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