Myers’ PSYCHOLOGY

(6th Ed)

Chapter 17

Stress and Health

James A. McCubbin, PhDClemson 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 HealthLeading causes of death in the US in

1900 and 1991PercentageU.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

Stress Appraisal

Stressful event(tough math test)

Threat(“Yikes! This isbeyond me!”)

Challenge(“I’ve got to apply

all I know”)

Panic, freeze up

Aroused, focused

Appraisal Response

Pituitary hormone in the bloodstream stimulatesthe outer part of the adrenalgland to release the stress hormone cortisol

Sympathetic nervoussystem releases the stress hormonesepinephrine andnorepinephrinefrom 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 Events

Catastrophic Events earthquakes, combat stress, floods

Life Changes death of a loved one, divorce, loss of

job, promotionDaily Hassles

rush hour traffic, long lines, job stress, burnout

Stress and ControlHealth consequences of a loss of control

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 Disease

Psychophysiological Illness “mind-body” illness any stress-related physical illness

some forms of hypertensionsome headaches

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(immunesuppression)

UCS(drug)

UCR(immunesuppression)

CS(sweetenedwater)

CS(sweetenedwater) CR

(immunesuppression)

Stress and DiseaseNegative emotions and health-related

consequences

Unhealthy behaviors(smoking, drinking,

poor nutrition and sleep)

Persistent stessorsand negative

emotions

Release of stresshormones

Heartdisease

Immunesuppression

Autonomic nervoussystem effects

(headaches,hypertension)

Promoting Health

Aerobic Exercise sustained

exercise that increases heart and 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

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

Promoting HealthSocial support across the life span

12-14 18-19 25-34 45-54 65-74 15-17 20-24 35-44 55-64 75+ Age in years

100%

90

80

70

60

50

Percentagewith high

support

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

Promoting Health Predictors of mortality

1

0.8

0.6

0.4

0.2

0

Men Women

Not smoking Regular exercise Weekly religious attendance

Relativerisk

of dying

Alternative systems ofmedical practice

Bioelectromagneticapplications

Diet, nutrition,life-style changes

Herbal medicine

Manual healing

Mind-body control

Pharmacological and biological treatments

Subfields of Alternative MedicineHealth care ranging from self-care according to folk principles,to care rendered in an organized health care system based onalternative 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 traditionsfor pharmacological use

Using touch and manipulation with the hands as a diagnosticand 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

Promoting Health The religion factor is mulitidimensional

Religiousinvolvement

Healthybehaviors

(less smoking,drinking)

Social support(faith

communities,marriage)

Positiveemotions

(less stress,anxiety)

Better health(less immune systemsuppression, stress

hormones, and suicide)

Promoting Health Smoking-related early deaths

40,000

30,000

20,000

10,000

0

33,348

1,686 1,135 556 202

Smoking Suicide Vehicle HIV/ Homicide crash AIDS

Cause of death

Numberof deaths

per 100,000

Promoting Health Fewer Canadian smokers

Males

Females

1970 1974 1978 1982 1986 1990 1994- 1996- 1995 1997

Year

60%

50

40

30

20

10

0

Percentageof Canadians

smoking

Smoking Prevention

Smoking has made a partial comeback among U.S. teens

1975 1980 1985 1990 1995 1999Year

30%

25

20

15

10

5

0

Percentage ofU.S. high school

seniors whosmoke daily

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

Control school

School with smokingPrevention program

Fewer teens took upsmoking when “inoculated” against it

Obesity and Weight ControlObesity and mortality

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

2.8

2.6

2.4

2.2

2.0

1.8

1.6

1.4

1.2

1.0

0.8

0.6

Relativerisk ofdeath

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

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 8 16 24 32

Weight Control

Most lost weight is regained

-20

-15

-10

-5

0

5

10

1 2 3 4 5

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

<2 2-3 >4Hours of television watched per day

in 1990s study

Boys Girls

32

30

28

26

24

22

20

Skinfold fatmeasure (mm)