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Psychological Effects on the Cardiovascular System

Psychological Effects on the Cardiovascular System. Dick Jennings. Behavioral Medicine . Understand how psychological factors can influence the initiation, course, and outcome of disease (and health maintenance) The relationship between mind and body is a central concept

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Psychological Effects on the Cardiovascular System

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  1. Psychological Effects on the Cardiovascular System Dick Jennings

  2. Behavioral Medicine • Understand how psychological factors can influence the initiation, course, and outcome of disease (and health maintenance) • The relationship between mind and body is a central concept • The concept of stress and its physiological sequelae is the lay theory of behavioral medicine How should we conceptualize the relationship?

  3. Why we worry about stress..

  4. Components of Stress • Threat to well-being • Emotional reactions • Emotions alter physiology • Over time (and typically in combination with other factors), disease occurs

  5. Motor/Action System Bodily States Autonomic Nervous System Heart Central Nervous System Vasculature Idea/affect/motiv Endocrine System Bodily State Feedback EnvironmentalEvents Immune System

  6. Response Systems..

  7. Netter (1962) CIBA collection of Medical Illustrations. Pp 164-165

  8. Functional Responsivity of the Autonomic Nervous System • Support for action— orienting, anticipating, exercising,thought • Metabolism— salt/water balance, digestion, respiratory sinus arrhythmia • Affect— fear, anger, grief, disgust • STRESS??

  9. Sympathetic and Parasympathetic • Sympathetic • Activating/energy mobilizing • Thoracic cord to paravertebral ganglia—processing for organ specificity • Engage endocrine system • Norepinephrine transmitter..modulation via alpha and beta adrenergic receptors (co-release peptides, opiates, …..) • Parasympathetic • Conserving/energy restoring • Cranial and sacral cord, Xth nerve—Vagus—synapse at end organ • Relates to immune system in development and possible cytokine release • Acetylcholine transmitter…muscarinic and nicotinic receptors

  10. Organized behavioral/autonomic action

  11. Controversial translation of stressful thoughts to physiology

  12. Stress • Darwin—changing environment leads to adaption. Stress? • Cannon—physiological reactions maintain homeostasis. Stress? Defending homeostatic target range. • Selye (1946)—Stress as non specific damaging agents (external to person) inducing generalized, stereotypic reaction—General Adaptation Syndrome defines stress by the physiological reaction. • Selye—linear concept, non-psychological, non-behavioral. Stress required return to homeostasis not adaptation to new situation. • Holmes/Rahe—stress as disease of adaption (literal Selye—closer to Cannon)

  13. Stress--continued • Mason—patterns response of neuroendocrine system dependent upon situation • Lazarus—an interactive (nonlinear) stress syndrome—threat, evaluation, coping, re-evaluation. • Weiner—patterns of integrated action, biorhythms, dysregulation, taxonomic stress • McEwan—allostasis. The weight of adjustment. Separate systems that guide adjustment but may be overtaxed.

  14. The Stress Experiment

  15. Cardiovascular Reactivity Individuals show changes in heart rate and blood pressure when exposed to brief laboratory stressors/challenges Individuals are reasonably consistent across time in the magnitude of these responses to stressors. These responses are associated with and predictive of cardiovascular disease. The brain may have something to do with this.

  16. Issues in Cardiovascular Reactivity • Generality over instances within individual, over stressors, over life span • Variety of reactivity—cardiac, vascular, vagal, sympathetic…. • Source of reactivity—genetic, affect, stressors • Person-Environment interaction • Activation or Recovery?

  17. From web SuperCourse

  18. Jennings, Kamarck, Manuck, Everson-Rose, Kaplan, & Salonen, Circulation, 2005

  19. From Gianaros et al., Psychophysiology, 2005

  20. From Gianaros et al., PSOM Med, 2005

  21. Mind=Body Hypothesis • Brain coordinates function of the whole organism • Brain adjusts evolutionary mechanisms that, e.g., keeps the heart beating. • Brain organizes/initiatiates behavior attempting to optimize reaching our biological and psychological goals • Behavioral patterns—driving autonomic, motoric, endocrine and immune outputs-- can then disrupt regulation of peripheral bodily function. • Behavioral focus can ignore restorative processes responsive to bodily afference.

  22. The path from psychosocial to illness • Communication and coordination within our body is via the nervous, endocrine, and immune systems. • The brain’s impact on these systems are the pathways from psychosocial to illness. • Individual differences in behavior and biological characteristics impact these pathways and have been related to illness.

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