STRESS AND

HEALTH

CHAPTER 16

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STRESS & HEALTH

Where are we going today?

• Definitions of stress

• Causes: Bring on the stressors!

• How does stress affect us physically?

• Physiological Stress Response

• Stress & the Immune System

• PTSD – post-traumatic stress disorder

• Coping Strategies for Stress

HEALTH PSYCHOLOGY

Can the mind affect the body to the point of death?

• Walter Cannon reviewed reports from around the world

• Physical trauma can cause death, why not

psychological trauma?

• Profound link between the mind and the body

• This research is just one part of a larger area looking

into the relationship between mind-body-health

Health psychology (a part of behavioral medicine) is:

interested in how various factors (biological, psychological,

and social) are related to the development and maintenance

of disease, as well as the promotion of health.

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EXPERIENCING STRESS

The term stress means different things to different people

• Lay person – tension and unpleasant feelings

• Athlete – training before a contest

• Business – work load and time pressure

Psychologists use different definitions and measure it in

different ways

• Major life events

• Daily hassles

• Biological measures

Most common definition focuses on:

Person-Environment Fit- poor fit results in stress

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DEFINITIONS OF STRESS

Stressor: situation or stimulus producing stress

Stress as a physical force

• Most simplistic view

• Emphasis on external events

• Need to simply resist external pressure

Stress as an internal tension

• Way mentally deal with stressor

• Internal war to cope with the overwhelming

• May eventually lead to disease

Stress as body arousal

• Medical research shows that people react physiologically

the same way regardless of type of stress

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YERKES-DODSON RULE

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TYPES OF STRESSORS

Catastrophes: war, natural disaster, trauma

Societal: pressures of social, cultural, and

economic environment

Hassles: minor annoyances or frustrations

• Usually involves blocking of a goal

Any changes in the status quo

Social Readjustment Rating Scale

> 300 = 70% chance of stress-related illness

Acute stress versus chronic stress

Chronic = bad!

WHY DO WE HAVE STRESS?

Is stress a positive or negative emotion?

Evolutionary benefit

• Fight or Flight survival mechanism

• Our stress response is an adaptive response to

that environment

Models of stress:

General Adaptation Syndrome

• Selyé was not the first to use the term stress • Examined link between stress and disease

• Started with environmental focus

• Non-specific response to the environment

• Homeostasis

PHYSICAL STRESS RESPONSE

Hans Selye 1930s - General Adaptation Syndrome:

changes in physiology in response to a stressor

– Alarm reaction: fast but short response

– Release of steroid hormones, increase BP

– Resistance Stage: chronic response

– Reduction hormone levels, continue shift

energy to stress, body adapted to stress

– Exhaustion: depletion of resources

– Increase in hormone levels, dangerously low

levels of immune system, increased sensitivity

to stressor

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MODEL OF STRESS

SELE’S GENERAL ADAPTATION SYNDROME

(GAS)

HORMONES & STRESS

Neurons provide

short-term acute

activation of the

sympathetic nervous

system ->

fight or flight

Hormones provide

chronic activation of

the sympathetic

nervous system

STRESS ACTIVATED HORMONES

HPA axis:

Hypothalamus and Pituitary stimulate the Adrenal cortex to release cortisol

Cortisol stimulates the body to elevate the blood glucose level & increase basal metabolism

Glucocorticoid receptors are found on almost every cell in the body

IMPACT OF STRESS ON

GENERAL HEALTH

Chronic stress increases

the risk of developing

hypertension

Air traffic controllers have a

high rate of burnout –

chronic stress

High stress airports

Low stress airports

IMPACT OF STRESS ON

THE IMMUNE SYSTEM

Natural killer cells

(lymphocytes) search out

foreign antigens and

destroy them

Stress steals the energy

needed to maintain normal

levels of natural killer cells

STRESS & RECOVERY

FROM INJURY

Stress takes energy

away from recovery

processes in the body

Healing of a wound

following a biopsy

- Control group vs

Caregivers of elderly

family members

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STRESS AND DISEASE

STRESS AND DISEASE

Exams can be

dangerous to your

health

After exam cold or flu?

Not everyone gets sick

• Exposure ≠

Contraction

• Contraction ≠

Symptoms or illness

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Stressor Illness

Physiological

Change

Behavioral

change

Stress

Reactivity

Stress Recovery

Allostatic Load

Stress

Resistance

How does chronic

stress impact the

immune system?

STRESS & THE

IMMUNE SYSTEM

Method:

Ss given nasal spray

containing a

cold virus

Finding:

Reported levels of

stress positively

correlated with

increased probability

of contracting cold

STRESS & THE IMMUNE SYSTEM

Method: Ss kept a 12-week record of daily events

Results: 3-5 days prior to upper respiratory infection there was increase in undesirable with decrease in desirable events

POST-TRAUMATIC STRESS DISORDER

(PTSD)

Post-Traumatic Stress Disorder (PTSD) –

delayed stress reaction to a major stressor

• Flashbacks of trauma (hallucinations)

• Avoidance of stimuli associated with trauma

• Chronic arousal

• Physical symptoms: sleep loss, weight loss,

exaggerated startle response

• Pain-control system may become constantly

activated

• Involves diminished pleasure

• Alienation from other people (guilt, fear)

PTSD - TREATMENT

Medically treat the individual symptoms

• Sleep disturbances, anxiety, depression

Cognitive-Behavioral Therapy

• Exposure / Desensitization procedures

• PTSD = Type of conditioning – so use extinction

• Stress coping mechanisms

• Cognitive thought patterns – rationalization of

the traumatic event and avoidance

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COPING WITH STRESS

Coping definition

Constantly changing efforts to manage the specific

demands that are appraised as exceeding the

resources of the individual

Approach versus Avoidance

• Approach: Confronting problem, gathering information,

taking direct action

• Avoidance: Minimize importance of event

Problem-focused versus Emotion-focused

• Problem-focused: proactive attempt to reduce

demands, increase resources

• Emotion-focused: Manage emotions evoked by event

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COPING WITH STRESS

Social Support

• Push (constant support) versus Pull (demand from

others)

• Informational support: Others who have had similar

experiences provide information

• Emotional support: Warmth and nurturance, single

confidant, more important for men

• Appraisal support: Helping others understand and

identify coping strategies

• Tangible support: Provision of material support,

services, financial assistance, or goods

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CONTROL AND STRESS

Attributions of control over the environment are

important in the experience of stress

Andy Baum and Three Mile Island

• Three Mile Island was a nuclear power plant near

Harrisburg, PA that had a core meltdown in 1979

• Many people started to report illnesses and moved

away from Harrisburg

• Health effects or lack of control?

• Compared people with radon gas in basement to

people who stayed near the power plant

• More stress with TMI accident compared with people

who were exposed to radon gas

CONTROL AND STRESS

Perceived control predicts amount of stress experienced

Langer and Rodin (1976)

• Nursing home residents

• One group was given more control: move furniture,

choose menu items, sit with different people, take care

of a plant

• Control group: no change in routine, were given a plant

but were not asked to care for it

• Overall results showed that having more control and

more responsibility was very beneficial for the first group

• Results were maintained for 18 months after the study

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ROLE OF PERSONALITY TYPES

Personality does influence response to stressor and use of coping mechanisms

Type A – intense, aggressive, competitive, impatient

Type B – relaxed, laidback, unmotivated, patient

Ineffective use of coping mechanisms may prolong stress response

Prolonged stress increases susceptibility to disease and illness

So, personality can play an indirect role in your susceptibility to disease

PERSONALITY AND STRESS

Angriest Cities

(Men’s Health, 2006)

Worst Cities for

Men’s Health (Men’s

Health, 2010)

Worst Cities for

Women’s Health

(Women’s Health

2010)

Orlando, FL Detroit, MI St. Petersburg, FL

St. Petersburg, FL Jacksonville, FL Birmingham, AL

Detroit, MI Riverside, CA Modesto, CA

Baltimore, MD Bakersfield, CA Cleveland, OH

Nashville, TN Memphis, TN Detroit, MI

Wilmington, DE Birmingham, AL Charleston, WV

Miami, FL St. Petersburg, FL Toledo, OH

Memphis, TN Las Vegas, NV Memphis, TN

Jacksonville, FL St. Louis, MO St. Louis, MO

St. Louis, MO Charleston, WV Bakersfield, CA

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STRESS MANAGEMENT

What to do about stress?

• Gain control over your environment

• Need to find ways to decrease stress after it happens

• Time management

• Relaxation techniques

• Progressive muscle relaxation

• Autogenic relaxation

• Meditation

• Biofeedback

• Exercise, Don’t smoke, Nutrition, Avoid risky behavior

• Aerobic exercise is very effective in improving mood and

decreasing stress

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STRESS MANAGEMENT

Ongoing study in Alameda County CA (Berkley)

Identified health related behaviors (More the better, >6)

• Getting 7-8 hours of sleep a night

• Breakfast

• Rarely eat between meals

• Drinking moderate amounts of wine

• 1 drink a day better than 0 and more than 2

• No smoking

• Exercise regularly

• Maintain healthy weight

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