a good thing. It could be these beliefs that stress is bad that explain why some people get more physical (somatic) ill-health symptoms than others. Fischer et al. conducted a quasi-experiment to investigate this hypothesis. It was the first study of its kind to see if there was a link between negative stress beliefs and physical symptoms.

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Negative Stress Beliefs Predict Somatic Symptoms in Students Under Academic Stress

(Fischer et al. 2016)

Aim: To see how stress beliefs can affect physical symptoms of health.


  • Quasi-experimental design (according to the researchers).
  • Participants were 216 students from the University of Marburg in Germany (mostly females of high socioeconomic status).
  • They took two questionnaires measuring their stress beliefs, stress levels, and somatic symptoms:
    • the Screening Scale for the Assessment of Chronic Stress (SSCS)
    • the Beliefs About Stress Scale (BASS).
  • Informed consent was gathered from all participants and the study was approved by a local ethics committee.
  •  Data was gathered in April at the beginning of the summer term (low stress period) and again in September at the end of their summer term (high stress period).


The results showed that having negative stress beliefs (e.g. “stress is bad for you”) led to more somatic symptoms (i.e. health problems) during a stressful period. Moreover, this effect happened “…via an additional increase in stress during the examination period.” In other words, students who appraised stress was bad for them experienced higher levels of stress and this is why they had more physical symptoms related to stress.


These results suggest that being “…convinced that stress is bad for you may … lead to a higher somatic symptom load when stress levels increase.” Some physical health problems could be explained by negative beliefs about stress.

Applications for IB Psychology:

This study could be relevant for the following IB exam topics:

  • Health problems – cognitive explanations
  • Health beliefs and dispositional factors
  • Risk and/or protective factors
  • Determinants of health
  • Biopsychosocial model of health

Critical Thinking Considerations

  • The researchers stated that “One limitation of the present study is the use of a student sample, which mainly consisted of young, healthy women with a high socioeconomic status. This limits the generalizability of the findings to the general population, although the female preponderance seems less problematic seeing that women are more frequently affected by medically unexplained conditions.” What does this second sentence mean? Do you agree that the focus on women is less problematic? Why might these findings not generalize to other genders, age groups or ethnicities?
  • Cognitive appraisals might affect the stress response, but what factors might affect someone’s cognitive appraisal in the first place? For example, do you think gender, race or socioeconomic status might be a factor?


  • Fischer, S., Nater, U. M., & Laferton, J. A. (2016). Negative Stress Beliefs Predict Somatic Symptoms in Students Under Academic Stress. International journal of behavioral medicine23(6), 746–751.
  • Lazarus, Richard. A Laboratory Approach to the Dynamics of Psychological Stress. Administrative Science Quarterly, Vol 8. No 2. Sept. 1963.