Chapter 14

Stress and Health

James A. McCubbin, PhDClemson University

Modified by Pamela HammondBrantley County High School

What do you think?

Take out a scrap piece of paper Brainstorm: Write down all of the things

that stress you out; free flow thought Rank your stressors from least to worst

Fact or Falsehood?

T F 1. Half of all deaths in the United States are due to people’s behavior.T F 2. Cancer rates are higher among concentration camp survivors.T F 3. Compared to others, pessimists are more than twice as likely to develop

heart disease.T F 4. Writing about personal traumas in a diary reduces stress and the likelihood

of health problems during ensuing months.

T F 5. Those who do not exercise are twice as likely as exercisers to report being not “too

happy.”T F 6. Religious faith and health show a strong positive correlation.T F 7. Smoking a cigarette takes 12 minutes off one’s life expectancy.T F 8. Genes influence one’s propensity to cigarette addiction.T F 9. It is possible for two people of the same height, age, and activity level to

maintain the same weight, even if one of them eats much more than the other does.

T F 10. Most people who lose weight on a weight-loss program will eventually regain most

of it.

Answers:

All are true except number 2

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 Illness Leading causes of death in the US in

1900 and 2000

Stress and Illness

Stress the process by

which we perceive and respond to certain events, called stressors, that we appraise as threatening or challenging

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)

Stress and Illness

General Adaptation Syndrome Selye’s

concept of the body’s adaptive response to stress in three stages

Stressresistance

Phase 1Alarm

reaction(mobilize

resources)

Phase 2Resistance(cope with stressor)

Phase 3Exhaustion(reservesdepleted)

The body’s resistance to stress canlast only so long before exhaustion sets in

Stressoroccurs

Three Stages of the General Adaptation Syndrome

1) Alarm Reaction--general arousal caused by:

*increase of adrenal glands

*reaction of sympathetic nervous system

If stressor is not removed, organism moves to:

2) Resistance--arousal subsidies because of:

*decrease in adrenal output

*counter reaction of parasympathetic nervous system

If stressor is not removed, organism moves to:

3) Exhaustion-- general arousal of Stage 1 reappears:

Powerful parasympathetic response opposes arousal.

If stressor is not removed in time, death occurs.

Stressful Life Events

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, AP Psychology…school in general

Stressful Life Events Chronic Stress by Age

Stress and the Heart

Type A Friedman and Rosenman’s term for

competitive, hard-driving, impatient, verbally aggressive, and anger-prone people

Type B Friedman and Rosenman’s term for

easygoing, relaxed people Quiz: Are you Type A or Type B?

(14.8)

Personal Factors in Reactions to Stress

Gender differences Women more likely to have lasting

reactions to traumatic events; at more risk for exposure

Marriage and committed relationships have health benefits Social buffer against stress Live healthier, longer lives on average Loss of spouse affects men more Maybe marriage is choice of healthier

people

Personal Factors in Reactions to Stress

Gender differences Fight-or-flight important to both sexes Men more likely to use fight-or-flight

response Women more likely to tend-and-

befriend Creates alliances for future if reoccurrence Average response to workplace stress

Mothers more nurturing to children Fathers more grouchy or withdrawn

Personal Factors in Reactions to Stress

Ethnic differences Minority groups experience more

stress Few advantages and opportunities Stressful interactions with majority

culture due to stereotypes, discrimination, prejudice

Rapid acculturation of immigrant children clash with family pressures to maintain old culture (ie: language, customs)

Stress and the Heart

Coronary Heart Diseaseclogging of the vessels that nourish the heart muscle

leading cause of death in many developed countries

Stress and the Heart

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 and the Heart

Stress and Disease

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

some forms of hypertension some headaches

distinct from hypochondriasis-- misinterpreting normal physical sensations as symptoms of a disease

Stress and the Immune System

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 does not directly cause disease When energy is diverted from immune

system activities and directed toward stress-response system vulnerability to infection and disease increases Acceleration of AIDS Rapid spread of cancerous cells

Stress and the Immune System

Stress and Disease

Negative emotions and health-related consequences

Mind and body interact; everything psychological is simultaneously physiological

Unhealthy behaviors(smoking, drinking,

poor nutrition and sleep)

Persistent stressorsand negative

emotions

Release of stresshormones

Heartdisease

Immunesuppression

Autonomic nervoussystem effects

(headaches,hypertension)

Promoting Health

Coping with stress Problem-focused coping: when we feel a

sense of control and think we can change the situation Change the stressor or the way we interact

with that stressor

Emotion-focused coping: when we feel we have no or little control over the situation Avoid or ignore a stressor Meet emotional needs

Perceived Control

Health consequences of a loss of control Higher than normal susceptibility

to infections, cardiovascular disease, and possibly, a shorter life span

Diminished immune system responses

Explanatory style

Optimists, more than pessimists, feel they have more control over stressor Cope better with stressors Better moods Stronger immune systems Live longer Laugh more, less sarcastic

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

Social Support

Supportive family members, friends, companionable pets help people cope with stress Fosters stronger immune systems Lowers blood pressure

Nursing homes Therapy pets People feel loss of control, die sooner

Promoting Health Social 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

Promoting Health

Aerobic Exercise sustained exercise that increases heart and lung fitness

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

Life events

Tendency toward

Health Illness

Personal appraisal

Challenge Threat

Personality typeEasy going

Non depressedOptimistic

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

Promoting Health Religious Attendance

Promoting Health The religion factor is multidimensional

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

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

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