Chapter 17- Stress and Health

What is Stress?

Health Psychology- psychology’s contribution to behavioral medicine

Stress - the process by which we appraise and cope with threats and challenges How a person perceives and evaluates

and event makes a difference - the cognitive model of stress▪ Cognitive- thinking and understanding

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

Stressful Life Events

Distress and Eustress 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 Gradually weaken the

body’s defense system and can lead to hypertension

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

Physiological Reaction: Fight or Flight (Cannon)

When faced with a stressor, the body reacts with immediate arousal. ▪ Hormones are produced that increase the

amount of blood sugar for extra energy▪ Adrenaline is produced, causing rapid

heartbeat and breathing and enabling the body to use energy more quickly

Used to prepare a person or animal for self-defense Left over from the past; doesn’t work for most of

today’s stress

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

1)

Ala

rm

Mobilization of fight or flight defensesExceptional alertness

2)

Resi

stance

Find means to cope with the stressor, at least superficiallyMay suffer psychosomatic symptoms from pretending strain is nonexistent

3)

Exhaust

ionReaching the

breaking pointExhaustion and disorientation may developResponses that were good for immediate resistance to stress are detrimental in the long run

General Adaptation Syndrome (Selye)3 Stages of Stress Reactions:

Measuring Stress

The SRRS- Holmes and Rahe› Measured stress using

LCU (life-change units)› Higher score =

higher likelihood of stress-related diseases

› PERCEPTION MATTERS!

The SRRS

Stress and Control (Selye)

Health consequences of a loss of control

No connection to shock source

To shock control To shock source

“Executive” rat “Subordinate” rat Control rat

Perceived Control

All are most stressful when perceived as negative and uncontrolled

The result is vulnerability to ill health and often earlier death

Losing control provokes an outpouring of stress hormones Examples: poverty, optimism

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

Type A & Type B Personalities Type A- in a chronic state of stress;

almost constant flow of adrenaline into the blood stream

Type B- generally relaxed and patient

Type A people are more prone to heart disease▪ They are more likely to smoke more, sleep

less, and drink more caffeine▪ Their temperament may contribute directly-

more physiologically reactive when threatened with a lack of control

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

Stress and Disease

Psychophysiological Illness “mind-body” illness any stress-related physical illness▪ some forms of hypertension▪ some headaches

Different from hypochondriasis▪ misinterpreting normal physical sensations

as symptoms of a disease

Stress and Disease

Conditioning of immune suppression; sweetened water alone could trigger immune suppression in rats

UCS(drug)

UCR(immunesuppression)

UCS(drug)

UCR(immunesuppression)

CS(sweetenedwater)

CS(sweetenedwater) CR

(immunesuppression)

1 2 3 4 5 6 71. Doesn't mind leaving things temporarily unfinished Must get things finished once started2. Calm and unhurried about appointments Never late for appointments3. Not competitive Highly competitive4. Listens well; lets others finish speaking Anticipates others In conversation (nods, interrupts)5. Never in a hurry, even when pressured Always in a hurry6. Able to wait calmly Uneasy when waiting7. Easygoing Always going full speed ahead8. Takes one thing at a time Tries to do more than one thing at a time; thinks about what to do next9. Slow and deliberate in speech Vigorous and forceful in speech (uses a lot of gestures)10. Concerned with satisfying him/herself, not others Wants recognition by others for a job well done11. Slow doing things Fast doing things (eating, walking) 12. Serene Hard Driving13. Expresses feelings openly Holds feelings in14. Has a large number of interests Few interests outside work15. Satisfied with job Ambitious; wants quick advancement at job16. Never sets own deadlines Often sets own deadlines17. Feels limited responsibility Always feels responsible18. Never judges things in terms of numbers Often judges performance in terms of numbers19. Casual about work Takes work very seriously (works weekends, bring home work)20. Not very precise Very precise (careful about detail)

If you scored over 110 you are a Type A1 If you are in this category and especially if you are over 40 and smoke, you have a high risk of developing cardiac illness and other stress-related illnesses.

If you scored 80 – 109 you are a Type A2 You are also a cardiac-prone personality but your risk of heart disease is not quite as high as a Type A1

If your score is 60 - 79, you are a Type AB You are a mixture of Type A and Type B patterns. This is a healthier pattern than either A1 or A2, but you have the potential for slipping into Type A behavior and you should recognize this.

If your score is under 59, you are a Type B 30 - 50: Type B2 0 – 29: Type B1 This personality complex is characterized by general relaxation

and coping adequately with stress. You express few of the reactions associated with cardiac disease.

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 Health

Biofeedback system for

electronically recording, amplifying, and feeding back information regarding a subtle physiological state▪ blood pressure▪ muscle tension

Promoting Health Modifying 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

Obesity and Weight Control

Obesity 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

7) Excessive time spend in the resistance phase of Selye’s general adaptation syndrome can contribute to› Increased time needed to adapt to new

emotional situations› Decreased motivation to perform novel taskes› Stress-related diseases like ulcers or heart

conditions› A reduction in the drive to achieve goals› Resistance to learning skills needed for novel

tasks

8) Perceived control over a stressful event tends to result in Less reported stress More frustration regarding the stressful

event More motivation to solve the stressful

problem Increased arousal Higher hear and respiration rates

http://www.pbs.org/wgbh/nova/body/obesity.html