Myers’ PSYCHOLOGY

(7th Ed)

Chapter 14

Stress and Health

James A. McCubbin, PhDClemson University

Worth Publishers

Stress & Health

Behavioral Medicine interdisciplinary field that integrates

behavioral & med. knowledge & applies that knowledge to health & disease

Health Psychology subfield of psych. that provides psychology’s

contribution to behavioral medicine Stress

process by which we perceive & respond to certain events, called stressors, we decide are threatening or challenging

Stress & Illness

Leading causes of death in the US in 1900 & 2000

Stress Appraisal: Test anxiety

Stressful event(tough math test)

Threat(“Yikes! This isbeyond me!”)

Challenge(“I’ve got to apply

all I know”)

Panic, freeze up

Aroused, focused

Appraisal Response

Stress process…

Cerebral cortex: (perceives stressor) then to

thalamus hypothalamus + pituitary

Pituitary hormone: in the bloodstream stimulates outer part of the adrenal gland to release the stress hormone cortisol

Sympathetic NS: releases stress hormone epinephrine & norepinephrine from nerve endings in the inner part of the adrenal glands

Pituitary hormone in the bloodstream stimulatesouter part of adrenalGland..releases the stress hormone cortisol

Sympathetic NS releases stress hormonesepinephrine &norepinephrinefrom inner part ofthe adrenal glands

Thalamus

Hypothalamus

Pituitary gland

Adrenal glands

Cerebral cortex(perceives stressor)

Stress & Illness General Adaptation Syndrome

Selye’s idea of the body’s adaptive response to stress in 3 stages:

1. Alarm2. Resistance3. Exhaustion

Stressresistance

Phase 1Alarm

reaction(mobilize

resources)

Phase 2Resistance(cope w/ stressor)

Phase 3Exhaustion(reservesdepleted)

The body’s resistance to stress canlast only so long before exhaustion sets in

Stressoroccurs

Causes or triggers of stress?

Stressful life events Perceived loss of control Age Biological/physiological traits Personality traits:

a) Pessimistic

b) Quick to angerc) Obsessive and/or perfectionist

d) High risk

Stressful Life Events: Catastrophic Events Ex’s:

Earthquakes combat stress floods

Life Changes Ex’s: death of a loved one divorce loss of job promotion

Daily Hassles Ex’s: rush hour traffic long lines job stress Burnout Can these cause loss of

control??

Stressful Life Events Chronic Stress by Age: Note: Schizophrenia can be triggered by

stress… When do you think it usually

shows up?

Perceived 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

Perceived Control Equality & Longevity:

Stress & the Heart: Coronary Heart Disease-clogging of heart muscle’s nourishing vessels --leading cause of death in many developed countries

Hopelessnessscores

3.5

3

2.5

2

1.5

1

0.5

0Heart attack Death

Low risk Moderate risk High risk

Men who feel extreme hopelessnessare at greater risk for heart attacksand early death

Stress & the Heart: Personality Types Type A

Friedman and Rosenman’s term for competitive, hard-driving, impatient, verbally aggressive, & anger-prone people

*Possible sub-category of “A”?? Some say there’s a..

TYPE D: Newer term: --gets very angry, is destructive emotionally …road-rage, etc. (distressed, destructive) -A special form of Type A

Type B Friedman & Rosenman’s term for

easygoing, relaxed people (“calm-water”)

Personality & Stress on the Heart:

Pessimists: ___% Optimists: ___%

Emotion: ADD Stress & Disease

Psycho-physiological Illness “mind-body” illness any stress-related physical illness

some forms of hypertension (hi BP & some headaches

Is NOT hypochondriasis– thinking you are sick all the time…

Lymphocytes: 2 types of white blood cells that are part of the body’s immune system B lymphocytes form in the bone marrow

- fight bacterial infections T lymphocytes form in the thymus

- attack cancer cells, viruses, and foreign substances

Stress and Disease

Conditioning of immune suppression

UCS(drug)

UCR(immunesuppression)

UCS(drug)

UCR(immunesuppression)

CS(sweetenedwater)

CS(sweetenedwater) CR

(immunesuppression)

Stress and Disease Negative emotions and health-related

consequences

Unhealthy behaviors(smoking, drinking,

poor nutrition and sleep)

Persistent stressorsand negative

emotions

Release of stresshormones

Heartdisease

Immunesuppression

Autonomic nervoussystem effects

(headaches,hypertension)

Promoting Good Health

Biofeedback electronically records,

amplifies, & feeds back info RE: a subtle

physiological state BP (blood pressure)

muscle tension

Aerobic Exercise sustained exercise that

increases heart & lung fitnessDepression lessened way

more w/ aerobic exercise than w/o

-relaxation helped also…but not as much as the exercise!

Promoting Health Modifying Type A life-style can

reduce recurrence of heart attacks

Percentageof patients

with recurrentheart attacks

(cumulativeaverage)

6

5

4

3

2

1

0

Year1978 1979 1980 1981 1982

Life-style modification patients

Control patients

Modifying life-stylereduced recurrent

heart attacks

Promoting Health Social 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

Percentagewith high

support

Life events

Tendency toward

Health Illness

Personal appraisal

Challenge Threat

Personality typeEasy going

NondepressedOptimistic

HostileDepressedPessimistic

Personality habitsNonsmoking

Regular exerciseGood nutrition

SmokingSedentary

Poor nutrition

Level of social support

Close, enduring Lacking

Promoting Health: Why might the 3rd

aspect below have an effect? Predictors of mortality

1

0.8

0.6

0.4

0.2

0

Men Women

Not smoking Regular exercise Weekly religious attendance

Relativerisk

of dying

Promoting Health Religious Attendance

Promoting Health

Complementary & Alternative Medicine (non-Western) unproven health care treatments not taught widely

in medical schools not used in hospitals not usually reimbursed by insurance companies

Alternative systems ofmedical practice

Bioelectromagneticapplications

Diet, nutrition,life-style changes

Herbal medicine

Manual healing

Mind-body control

Pharmacological and biological treatments

Subfields of Alternative MedicineHealth care ranging from self-care according to folk principles,to care rendered in an organized health care system based onalternative 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 traditionsfor pharmacological use

Using touch and manipulation with the hands as a diagnosticand 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

Promoting Health Smoking-related early deaths

40,000

30,000

20,000

10,000

0

33,348

1,686 1,135 556 202

Smoking Suicide Vehicle HIV/ Homicide crash AIDS

Cause of death

Numberof deaths

per 100,000

The Physiological Effects of Nicotine

Promoting Health Fewer Canadian smokers

Males

Females

1970 1974 1978 1982 1986 1990 1994- 1996- 1995 1997

Year

60%

50

40

30

20

10

0

Percentageof Canadians

smoking

Smoking Prevention

U.S. teen smoking

Smoking Prevention: Inoculation = prevention programs… These DO have an effect!

Results of a smoking inoculation program

Percentageof studentswho smoke

20

15

10

5

0 0 4 9 12 16 21 33

Seventh grade Eighth grade Ninth grade

Months of study

Control school

School with smokingPrevention program

Fewer teens took upsmoking when “inoculated” against it

Obesity & Weight Control

Obesity and body mass index

Obesity & Weight Control

Obesity 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)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

Relativerisk ofdeath

Weight Discrimination

When women applicants were made to look overweight, subjects were less willing to hire

Willingnessto hire scale

(from1:definitely

not hire to7: definitely

hire)

0

1

2

3

4

5

6

7

Women Men

Normal Overweight

Weight Control

Effects of a severe dietCaloric

intakein

caloriesper day

Body weight

in kilograms

Metabolism:Oxygen

consumptionin liters

per hour

3000

2000

1000

0 8 16 24 32

Days

165

160

155

150

145

140

Days Days

26

25

24

23

22

218 16 24 32 8 16 24 32

Weight Control: Cigs down, but weight up??

Trading risks

Weight Control Thinning of Miss America

Weight Control

Most lost weight is regained

-20

-15

-10

-5

0

5

10

1 2 3 4 5

Weightchange

in pounds

Posttreatment

Years of follow-up

Startingpoint

Normal trend for untreated obesepeople: Gradually rising weight

After participation in behavioralProgram: Much of initial weight

loss regained

Weight Control Obesity:

more common among those who watched the most TV

<2 2-3 >4Hours of television watched per day

in 1990s studyBoys Girls

32

30

28

26

24

22

20

Skinfold fatmeasure (mm)

Create a CHART!!Working in PAIRS….Create a chart showing the RISK FACTORS

for health that can be affected by behavior &/or personality…and the positive factors in behaviors that can help keep you healthy: Something like this….

Positive health factors l Health Risk factors