2. Stress and Illness – Overview What is the relationship between stress and illness? –Stress and changes in physiology –Stress and changes in behaviour Moderating factors: e.g., coping, social support, personality and control Stress: Portrait of a Killer, National Geo DVD

3. Stress and Illness – Key point If you repeatedly turn on the stress-response, or if you cannot appropriately turn off the stress-response at the end of a stressful event, the stress-response can eventually become as damaging as some stressors themselves. A large percentage of stress-related diseases are disorders of excessive stress-response. Robert Sapolsky – Why Zebras Don’t Get Ulcers

4. Psychophysiological model of the stress response

5. Fig. 1. Negative emotionality in children with one of two brain-derived neurotrophic factor (BDNF) genotypes—valine (val) homozygous or at least one methionine (met) allele—as a function of the presence or absence of parental depression (n = 400). Hayden E P et al. Psychological Science 2010;0956797610385357 Copyright © by Association for Psychological Science

6. Fig. 2. Negative emotionality in children with one of two brain-derived neurotrophic factor (BDNF) genotypes—valine (val) homozygous or at least one methionine (met) allele—as a function of the presence or absence of parental discord (n = 332). Hayden E P et al. Psychological Science 2010;0956797610385357 Copyright © by Association for Psychological Science

7. Psychophysiological model of the stress response

8. This acute response is not typically problematic. Chronically, however, it’s a different story…

9. Health Consequences of Chronic Stress SAM   BP, HR, epi) HPA  immuno- suppression

10. Coronary Heart Disease and Stress Rates of CHD is higher in those with high stress jobs. Why? –BP chronically elevated (wear and tear!) –Epi  circulating platelets clump together –Atherosclerosis (plaques) Kaplan’s research with monkeys (re: social stress & unstable hierarchy -- low control)

11. Research study: “Overload in Working Mothers” BCBS workers Measures: –Urine samples (to look for metabolites of stress hormones) –Daily mood scale Results: feel stressed (esp w/ children at home) – High stress (low perceived control + high demand) – increased urinary neurohormones

12. Immunity and Stress T cell

13. Immune System Overview

14. Psychoneuroimmunology (PNI) Subfield of health psychology that emphasizes the interaction of psychological, neuroendocrine, and immunological processes in stress and illness

15. PNI: From stressor to illness We differ as to the pattern and frequency of stressors to which we are exposed These variations determine the magnitude and frequency with which we turn on the stress- response The magnitude and frequency of the stress response regulate immune competence (e.g., via glucocorticoids) Level of immune competence determines susceptibility to disease

16. PNI Studies Immunosuppression has been linked to divorce, bereavement, unemployment, exam periods, occupational stress, and stressful bouts of exercise –e.g., Life stress and exposure to cold viruses Wound studies (Kiecolt-Glaser) Animal studies show that tumor cells grow more rapidly in animals exposed to electric shock, loud noise, or other stressors

17. Sapolsky’s baboons High and Low Social Status –High cortisol is associated with low social status (instability and less controllability) –Low status – Fewer lymphocytes and weak immune system

18. Sapolsky’s baboons Studies with dominant male baboons suggest that attitude (“personality”) is a more important mediator of physiology than rank alone (i.e., just being alpha male isn’t necessarily good, if one is high-strung about it…)

19. Moderators of the stress-illness relationship Perception / Appraisal Personality Social Support Control Coping skills How do these relate to you? What gets you “stressed” and why?

20. Moderators of the stress-illness relationship: Perception Many situations are not inherently stressful… depends on appraisal: Primary appraisal — determination of an event’s meaning Secondary appraisal — evaluation of one’s ability to meet the demands of a challenging event Cognitive appraisals are extremely susceptible to one’s current state of mood, health, motivation

21. “I have had a great many troubles in my life… And most never happened…” Mark Twain Perception and stress

22. Increasing social support Time management Emotion-focused coping or problem-focused coping Reducing the impact of the stress reaction Etc… Developing Coping Skills