1. 1 Stress and Disease Dr. Donald B. Giddon Harvard University, Fall 2013 QUESTION 3: Why is a particular organ or system a target of stress?

2. Stimulus specificity Response specificity Individual response hierarchy Symptom specificity 2

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4. Bases of Organ Specificity/Diathesis Genetic Psycho Dynamic Learning/Conditioning Personality Conflict Attitudes 4

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6. Affective Psychological Responses To Self Confrontation With Computer Displayed Profile Images Anderson, Amram, Giddon Psychophysiology 35(1)S16, 1998 6

7. Purpose To Investigate The Affective Responses To Self Confrontation With Computer Imaging. Hypothesis –The affective and physiological responses to self confrontation with computer images would differ from responses to computer image distortions of other neutral faces. 7

8. Method Confront Subjects With Computer Images of Own Profile, and Images of “Control” Profiles. Measure Physiological Responses That Reflect The Affective State of The Subject. –Peripheral Blood Volume Pulse Wave. –Heart Rate. –Heart Rate Variability. –Affective Measures of Pleasantness, Acceptability, Similar to Self, Tenseness, Concern 8

9. Blood Volume Pulse Wave (BVP) Photoplethysmograph –Measures the variation in the opacity of a limb caused by the changing quantity and quality of blood contained in it. (Pulse Oximeter) –One of the cardiovascular parameters strongly influenced by the mental processes is the blood volume pulse of the peripheral tissues. –Measured In Millimeters. 9

10. Heart Rate Measured in Interbeat Interval (IBI) in Milliseconds. Increases During Stress, Physical Exertion, Sympathetic Stimulation. Decreases During Relaxation, Slow Wave Sleep, Parasympathetic Stimulation, Psychological Orientation. 10

11. HR Variability (HRV) Standard Deviation of The Beat To Beat Interval Per Unit TIme. Increases During Stress, Physical Exertion, Sympathetic Stimulation. Decreases During Relaxation, Slow Wave Sleep, Parasympathetic Stimulation, Psychological Orientation. 11

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13. Prior to Viewing Baseline Physiologic Recording. Mental Math Task. –Cognitive/Affective Control. –Subtract 17 from 287. 13

14. Results Physiological Analysis. –Completed For 10 Subjects. –Values Averaged (S1,S2) (O1,O2) IBI HRV BVP Subjective Analysis. –Completed For 16 Subjects. –Values Averaged (S1,S2) (O1,O2) Semantic Differential. 14

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19. Summary of Group Results Averaging of individual results revealed no change for group. No generalizable pattern for physiological data. Each individual has own pattern of physiologic responses (individual response hierarchy) Identified own true profiles Found unaltered Most Acceptable When individual responses averaged across group, no significant difference to self and other images. 19

20. Conclusion Individual pattern of responding to computer images of own and other faces. 20

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22. What Have We Covered? Question1 – What is stressful for a given individual? Question 2- What are the mediators or pathways to diseases Today, Question 3 – Why is a particular organ or system a target of stress? Still to do, Question 4 – What are the Cognitive, Affective and Behavioral Responses to Disease ? 22

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39. Disorders Associated with Increased Stress System Activity Severe chronic disease Anorexia Melancholic depression, Personality disorders, Obsessive compulsive disorder Active EtOH, EtOH/Narcotic Withdrawal, Excessive exercise Malnutrition Hyperthyroidism PMS 39

40. Behavioral Responses Voluntary and Semi-Voluntary E.g. Habits –Bruxism –Smoking 40

41. Vulnerability Combination High life stress and Low social support and Poor coping skills Increased risk of injury Resiliency Factors either Low life stress or High social support or Good coping skills Lower risk of injury Interaction of Psychosocial Causal Factors Accident Prone Behavior 41

42. Review of Other Responses to Stress Disorders Associated with Decreased Stress Response Atypical depression Cushing’s Syndrome Seasonal Affective Disorder Hypothyroidism. Obesity--some forms. PTSD. Nicotine W/D. Inflammatory Disease Allergy/Atopy 42

43. l l Depression F F Women 2X more likely to suffer from depression as men. Depression significantly associated with morbidity and mortality. F FDepressed, elderly pts show more physical illness than matched controls. Significantly higher 4-year mortality. F FDepressed, HIV pts show greater progression of HIV than non-depressed. F FLinear relationship between depressed affect and cellular immune parameters. F FEvolutionary significance 43