1. Myers’ PSYCHOLOGY (6th Ed)
Chapter 17
Stress and Health
James A. McCubbin, PhD
Clemson University
Worth Publishers

2. Stress and Health Behavioral Medicine Health Psychology
interdisciplinary field that integrates behavioral and medical knowledge and applies that knowledge to health and disease
Health Psychology
subfield of psychology that provides psychology’s contribution to behavioral medicine

3. Stress and Health Leading causes of death in the US in 1900 and 1991
Percentage
U.S.deaths 30 20 10
Tuber-
culosis
Pneu-
monia
Diarrhea/
enteritis
Heart
disease
1900
Cancer
Strokes
Chronic
lung disease
1991
Unlike many leading
killers a century ago,
today’s major
killers are more
lifestyle-related

4. What is Stress?
Stressors
Catastrophes
Life changes
Hassles
Intervening
factors
Appraisal
Perceived control
Personality
Social support
Coping behaviors
Stress
reactions
Physiological
Emotional
Behavioral
Stress
the process by which we perceive and respond to certain events, called stressors, that we appraise as threatening or challenging

5. Stress Appraisal Appraisal Response Stressful event (tough math test)
Threat
(“Yikes! This is
beyond me!”)
Challenge
(“I’ve got to apply
all I know”)
Panic, freeze up
Aroused, focused
Appraisal
Response

6. Pituitary hormone in the
bloodstream stimulates
the outer part of the adrenal
gland to release the stress
hormone cortisol
Sympathetic nervous
system releases the
stress hormones
epinephrine and
norepinephrine
from nerve endings
in the inner part of
the adrenal glands
Thalamus
Hypothalamus
Pituitary gland
Adrenal glands
Cerebral cortex
(perceives stressor)

7. What is Stress? General Adaptation Syndrome
resistance
Phase 1
Alarm
reaction
(mobilize
resources)
Phase 2
Resistance
(cope with
stressor)
Phase 3
Exhaustion
(reserves
depleted)
The body’s resistance to stress can only
Last so long before exhaustion sets in
Stressor
occurs
General Adaptation Syndrome
Selye’s concept of the body’s adaptive response to stress as composed of three stages

8. Stressful Life Events Catastrophic Events Life Changes Daily Hassles
earthquakes, combat stress, floods
Life Changes
death of a loved one, divorce, loss of job, promotion
Daily Hassles
rush hour traffic, long lines, job stress, burnout

9. Stress and Control Health consequences of a loss of control
No connection
to shock source
To shock control
To shock source
“Executive” rat
“Subordinate” rat
Control rat

10. What is Stress? Burnout Coronary Heart Disease
physical, emotional and mental exhaustion brought on by persistent job-related stress
Coronary Heart Disease
clogging of the vessels that nourish the heart muscle
leading cause of death in the United States

11. Stress & Coronary Heart Disease
Hopelessness
scores
3.5 3
2.5 2
1.5 1
0.5
Heart attack
Death
Low risk
Moderate risk
High risk
Men who feel extreme hopelessness
are at greater risk for heart attacks
and early death

12. Stress & Coronary Heart Disease
Type A
Friedman and Rosenman’s term for people who are competitive, hard-driving, impatient, verbally aggressive, anger-prone
Type B
Friedman and Rosenman’s term for easygoing, relaxed people

13. Stress and Disease Psychophysiological Illness “mind-body” illness
any stress-related physical illness
some forms of hypertension
some headaches
distinct from hypochondriasis – misinterpreting normal physical sensations as symptoms of a disease

14. Stress and Disease Lymphocytes
two types of white blood cells that are part of the body’s immune system
B lymphocytes form in the bone marrow and release antibodies that fight bacterial infections
T lymphocytes form in the thymus and, among other duties, attack cancer cells, viruses and foreign substances

15. Stress and Disease Conditioning of immune suppression UCS (drug) UCR
(sweetened
water) CR
Conditioning of immune suppression

16. poor nutrition and sleep)
Stress and Disease
Negative emotions and health-related consequences
Unhealthy behaviors
(smoking, drinking,
poor nutrition and sleep)
Persistent stessors
and negative
emotions
Release of stress
hormones
Heart
disease
Immune
suppression
Autonomic nervous
system effects
(headaches,
hypertension)

17. Promoting Health Aerobic Exercise
Depression
score 14 13 12 11 10 9 8 7 6 5 4 3
Before treatment
evaluation
After treatment
No-treatment
group
Aerobic
exercise
Relaxation
treatment
Aerobic Exercise
sustained exercise that increases heart and lung fitness
may also alleviate depression and anxiety

18. Promoting Health Biofeedback
system for electronically recording, amplifying, and feeding back information regarding a subtle physiological state
blood pressure
muscle tension

19. Life-style modification patients
Promoting Health
Modifying Type A life-style can reduce recurrence of heart attacks
Percentage
of patients
with recurrent
heart attacks
(cumulative
average) 6 5 4 3 2 1
Year
Life-style modification patients
Control patients
Modifying life-style
reduced recurrent

20. Promoting Health Social support across the life span Percentage
Age in years
100% 90 80 70 60 50
Percentage
with high
support

21. Level of social support
Life events
Tendency toward
Health
Illness
Personal appraisal
Challenge
Threat
Personality type
Easy going
Nondepressed
Optimistic
Hostile
Depressed
Pessimistic
Personality habits
Nonsmoking
Regular exercise
Good nutrition
Smoking
Sedentary
Poor nutrition
Level of social support
Close, enduring
Lacking

22. Promoting Health Predictors of mortality 1 0.8 Relative 0.6 risk
0.4
0.2
Men
Women
Not smoking Regular exercise Weekly religious
attendance
Relative
risk
of dying

23. Subfields of Alternative Medicine
Alternative systems of
medical practice
Bioelectromagnetic
applications
Diet, nutrition,
life-style changes
Herbal medicine
Manual healing
Mind-body control
Pharmacological and
biological treatments
Subfields of Alternative Medicine
Health care ranging from self-care according to folk principles,
to care rendered in an organized health care system based on
alternative traditions or practices
The study of how living organisms interact with electromagnetic (EM) fields
The knowledge of how to prevent illness, maintain health, and
reverse the effects of chronic disease through dietary or
nutritional intervention
Employing plan and plant products from folk medicine traditions
for pharmacological use
Using touch and manipulation with the hands as a diagnostic
and therapeutic tool
Exploring the mind’s capacity to affect the body, based on
traditional medical systems that make use of the interconnected-
ness of mind and body
Drugs and vaccines not yet accepted by mainstream medicine

24. Promoting Health Complementary and Alternative Medicine
unproven health care treatments not taught widely in medical schools, not used in hospitals, and not usually reimbursed by insurance companies

25. Promoting Health The religion factor is mulitidimensional Religious
involvement
Healthy
behaviors
(less smoking,
drinking)
Social support
(faith
communities,
marriage)
Positive
emotions
(less stress,
anxiety)
Better health
(less immune system
suppression, stress
hormones, and suicide)

26. Promoting Health Smoking-related early deaths Number of deaths
40,000
30,000
20,000
10,000
33,348
1,686
1,135
556
202
Smoking Suicide Vehicle HIV/ Homicide
crash AIDS
Cause of death
Number
of deaths
per 100,000

28. Promoting Health Fewer Canadian smokers Percentage of Canadians
Males
Females
Year
60% 50 40 30 20 10
Percentage
of Canadians
smoking

29. Smoking Prevention
Year
30% 25 20 15 10 5
Percentage of
U.S. high school
seniors who
smoke daily
Smoking has made a partial comeback among U.S. teens

30. Smoking Prevention Results of a smoking inoculation program Percentage
of students
who smoke 20 15 10 5
Seventh grade
Eighth grade
Ninth grade
Months of study
Control school
School with smoking
Prevention program
Fewer teens took up
smoking when “inoculated”
against it

31. Obesity and Weight Control
Obesity and mortality
Body-mass index (BM I)
Men
Women
2.8
2.6
2.4
2.2
2.0
1.8
1.6
1.4
1.2
1.0
0.8
0.6
Relative
risk of
death

32. Weight Discrimination
Willingness
to hire scale
(from1:
definitely
not hire to
7: definitely
hire) 1 2 3 4 5 6 7
Women
Men
Normal
Overweight
When women applicants were made to look overweight, subjects were less willing to hire

33. Weight Control Effects of a severe diet Days Caloric intake in
calories
per day
Body
weight
kilograms
Metabolism:
Oxygen
consumption
in liters
per hour
3000
2000
1000
Days
165
160
155
150
145
140 26 25 24 23 22 21

34. Weight Control Most lost weight is regained Weight change in pounds
-20
-15
-10 -5 5 10 1 2 3 4
Weight
change
in pounds
Post
treatment
Years of follow-up
Starting
point
Normal trend for untreated obese
people: Gradually rising weight
After participation in behavioral
Program: Much of initial weight
Loss regained
Most lost weight is regained

35. Hours of television watched per day
Weight Control
< >4
Hours of television watched per day
in 1990s study
Boys
Girls 32 30 28 26 24 22 20
Skinfold fat
measure (mm)
Obesity was more common among those who watched the most television