Emotion, learning and health Preston Lodge High School 26 th October

20 th century trends in life expectancy in Scotland and 16 other Western European countries Males Year of birth Life expectancy in years Scotland

Its all about the brain

All shapes and sizes!

Aaron Antonovsky

.....expresses the extent to which one has a feeling of confidence that the stimuli deriving from one's internal and external environments in the course of living are structured, predictable and explicable, that one has the internal resources to meet the demands posed by these stimuli and, finally, that these demands are seen as challenges, worthy of investment and engagement." Sense of coherence....

For the creation of health the social and physical environment must be: u Comprehensible u Manageable u Meaningful

STRESS AND GRADE OF EMPLOYMENT: MEN Salivary Cortisol Time of Day Steptoe et al. 2003, Psychosomatic Medicine, 65,

20 th century trends in life expectancy in Scotland and 16 other Western European countries Males Year of birth Life expectancy in years Scotland

Attachment theory Infants develop the attachment behaviours that optimally enhance their survival in their own characteristic environments. Crittenden, 2000

Attachment theory u Ainsworth –Deep emotional connection that infant develops with primary caregiver –Reflects an internal working modelexpressing the infants expectations of parental behaviour in meaningful situations –Basis for development of later relationships u Increasingly recognised as determinant of later emotional, cognitive and social outcomes

Serve and return The instruction to attend to the primary caregiver is genetic, the outcome depends on what happens Balbernie, 2001

Engaged to respond to danger Disengaged... Who needs to bother about differential calculus?

Environmental determinants of inflammatory status CRP (median) mg/dl affluent deprived

P<0.001 P=0.03 Quartile of hs-CRP (Range, mg/dL) P Trend < – – – – Relative Risk of MI Ridker. N Engl J Med. 1997;336:973– hs-CRP and Risk of Future MI in Apparently Healthy Men

Inflammation in plaques Inflammatory cells MMPs, IL-6, IL-15, IL-18, CRP Lumen Core Cap Thin Fibrous Cap InflammatoryCells SMCapoptosis Degradedmatrix Unstable cytokinesMMP

Q1 : <0.66 mg/l Q5: > 4.18 mg/l Years in study % diabetic CRP and cumulative risk of type 2 diabetes Freeman et al. Diabetes 2002,51;1596

Adipocyte programming insulin resistance, inflammation and ALP Adipose stores NEFAs liver CRP SAA IL-6/IL-6sR TNF- TNF- sR-I triglyceride Low HDL small LDL Atherogenic Lipoprotein Phenotype Pro-inflammatory state skeletal muscle Insulin resistance

The Stroop Test a test of response inhibition Say the colour names of the shapes Say the word names Say the names of the colours that the words are printed in ShapesWords

pSoBid: Stroop test p<0.001 Age (years) Colour-word score

pSoBid: Verbal Learning p<0.001 Age (years) Word recall

The Trails Test: a test of executive function Trails ATrails B

pSoBid: Trails B p<0.001 Age (years) Seconds

pSoBid: Choice reaction time p<0.001 milliseconds Age (years)

pSoBid: psychological state All p<0.001 GHQ = General Health Questionnaire; SoC = Sense of Coherence; RSE = Rosenberg Self-Esteem Scale; BHS = Beck Hopelessness Scale; GSE = Generalised Self-Efficacy Scale

The Dunedin cohort u 1000 children recruited in late 1972/3 u At age 3, at risk children identified on the basis of chaotic circumstances, emotional behaviour, negativity and poor attentiveness u As adults, those at risk were more likely to : –be unemployed –have criminal convictions (especially for violence) –been pregnant as a teenager –have a substance abuse problem –exhibit signs of insulin resistance and metabolic syndrome

Opportunity to escape poverty, decent housing, social networks, self esteem and sense of control Consistent parenting, safe, nurturing early years, supportive education Health related behaviours

Opportunity to escape poverty, decent housing, social networks, self esteem and sense of control Consistent parenting, safe, nurturing early years, supportive education Health related behaviours Comprehensible Manageable Meaningful

How many new neurons? >9,000 per day – 250,000 per month in the young adult rat (Cameron & McKay, 2001)

Adult neurogenesis in the hippocampus ?

20 th century trends in life expectancy in Scotland and 16 other Western European countries Males Year of birth Life expectancy in years Scotland

Fit or fat?