PSYCHOLOGY
Stress and Health
Stress and HealthBehavioral 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 Health
Leading causes of death in the US in 1900 and 1991
PercentageU.S.deaths
30
20
10
0 Tuber-culosis
Pneu-monia
Diarrhea/enteritis
Heartdisease
1900
PercentageU.S.deaths
30
20
10
0 Heartdisease
Cancer Strokes Chroniclung disease
1991
Unlike many leading killers a century ago,
today’s majorkillers are more lifestyle-related
What is Stress?
Stress the process by
which we perceive and respond to certain events, called stressors, that we appraise as threatening or challenging
StressorsCatastrophes
Life changes
Hassles
InterveningfactorsAppraisal
Perceived control
Personality
Social support
Coping behaviors
StressreactionsPhysiological
Emotional
Behavioral
Pituitary hormonein the bloodstream
stimulates the outerpart of the adrenalgland to release
the stress hormonecortisol
Sympathetic nervoussystem releases the
stress hormonesepenephrine andnorepinephrine
from nerve endings in the inner part ofthe adrenal glands
Thalamus
Hypothalamus
Pituitary gland
Adrenal glands
Cerebral cortex(perceives stressor)
What is Stress?
General Adaptation Syndrome Selye’s concept of
the body’s adaptive response to stress as composed of three stages
Stressresistance
Phase 1Alarm
reaction(mobilize
resources)
Phase 2Resistance(cope with stressor)
Phase 3Exhaustion(reservesdepleted)
The body’s resistance to stress can onlyLast so long before exhaustion sets in
Stressoroccurs
Stressful Life EventsCatastrophic Events
earthquakes, combat stress, floodsLife Changes
death of a loved one, divorce, loss of job, promotion
Daily Hassles rush hour traffic, long lines, job stress, burnout
Perceived Control loss of control can increase stress hormones
Stress and ControlAnimal studies of control and helplessness
No connection to shock source
To shock control To shock source
“Executive” rat “Subordinate” rat Control rat
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
Stress & Coronary Heart Disease
Hopelessnessscores
3.5
3
2.5
2
1.5
1
0.5
0 Heart attack DeathLow risk Moderate risk High risk
Men who feel extreme hopelessnessare at greater risk for heart attacksand early death
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 DiseasePsychosomatic Disease
psychologically caused physical symptoms
Psychophysiological Illness “mind-body” illness any stress-related physical illness distinct from hypochondriasis –
misinterpreting normal physical sensations as symptoms of a disease
Stress and DiseaseLymphocytes
two types of white blood cells that are part of the body’s immune systemB 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
Conditioning of immune suppression
UCS(drug)
UCR(immune suppression)
UCS(drug)
CS(sweetened water)
UCR(immune suppression)
CS(sweetened water)
CR(immune suppression)
Stress and DiseaseNegative emotions and health-related
consequences
Unhealthy behaviors(smoking, drinking,
poor nutrition and sleep)
Negativeemotions
Stresshormones
Heartdisease
Immunesuppression
Autonomic nervoussystem effects
(headaches,hypertension)
Promoting Health
Aerobic Exercise sustained
exercise that increases heart vand lung fitness
may also alleviate depression and anxiety
Depressionscore
14
13
12
11
10
9
8
7
6
5
4
3 Before treatmentevaluation
After treatmentevaluation
No-treatmentgroup
Aerobicexercise
group
Relaxationtreatment
group
Promoting HealthBiofeedback
system for electronically recording, amplifying, and feeding back information regarding a subtle physiological stateblood pressuremuscle tension Patient observes
Promoting HealthModifying Type A life-style can
reduce recurrence of heart attacks
Percentageof patients
with recurrentheart attacks
(cumulativeaverage)
6
5
4
3
2
1
0
Year1978 1979 1980 1981 1982
Life-style modification patients
Control patients
Modifying life-stylereduced recurrent
heart attacks
Life events
Tendency toward
Health Illness
Personal appraisal
Challenge Threat
Personality typeEasy going
NondepressedOptimistic
HostileDepressedPessimistic
Personality habitsNonsmoking
Regular exerciseGood nutrition
SmokingSedentary
Poor nutrition
Level of social support
Close, enduring Lacking
Prevention 14% of US Gross Domestic
Product is spent on health care2/3 of organizations with >50
employees have health promoting programs health assessments fitness training smoking cessation stress management
Prevention
Prudential’s experience with a fitness program reduced sick days by 20% reduced medical costs by 46%
saved $1.93 for every dollar spent on health care
Smoking Some estimates show smoking
kills about 20 loaded jumbo jets per day
Smoking is a pediatric disease rebellious youth modeling behavior, social rewards targeted ad campaigns
Why not quit? Nicotine delivery system
1. Arouses thebrain to a state
of increasedalertness
2. Increasesheart rateand bloodpressure
3. At high levels, relaxes muscles and
triggers the release of endorphins, natural
opiates that may reduce stress
4. Reducescirculation toextremities
1. Suppressesappetite for
carbohydrates
How to QuitEducation
eliminate the social reinforcement increase social support for quitting
Cost tax it to shorten the time between behavior and
punishment reduces smoking by 4% for every 10% increase
in costs
Nicotine Replacement- Patch & Gum reduce pharmacological addiction then treat psychological addiction
Smoking Prevention
Smoking has made a partial comeback among U.S. teens
Percentage of U.S.high school seniors
who smoke daily
30
25
20
15
10
5
01976 1980 1985 1990 1996
Year
Smoking Prevention
Results of a smoking inoculation program
Percentageof studentswho smoke
20
15
10
5
0 0 4 9 12 16 21 33
Seventh grade Eighth grade Ninth grade
Months of study
Fewer teens took upsmoking when
“inoculated” against it
Control school
School with smokingPrevention program
Weight Discrimination
When women applicants were made to look overweight, subjects were less willing to hire
Willingnessto hire scale
(from1:definitely
not hire to7: definitely
hire)
0
1
2
3
4
5
6
7
Women Men
Normal Overweight
Weight ControlEffects of a severe diet
8 16 24 32
Caloric intake
in caloriesper day
Body weight
in kilograms
Metabolism:Oxygen
consumptionin liters
per hour
3000
2000
1000
0 8 16 24 32
Days
165
160
155
150
145
140
Days Days
26
25
24
23
22
218 16 24 32
Weight Control
Most lost weight is regained
Weightchange
in pounds
Posttreatment
Years of follow-up
Startingpoint
Normal trend for untreated obesepeople: Gradually rising weight
After participation in behavioralProgram: Much of initial weight
Loss regained
Weight Control
Obesity was more common among those who watched the most television
Hours of TV watched per day
Percentageobese
0-1 1-2 2-3 3-4 4-5 Morethan 5
0
5
10
15
20
25