1. PSYCHOLOGY Stress and Health

2. zBehavioral Medicine yinterdisciplinary field that integrates behavioral and medical knowledge and applies that knowledge to health and disease zHealth Psychology ysubfield of psychology that provides psychology’s contribution to behavioral medicine

3. Stress and Health zLeading causes of death in the US in 1900 and 1991 Percentage U.S.deaths 30 20 10 0 Tuber- culosis Pneu- monia Diarrhea/ enteritis Heart disease 1900 Percentage U.S.deaths 30 20 10 0 Heart disease CancerStrokes Chronic lung disease 1991 Unlike many leading killers a century ago, today’s major killers are more lifestyle-related

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

5. 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 epenephrine and norepinephrine from nerve endings in the inner part of the adrenal glands Thalamus Hypothalamus Pituitary gland Adrenal glands Cerebral cortex (perceives stressor)

6. What is Stress? zGeneral Adaptation Syndrome ySelye’s concept of the body’s adaptive response to stress as composed of three stages Stress 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

7. Stressful Life Events zCatastrophic Events yearthquakes, combat stress, floods zLife Changes ydeath of a loved one, divorce, loss of job, promotion zDaily Hassles yrush hour traffic, long lines, job stress, burnout zPerceived Control yloss of control can increase stress hormones

8. Stress and Control zAnimal studies of control and helplessness No connection to shock source To shock controlTo shock source “Executive” rat“Subordinate” ratControl rat

9. What is Stress? zBurnout yphysical, emotional and mental exhaustion brought on by persistent job-related stress zCoronary Heart Disease yclogging of the vessels that nourish the heart muscle yleading cause of death in the United States

10. Stress & Coronary Heart Disease Hopelessness scores 3.5 3 2.5 2 1.5 1 0.5 0 Heart attack Death Low riskModerate riskHigh risk Men who feel extreme hopelessness are at greater risk for heart attacks and early death

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

12. Stress and Disease zPsychosomatic Disease ypsychologically caused physical symptoms zPsychophysiological Illness y“mind-body” illness yany stress-related physical illness ydistinct from hypochondriasis – misinterpreting normal physical sensations as symptoms of a disease

13. Stress and Disease zLymphocytes ytwo types of white blood cells that are part of the body’s immune system xB lymphocytes form in the bone marrow and release antibodies that fight bacterial infections xT lymphocytes form in the thymus and, among other duties, attack cancer cells, viruses and foreign substances

14. Stress and Disease zConditioning of immune suppression UCS (drug) UCR (immune suppression) UCS (drug) CS (sweetened water) UCR (immune suppression) CS (sweetened water) CR (immune suppression)

15. Stress and Disease zNegative emotions and health-related consequences Unhealthy behaviors (smoking, drinking, poor nutrition and sleep) Negative emotions Stress hormones Heart disease Immune suppression Autonomic nervous system effects (headaches, hypertension)

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

17. Promoting Health zBiofeedback ysystem for electronically recording, amplifying, and feeding back information regarding a subtle physiological state xblood pressure xmuscle tension Patient observes

18. Promoting Health zModifying Type A life-style can reduce recurrence of heart attacks Percentage of patients with recurrent heart attacks (cumulative average) 65432106543210 Year 1978 1979 1980 1981 1982 Life-style modification patients Control patients Modifying life-style reduced recurrent heart attacks

19. Life events Tendency toward HealthIllness Personal appraisal ChallengeThreat 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, enduringLacking

20. Prevention z14% of US Gross Domestic Product is spent on health care z2/3 of organizations with >50 employees have health promoting programs yhealth assessments yfitness training ysmoking cessation ystress management

21. Prevention zPrudential’s experience with a fitness program yreduced sick days by 20% yreduced medical costs by 46% ysaved $1.93 for every dollar spent on health care

22. Smoking zSome estimates show smoking kills about 20 loaded jumbo jets per day zSmoking is a pediatric disease yrebellious youth ymodeling behavior, social rewards ytargeted ad campaigns zWhy not quit? yNicotine delivery system

23. 1. Arouses the brain to a state of increased alertness 2. Increases heart rate and blood pressure 3. At high levels, relaxes muscles and triggers the release of endorphins, natural opiates that may reduce stress 4. Reduces circulation to extremities 1. Suppresses appetite for carbohydrates

24. How to Quit zEducation yeliminate the social reinforcement yincrease social support for quitting zCost ytax it to shorten the time between behavior and punishment yreduces smoking by 4% for every 10% increase in costs zNicotine Replacement- Patch & Gum yreduce pharmacological addiction ythen treat psychological addiction

25. Smoking Prevention zSmoking has made a partial comeback among U.S. teens Percentage of U.S. high school seniors who smoke daily 30 25 20 15 10 5 0 1976 1980 1985 1990 1996 Year

26. Smoking Prevention zResults of a smoking inoculation program Percentage of students who smoke 20 15 10 5 0 0 4 9 12 16 21 33 Seventh gradeEighth gradeNinth grade Months of study Fewer teens took up smoking when “inoculated” against it Control school School with smoking Prevention program

27. Weight Discrimination zWhen women applicants were made to look overweight, subjects were less willing to hire Willingness to hire scale (from1: definitely not hire to 7: definitely hire)

28. Weight Control zEffects of a severe diet 8 16 24 32 Caloric intake in calories per day Body weight in kilograms Metabolism: Oxygen consumption in liters per hour 3000 2000 1000 0 8 16 24 32 Days 165 160 155 150 145 140 Days 26 25 24 23 22 21 8 16 24 32

29. Weight Control zMost lost weight is regained 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

30. Weight Control zObesity was more common among those who watched the most television Hours of TV watched per day Percentage obese 0-1 1-2 2-3 3-4 4-5More than 5