1. 10
Health and Stress

2. 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

3. 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? How do psychological factors influence cancer patients' quality of life? How do males and females differ with regard to health? 3

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

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

6. 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?

7. 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?

8. 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?

9. 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?

10. 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?

11. 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?

12. 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?

13. 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?

14. 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?

15. Figure 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).

16. 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?

17. 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?

18. 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?

19. 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?

20. 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?

21. 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?

22. Figure 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.

23. 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?

24. 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?

25. 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?

26. 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?

27. 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?

28. 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?

29. 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?

30. Figure 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).

31. 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?

32. 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?

33. Figure 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).

34. Theories of Stress Responses34

35. 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?

36. 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?

37. 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?

38. 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?

39. 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?

40. 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?

41. Factors That Promote Resilience41

42. 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?

43. 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?

44. 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?

45. 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?

46. 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?

47. 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?

48. 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?

49. 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?

50. 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?

51. 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?

52. 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?

53. 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?

54. 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?

55. 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?

56. 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?

57. 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?

58. Table 10.1 Alcohol Poisoning

59. 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?

60. 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?

61. 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?

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

63. 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?

64. 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?

65. 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?

66. 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 66

67. 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?

68. 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?

69. 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?

70. 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?

71. 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?

72. 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?

73. 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?

74. 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?

75. Figure 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

76. Table 10.2 Benefits of Lifestyle Changes76