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Myers’ PSYCHOLOGY (7th Ed) Chapter 14 Stress and Health James A. McCubbin, PhD Clemson University Worth Publishers Stress and Health Behavioral Medicine interdisciplinary field that integrates behavioral and medical knowledge and applies that knowledge to health and disease Health Psychology subfield of psychology that provides psychology’s contribution to behavioral medicine Stress and Illness Leading causes of death in the US in 1900 and 2000 Stress and Illness Stress the process by which we perceive and respond to certain events, called stressors, that we appraise as threatening or challenging Stress Appraisal Appraisal Response Threat (“Yikes! This is beyond me!”) Panic, freeze up Challenge (“I’ve got to apply all I know”) Aroused, focused Stressful event (tough math test) Cerebral cortex (perceives stressor) Thalamus Hypothalamus Pituitary hormone in the bloodstream stimulates the outer part of the adrenal gland to release the stress hormone cortisol Pituitary gland Sympathetic nervous system releases the stress hormones epinephrine and norepinephrine from nerve endings in the inner part of the adrenal glands Adrenal glands Stress and Illness The body’s resistance to stress can last only so long before exhaustion sets in Stress resistance Stressor occurs Phase 1 Alarm reaction (mobilize resources) Phase 2 Resistance (cope with stressor) Phase 3 Exhaustion (reserves depleted) General Adaptation Syndrome Selye’s concept of the body’s adaptive response to stress in three stages Stressful Life Events Catastrophic Events earthquakes, combat stress, floods Life Changes death of a loved one, divorce, loss of job, promotion Daily Hassles rush hour traffic, long lines, job stress, burnout Stressful Life Events Chronic Stress by Age Perceived Control Health consequences of a loss of control “Executive” rat To shock control “Subordinate” rat To shock source Control rat No connection to shock source Perceived Control Equality and Longevity Stress and the Heart Coronary Heart Disease clogging of the vessels that nourish the heart muscle leading cause of death in many developed countries Stress and the Heart Hopelessness scores 3.5 3 Men who feel extreme hopelessness are at greater risk for heart attacks and early death 2.5 2 1.5 1 0.5 0 Heart attack Low risk Death Moderate risk High risk Stress and the Heart Type A Friedman and Rosenman’s term for competitive, hard-driving, impatient, verbally aggressive, and anger-prone people Type B Friedman and Rosenman’s term for easygoing, relaxed people Stress and the Heart Stress and Disease Psychophysiological Illness “mind-body” illness any stress-related physical illness some forms of hypertension some headaches distinct from hypochondriasis-misinterpreting normal physical sensations as symptoms of a disease Stress and Disease Lymphocytes two types of white blood cells that are part of the body’s immune system 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 Stress and Disease UCS (drug) UCR (immune suppression) CS (sweetened water) CS (sweetened water) Conditioning of immune suppression UCS (drug) UCR (immune suppression) CR (immune suppression) Stress and Disease Negative emotions and health-related consequences Heart disease Persistent stressors and negative emotions Unhealthy behaviors (smoking, drinking, poor nutrition and sleep) Release of stress hormones Immune suppression Autonomic nervous system effects (headaches, hypertension) Promoting Health Depression 14 score 13 No-treatment group 12 11 10 Relaxation treatment group 9 8 7 6 Aerobic exercise group 5 4 3 Before treatment evaluation After treatment evaluation Aerobic Exercise sustained exercise that increases heart and lung fitness Promoting Health Biofeedback system for electronically recording, amplifying, and feeding back information regarding a subtle physiological state blood pressure muscle tension Promoting Health Modifying Type A life-style can reduce recurrence of heart attacks Percentage 6 of patients with recurrent 5 heart attacks (cumulative 4 average) 3 Control patients Modifying life-style reduced recurrent heart attacks 2 Life-style modification patients 1 0 1978 1979 1980 Year 1981 1982 Promoting Health Social support across the life span Percentage with high support 100% 90 80 70 60 50 12-14 18-19 15-17 25-34 20-24 45-54 35-44 Age in years 65-74 55-64 75+ Life events Personal appraisal Challenge Threat Personality type Hostile Depressed Pessimistic Easy going Nondepressed Optimistic Personality habits Smoking Sedentary Poor nutrition Nonsmoking Regular exercise Good nutrition Level of social support Close, enduring Lacking Tendency toward Health Illness Promoting Health Predictors of mortality 1 Relative risk 0.8 of dying 0.6 0.4 0.2 0 Not smoking Regular exercise Weekly religious attendance Women Men Promoting Health Religious Attendance Promoting Health The religion factor is mulitidimensional Healthy behaviors (less smoking, drinking) Religious involvement Social support (faith communities, marriage) Positive emotions (less stress, anxiety) Better health (less immune system suppression, stress hormones, and suicide) Promoting Health Complementary and Alternative Medicine unproven health care treatments not taught widely in medical schools, not used in hospitals, and not usually reimbursed by insurance companies Subfields of Alternative Medicine Alternative systems of medical practice 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 Bioelectromagnetic applications The study of how living organisms interact with electromagnetic (EM) fields Diet, nutrition, life-style changes The knowledge of how to prevent illness, maintain health, and reverse the effects of chronic disease through dietary or nutritional intervention Herbal medicine Employing plan and plant products from folk medicine traditions for pharmacological use Manual healing Using touch and manipulation with the hands as a diagnostic and therapeutic tool Mind-body control Exploring the mind’s capacity to affect the body, based on traditional medical systems that make use of the interconnectedness of mind and body Pharmacological and biological treatments Drugs and vaccines not yet accepted by mainstream medicine Promoting Health Smoking-related early deaths 40,000 Number of deaths per 100,000 30,000 33,348 20,000 10,000 0 1,686 1,135 Smoking Suicide Vehicle crash 556 HIV/ AIDS Cause of death 202 Homicide The Physiological Effects of Nicotine Promoting Health Fewer Canadian smokers 60% Percentage of Canadians 50 smoking Males 40 Females 30 20 10 0 1970 1974 1978 1982 Year 1986 1990 1994- 19961995 1997 Smoking Prevention U.S. teen smoking Smoking Prevention Results of a smoking inoculation program Percentage 20 of students who smoke 15 Control school Fewer teens took up smoking when “inoculated” against it 10 5 School with smoking Prevention program 0 0 4 Seventh grade 9 12 16 21 Eighth grade Months of study 33 Ninth grade Obesity and Weight Control Obesity and body mass index Obesity and Weight Control Obesity and mortality 2.8 Relative risk of death 2.6 2.4 2.2 2.0 1.8 1.6 1.4 1.2 1.0 0.8 0.6 18.5 18.5- 20.5- 22.0- 23.5- 25.0- 26.5- 28.0- 30.0- 32.0- 35.020.4 21.9 23.4 24.9 26.4 27.9 29.9 31.9 34.9 39.9 Men Body-mass index (BM I) Women 40 Weight Discrimination 7 6 When women applicants were made to look overweight, subjects were less willing to hire Willingness to hire scale 5 (from1: definitely 4 not hire to 7: definitely 3 hire) 2 1 0 Women Normal Men Overweight Weight Control Effects of a severe diet 165 Metabolism: Oxygen consumption in liters per hour 26 160 25 155 24 150 23 145 22 140 21 Body weight in kilograms Caloric intake in calories per day 3000 2000 1000 0 8 16 Days 24 32 8 16 24 Days 32 8 16 24 Days 32 Weight Control Trading risks Weight Control Thinning of Miss America Weight Control 10 Weight 5 change in pounds 0 Most lost weight is regained Starting point Normal trend for untreated obese people: Gradually rising weight -5 -10 After participation in behavioral Program: Much of initial weight loss regained -15 -20 Post treatment 1 2 3 Years of follow-up 4 5 Weight Control Obesity was more common among those who watched the most television Skinfold fat measure (mm) 32 30 28 26 24 22 20 <2 2-3 >4 Hours of television watched per day in 1990s study Boys Girls