1. Chapter 14: Stress and Health

2. Studying the Effects of Stress on Health Behavioral Medicine: field that combines knowledge of biomedical perspective and behavioral perspective to study and treat health and illness. Term is often used interchangeably with Psychiatry. Behavioral Medicine: field that combines knowledge of biomedical perspective and behavioral perspective to study and treat health and illness. Term is often used interchangeably with Psychiatry. Health Psychology: subfield of psychology that is used to contribute to behavioral medicine. Looks at psychological causes of illness and stress (cognitive, environment, social, biological, etc.) Health Psychology: subfield of psychology that is used to contribute to behavioral medicine. Looks at psychological causes of illness and stress (cognitive, environment, social, biological, etc.)

3. Killers of Yesterday and Today 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

4. What is Stress? Stress is the process by which we respond to events, that we appraise as threatening or challenging. Stress is the process by which we respond to events, that we appraise as threatening or challenging. Stressors: are the events/things that stress us out! Stressors: are the events/things that stress us out!

5. Stress Can Be Harmful or Helpful Depending on Your 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

6. Biology of Stress? What is Activated When You Feel Stress? Stress-Response Cycle Includes: 1. Sympathetic N.S. prompts the release of adrenaline (epinephrine) from the inner part of the adrenal glands 2. Cerebral cortex (through hypothalamus and pituitary gland) directs the outer part of the adrenal glands to release of a glucocorticoid stress hormone (cortisol). Epinephrine works faster!

7. Animals and Humans Tend to React To Stress In the Same Pattern. Hans Selye discovered the responsive cycle for how we react to stress which he named the: Hans Selye discovered the responsive cycle for how we react to stress which he named the: General Adaptation Syndrome (GAS) General Adaptation Syndrome (GAS) –Phase 1: Alarm: activation of sympathetic nervous system. –Phase 2: Resistance: arousal remains high as you attempt to cope with the stressor. “Fight or Flight.” –Phase 3: Exhaustion: body becomes run down with constant stress which can leave you more vulnerable to illness or even death.

8. Stressful Life Events Can Create Serious Health Risks Categories of Stressful Life Events: 1. Catastrophes: unavoidable natural disasters, etc. 2.Significant Life Changes: loss of loved one, leaving home, loss of job, etc. 3. Everyday Hassles: traffic, long lines at Best Buy, etc.

9. Perceived Control’s Effect on Health and Stress Stressful events are especially harmful if they are perceived as negative and uncontrollable. Stressful events are especially harmful if they are perceived as negative and uncontrollable. Those who feel stressful events are beyond their control are also more susceptible to illness and disease. Those who feel stressful events are beyond their control are also more susceptible to illness and disease.

10. The Rat With No Control Over the Shocks Develops Ulcers No connection to shock source To shock controlTo shock source “Executive” rat“Subordinate” ratControl rat

11. Persistent Day to Day Stress May Lead to Burnout Burnout: physical, emotional, and mental exhaustion brought on by persistent job-related stress. Burnout: physical, emotional, and mental exhaustion brought on by persistent job-related stress. Often common in teachers, nurses, and police officers. Often common in teachers, nurses, and police officers.

12. Stress and Heart Disease Although relatively rare in 1900, by the 1950s coronary heart disease has become the leading cause of death in America. Although relatively rare in 1900, by the 1950s coronary heart disease has become the leading cause of death in America. Coronary Heart Disease: when vessels of heart are clogged which stops heart muscles from being nourished. Coronary Heart Disease: when vessels of heart are clogged which stops heart muscles from being nourished. Many behavioral factors help contribute to this disease but stress is also a major factor. Many behavioral factors help contribute to this disease but stress is also a major factor.

13. Hopelessness and 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

14. Personality Type and Heart Disease Type A Personality: competitive, hard driving, impatient, verbally aggressive, and anger prone people. Type A Personality: competitive, hard driving, impatient, verbally aggressive, and anger prone people. Type B Personality: easy-going and relaxed people. Type B Personality: easy-going and relaxed people. Who’s at greater risk for heart disease?

15. Stress Related Illnesses Psychophysiological Illnesses: “mind- body” illnesses. Physical illnesses caused by stress. Psychophysiological Illnesses: “mind- body” illnesses. Physical illnesses caused by stress. Ex: Hypertension and some headaches. Ex: Hypertension and some headaches. Blood pressure also increases due to too much stress. Blood pressure also increases due to too much stress. Are also referred to as psychosomatic disorders. This does not mean that symptoms are not real, it just means they have psychological causes. Are also referred to as psychosomatic disorders. This does not mean that symptoms are not real, it just means they have psychological causes.

16. Fighting Disease With Immune System Lymphocytes: Lymphocytes: Main defender against disease in immune system made up of two types of white blood cells. Main defender against disease in immune system made up of two types of white blood cells. B lymphocytes form in the bone marrow and release antibodies that fight bacterial infections 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 T lymphocytes form in the thymus and, among other duties, attack cancer cells, viruses and foreign substances

17. Fighting Disease with Immune System Macrophage: other agent of immune system which identifies, pursues, and ingests harmful invaders. Macrophage: other agent of immune system which identifies, pursues, and ingests harmful invaders.

18. Problems with Immune System Immune System can either react too strongly or under react to harmful bodies. Immune System can either react too strongly or under react to harmful bodies. Over-reaction causes body to attack its own tissues. Ex: arthritis, allergies, lupus, M.S. Over-reaction causes body to attack its own tissues. Ex: arthritis, allergies, lupus, M.S. Under-reaction causes harmful bodies to spread. Ex: cancer Under-reaction causes harmful bodies to spread. Ex: cancer Stress can divert energy away from the immune system making illnesses more likely. Stress can divert energy away from the immune system making illnesses more likely.

19. Conditioning the Immune System Experiments have been conducted illustrating power to condition the immune system to respond in certain ways. Experiments have been conducted illustrating power to condition the immune system to respond in certain ways. UCS (drug) UCR (immune suppression) UCS (drug) UCR (immune suppression) CS (sweetened water) CS (sweetened water) CR (immune suppression)

20. Promoting Health Aerobic Exercise has positive psychological and physical benefits. Aerobic Exercise has positive psychological and physical benefits. Increases heart and lung fitness and may also help alleviate depression and anxiety. Increases heart and lung fitness and may also help 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

21. Using Biofeedback to Improve Health Biofeedback: system for electronically recording, amplifying, and feeding back information regarding a subtle physiological state like blood pressure and muscle tension in order to allow a person to control autonomic functions like heart rate. Biofeedback: system for electronically recording, amplifying, and feeding back information regarding a subtle physiological state like blood pressure and muscle tension in order to allow a person to control autonomic functions like heart rate.

22. Promoting Health A strong social network which offers support strongly promotes health during an illness and when healthy. A strong social network which offers support strongly promotes health during an illness and when healthy. % with high support

23. Promoting Health Spirituality and Faith Communities has a strong correlation with positive health and enhancing medical treatment. Spirituality and Faith Communities has a strong correlation with positive health and enhancing medical treatment. Possible reasons behind correlation with religion? Possible reasons behind correlation with religion? –Religiously active people:  drink and smoke less  tend to have a larger support network  may have a greater sense of peace about the future (hope)

24. Overview of Healthy and Unhealthy Tendencies 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