College of Education

School of Continuing and Distance Education 2014/2015 – 2016/2017

PSYC 221 Introduction to General Psychology

Session 11 – Psychology and health

Lecturer: Dr. Joana Salifu Yendork, Psychology Department Contact Information: jyendork@ug.edu.gh

Session Overview

• As we go through our everyday activities, we encounter myriad situations, events and encounters that cause emotional suffering. In psychology, stress is used to connote the psychological and physiological responses of humans to the emotional, physical and mental strain on the individual’s wellbeing. We will focus on defining stress, how it affects our well-being, how to cope with stress and what lead to a sense of well-being. We will also learn about how psychological factors affect health-related problems such as heart diseases, cancer and smoking.

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Session Outline

The key topics to be covered in the session are as follows:

• Health psychology

• Stress

• Stress and susceptibility to diseases

• Promoting health and wellness

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Reading List

• Chapter 11 of Feldman (2007), Essentials of understanding psychology

• Chapter 11 of Myers (2008), Exploring psychology

• Chapter 7 of Akotia and Mate-Kole (2014), Contemporary psychology: Readings from Ghana

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HEALTH PSYCHOLOGY Topic One

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Health psychology

• Health psychology is the branch of psychology that investigates the psychological factors related to wellness and illness, including the prevention, diagnosis, and treatment of medical problems.

• Their functions include: – Investigation of the effects of psychological factors such as stress on illness.

– Examination of the psychological principles underlying treatments for disease and illness.

– Study of disease prevention, e.g. the assessment of how healthful behavior can help people avoid health problems such as heart disease and stress.

• Health psychologists recognize that good health and the ability to cope with illness are affected by psychological factors such as thoughts, emotions, and the ability to manage stress.

• Health psychologists view the mind and the body as two parts of a whole human being that cannot be considered independently.

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STRESS Topic Two

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Stress

• Stress the process by which individuals perceive and respond to certain events (called stressors), that we appraise as threatening or challenging.

• a stressor is an event or condition which we view as threatening, challenging, or overwhelming.

• Examples include poverty, an explosion, a psychology test, feeling cold, being in a plane, and loud noises.

• appraisal refers to deciding whether to view something as a stressor.

• stress reaction refers to any emotional and physical responses to the stressor such as rapid heartbeat, elevated cortisol levels, and crying.

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Stress

• Stress can be a stimulus (missing an appointment), at other times it is a response (sweating while taking a test) and a process.

• The experience of stress vary from person to person although some events (e.g. death of a love one) is generally considered stressful

• For an event to be considered stressful, it must perceive it as threatening and must lack the resources to effectively deal with the event.

• Stress can be adaptive when it is short lived or when perceived as challenging:

– in a fearful situation, we can run away and save our lives.

– mobilize the immune system for fending off infections and healing wounds

– Stress also arouses and motivates us to conquer problems which can enhance self-esteem and a deepened spirituality and sense of purpose

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Stress

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Stress

• Stress can be maladaptive when it is severe or prolonged:

– If it is prolonged (chronic stress), it increases our risk of illness and health problems such as elevated rates of circulatory, digestive, respiratory, and infectious diseases.

• The severity of stress is greatest when:

– important goals are threatened,

– the threat is immediate

– or the anticipation of a threatening event extends over a long period.

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Stress response system

• Cannon proposed that the stress response (fast) was a fight-or-flight response marked by the outpouring of epinephrine and norepinephrine from the inner adrenal glands, increasing heart and respiration rates, mobilizing sugar and fat, and dulling pain.

• Hans Selye (1936, 1976) extended Cannon’s research and proposed the General Adaptation Syndrome (GAD).

• According to Selye, a stress response to any kind of stimulation is similar. The stressed individual goes through three phases.

• Phase 1 (alarm): experience an alarm reaction due to the sudden activation of sympathetic nervous system.

– Increased heart rate, blood is diverted to skeletal muscles.

– Feelings of faintness of shock

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Stress response system

• Phases 2 (resistance): Individual mobilizes resources and is ready to fight the challenge

– temperature, blood pressure, and respiration remain high,

– sudden outpouring of hormones.

• Phase 3 (exhaustion ): if the stress persist, the body’s reserves might eventually deplete and the body becomes vulnerable to illness or even, in extreme cases, collapse and death

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Categorizing stressors • What events provoke stress responses?

• Three categories have been identified:

– Catastrophes/cataclysmic events

– Significant life changes/personal stressors,

– Daily hassles/background stressors

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Categorizing stressors • Catastrophes/cataclysmic events:

unpredictable large scale events that are generally appraised as stressful. – E.g. earthquakes, combat stress, war/combat, and

wildfires and floods – These experiences could lead individuals to become

depressed, sleepless, and anxious.

• Appraisal is not essential in a catastrophic event. Most people agree that the event is harmful and overwhelming

• Short-term effects include increased heart attacks on the day of the event

• Long term effects include depression, nightmares, anxiety, and flashbacks.

• Bonding: both the trauma and the recovery are shared with others.

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Categorizing stressors

• Significant life changes: The death of a loved one, a divorce, a loss of job, or a promotion can bring increased challenge and stress and may leave individuals vulnerable to disease. – Typically, these stressors produce immediate major reaction that soon

tapers off

• Change is often challenging. • New roles, new priorities, and new tasks can put a strain on our

coping resources. • The challenge, and the negative impact on health, increases

when:

– the changes are painful, such as a death in family, loss of job, or heart attack.

– the changes are in a cluster, and there are too many at once.

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Categorizing stressors

• Daily hassles: are common/everyday problems we encounter

– E.g. Rush hour traffic, long lines, job stress, and becoming burnt-out

– Daily difficulties can be caused by the lack of social power and freedom: being bullied

living in poverty

living under oppressive political conditions

– These sources of stress, when persistent can lead to health such as hypertension

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Beneficial and Harmful Stress Effects

• A brief experience of stress can be beneficial: –improving immune system response

–motivating action

–focusing priorities

–feeling engaged, energized, and satisfied

–providing challenges that encourage growth, knowledge, and self-esteem

•Extreme or prolonged stress, causes problems: –mental and physical coping systems become overwhelmed and defeated rather than strengthened

–immune functioning and other health factors decline because of damage

–DNA telomeres (chromosome tips) shorten, cells lose ability to divide, cells die, tissue stops regenerating, early aging and death

STRESS AND SUSCEPTIBILITY TO DISEASES

Topic Three

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Stress and susceptibility to diseases

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• Why are some of us more prone than others to coronary heart disease?

• Behavioral and physiological factors contribute to heart disease – smoking, obesity, a high-fat diet, physical inactivity, and an elevated cholesterol

level—increase the risk of heart disease.

• The psychological factors of stress and personality also play a big role. – Chronic stress and personality styles that worsen the experience of stress

• Stress that leads to elevated blood pressure may result in coronary heart disease, a clogging of the vessels that nourish the heart muscle.

• People with a type A personality are impatient, verbally aggressive, and always pushing themselves and others to achieve.

• People with a type B personality are more relaxed and go with the flow. (Friedman and Rosenman, 1974).

• Type A personalities are more likely to develop coronary heart disease due to tendency for heightened anger associated with aggressively reactive temperaments

Stress and susceptibility to diseases

• When we feel severe stress, our ability to cope with it is impaired.

• Stress can lead to diseases called psychophysiological illness

• This term is used to connote any stress-related physical illness such as hypertension and some headaches.

• Stress can also affect our resistance to disease

• Psychoneuroimmunology (PNI) is a developing field that focuses on the study of the health effects of psychological, neural, and endocrine processes on the immune system as well as how all these factors influence our health and wellness.

• The immune system consist of:

– B lymphocytes fight bacterial infections

– T lymphocytes attack cancer cells and viruses

– microphages ingest foreign substances

– Natural killer cells pursue disease cells

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Stress and susceptibility to diseases

• During stress, stress hormones, which suppress the disease-fighting lymphocytes are secreted, thus suppressing the immune system less active.

• During stress, energy is mobilized away from the immune system making it vulnerable

• People with the highest life stress scores were also the most vulnerable when exposed to an experimental cold virus (Cohen et al., 1991).

• Stress and negative emotions may accelerate the progression from human immunodeficiency virus (HIV) to acquired immune deficiency syndrome (AIDS; Kiecolt-Glaser & Glaser, 1995; Leserman & others, 1999).

• Stress does not create cancer cells but may affect their growth by weakening the body’s natural defenses against proliferating, malignant cells (Myers, 2008; Feldman, 2007)

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Depression and Heart Disease

Why does depression appear so often with heart disease? Does one cause the other?

One possible answer is that the two problems are both caused by chronic stress.

There may be an intervening variable: excessive inflammation.

Summary: Stress and diseases (Feldman, 2007)

Adopted from Feldman, 2007 Slide 24

PROMOTING HEALTH AND WELLNESS

Topic Four

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Coping with stress

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• What factors affect our ability to cope with stress? • Stressors are unavoidable and we need to learn to cope with

them in order to prevent stress-related diseases • Some stressors can be addressed directly through the use of

problem-focused coping but for those we cannot directly address, we may use emotion-focused coping

• Problem-focused coping is used when the individual feel a sense of control over the situation whereas emotion-focused strategies are used when we feel we cannot control the situation

• Several factors affect our ability to cope successfully: • Sense of control, explanatory styles and supportive

connection

Coping with Stress

Risk: magnifying emotional distress, especially if trying to change something that’s difficult to change (e.g. another person’s traits).

Risk: ignoring the problem.

We might focus on this style of coping when we perceive the stressor as something we cannot change.

Problem-focused coping means reducing the stressors, such as by working out a conflict, or tackling a difficult project.

Emotion-focused coping means reducing the emotional impact of stress by getting support, comfort, and perspective from others.

Coping with stress

• Perceived control: research in both humans and animals show that perceived loss/lack of control over a stressful situation is associated with vulnerability to ill health – Losing control is linked to rise in stress hormones, blood pressure

increases, and drop in immune responses (Rodin, 1986; Sapolsky, 2005).

• Explanatory style: People with an optimistic (instead of pessimistic) explanatory style tend to have more control over stressors, cope better with stressful events, have better moods, and have a stronger immune system.

• Social support: Supportive family members, marriage partners, and close friends help people cope with stress. Social support: – Calms the cardiovascular system, – Lowers blood pressure and stress hormones – Provide the opportunity to confide painful feelings

• Having a sense of control, an optimistic explanatory style, and social support can reduce stress and improve health.

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Managing stress • What tactics can we use to manage stress and reduce stress-

related ailments? • Sometimes we cannot alleviate stress and simply need to

manage our stress in a healthful way • Aerobic exercise, biofeedback, relaxation, meditation, and

spirituality may help us gather inner strength and lessen the effects of stress

Some ways to reduce the health effects of stress include: address the stressors. soothe emotions. increase one’s sense of control over stressors. exchange optimism for pessimism. get social support.

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Managing stress

• Aerobic exercise: studies suggest that aerobic exercise can

elevate mood and well-being because: – it raises energy, increases self-confidence, and lowers tension,

depression, and anxiety. – modestly enhances cognitive abilities, such as memory (Etnier &

others, 1997) – strengthens the heart, increases blood flow, keeps blood vessels open,

and lowers both blood pressure and the blood pressure reaction to stress (Ford, 2002; Manson, 2002).

– Aerobic exercise triggers certain genes to produce proteins which guard against more than 20 chronic diseases and conditions.

– Aerobic exercise reduces the risk of heart disease, cognitive decline and dementia, and early death.

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Managing stress

• Biofeedback systems use electronic devices to inform people about their physiological responses and gives them the chance to bring their response to a healthier range.

• Relaxation and meditation have similar effects in reducing tension and anxiety.

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Managing stress

• Use of relaxation techniques can reduce headaches, high blood pressure, anxiety, and insomnia, and improve immune functioning.

• People who meditate can learn to create a relaxation response: relaxed muscles, lower blood pressure, and slowed heart rate and breathing.

• Meditation also increases brain activity associated with positive emotions.

• Steps to get the relaxation response: focus attention on breathing, a focus word, and relaxing muscles from toes upward.

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Managing stress

• Regular religious attendance has been a reliable predictor of a longer life span with a reduced risk of dying.

• Investigators suggest there are three factors that connect religious involvement and better health.

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Sample Questions

• Discuss ways in which stress can be managed.

• Explain the relationship between stress and physical illnesses

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References

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