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Myers’ PSYCHOLOGY (6th Ed). Chapter 17 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
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Myers’ PSYCHOLOGY (6th Ed) Chapter 17 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
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
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
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
Cerebral cortex (perceives stressor) Pituitary hormone in the bloodstream stimulates the outer part of the adrenal gland to release the stress hormone cortisol Thalamus Hypothalamus 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
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
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
“Executive” rat “Subordinate” rat Control rat To shock control To shock source No connection to shock source Stress and Control • Health consequences of a loss of control
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
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
Stress & Coronary Heart Disease • Type A • Friedman and Rosenman’s term for people who are competitive, hard-driving, impatient, verbally aggressive, anger-prone • Type B • Friedman and Rosenman’s term for easygoing, relaxed people
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
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
Heart disease Persistent stessors and negative emotions Release of stress hormones Immune suppression Unhealthy behaviors (smoking, drinking, poor nutrition and sleep) Autonomic nervous system effects (headaches, hypertension) Stress and Disease • Negative emotions and health-related consequences
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
Promoting Health • Biofeedback • system for electronically recording, amplifying, and feeding back information regarding a subtle physiological state • blood pressure • muscle tension
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
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
Life events Personal appraisal Challenge Threat Personality type Easy going Nondepressed Optimistic Hostile Depressed Pessimistic Personality habits Nonsmoking Regular exercise Good nutrition Smoking Sedentary Poor nutrition Level of social support Close, enduring Lacking Tendency toward Health Illness
Relative risk of dying Not smoking Regular exercise Weekly religious attendance Women Men Promoting Health 1 0.8 0.6 0.4 0.2 0 • Predictors of mortality
Subfields of Alternative Medicine Alternative systems of medical practice Bioelectromagnetic applications Diet, nutrition, life-style changes Herbal medicine Manual healing Mind-body control Pharmacological and biological treatments 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 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 traditions for pharmacological use Using touch and manipulation with the hands as a diagnostic and 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 • 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
Healthy behaviors (less smoking, drinking) Religious involvement Social support (faith communities, marriage) Better health (less immune system suppression, stress hormones, and suicide) Positive emotions (less stress, anxiety) Promoting Health • The religion factor is mulitidimensional
Number of deaths per 100,000 33,348 1,686 1,135 556 202 Smoking Suicide Vehicle HIV/ Homicide crash AIDS Cause of death Promoting Health 40,000 30,000 20,000 10,000 0 • Smoking-related early deaths
60% 50 40 30 20 10 0 Percentage of Canadians smoking Males Females 1970 1974 1978 1982 1986 1990 1994- 1996- 1995 1997 Year Promoting Health • Fewer Canadian smokers
30% 25 20 15 10 5 0 Percentage of U.S. high school seniors who smoke daily 1975 1980 1985 1990 1995 1999 Year Smoking Prevention • Smoking has made a partial comeback among U.S. teens
20 15 10 5 0 Percentage of students who smoke Fewer teens took up smoking when “inoculated” against it Control school School with smoking Prevention program 0 4 9 12 16 21 33 Seventh grade Eighth grade Ninth grade Months of study Smoking Prevention • Results of a smoking inoculation program
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
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
Metabolism: Oxygen consumption in liters per hour Body weight in kilograms Caloric intake in calories per day 26 25 24 23 22 21 165 160 155 150 145 140 3000 2000 1000 0 8 16 24 32 8 16 24 32 8 16 24 32 Days Days Days Weight Control • Effects of a severe diet
10 Weight change in pounds Starting point 5 0 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 4 5 Years of follow-up Weight Control • Most lost weight is regained
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 Weight Control • Obesity was more common among those who watched the most television