Stress and Health Chapter 14 James A. McCubbin, PhD Clemson University Modified by Pamela Hammond Brantley 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 Health Psychology 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 Appraisal Response Stressful event (tough math test) Threat (“Yikes! This is beyond me!”) Challenge (“I’ve got to apply all I know”) Panic, freeze up Aroused, focused Appraisal Response

Pituitary hormone in the bloodstream stimulates the outer part of the adrenal gland to release the stress hormone cortisol Sympathetic nervous system releases the stress hormones epinephrine and norepinephrine from nerve endings in the inner part of the adrenal glands Thalamus Hypothalamus Pituitary gland Adrenal glands Cerebral cortex (perceives stressor)

Stress and Illness General Adaptation Syndrome resistance Phase 1 Alarm reaction (mobilize resources) Phase 2 Resistance (cope with stressor) Phase 3 Exhaustion (reserves depleted) The body’s resistance to stress can last only so long before exhaustion sets in Stressor occurs General Adaptation Syndrome Selye’s concept of the body’s adaptive response to stress in three stages

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 Life Changes Daily Hassles 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 Type B 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 Disease clogging of the vessels that nourish the heart muscle leading cause of death in many developed countries

Stress and the Heart Hopelessness scores Heart attack Death 3.5 3 2.5 1.5 1 0.5 Heart attack Death Low risk Moderate risk High risk Men who feel extreme hopelessness are at greater risk for heart attacks and 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 and the Immune System 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

poor nutrition and sleep) 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 stressors and negative emotions Release of stress hormones Heart disease Immune suppression Autonomic nervous system 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

Life-style modification patients Promoting Health Modifying Type A life-style can reduce recurrence of heart attacks Percentage of patients with recurrent heart attacks (cumulative average) 6 5 4 3 2 1 Year 1978 1979 1980 1981 1982 Life-style modification patients Control patients Modifying life-style reduced recurrent

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 Percentage 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 Percentage with high support

Promoting Health Aerobic Exercise Depression score 14 13 12 11 10 9 8 7 6 5 4 3 Before treatment evaluation After treatment No-treatment group Aerobic exercise Relaxation treatment Aerobic Exercise sustained exercise that increases heart and lung fitness

Promoting Health Biofeedback system for electronically recording, amplifying, and feeding back information regarding a subtle physiological state blood pressure muscle tension

Level of social support Life events Tendency toward Health Illness Personal appraisal Challenge Threat Personality type Easy going Non depressed Optimistic Hostile Depressed Pessimistic Personality habits Nonsmoking Regular exercise Good nutrition Smoking Sedentary Poor nutrition Level of social support Close, enduring Lacking

Promoting Health Predictors of mortality 1 0.8 Relative 0.6 risk 0.4 0.2 Men Women Not smoking Regular exercise Weekly religious attendance Relative risk of dying

Promoting Health Religious Attendance

Promoting Health The religion factor is multidimensional Religious involvement Healthy behaviors (less smoking, drinking) Social support (faith communities, marriage) Positive emotions (less stress, anxiety) Better health (less immune system suppression, 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

Subfields of Alternative Medicine Alternative systems of medical practice Bioelectromagnetic applications Diet, nutrition, life-style changes Herbal medicine Manual healing Mind-body control Pharmacological and biological treatments Subfields of Alternative Medicine Health care ranging from self-care according to folk principles, to care rendered in an organized health care system based on alternative 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 traditions for pharmacological use Using touch and manipulation with the hands as a diagnostic and 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