Chapter 14

1. Chapter 14 Stress & Health

2. Chapter 14: Outline • Stress & Illness • Stress and Stressors • Stress and the Heart • Stress and susceptibility to Disease • Promoting Health • Coping with stress • Modifying illness-related behaviors

3. Stress & Illness • Behavioral Medicine • Health Psychology

5. Stress and Stressors • Stress • the process by which we perceive & respond to certain events, called stressors, that we appraise as threatening or challenging

7. Stress & Stressors • Stress Response System • Sympathetic nervous system increases heart rate and respiration…. • “Fight or Flight”

8. Cerebral cortex (perceives stressor) Pituitary hormone in the bloodstream stimulates the outer part of the adrenal gland to release the stress hormone cortisol Thalamus Hypothalamus Pituitary gland Sympathetic nervous system releases the stress hormones epinephrine and norepinephrine from nerve endings in the inner part of the adrenal glands Adrenal glands

9. Stress & Stressors • General Adaptation Syndrome

10. Stress & Stressors • Stressful Life Events • Catastrophic Events • Life Changes • Daily Hassles

12. Perceived Control: Equality & Longevity

13. Stress & Stressors • Stress & the Heart • Coronary Heart Disease • clogging of the vessels that nourish the heart muscle • leading cause of death in many developed countries • Genetics & environment

14. 3.5 3 2.5 2 1.5 1 0.5 0 Hopelessness scores Men who feel extreme hopelessness are at greater risk for heart attacks and early death Heart attack Death Low risk Moderate risk High risk Stress & Stressors

15. Stress & Stressors • Stress & the Heart • Type A • Type B

16. Live longer with a better attitude

17. Stress & Stressors • Stress & Susceptibility to Disease • Psychophysiological Illness • “mind-body” illness

18. Stress & Stressors • Stress & Susceptibility to Disease • Stress makes a person more vulnerable to infections & malignancy because of the reduction of the immune system. • Lymphocytes • two types of white blood cells that are part of the body’s immune system • B lymphocytes • T lymphocytes

19. Stress & Stressors • Stress & Susceptibility to Disease • AIDS • Cancer

20. Heart disease Persistent stressors and negative emotions Release of stress hormones Immune suppression Unhealthy behaviors (smoking, drinking, poor nutrition and sleep) Autonomic nervous system effects (headaches, hypertension) Stress & Stressors

21. UCS (drug) UCR (immune suppression) CS (sweetened water) UCS (drug) UCR (immune suppression) CS (sweetened water) CR (immune suppression) Stress & Stressors • Stress & Susceptibility to Disease • Conditioning the Immune System

22. 14 13 12 11 10 9 8 7 6 5 4 3 Depression score No-treatment group Relaxation treatment group Aerobic exercise group Before treatment evaluation After treatment evaluation Promoting HealthA. Coping with Stress • Stress is unavoidable so we must manage it • Aerobic Exercise

23. Promoting HealthA. Coping with Stress • Stress is unavoidable so we must manage it • Aerobic Exercise

24. Promoting HealthA. Coping with Stress • Biofeedback & Relaxation

25. 6 5 4 3 2 1 0 Percentage of patients with recurrent heart attacks (cumulative average) Control patients Modifying life-style reduced recurrent heart attacks Life-style modification patients 1978 1979 1980 1981 1982 Year Promoting HealthA. Coping with Stress • Modifying Type A life-style can reduce recurrence of heart attacks

26. Percentage with high support 100% 90 80 70 60 50 12-14 18-19 25-34 45-54 65-74 15-17 20-24 35-44 55-64 75+ Age in years Promoting HealthA. Coping with Stress • Social Support can promote health

27. Promoting HealthA. Coping with Stress • Spirituality & Faith Communities

28. Healthy behaviors (less smoking, drinking) Religious involvement Social support (faith communities, marriage) Better health (less immune system suppression, stress hormones, and suicide) Positive emotions (less stress, anxiety) Promoting HealthA. Coping with Stress • Spirituality & Faith Communities • The religion factor is multidimensional

29. Relative risk of dying Not smoking Regular exercise Weekly religious attendance Women Men Promoting HealthB. Modifying Illness-Related Behaviors • Predictors of mortality

30. Promoting HealthB. Modifying Illness-Related Behaviors • Complementary & Alternative Medicine

31. 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 Alternative systems of medical practice Bioelectromagnetic applications Diet, nutrition, life-style changes Herbal medicine Manual healing Mind-body control Pharmacological and biological treatments

32. Promoting HealthB. Modifying Illness-Related Behaviors • Smoking • Tobacco kills ~ 4 million of its 1.2 billion customers • Smoking correlates with higher rates of depression, chronic disease and divorce

33. Number of deaths per 100,000 33,348 1,686 1,135 556 202 Smoking Suicide Vehicle HIV/ Homicide crash AIDS Cause of death Promoting HealthB. Modifying Illness-Related Behaviors • Smoking-related early deaths 40,000 30,000 20,000 10,000 0

34. The Physiological Effects of Nicotine

35. 20 15 10 5 0 Percentage of students who smoke Fewer teens took up smoking when “inoculated” against it Control school School with smoking Prevention program 0 4 9 12 16 21 33 Seventh grade Eighth grade Ninth grade Months of study Promoting HealthB. Modifying Illness-Related Behaviors • Programs to stop smoking

36. Promoting HealthB. Modifying Illness-Related Behaviors • Weight Control • 65% of Americans are overweight • Our bodies store fat for times of “scarcity” • which Americans never have

37. Promoting HealthB. Modifying Illness-Related Behaviors • Obesity and body mass index

38. 7 6 Willingness to hire scale (from1: definitely not hire to 7: definitely hire) 5 4 3 2 1 0 Women Men Normal Overweight Promoting HealthB. Modifying Illness-Related Behaviors • When women applicants were made to look overweight, subjects were less willing to hire

39. Promoting HealthB. Modifying Illness-Related Behaviors • Weight Control • ~30 billion fat cells. When obese the fat cells swell & divide into more

40. Promoting HealthB. Modifying Illness-Related Behaviors • Weight Control • 6x more common in lower class

41. Promoting HealthB. Modifying Illness-Related Behaviors • Trading risks

42. Promoting HealthB. Modifying Illness-Related Behaviors • Thinning of Miss America

43. 10 Weight change in pounds Starting point 5 0 Normal trend for untreated obese people: Gradually rising weight -5 -10 After participation in behavioral Program: Much of initial weight loss regained -15 -20 Post treatment 1 2 3 4 5 Years of follow-up Promoting HealthB. Modifying Illness-Related Behaviors

44. Skinfold fat measure (mm) 32 30 28 26 24 22 20 <2 2-3 >4 Hours of television watched per day in 1990s study Boys Girls Promoting HealthB. Modifying Illness-Related Behaviors