10 Health and Stress

Learning Objectives 10.1 How does the life events approach describe stress? 10.2 What do hassles, uplifts, and choices contribute to stress? 10.3 What variables contribute to workers' comfort zone? 10.4 What are some social sources of stress? 10.5 How does the biopsychosocial model approach health and illness? 10.6 How does the fight-or-fight response affect health? 2

Learning Objectives 10.7 How do theorists explain physiological and psychological responses to stress? 10.8 What factors promote resilience in the face of stress? 10.9 How do lifestyle, heredity, and personality influence coronary heart disease? 10.10 How do psychological factors influence cancer patients' quality of life? 10.11 How do males and females differ with regard to health? 3

Learning Objectives 10.12 How do researchers explain ethnic group differences in health? 10.13 How does smoking affect health? 10.14 What are some health risks of alcohol abuse? 10.15 What is the difference between bacterial and viral STDs? 10.16 How do diet and exercise affect health? 10.17 What are the benefits and risks associated with alternative medicine? 4

Overview Sources of Stress The Health-Stress Connection Health and Illness Lifestyle and Health

Sources of Stress: The Life Events Approach LO 10.1 Stress physiological and psychological response to a condition that threatens or challenges requires adaptation Stressor any stimulus or event capable of producing physical or emotional stress 10.1 How does the life events approach describe stress?

Sources of Stress: The Life Events Approach LO 10.1 Life Events Approach A person's well-being can be threatened by major life changes. includes events most people experience as well as rare events 10.1 How does the life events approach describe stress?

The Social Readjustment Rating Scale LO 10.1 Holmes and Rahe (1967) The scale measures the impact of life events. ranges from most to least stressful Changes can be positive or negative. 10.1 How does the life events approach describe stress?

The Social Readjustment Rating Scale LO 10.1 The scale assigns point values to 43 life events. Score ranges from 11 to 100. Scores correlate with a variety of health indicators. A score over 300 means a 50 percent chance of becoming ill within 2 years. 10.1 How does the life events approach describe stress?

The Social Readjustment Rating Scale LO 10.1 Criticism of SRRS The scale assigns point values without accounting for how an individual perceives or copes with a particular stressor. 10.1 How does the life events approach describe stress?

Catastrophic Events Posttraumatic Stress Disorder (PTSD) LO 10.1 Posttraumatic Stress Disorder (PTSD) prolonged and severe reaction to catastrophic event or severe, chronic stress effects can linger for years, especially with personal connection 10.1 How does the life events approach describe stress?

Catastrophic Events Posttraumatic Stress Disorder (PTSD) LO 10.1 Posttraumatic Stress Disorder (PTSD) flashbacks, nightmares, intrusive memories survivor guilt Depression and alcoholism are more common in female survivors. 10.1 How does the life events approach describe stress?

Everyday Stressors Hassles (Lazarus & DeLongis, 1983) Uplifts irritating demands that occur daily may cause more stress than major life changes Uplifts positive experiences in life may neutralize effects of hassles uplifts for some individuals may be stressors for others 10.2 What do hassles, uplifts, and choices contribute to stress?

Everyday Stressors: Making Choices LO 10.2 Three Choice-Related Conflicts Approach-approach conflict having to choose between equally desirable alternatives Avoidance-avoidance conflict having to choose between equally undesirable alternatives Approach-avoidance conflict The choice has both desirable and undesirable features. 10.2 What do hassles, uplifts, and choices contribute to stress?

Figure 10.1 Variables in Work Stress For a person to function effectively and find satisfaction on the job, these nine variables should fall within the person’s comfort zone. Source: Albrecht (1979).

Social Sources of Stress LO 10.4 Racism historical racism experienced by groups that have a history of repression Most research has focused on African Americans. A higher incidence of high blood pressure may be related to historical racism. A strong sense of ethnic identity may offset the effects of racism. 10.4 What are some social sources of stress?

Social Sources of Stress LO 10.4 Socioeconomic Status (SES) financial, educational, and occupational factors contributing to status Low-SES persons have more colds, flu, higher LDL cholesterol, and higher levels of stress hormones. Perceived SES may be more predictive of health problems than actual SES. 10.4 What are some social sources of stress?

Social Sources of Stress LO 10.4 Unemployment People forced out of jobs experience heightened risks of stress-related illnesses in the months that follow job loss. Unemployment diminishes an individual's sense of control over what happens. 10.4 What are some social sources of stress?

Social Sources of Stress LO 10.4 Acculturative Stress adjustment to life in a new culture Immigrants with an integration orientation are more satisfied with their lives. 10.4 What are some social sources of stress?

Biopsychosocial Model The Health-Stress Connection: The Biopsychosocial Model of Health and Illness LO 10.5 Biomedical Model explains illness solely in terms of biological factors focuses more on illness than on health Biopsychosocial Model focuses on health as well as illness Both are determined by a combination of biological, psychological, and social factors. 10.5 How does the biopyschosocial model approach health and illness?

The Health-Stress Connection: The Biopsychosocial Model of Health and Illness Health Psychology concerned with psychological factors contributing to health, illness, and recovery 10.5 How does the biopyschosocial model approach health and illness?

Figure 10.2 The Biopsychosocial Model of Health and Illness According to the biopsychosocial model, the combined effects of risk and protective factors determine both health and illness. Risk factors move the system toward illness, while protective factors moderate the effects of risk factors and increase the chances that a state of health will be maintained.

The Physiology of the Health-Stress Connection Fight-or-Flight Response The sympathetic nervous system and endocrine glands prepare the body to fight or flee. 10.6 How does the fight-or-flight response affect health?

The Physiology of the Health-Stress Connection Fight-or-Flight Response Maintaining the fight-or-flight response over time influences health in 2 ways. Biochemicals associated with fight-or-flight response affect how the body functions. The body pumps out large amounts of neuropeptide Y (NPY). 10.6 How does the fight-or-flight response affect health?

The Physiology of the Health-Stress Connection Fight-or-Flight Response Maintaining the fight-or-flight response over time influences health in 2 ways. Biochemicals associated with fight-or-flight response affect how the body functions. NPY reduces anxiety but also constricts blood vessels, leaving vessels more vulnerable to blockages. 10.6 How does the fight-or-flight response affect health?

The Physiology of the Health-Stress Connection Fight-or-Flight Response Maintaining the fight-or-flight response over time influences health in 2 ways. Fight or flight suppresses body's immune system, affecting white blood cells called lymphocytes. 10.6 How does the fight-or-flight response affect health?

The Physiology of the Health-Stress Connection Psychoneuroimmunology Psychologists, biologists, and medical researchers combine their expertise to study effects of psychological factors on the immune system. Periods of high stress are correlated with increased symptoms of many infectious diseases. Stress may decrease the effectiveness of certain vaccines. 10.7 How do theorists explain physiological and psychological responses to stress?

The Physiology of the Health-Stress Connection Psychoneuroimmunology Psychologists, biologists, and medical researchers combine their expertise to study effects of psychological factors on the immune system. Stress can suppress the immune system long after the stressful experience is over. 10.7 How do theorists explain physiological and psychological responses to stress?

The Physiology of the Health-Stress Connection Psychoneuroimmunology Psychologists, biologists, and medical researchers combine their expertise to study effects of psychological factors on the immune system. Academic pressures, poor marital relationships, and sleep deprivation have been linked to lowered immune response. 10.7 How do theorists explain physiological and psychological responses to stress?

Figure 10.3 The General Adaptation Syndrome The three stages in Selye’s general adaptation syndrome are (1) the alarm stage, during which there is emotional arousal and the defensive forces of the body are mobilized for fight or flight; (2) the resistance stage, in which intense physiological efforts are exerted to resist or adapt to the stressor; and (3) the exhaustion stage, when the organism fails in its efforts to resist the stressor. Source: Selye (1956).

Theories of Stress Response: General Adaptation Syndrome LO 10.7 Hans Selye (1907–1982) There is a predictable sequence of reactions organisms show in response to stressors. Three stages: alarm, resistance, exhaustion Most harmful effects of stress are due to prolonged secretion of glucocorticords. 10.7 How do theorists explain physiological and psychological responses to stress?

Theories of Stress Response: Cognitive Theory of Stress LO 10.7 Richard Lazarus (1966) Stress results from a person's perception of stress, not the stressors themselves. 10.7 How do theorists explain physiological and psychological responses to stress?

Figure 10.4 Lazarus and Folkman’s Psychological Model of Stress Lazarus and Folkman emphasize the importance of a person’s perceptions and appraisal of stressors. The stress response depends on the outcome of the primary and secondary appraisals, whether the person’s coping resources are adequate to cope with the threat, and how severely the resources are taxed in the process. Source: Folkman (1984).

Theories of Stress Responses 34

Risk and Resilience: Coping Strategies LO 10.8 Risk/Resilience Model Risk and protective factors interact to produce or protect us from illness. Coping Strategies efforts to deal with demands perceived as taxing or overwhelming problem-focused coping response aimed at reducing, modifying, or eliminating source of stress 10.8 What factors promote resilience in the face of stress?

Risk and Resilience: Coping Strategies LO 10.8 Coping Strategies emotion-focused coping reappraisal of a stressor to reduce its emotional impact A combination of strategies is the best approach. 10.8 What factors promote resilience in the face of stress?

Risk and Resilience: Coping Strategies LO 10.8 Optimism Optimists are more stress-resistant than pessimists. lower death rates noted in a long-term study in Finland 10.8 What factors promote resilience in the face of stress?

Risk and Resilience: Coping Strategies LO 10.8 Hardiness combination of commitment, control, and challenge Hardy individuals tend to remain healthy despite high levels of stress. 10.8 What factors promote resilience in the face of stress?

Risk and Resilience: Coping Strategies LO 10.8 Religious Faith Involvement with religion has been associated with lower rates of cancer, heart disease, and stroke. Social Support tangible and/or emotional support provided by family members, friends, and others 10.8 What factors promote resilience in the face of stress?

Risk and Resilience: Coping Strategies LO 10.8 Social Support Characteristics of People with High Levels of Social Support Less likely to catch colds Lower levels of depression when suffering from chronic illnesses Recover faster from illness Have a higher probability of surviving a heart attack Perceived Control 10.8 What factors promote resilience in the face of stress?

Factors That Promote Resilience 41

Health and Illness: Coronary Heart Disease LO 10.9 Caused by narrowing or blockage of coronary arteries Responsible for 25 percent of all deaths Largely attributable to lifestyle sedentary lifestyle job with most of the time spent sitting less than 20 minutes of exercise 3 times per week 10.9 How do lifestyle, heredity, and personality influence coronary heart disease?

Health and Illness: Coronary Heart Disease LO 10.9 Largely attributable to lifestyle sedentary lifestyle is primary modifiable risk factor Other modifiable risk factors are high serum cholesterol level, cigarette smoking, and obesity. Family history is also a risk factor. 10.9 How do lifestyle, heredity, and personality influence coronary heart disease?

Health and Illness: Personality Influence LO 10.9 Type A Behavior Pattern time urgency, impatience, competitiveness, hostility, and anger increased risk for coronary heart disease Type B Behavior Pattern relaxed, easygoing approach to life, without time urgency, competitiveness, and hostility lower risk of coronary heart disease 10.9 How do lifestyle, heredity, and personality influence coronary heart disease?

Health and Illness: Personality Influence LO 10.9 Type D Behavior Pattern emotional distress combined with tendency to suppress negative emotions associated with increased risk of coronary heart disease Anger and Hostility may be part of a larger complex of variables that includes other forms of emotional distress 10.9 How do lifestyle, heredity, and personality influence coronary heart disease?

Health and Illness: Cancer LO 10.10 Second leading cause of death in US Collection of diseases rather than a single entity Cells do not stop dividing like normal cells. 10.10 How do psychological factors influence cancer patients' quality of life?

Health and Illness: Cancer LO 10.10 Psychological factors can improve quality of life and reduce distress in cancer patients. Maintaining an optimistic outlook Accepting the reality of the situation Keeping a sense of humor Social support 10.10 How do psychological factors influence cancer patients' quality of life?

Health and Illness: Cancer LO 10.10 Coping Strategies that Increase Distress Denial Social withdrawal 10.10 How do psychological factors influence cancer patients' quality of life?

Health and Illness: Gender and Health LO 10.11 Women's postsurgical mortality rate is higher than men's. Women have higher rates of postsurgical infection and stroke. A higher rate of blood transfusion may create greater infection rates. 10.11 How do males and females differ with regard to health?

Health and Illness: Gender and Health LO 10.11 Men have higher death rates from all causes, although women tend to be less healthy. Need to examine interactions in gender differences in physiological, psychological, and social domains 10.11 How do males and females differ with regard to health?

Health and Illness: Ethnic Group Differences in Health LO 10.12 Some racial and ethnic groups have higher incidences of chronic conditions compared to others. African Americans higher rates of diabetes, arthritis, and high blood pressure than white Americans more likely to die from cancer and heart disease 10.12 How do researchers explain ethnic group differences in health?

Health and Illness: Ethnic Group Differences in Health LO 10.12 These differences cannot be explained by socioeconomic factors alone. The differences may result from racial patterning. tendency of groups to maintain shared behavior patterns, such as diet 10.12 How do researchers explain ethnic group differences in health?

Lifestyle and Health: Smoking and Health LO 10.13 The number 1 cause of preventable diseases and deaths in US directly related to over 400,000 deaths each year Smoking related to: Heart disease, lung cancer, chronic bronchitis 10.13 How does smoking affect health?

Lifestyle and Health: Smoking and Health LO 10.13 Smoking related to: Low birth weight and retarded fetal development in babies born to smoking mothers Passive smoking is related to an increased risk of heart attack. 10.13 How does smoking affect health?

Lifestyle and Health: Alcohol Abuse LO 10.14 Excessive alcohol consumption can damage virtually every organ in the body. liver, stomach, heart, and brain CT scans show brain shrinkage in alcoholics. Shrinkage is apparent even when no cognitive loss is yet noticeable. 10.14 What are some health risks of alcohol abuse?

Lifestyle and Health: Alcohol Abuse LO 10.14 Compared to nonalcoholics, alcoholics: Are 3 times more likely to die in car accidents Are twice as likely to die of cancer Brain-imaging techniques and genetic predisposition for alcoholism Brains of alcoholics respond differently to visual and auditory stimuli than those of nonalcoholics. 10.14 What are some health risks of alcohol abuse?

Lifestyle and Health: Alcohol Abuse LO 10.14 Since the late 1950s, the American Medical Association has referred to alcoholism as a disease. 10.14 What are some health risks of alcohol abuse?

Table 10.1 Alcohol Poisoning

Lifestyle and Health: Sexually Transmitted Diseases LO 10.15 The incidence of STDs has greatly increased over the past 30 years. Greater sexual activity among young people More permissive attitudes toward sex Use of nonbarrier methods of contraception 10.15 What is the difference between bacterial and viral STDs?

Lifestyle and Health: Sexually Transmitted Diseases LO 10.15 Bacterial STDs Cured with antibiotics Transmitted through physical contact involving the genitals or intercourse Chlamydia, gonorrhea, syphilis Viral STDs Considered incurable Genital herpes, genital warts (human papilloma virus), HIV/AIDS 10.15 What is the difference between bacterial and viral STDs?

Sexually Transmitted Diseases: HIV/AIDS LO 10.15 Acquired Immune Deficiency Syndrome (AIDS) is caused by infection with the Human Immunodeficiency Virus (HIV). Two Major Advances in Treatment AZT can prevent the transmission of HIV from a pregnant woman to her fetus. Antiretroviral drugs have prevented millions of deaths by interfering with HIV's ability to invade healthy cells. 10.15 What is the difference between bacterial and viral STDs?

Figure 10.5 Milestones from the History of HIV/AIDS Source: Kaiser Family Foundation (2012); UNAIDS (2011).

Sexually Transmitted Diseases: HIV/AIDS LO 10.15 The number of new cases of HIV/AIDS in developing regions has leveled off. HIV is transmitted primarily through: Exchange of blood Semen Vaginal secretions during sexual contact IV (intravenous) drug users sharing contaminated needles or syringes 10.15 What is the difference between bacterial and viral STDs?

Sexually Transmitted Diseases: HIV/AIDS LO 10.15 Almost 1/3 of new HIV cases resulted from heterosexual contact. Circumcision reduces the risk of HIV transmission. Presence of another STD in an HIV-infected person causes higher levels of the communicable form of the virus in his or her bodily fluids. 10.15 What is the difference between bacterial and viral STDs?

Sexually Transmitted Diseases: HIV/AIDS LO 10.15 AIDS-Related Dementia The cortex of an AIDS victim gradually thins as the disease gains ground. 10.15 What is the difference between bacterial and viral STDs?

Figure 10.6 How HIV is Transmitted in AIDS Cases in the United States Source: Centers for Disease Control (CDC) (2012a). HIV surveillance -Epidemiology of HIV infection (through 2010). Retrieved January 7, 2013 from http://www.cdc.gov/hiv/topics/surveillance/resources/slides/general/index.htm 66

Lifestyle and Health: Diet and Exercise LO 10.16 Obesity increases the risk of chronic conditions. heart disease, high blood pressure, type 2 diabetes Insufficient amounts of particular nutrients contribute to health problems. anemia: iron deficiency 10.16 How do diet and exercise affect health?

Lifestyle and Health: Diet and Exercise LO 10.16 Regular Fast Food Consumption at risk for obesity and nutritional deficiencies Five a Day Plan Eat 5 servings of fruits and vegetables each day. 10.16 How do diet and exercise affect health?

Lifestyle and Health: Diet and Exercise LO 10.16 Exercise has both mental and physical benefits. More than 1/3 of Americans get no exercise at all. 10.16 How do diet and exercise affect health?

Lifestyle and Health: Diet and Exercise LO 10.16 Regular aerobic exercise has numerous health benefits. Improved mood Combats chronic diseases such as high blood pressure, diabetes, and osteoporosis Helps manage weight Boosts energy level 10.16 How do diet and exercise affect health?

Lifestyle and Health: Diet and Exercise LO 10.16 Regular aerobic exercise has numerous health benefits. Promotes better sleep Improves sexual intimacy Enhances enjoyment of life 10.16 How do diet and exercise affect health?

Lifestyle and Health: Diet and Exercise LO 10.16 Strength training has been found to reduce sarcopenia. age-related process: muscle deteriorates Strength training also reduces the loss of bone mass to osteoporosis. 10.16 How do diet and exercise affect health?

Alternative Medicine LO 10.17 Treatments or therapies not scientifically demonstrated to be effective Some are effective at preventing and treating illness. Pharmacological effects of alternative treatments may interfere with those drugs prescribed by physicians. 10.17 What are the benefits and risks associated with alternative medicine?

Alternative Medicine LO 10.17 Treatments or therapies not scientifically demonstrated to be effective Alternative treatments may cause delays in seeking conventional treatment. 10.17 What are the benefits and risks associated with alternative medicine?

Figure 10.7 Alternative Therapies In the United States, 38% of adults and 12% of children use one or more alternative treatments to treat or prevent disease. The “other” category includes acupuncture, biofeedback, guided imagery, progressive relaxation, hypnosis, Pilates, traditional healers, and a host of other treatments. Source: Barnes et al. (2007). 75

Table 10.2 Benefits of Lifestyle Changes 76