Stress and

Health

Chapter 14

1

Stress• Stress

–The process by which we perceive and respond to certain events, called stressorsstressorsstressorsstressors, that we appraise as threatening or challenging

2

Stress Appraisal

3

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

Stress• Hans Selye (1907 – 1982)

–Psychologist who researched stress– Developed the concept of the GENERAL ADAPTATION GENERAL ADAPTATION GENERAL ADAPTATION GENERAL ADAPTATION SYNDROMESYNDROMESYNDROMESYNDROME

4

Stress• General Adaptation Syndrome

–Alarm Reaction – nervous system activated in response to stressor

–Resistance – body responds with physiological reactions to cope with the stressor

–Exhaustion – body’s resistance to stress in depleted (physical deterioration)

5

General Adaptation Syndrome

6

General Adaptation Syndrome

7

General Adaptation Syndrome

8

Stress• Burnout

–Physical, emotional, and mental exhaustion brought on by persistent stress

• Can result in:–Depression–Decreased performance–Cynicism

9

Stressful Life Events• Catastrophic Events

– Earthquake, flood, combat stress• Life Changes

–Death of a loved one, marriage, divorce, loss of a job, promotion, leaving home for college

• Daily Hassles–Rush hour traffic, long lines, job/school, living situations, economic difficulties

10

Stressful Life Events• Chronic Stress by Age

11

Perceived Control• The sense of control or influence one has over stressful events in one’s life

• Most studies suggest the lower the perceived control the larger the potential for health-related problems–LPC = lower immunity to disease

12

Perceived Control• Health Consequences of a Loss of Control

13

No connection

to shock source

To shock control To shock source

“Executive” rat “Subordinate” rat Control rat

Explanatory Style• Optimism

– Generally positive outlook on life/future– Optimists have stronger immune systems and recover faster from health problems

– Bad events are temporary, not their fault, and will not have broader effects beyond present circumstances

• Pessimism– Tendency to expect the worst– See the negative as permanent in nature

14

Stress• Stress Hormones

–Hormones released in response to stress–The body must work to rid the body of the S. H.

–Pessimism and perceived lack of control both produce more S. H.

15

Stress and Illness• Stress-Cancer Connection

– No conclusive evidence of a connection

–Two conclusions:• Stress does not create cancer cells• Stress affects the body’s malignancy-fighting ability

16

Stress and Illness• Coronary Heart Disease

–Clogging of the vessels that nourish the heart muscle

• Friedman and Rosenman–Measured blood cholesterol level and clotting speed.

–40 tax accountants• January – March = normal• April 15 = dangerously high• May and June = returned to normal

17

Stress and Illness

18

Stress and Illness• Type A

–Competitive, hard-driving, impatient, verbally aggressive, and anger-prone

–More prone to heart attacks and other stress related illnesses

• Type B–Easygoing, laid-back, and relaxed

19

Stress and Illness• Leading causes of death in the US in 1900 and 2000

20

Stress and Illness• Negative Emotions and Health-Related Consequences

21

Unhealthy behaviors

(smoking, drinking,

poor nutrition and sleep)

Persistent stressors

and negative

emotions

Release of stress

hormones

Heart

disease

Immune

suppression

Autonomic nervoussystem effects

(headaches,hypertension)

Stress and Health• Health Psychology

–A subfield of psychology that focuses on how stress affects our well being and our health

• Behavioral Medicine– Interdisciplinary field that integrates behavioral and medical knowledge and applies that knowledge to health and disease

22

Promoting Health• Play “The Nature of Stress” (5:39) Module #2 from The World of Abnormal Psychology.

• http://www.learner.org/resources/series60.html

23

Promoting Health• Aerobic Exercise

– Sustained exercise that increases heart and lung fitness

• Benefits of Daily Exercise– Reduces anxiety and depression

– Greater self-confidence and self-discipline

24

Promoting Health• Modifying Type A lifestyle can reduce recurrence of heart attack

25

Percentageof patients

with recurrentheart attacks

(cumulativeaverage)

6

5

4

3

2

1

0

Year

1978 1979 1980 1981 1982

Life-style modification patients

Control patients

Modifying life-stylereduced recurrent

heart attacks

Life events

Tendency toward

Health Illness

Personal appraisal

Challenge Threat

Personality type

Easy goingNondepressed

Optimistic

Hostile

Depressed

Pessimistic

Personality habits

NonsmokingRegular exerciseGood nutrition

Smoking

Sedentary

Poor nutrition

Level of social support

Close, enduring Lacking

26

Promoting Health• Religious Attendance

27

Promoting Health• The Religion Factor is multidimensional

28

Religious

involvement

Healthy

behaviors

(less smoking,

drinking)

Social support

(faith

communities,

marriage)

Positive

emotions

(less stress,

anxiety)

Better health

(less immune system

suppression, stress

hormones, and suicide)

Promoting Health• Benefits of Social Support

–Makes people feel liked and wanted– SS leads to

• Less physical problems• More pleasure in life• Longer life span

29

Promoting Health• Complementary and Alternative Medicines–Unproven health care treatment–Not taught widely in med school–Not used in hospitals–Not usually reimbursed by insurance companies

30

Promoting Health• Smoking-related early deaths

31

33,348

1,686 1,135 556 202

Smoking Suicide Vehicle HIV/ Homicidecrash AIDS

Cause of death

Numberof deaths

per 100,000

The

Physiological

Effects of

Nicotine

Smoking Prevention• U.S. teen smoking

33

Obesity and Weight Control• Body Mass Index (BMI)

–A person’s weight in kilograms divided by their squared height in meters

–U.S. guideline suggest a person’s BMI should be below 25

–The World Health Organization defines obesity as a BMI of 30 or over

34

Obesity and Weight Control

Obesity and BMI

35

Obesity and Weight ControlObesity 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)

Men Women

2.8

2.6

2.4

2.2

2.0

1.8

1.6

1.4

1.2

1.0

0.8

0.6

Relativerisk of

death

Weight Discrimination• When woman applicants were made to look overweight, subjects were less willing to hire

Willingnessto hire

scale

(from1:

definitelynot hire to

7: definitely

hire)

0

1

2

3

4

5

6

7

Women Men

Normal Overweight

37

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

08 16 24 32

Days

165

160

155

150

145

140

Days Days

26

25

24

23

22

218 16 24 32 8 16 24 32

Weight Control• Trading Risks

Weight Control• Thinning of Miss America

Weight Control

• Most lost weight is regained

-20

-15

-10

-5

0

5

10

1 2 3 4 5

Weightchange

in pounds

Posttreatment

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

41

Weight Control

• Obesity was more common among those who watched the most TV

<2 2-3 >4Hours of television watched per day

in 1990s study

Boys Girls

32

30

28

26

24

22

20

Skinfold fatmeasure (mm)

42