Modules 38 & 39 Health and Stress

Health Psychology – studies how biological, psychological and social factors influence health, illness and treatment. Biopsychosocial Model

Health Psychology Understand the relationship between Mind and Body - Educate people about health risks. Design programs to reduce health risks and promote healthy behaviors.

Epidemiological Studies - large number of people - Patterns (correlations) between lifestyle and health outcomes - look for risk factors of disease.

Top 5 causes of Death are related to Lifestyle choices

Stressors: Events or situations that are perceived as harmful, threatening, or challenging and thus trigger stress response. Stress –play role in 50% to 70 % of all physical illness. Stress is a Reaction to a Stressor.

Is all stress bad. No. Neurological/physical response to threats Is all stress bad? No. Neurological/physical response to threats. Motivation

Catastrophes: followed by increased rates of psychological disorders such as depression and anxiety that can be long-lasting.   Attempts at quantifying the impact of stressors have proven difficult because of the very fact that different people appraise stressors in different ways, and have varying levels of resources with which to respond to the stressor. Stressors can also be interrelated. For example, the daily hassle commuting is likely more stressful to someone of a low socioeconomic status who can’t afford to be late for work and must take public transportation than someone who has flexible hours. Some events, like catastrophes, are more universally appraised as threatening and challenging. Even some significant life changes, including positive ones such as marriage, appear to have some stress-related negative health effects for many people. “Stress on the Job” video starts automatically on the next slide.

Not all Stressors are negative experiences significant life events/changes Not all Stressors are negative experiences   Attempts at quantifying the impact of stressors have proven difficult because of the very fact that different people appraise stressors in different ways, and have varying levels of resources with which to respond to the stressor. Stressors can also be interrelated. For example, the daily hassle commuting is likely more stressful to someone of a low socioeconomic status who can’t afford to be late for work and must take public transportation than someone who has flexible hours. Some events, like catastrophes, are more universally appraised as threatening and challenging. Even some significant life changes, including positive ones such as marriage, appear to have some stress-related negative health effects for many people. “Stress on the Job” video starts automatically on the next slide. APA Learning Goal 1: Knowledge Base of Psychology

Measuring Stress Social Readjustment Scale - any change, whether negative or positive is inherently stress producing. not a good predictor of poor physical or mental health. does not take into account subjective appraisal of the event ability to cope Assumes event is the same for everyone

Instead of asking about events we can ask about experiencing Stress

Daily Hassles Scale better predictor of physical symptoms and psychological distress. Social/cultural Stressors: poverty, low social status, discrimination

Conflict as a source of Stress Approach-Approach conflict – win/win easily resolved and not too stressful Avoidance-Avoidance people often to delay, thus avoiding either. Approach-Avoidance Vacillation People feel stuck and experience Stress and anxiety.

Physiological Stress Response Triggered whenever your mind determines that you are under threat. Response is the same regardless of the type of stress!

Fight-or-flight response (Cannon)—rapidly occurring chain of internal physical reactions that prepare people to either fight or take flight from an immediate threat - activates Sympathetic Nervous System (SNS)  Heart rate, BP, release of epinephrine, adrenaline, and endorphins.  Digestion Increases general arousal level and reduces concentration.

Glucocortical Stress Hormones Glucocorticoids, Catecholamines, etc.. Muscle: Net loss of amino Acids (glucose) Liver: Fat Cells: Heart rate: Increased Immune system: Stress Posterior Pituitary Gland Hypothalamus Anterior (-) CRH ACTH Adrenals Kidney

Stress and The Adrenal Glands

Catecholamine epinephrine and norepinephrine Short term elevation (20 to 60 mins) Triggers fight or flight response Glucocorticoids Reduced inflammation and enhance tone of circulatory system. In long run they weaken important systems, lower immunity and lead to illness. Prolonged stress also linked to depression & other psychological symptoms.

General Adaptation Syndrome (GAS) Stage 1. Alarm - SNS response. - good for short term stressors, but when prolonged . . . Stage 2. Resistance - prolonged period of moderate arousal - continued high levels of hormones that elevate blood sugars -- increase metabolism - increase immune response

- prolonged metabolic increase decreases immune response. Stage 3. Exhaustion - prolonged metabolic increase decreases immune response. Immune Response Alarm Resistance Exhaustion

Student Syndrome – students more likely to get sick after exam period. Burnout - psychological, physical and behavioral dysfunction in response to continuous, chronic stress.

Telomeres Shortening of Telomeres normally occurs with age. Stress appears to increase the rate of shortening! Stress does age people. Presidents actually tend to live pretty long: WHY? Access to superior medical care, good education, and it takes an inherently healthy person to endure the rigors of a presidential campaign and administration.

Stress and Illness Psychosomatic illness Psychophysiological Illness Psychoneuroimmunology (Mind/Body) SNS is a direct link between CNS and the physical systems of the body.

Stress and the Immune System Lymphocytes – white blood cells that fight viruses and bacteria Lymphocytes have receptors for neurotransmitters and hormones AND they also produce these chemical messengers.

Problems develop when the immune system is either underactive or overactive. Underactive - does not protect against disease. Overactive – Immune system may attack one’s own body tissue. Arthritis Allergies Autoimmune disorders

Woman have stronger immune systems than men Woman have stronger immune systems than men. Also more susceptible to autoimmune disorders!

Personality, Stress and Illness Type A - competitive, workaholic, impatient, quick to anger. Type B - less competitive, easy-going, less hostile Cynical Hostility is the most predictive Type A behavior for Heart Disease.

Type A individuals are more susceptible to negative effects of stress, including vulnerability to heart disease, with anger and hostility being primary factors. Low Hostility High Hostility

How Do You Deal with Stress?

Components of Stress Reactions Stressors Personality Cognitive Appraisal Physical Response

Stress Coping Techniques 1) Assess Stressors - reduce those you do not need. 2) Cognitive Appraisal - Sense of Control - Predictability - plan to cope - time management

3) Work on your reaction to Stress Optimism!! Positive outlook Explanatory Style Explain failures as external (situational), unstable (temporary) and specific. Hardy Personality - commitment to activities - see their activities as worthwhile - see potential stressors as a challenge - sense of control

4) Social Support 5) Journal Writing

Blunting Strategies Exercise Distraction Relaxation

6) Aerobic Exercise! Moderate exercise adds two years to your life! Text lists many benefits – but misses one. That physical exertion often tricks the SNS into thinking that the threat is over -- Turns off fight or flight response!

7) Distraction Taking one’s mind off problems can help when the stressor involves a waiting period (i.e., did I get the job) but if it is distracting for coping with the stress, it can make it worse!

The SNS is part of the autonomic system. We do not have voluntary control over it. We do however have indirect control. Components of Relaxation Control of Breathing - changes SNS response

Imagery – Nervous system responds to imagery the same way it does to reality. Calming thoughts and images activate PNS turning off Fight or flight (SNS) response. Progressive Relaxation - systematic tensing and relaxing of muscle groups