1. Myers’ PSYCHOLOGY (7th Ed) Chapter 14 Stress and Health James A. McCubbin, PhD Clemson University Worth Publishers

2. Stress & Health  Behavioral Medicine  interdisciplinary field that integrates behavioral & med. knowledge & applies that knowledge to health & disease  Health Psychology  subfield of psych. that provides psychology’s contribution to behavioral medicine  Stress  process by which we perceive & respond to certain events, called stressors, we decide are threatening or challenging

3. Stress & Illness  Leading causes of death in the US in 1900 & 2000

4. Stress Appraisal: Test anxiety Stressful event (tough math test) Threat (“Yikes! This is beyond me!”) Challenge (“I’ve got to apply all I know”) Panic, freeze up Aroused, focused Appraisal Response

5. Stress process…  Cerebral cortex: (perceives stressor) then to  thalamus  hypothalamus + pituitary  Pituitary hormone: in the bloodstream stimulates outer part of the adrenal gland to release the stress hormone cortisol  Sympathetic NS: releases stress hormone epinephrine & norepinephrine from nerve endings in the inner part of the adrenal glands

6. Pituitary hormone in the bloodstream stimulates outer part of adrenal Gland..releases the stress hormone cortisol Sympathetic NS releases stress hormones epinephrine & norepinephrine from inner part of the adrenal glands Thalamus Hypothalamus Pituitary gland Adrenal glands Cerebral cortex (perceives stressor )

7. Stress & Illness  General Adaptation Syndrome  Selye’s idea of the body’s adaptive response to stress in 3 stages: 1.Alarm 2.Resistance 3.Exhaustion Stress resistance Phase 1 Alarm reaction (mobilize resources) Phase 2 Resistance (cope w/ stressor) Phase 3 Exhaustion (reserves depleted) The body’s resistance to stress can last only so long before exhaustion sets in Stressor occurs

8. Causes or triggers of stress? Stressful life events Perceived loss of control Age Biological/physiological traits Personality traits: a) Pessimistic b) Quick to anger c) Obsessive and/or perfectionist d) High risk

9. Stressful Life Events:  Catastrophic Events Ex’s:  Earthquakes  combat stress  floods  Life Changes Ex’s:  death of a loved one  divorce  loss of job  promotion  Daily Hassles Ex’s:  rush hour traffic  long lines  job stress  BurnoutCan these cause loss of control??

10. Stressful Life Events  Chronic Stress by Age: Note: Schizophrenia can be triggered by stress… When do you think it usually shows up?

11. Perceived Control  Health consequences of a loss of control : No connection to shock source To shock controlTo shock source “Executive” rat“Subordinate” ratControl rat

12. Perceived Control  Equality & Longevity:

13. Stress & the Heart: Coronary Heart Disease - clogging of heart muscle’s nourishing vessels --leading cause of death in many developed countries Hopelessness scores 3.5 3 2.5 2 1.5 1 0.5 0 Heart attack Death Low riskModerate riskHigh risk Men who feel extreme hopelessness are at greater risk for heart attacks and early death

14. Stress & the Heart: Personality Types  Type A  Friedman and Rosenman’s term for competitive, hard-driving, impatient, verbally aggressive, & anger-prone people *Possible sub-category of “A”?? Some say there’s a.. TYPE D: Newer term: --gets very angry, is destructive emotionally …road-rage, etc. (distressed, destructive) -A special form of Type A Type B  Friedman & Rosenman’s term for easygoing, relaxed people (“calm-water”)

15. Personality & Stress on the Heart: Pessimists: ___% Optimists: ___%

16. Emotion: ADD Stress & Disease Psycho-physiological Illness  “mind-body” illness  any stress-related physical illness  some forms of hypertension (hi BP & some headaches  Is NOT hypochondriasis– thinking you are sick all the time…  Lymphocytes: 2 types of white blood cells that are part of the body’s immune system  B lymphocytes form in the bone marrow - fight bacterial infections  T lymphocytes form in the thymus - attack cancer cells, viruses, and foreign substances

17. Stress and Disease  Conditioning of immune suppression UCS (drug) UCR (immune suppression) UCS (drug) UCR (immune suppression) CS (sweetened water) CS (sweetened water) CR (immune suppression)

18. Stress and Disease  Negative emotions and health-related consequences Unhealthy behaviors (smoking, drinking, poor nutrition and sleep) Persistent stressors and negative emotions Release of stress hormones Heart disease Immune suppression Autonomic nervous system effects (headaches, hypertension)

19. Promoting Good Health  Biofeedback  electronically records, amplifies, & feeds back info RE: a subtle physiological state  BP (blood pressure)  muscle tension  Aerobic Exercise  sustained exercise that increases heart & lung fitness Depression lessened way more w/ aerobic exercise than w/o -relaxation helped also…but not as much as the exercise!

20. Promoting Health  Modifying Type A life-style can reduce recurrence of heart attacks Percentage of patients with recurrent heart attacks (cumulative average) 65432106543210 Year 1978 1979 1980 1981 1982 Life-style modification patients Control patients Modifying life-style reduced recurrent heart attacks

21. Promoting Health  Social support across the life span 12-14 18-19 25-34 45-54 65-74 15-17 20-24 35-44 55-64 75+ Age in years 100% 90 80 70 60 50 Percentage with high support

22. Life events Tendency toward HealthIllness Personal appraisal ChallengeThreat Personality type Easy going Nondepressed Optimistic Hostile Depressed Pessimistic Personality habits Nonsmoking Regular exercise Good nutrition Smoking Sedentary Poor nutrition Level of social support Close, enduringLacking

23. Promoting Health: Why might the 3 rd aspect below have an effect?   Predictors of mortality 1 0.8 0.6 0.4 0.2 0 Men Women Not smoking Regular exercise Weekly religious attendance Relative risk of dying

24. Promoting Health  Religious Attendance

25. Promoting Health Complementary & Alternative Medicine (non- Western)  unproven health care treatments not taught widely in medical schools  not used in hospitals  not usually reimbursed by insurance companies

26. Alternative systems of medical practice Bioelectromagnetic applications Diet, nutrition, life-style changes Herbal medicine Manual healing Mind-body control Pharmacological and biological treatments Subfields of Alternative Medicine Health care ranging from self-care according to folk principles, to care rendered in an organized health care system based on alternative traditions or practices The study of how living organisms interact with electromagnetic (EM) fields The knowledge of how to prevent illness, maintain health, and reverse the effects of chronic disease through dietary or nutritional intervention Employing plan and plant products from folk medicine traditions for pharmacological use Using touch and manipulation with the hands as a diagnostic and therapeutic tool Exploring the mind’s capacity to affect the body, based on traditional medical systems that make use of the interconnected- ness of mind and body Drugs and vaccines not yet accepted by mainstream medicine

27. Promoting Health  Smoking-related early deaths 40,000 30,000 20,000 10,000 0 33,348 1,6861,135 556202 Smoking Suicide Vehicle HIV/ Homicide crash AIDS Cause of death Number of deaths per 100,000

28. The Physiological Effects of Nicotine

29. Promoting Health  Fewer Canadian smokers Males Females 1970 1974 1978 1982 1986 1990 1994- 1996- 1995 1997 Year 60% 50 40 30 20 10 0 Percentage of Canadians smoking

30. Smoking Prevention  U.S. teen smoking

31. Smoking Prevention: Inoculation = prevention programs… These DO have an effect!  Results of a smoking inoculation program Percentage of students who smoke 20 15 10 5 0 0 4 9 12 16 21 33 Seventh gradeEighth gradeNinth grade Months of study Control school School with smoking Prevention program Fewer teens took up smoking when “inoculated” against it

32. Obesity & Weight Control  Obesity and body mass index

33. Obesity & Weight Control  Obesity and mortality 18.5 18.5- 20.5- 22.0- 23.5- 25.0- 26.5- 28.0- 30.0- 32.0- 35.0- 40 20.4 21.9 23.4 24.9 26.4 27.9 29.9 31.9 34.9 39.9 Body-mass index (BM I) MenWomen 2.8 2.6 2.4 2.2 2.0 1.8 1.6 1.4 1.2 1.0 0.8 0.6 Relative risk of death

34. Weight Discrimination  When women applicants were made to look overweight, subjects were less willing to hire Willingness to hire scale (from1: definitely not hire to 7: definitely hire ) 0 1 2 3 4 5 6 7 WomenMen NormalOverweight

35. Weight Control  Effects of a severe diet Caloric intake in calories per day Body weight in kilograms Metabolism: Oxygen consumption in liters per hour 3000 2000 1000 0 8 16 24 32 Days 165 160 155 150 145 140 Days 26 25 24 23 22 21 8 16 24 32

36. Weight Control: Cigs down, but weight up??  Trading risks

37. Weight Control  Thinning of Miss America

38. Weight Control  Most lost weight is regained -20 -15 -10 -5 0 5 10 12345 Weight change in pounds Post treatment Years of follow-up Starting point Normal trend for untreated obese people: Gradually rising weight After participation in behavioral Program: Much of initial weight loss regained

39. Weight Control  Obesity: more common among those who watched the most TV 4 Hours of television watched per day in 1990s study BoysGirls 32 30 28 26 24 22 20 Skinfold fat measure (mm)

40. Create a CHART!! Working in PAIRS…. Create a chart showing the RISK FACTORS for health that can be affected by behavior &/or personality…and the positive factors in behaviors that can help keep you healthy: Something like this…. Positive health factors l Health Risk factors