1. 1 PSYCHOLOGY (8th Edition) David Myers PowerPoint Slides Aneeq Ahmad Henderson State University Worth Publishers, © 2006

2. 2 Stress and Health Chapter 14

3. 3 Stress and Health Stress and Illness  Stress and Stressors  Stress and the Heart  Stress and the Susceptibility to Disease Promoting Health  Coping with Stress

4. 4 Stress and Health Promoting Health  Managing Stress  Modifying Illness-Related Behaviors  Thinking Critically About: Alternative Medicine – New Ways to Health, or Cold Snake Oil

5. 5 WHAT’S ON YOUR PLATE? Are you stressed out? How does your stress level vary – Throughout the day? Throughout the week? Throughout the school year?

6. 6 Stress Psychological states cause physical illness. Stress is any circumstance (real or perceived) that threatens a person’s well-being. When we feel severe stress, our ability to cope with it is impaired. Lee Stone/ Corbis

7. 7 Stress and Causes of Death Prolonged stress combined with unhealthy behaviors may increase our risk for one of today's four leading diseases.

8. 8 Behavioral Medicine Centers for Disease Control (CDC) claim that half of the deaths in the US are due to people’s behaviors (smoking, alcoholism, unprotected sex, insufficient exercise, drugs, and poor nutrition). Psychologists and physicians have thus developed an interdisciplinary field of behavioral medicine that integrates behavioral knowledge with medical knowledge.

9. 9 Health Psychology Health psychology is a field of psychology that contributes to behavioral medicine. The field studies stress-related aspects of disease and asks the following questions: 1.How do emotions and personality factors influence the risk of disease? 2.What attitudes and behaviors prevent illness and promote health and well-being? 3.How do our perceptions determine stress? 4.How can we reduce or control stress?

10. 10 Stress can be adaptive. In a fearful or stress- causing situation, we can run away and save our lives. Stress can be maladaptive. If it is prolonged (chronic stress), it increases our risk of illness and health problems. Stress and Illness

11. 11 Stress and Stressors Stress is a slippery concept. At times it is the stimulus (missing an appointment) and at other times it is a response (sweating while taking a test).

12. 12 Stress and Stressors Stress is not merely a stimulus or a response. It is a process by which we appraise and cope with environmental threats and challenges. When short-lived or taken as a challenge, stressors may have positive effects. However, if stress is threatening or prolonged, it can be harmful. Bob Daemmrich/ The Image Works

13. 13 The Stress Response System: A Dual Track System Walter Cannon saw stress responses as part of a unified mind-body system Cold, lack of oxygen as well as emotion-arousing incidents all trigger stress response. The first track is the sympathetic branch of the nervous system responding. SAM System for Alarm (Sympatho-adreno-medullary)

14. 14 The Stress Response System Canon proposed that the stress response (fast) was a fight-or- flight response marked by the outpouring of epinephrine and norepinephrine from the inner adrenal glands, increasing heart and respiration rates, mobilizing sugar and fat, and dulling pain.

15. Adrenal Glands Adrenal glands consist of the adrenal medulla and the cortex. The medulla secretes hormones (epinephrine and norepinephrine) during stressful and emotional situations, while the adrenal cortex regulates salt and carbohydrate metabolism.

16. 16 SAM SYSTEM Sympathetic branch of ANS Inner partInner part of adrenal gland Epinephrine and norepinephrines (catecholamines) (by adrenal grands) Activation of other organs (Sympath. N.C.) Physical changes needed to cope with stressors

17. 17 The Stress Response System The second trackThe second track is initiated in the cerebral cortex. (HPA System for Resistance) The cerebral cortex, by way of the hypothalamus and pituitary gland directs the second response.

18. 18 The Stress Response System The hypothalamus and the pituitary gland also respond to stress (slow) by triggering the outer adrenal glands to secrete glucocorticoids (cortisol).

19. 19 HPA SYSTEM Hypothalamus Pituitary gland Hormones such as ACTH Outer part of Adrenal gland Glucocorticoid stress hormones such as cortisol (FYI: scrape arteries) Releases the body’s energy supplies and fights inflammation

20. 20 General Adaptation Syndrome According to Hans Selye, a stress response to any kind of stimulation is similar. The stressed individual goes through three phases. EPA/ Yuri Kochetkov/ Landov

21. 21 GENERAL ADAPTATION SYNDROME (GAS) Alarm = heart rate, blood to muscles, faintness of shock Resistance = temperature, blood pressure, respiration high, outpouring of hormones Exhaustion = vulnerable to illness, in extreme cases collapse and death

22. 22 GENERAL ADAPTION SYNDROME (GAS) BASIC POINT: Prolonged stress can produce physical deterioration Examples: –Shortening of telomeres (DNA/aging) in women caring for children with serious illnesses –Shrunken hippocampus - abused children, combat soldiers

23. 23 GENERAL ADAPTATION SYNDROME (GAS) ESSENTIAL POINTS: –All life events cause some stress –Stress is not bad per se, but excessive or unnecessary stress should be avoided –Stress should be monitored through a battery of parameters not just a biochemical or behavioral approach

24. 24 WRITING ACTIVITY You have selected the college of your choice and been admitted. Unfortunately your father just lost his job and your mother is worried about being laid off. There are no family savings to pay for your college education. Describe what may happen to you physically over the next few months as you deal with this major stressor. Include the Dual Track System and GAS.

25. 25 Stressful Life Events Catastrophic Events: Catastrophic events like earthquakes, combat stress, and floods lead individuals to become depressed, sleepless, and anxious.

26. 26 Significant Life Changes The death of a loved one, a divorce, a loss of job, or a promotion may leave individuals vulnerable to disease.

27. 27 SIGNIFICANT LIFE CHANGES ACTIVITY Read the Social Readjustment Rating Scale (SRRS) Develop a Teenage Social Readjustment Scale. Select twenty events and assign LCU’s to them Compare your list with another group. How do the lists differ? How did the other group justify their rankings?

28. 28 Daily Hassles Rush hour traffic, long lines, job stress, and becoming burnt-out are the most significant sources of stress and can damage health Hypertension among residents of urban ghettos is high. What are some of the daily hassles of attending NPHS?

29. 29 Stress and the Heart Stress that leads to elevated blood pressure (hypertension) may result in Coronary Heart Disease(CHD), a clogging of the vessels that nourish the heart muscle. Plaque in coronary artery Artery clogged

30. 30 CHECKLIST - ANSWER YES OR NO 1 Do you find it difficult to restrain yourself from hurrying others’ speech (finishing their sentences for them)? 2 Do you often try to do more than one thing at a time (such as eat and read simultaneously)? 3 Do you often feel guilty if you use extra time to relax? 4 Do you tend to get involved in a great number of projects at once? 5 Do you find yourself racing through yellow lights when you drive?

31. 31 Continue with Survey 6 Do you need to win in order to derive enjoyment from games and sports? 7 Do you generally move, walk, and eat rapidly? 8 Do you agree to take on too many responsibilities? 9 Do you detest waiting in lines? 10 Do you have an intense desire to better your position in life and impress others?

32. 32 Personality Types Type A is a term used for competitive, hard- driving, impatient, verbally aggressive, and anger-prone people. Type B refers to easygoing, relaxed people (Friedman and Rosenman, 1974). Type A personalities are more likely to develop coronary heart disease. Cynical hostility seems to be key ingredient of this effect.

33. 33 Type A vs Type B When harassed, given a challenge, or threatened with a loss of control: –Type A’s: more physiologically reactive (hormonal secretions, pulse rate, blood pressure soar) –Type B’s: remain calm

34. 34 Pessimism and Heart Disease Pessimistic adult men are twice as likely to develop heart disease over a 10-year period (Kubzansky et al., 2001).

35. 35 Stress & Susceptibility to Disease A psychophysical illness is any stress-related physical illness such as hypertension or headaches. Hypochondriasis is a misinterpretation of normal physical sensations as symptoms of disease.

36. 36 PSYCHONEUROIMMUNOLOGY The interaction between psychology and physiology that affects body’s ability to defend against illness. Stressors can impair the immune system and cardiovascular system Immune system plays a critical role in autoimmune diseases and chronic diseases

37. 37 Stress and the Immune System: Types of Leukocytes B lymphocytes (in bone marrow) fight bacterial infections, T lymphocytes (from thymus) attack cancer cells and viruses, and microphages ingest foreign substances. Natural Killer Cells function as anitviral, antitumor agents. During stress, energy is mobilized away from the immune system making it vulnerable. Lennart Nilsson/ Boehringer Ingelhein International GmbH

38. 38 Stress and Colds People with the highest life stress scores were also the most vulnerable when exposed to an experimental cold virus.

39. 39 Stress and AIDS Stress and negative emotions may accelerate the progression from human immunodeficiency virus (HIV) to acquired immune deficiency syndrome (AIDS). UNAIDS/ G. Pirozzi

40. 40 Stress and Cancer Stress does not create cancer cells. Researchers disagree on whether stress influences the progression of cancer. However, they do agree that avoiding stress and having a hopeful attitude cannot reverse advanced cancer.

41. 41 Stress and Immune Conditioning If the immune system can be suppressed through conditioning, researchers believe that immune- enhancing responses can be inculcated to combat viral diseases.

42. 42 Health-Related Consequences Stress can have a variety of health-related consequences. Kathleen Finlay/ Masterfile

43. 43 Promoting Health Promoting health is generally defined as the absence of disease. We only think of health when we are diseased. However, health psychologists say that promoting health begins by preventing illness and enhancing well-being, which is a constant endeavor.

44. 44 Coping with Stress Reducing stress by changing events that cause stress or by changing how we react to stress is called problem-focused coping. Emotion-focused coping is when we cannot change a stressful situation, and we respond by attending to our own emotional needs.

45. 45 0 = strongly disagree; 1= mildly disagree; 3= strongly agree 1. Trying my best at school makes a difference. 2. Trusting to fate is sometimes all I can do in a relationship. 3. I often wake up eager to start on the day’s projects. 4. Thinking of myself as a free person leads to great frustration and difficulty. 5. I would be willing to sacrifice financial security in my future career if something really challenging came along. 6. It bothers me when I have to deviate from the routine or schedule I’ve set for myself.

46. 46 INVENTORY 7. An average citizen can have an impact on politics. 8. Without the right breaks, it is hard to be successful in life. 9. I know why I am doing what I’m doing at school. 10. Getting close to people puts me at risk of being obligated to them. 11. Encountering new situations is an important priority in my life. 12. I really don’t mind when I have nothing to do.

47. 47 SCORING Control score (#1 + #7) – (#2 + #8) = ___ Commitment Score (#3 + #9) – (#4 + #10) = ___ Challenge Score (#5 + #11) – (#6 + #12) = ___ Total Hardiness Score = Add all three –Hardy = 10 – 18 –Moderate hardiness = 0 – 9 –Low Hardiness = below 0

48. 48 HARDINESS The inventory was a scale for hardiness. How do you interpret the results?

49. 49 Perceived Control Research with rats and humans indicates that the absence of control over stressors is a predictor of health problems.

50. 50 SCENARIO John A. Grind is a freshman majoring in Physics at Cutthroat U. John was admitted to prestigious Cutthroat based on his outstanding high school academic record and extensive list of school related activities. To defray the $45,000 a year it costs to stay at Cutthroat, John holds down a job at the university library and maintains a 3.5 average which his merit scholarship is dependent upon. His current schedule is rigorous yet considering his ability and future career goals not unreasonable.

51. 51 SCENARIO CONTINUED Assume you are John’s counselor. He has come to you for help in dealing with the stress brought on by the recent changes in his life. You know that John has in the past exhibited Type A personality traits. You make note of John’s strained facial expressions, shaky voice, and the slight tremor in his hands.

52. 52 COPING WITH STRESS ACTIVITY 1. Explain why John might be having trouble dealing with the stress in his life. Include in your answer: Perceived control Explanatory style Social support 2.Develop a plan for John to manage his stress. Include in your answer: Aerobic exercise Biofeedback, relaxation, and meditation Spirituality and faith communities. Include a rationale for each of your recommendations.

53. 53 COPING WITH STRESS ALTERNATIVE ASSIGNMENT: –Develop a public service ad (visual or commercial) that deals with how to cope with stress. Include the same points as listed in the previous slide.

54. 54 ESSAY Essay will deal with pages 549 – 575. Special emphasis will be given to: –Dual track system –Selye’s GAS –Immune system Other areas will be necessary to support the above.

55. 55 Explanatory Style People with an optimistic (instead of pessimistic) explanatory style tend to have more control over stressors, cope better with stressful events, have better moods, and have a stronger immune system.

56. 56 Social Support Supportive family members, marriage partners, and close friends help people cope with stress. Their immune functioning calms the cardiovascular system and lowers blood pressure. Bob Daemmrich/ Stock, Boston

57. 57 Managing Stress Having a sense of control, an optimistic explanatory style, and social support can reduce stress and improve health.

58. 58 Aerobic Exercise Can aerobic exercise boost spirits? Many studies suggest that aerobic exercise can elevate mood and well- being because aerobic exercise raises energy, increases self- confidence, and lowers tension, depression, and anxiety.

59. 59 Biofeedback, Relaxation, and Meditation Biofeedback systems use electronic devices to inform people about their physiological responses and gives them the chance to bring their response to a healthier range. Relaxation and meditation have similar effects in reducing tension and anxiety.

60. 60 Life-Style Modifying a Type-A lifestyle may reduce the recurrence of heart attacks. Ghislain and Marie David De Lossy/ Getty Images

61. 61 Spirituality & Faith Communities Regular religious attendance has been a reliable predictor of a longer life span with a reduced risk of dying.

62. 62 Intervening Factors Investigators suggest there are three factors that connect religious involvement and better health.

63. 63 Managing Stress: Summary How can stress be managed?

64. 64 Modifying Illness-Related Behaviors The elimination of smoking would increase life expectancy more than any other preventive measure.

65. 65 Why Do People Smoke? 1.People smoke because it is socially rewarding. 2.Smoking is also a result of genetic factors. Russel Einhorn/ The Gamma Liason Network

66. 66 Why Do People Smoke? 3.Nicotine takes away unpleasant cravings (negative reinforcement) by triggering epinephrine, norepinephrine, dopamine, and endorphins. 4.Nicotine itself is rewarding (positive reinforcement).

67. 67 Biopsychosocial Factors: Smoking

68. 68 Helping Smokers Quit Smoking decreased in Western countries, especially in higher socioeconomic groups and more educated groups.

69. 69 Ways to Quit Smoking 1.Set a quit date. 2.Inform family and friends. 3.Throw away all cigarettes. 4.Review successful strategies. 5.Use a nicotine patch or gum. 6.Abstain from alcohol. 7.Exercise. Here are a few pointers on how to quit smoking:

70. 70 Smoking Abstinence Programs Smoking abstinence programs for teens provide: 1.Information about the effects of smoking 2.Information about peer, parent & media influence 3.Ways to refuse cigarettes

71. 71 Do Programs Work? Prevention programs do have an effect on smoking. Paul J. Milette/ Palm Beach Post

72. 72 Obesity and Weight Control Fat is an ideal form of stored energy and is readily available. In times of famine, an overweight body was a sign of affluence.

73. 73 Body Mass Index (BMI) Obesity in children increases their risk of diabetes, high blood pressure, heart disease, gallstones, arthritis, and certain types of cancer, thus shortening their life- expectancy.

74. 74 Obesity and Mortality The death rate is high among very overweight men.

75. 75 Social Effects of Obesity When women applicants were made to look overweight, subjects were less willing to hire them.

76. 76 Physiology of Obesity Fat Cells: There are 30-40 million fat cells in the body. These cells can increase in size or increase in number (75 million) in an obese individual (Sjöstrum, 1980).

77. 77 Set Points and Metabolism When reduced from 3,500 calories to 450 calories, weight loss was a minimal 6% and the metabolic rate a mere 15%. The obese defend their weight by conserving energy.

78. 78 The Genetic Factor Identical twin studies reveal that body weight has a genetic basis. The obese mouse on the left has a defective gene for the hormone leptin. The mouse on the right sheds 40% of its weight when injected with leptin. Courtesy of John Soltis, The Rockefeller University, New York, NY

79. 79 Activity Lack of exercise is a major contributor to obesity. Just watching TV for two hours resulted in a 23% increase of weight when other factors were controlled (Hu et al., 2003).

80. 80 Food Consumption Over the past 40 years average weight gain has increased. Health professionals are pleading with US citizens to limit their food intake.

81. 81 Trading Risks Although cigarette smoking has declined over the years in the Americas, obesity is on the rise.

82. 82 Losing Weight In the US, two-thirds of the women and half of the men say that they want to lose weight. The majority of them lose money on diet programs.

83. 83 Plan to Lose Weight When you are motivated to lose weight, begin a weight-loss program, minimize your exposure to tempting foods, exercise, and forgive yourself for lapses. Joe R. Liuzzo

84. 84 Alternative Medicine Other medicinal ways of achieving health