2. Myers’ PSYCHOLOGY Unit 14- Stress and Disorders Chapter 14- pg. 549- 561 Chapter 16- all

3. Answering Machine: Hello, and welcome to the mental health hotline. zIf you are obsessive-compulsive, press 1 repeatedly. zIf you are codependent, please ask someone to press 2 for you. zIf you have multiple personalities, press 3, 4, 5, and 6.

4. zIf you are paranoid, we know who you are and what you want. Stay on the line so we can trace your call. zIf you are delusional, press 7 and your call will be transferred to the mother ship. zIf you are schizophrenic, listen carefully and a small voice will tell you which number to press. zIf you are a manic-depressive, it doesn't matter which number you press, no one will answer.

5. zIf you are dyslexic, press 9696969696969696. zIf you have a nervous disorder, please fidget with the pound key until a representative comes on the line. zIf you have amnesia, press 8 and state your name, address, telephone, and mother's maiden name. zIf you have post-traumatic stress disorder, s-l-o-w-l-y and c-a-r-e-f-u-l-l-y press 0 0 0.

6. zIf you have bi-polar disorder, please leave a message after the beep or before the beep or after the beep. Please wait for the beep. zIf you have short-term memory loss, press 9. If you have short-term memory loss, press 9. If you have short-term memory loss, press 9. If you have short- term memory loss, press 9. zIf you have low self-esteem, please hang up. All operators are too busy to talk to you.

7. zIf you are menopausal, hang up, turn on the fan, lay down & cry. You won't be crazy forever. zIf you are blonde don't press any buttons, you'll just mess it up. Please remember these were only meant to make you smile zChapter 14 terms: behavioral medicine, health psychology, stress, G.A.S., coronary heart disease, Type A, Type B, psychophysiological illness, lymphocytes.

8. Stress and Health 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

9. 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

10. 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

11. Stress Appraisal 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

12. 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 )

13. 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

14. 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

15. Stress and Control zHealth consequences of a loss of control No connection to shock source To shock controlTo shock source “Executive” rat“Subordinate” ratControl rat

16. 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

17. 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

18. 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

19. Stress and Disease zPsychophysiological Illness y“mind-body” illness yany stress-related physical illness xsome forms of hypertension xsome headaches ydistinct from hypochondriasis – misinterpreting normal physical sensations as symptoms of a disease

20. 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

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

22. Stress and Disease zNegative 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)

23. Promoting Health zAerobic Exercise ysustained exercise that increases heart and 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

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

25. 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

26. Promoting Health zSocial support across the life span 12-14 18-19 25-34 45-54 65-74 15-17 20-24 35-44 55-64 75+ Age in years 100% 90 80 70 60 50 Percentage with high support

27. 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

28. Promoting Health zPredictors of mortality 1 0.8 0.6 0.4 0.2 0 Men Women Not smoking Regular exercise Weekly religious attendance Relative risk of dying

29. 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

30. Promoting Health zComplementary and Alternative Medicine yunproven health care treatments not taught widely in medical schools, not used in hospitals, and not usually reimbursed by insurance companies

31. Promoting Health zThe 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)

32. Promoting Health zSmoking-related early deaths 40,000 30,000 20,000 10,000 0 33,348 1,6861,135 556202 Smoking Suicide Vehicle HIV/ Homicide crash AIDS Cause of death Number of deaths per 100,000

34. Promoting Health zFewer Canadian smokers Males Females 1970 1974 1978 1982 1986 1990 1994- 1996- 1995 1997 Year 60% 50 40 30 20 10 0 Percentage of Canadians smoking

35. Smoking Prevention zSmoking has made a partial comeback among U.S. teens 1975 1980 1985 1990 1995 1999 Year 30% 25 20 15 10 5 0 Percentage of U.S. high school seniors who smoke daily

36. 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 Control school School with smoking Prevention program Fewer teens took up smoking when “inoculated” against it

37. Obesity and Weight Control zObesity and mortality 18.5 18.5- 20.5- 22.0- 23.5- 25.0- 26.5- 28.0- 30.0- 32.0- 35.0- 40 20.4 21.9 23.4 24.9 26.4 27.9 29.9 31.9 34.9 39.9 Body-mass index (BM I) MenWomen 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

38. 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 ) 0 1 2 3 4 5 6 7 WomenMen NormalOverweight

39. Weight Control zEffects of a severe diet 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

40. Weight Control zMost lost weight is regained -20 -15 -10 -5 0 5 10 12345 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

41. Weight Control zObesity was more common among those who watched the most television 4 Hours of television watched per day in 1990s study BoysGirls 32 30 28 26 24 22 20 Skinfold fat measure (mm)