Chapter 17- Stress and Health

1. Chapter 17- Stress and Health

2. What is Stress? • Health Psychology- psychology’s contribution to behavioral medicine • Stress - the process by which we appraise and cope with threats and challenges • How a person perceives and evaluates and event makes a difference - the cognitive modelof stress • Cognitive- thinking and understanding

3. Stressors Catastrophes Life changes Hassles Intervening factors Appraisal Perceived control Personality Social support Coping behaviors Stress reactions Physiological Emotional Behavioral What is Stress? • Stress • the process by which we perceive and respond to certain events, called stressors, that we appraise as threatening or challenging

4. Response Appraisal Threat (“Yikes! This is beyond me!”) Panic, freeze up Stressful event (tough math test) Challenge (“I’ve got to apply all I know”) Aroused, focused Stress Appraisal

5. Distress and Eustress 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 Gradually weaken the body’s defense system and can lead to hypertension Stressful Life Events

6. Percentage U.S.deaths Percentage U.S.deaths 30 20 10 0 30 20 10 0 Tuber- culosis Pneu- monia Diarrhea/ enteritis Heart disease Cancer Strokes Heart disease Chronic lung disease 1900 1991 Stress and Health • Leading causes of death in the US in 1900 and 1991 Unlike many leading killers a century ago, today’s major killers are more lifestyle-related

7. Physiological Reaction: Fight or Flight (Cannon) • When faced with a stressor, the body reacts with immediate arousal. • Hormones are produced that increase the amount of blood sugar for extra energy • Adrenaline is produced, causing rapid heartbeat and breathing and enabling the body to use energy more quickly • Used to prepare a person or animal for self-defense • Left over from the past; doesn’t work for most of today’s stress

8. The body’s resistance to stress can only Last 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) What is Stress? • General Adaptation Syndrome • Selye’s concept of the body’s adaptive response to stress as composed of three stages

9. General Adaptation Syndrome (Selye)3 Stages of Stress Reactions:

10. Measuring Stress • The SRRS- Holmes and Rahe • Measured stress using LCU (life-change units) • Higher score = higher likelihood of stress-related diseases • PERCEPTION MATTERS!

11. The SRRS

12. “Executive” rat “Subordinate” rat Control rat To shock control To shock source No connection to shock source Stress and Control (Selye) • Health consequences of a loss of control

13. Perceived Control • All are most stressful when perceived as negative and uncontrolled • The result is vulnerability to ill health and often earlier death • Losing control provokes an outpouring of stress hormones • Examples: poverty, optimism

14. What is Stress? • Burnout • physical, emotional and mental exhaustion brought on by persistent job-related stress • Coronary Heart Disease • clogging of the vessels that nourish the heart muscle • leading cause of death in the United States

15. 3.5 3 2.5 2 1.5 1 0.5 0 Hopelessness scores Men who feel extreme hopelessness are at greater risk for heart attacks and early death Heart attack Death Low risk Moderate risk High risk Stress & Coronary Heart Disease

16. Type A & Type B Personalities • Type A- in a chronic state of stress; almost constant flow of adrenaline into the blood stream • Type B- generally relaxed and patient • Type A people are more prone to heart disease • They are more likely to smoke more, sleep less, and drink more caffeine • Their temperament may contribute directly- more physiologically reactive when threatened with a lack of control

17. 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

18. Stress and Disease • Psychophysiological Illness • “mind-body” illness • any stress-related physical illness • some forms of hypertension • some headaches • Different from hypochondriasis • misinterpreting normal physical sensations as symptoms of a disease

19. UCS (drug) UCR (immune suppression) CS (sweetened water) UCS (drug) UCR (immune suppression) CS (sweetened water) CR (immune suppression) Stress and Disease • Conditioning of immune suppression; sweetened water alone could trigger immune suppression in rats

20. 1 2 3 4 5 6 7 1. Doesn't mind leaving things temporarily unfinished Must get things finished once started 2. Calm and unhurried about appointments Never late for appointments 3. Not competitive Highly competitive 4. Listens well; lets others finish speaking Anticipates others In conversation (nods, interrupts) 5. Never in a hurry, even when pressured Always in a hurry 6. Able to wait calmly Uneasy when waiting 7. Easygoing Always going full speed ahead 8. Takes one thing at a time Tries to do more than one thing at a time; thinks about what to do next 9. Slow and deliberate in speech Vigorous and forceful in speech (uses a lot of gestures) 10. Concerned with satisfying him/herself, not others Wants recognition by others for a job well done 11. Slow doing things Fast doing things (eating, walking) 12. Serene Hard Driving 13. Expresses feelings openly Holds feelings in 14. Has a large number of interests Few interests outside work 15. Satisfied with job Ambitious; wants quick advancement at job 16. Never sets own deadlines Often sets own deadlines 17. Feels limited responsibility Always feels responsible 18. Never judges things in terms of numbers Often judges performance in terms of numbers 19. Casual about work Takes work very seriously (works weekends, bring home work) 20. Not very precise Very precise (careful about detail)

21. If you scored over 110 you are a Type A1 If you are in this category and especially if you are over 40 and smoke, you have a high risk of developing cardiac illness and other stress-related illnesses. • If you scored 80 – 109 you are a Type A2 You are also a cardiac-prone personality but your risk of heart disease is not quite as high as a Type A1 • If your score is 60 - 79, you are a Type AB You are a mixture of Type A and Type B patterns. This is a healthier pattern than either A1 or A2, but you have the potential for slipping into Type A behavior and you should recognize this. • If your score is under 59, you are a Type B • 30 - 50: Type B2 0 – 29: Type B1 • This personality complex is characterized by general relaxation and coping adequately with stress. You express few of the reactions associated with cardiac disease.

22. 14 13 12 11 10 9 8 7 6 5 4 3 Depression score No-treatment group Relaxation treatment group Aerobic exercise group Before treatment evaluation After treatment evaluation Promoting Health • Aerobic Exercise • sustained exercise that increases heart and lung fitness • may also alleviate depression and anxiety

23. Promoting Health • Biofeedback • system for electronically recording, amplifying, and feeding back information regarding a subtle physiological state • blood pressure • muscle tension

24. 6 5 4 3 2 1 0 Percentage of patients with recurrent heart attacks (cumulative average) Control patients Modifying life-style reduced recurrent heart attacks Life-style modification patients 1978 1979 1980 1981 1982 Year Promoting Health • Modifying Type A life-style can reduce recurrence of heart attacks

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

26. 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 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 Obesity and Weight Control • Obesity and mortality

27. 7 6 Willingness to hire scale (from1: definitely not hire to 7: definitely hire) 5 4 3 2 1 0 Women Men Normal Overweight Weight Discrimination • When women applicants were made to look overweight, subjects were less willing to hire

28. 7) Excessive time spend in the resistance phase of Selye’s general adaptation syndrome can contribute to • Increased time needed to adapt to new emotional situations • Decreased motivation to perform novel taskes • Stress-related diseases like ulcers or heart conditions • A reduction in the drive to achieve goals • Resistance to learning skills needed for novel tasks

29. 8) Perceived control over a stressful event tends to result in • Less reported stress • More frustration regarding the stressful event • More motivation to solve the stressful problem • Increased arousal • Higher hear and respiration rates

30. http://www.pbs.org/wgbh/nova/body/obesity.html