stress, emotion and the heart. basic reading this course is not organised around a textbook. i shall...
TRANSCRIPT
![Page 1: Stress, emotion and the heart. Basic Reading This course is not organised around a textbook. I shall refer primarily to material in journals. Also consult](https://reader035.vdocuments.net/reader035/viewer/2022062619/5515d754550346d46f8b4900/html5/thumbnails/1.jpg)
Stress, emotion and the heart
![Page 2: Stress, emotion and the heart. Basic Reading This course is not organised around a textbook. I shall refer primarily to material in journals. Also consult](https://reader035.vdocuments.net/reader035/viewer/2022062619/5515d754550346d46f8b4900/html5/thumbnails/2.jpg)
Basic Reading
This course is not organised around a textbook. I shall refer primarily to material in journals. Also consult basic health psychology texts such as
EP Sarafino 2006 Health Psychology: biopsychosocial interactions (5th Edition)
S Taylor (2006) Health Psychology (6th Edition)
The is also an excellent by old book on the topic
A Steptoe (1981) Psychological factors in cardiovascular disorders.
Steptoe has also written a very good chapter on “Psychophysiological bases of disease” in Johnston & Johnston, Health Psychology, volume 8 of Bellack & Hersen Comprehensive Clinical Psychology (find under Bellack & Hersen)
![Page 3: Stress, emotion and the heart. Basic Reading This course is not organised around a textbook. I shall refer primarily to material in journals. Also consult](https://reader035.vdocuments.net/reader035/viewer/2022062619/5515d754550346d46f8b4900/html5/thumbnails/3.jpg)
Definition
Health Psychology
The study of psychological process in health, illness and health care
![Page 4: Stress, emotion and the heart. Basic Reading This course is not organised around a textbook. I shall refer primarily to material in journals. Also consult](https://reader035.vdocuments.net/reader035/viewer/2022062619/5515d754550346d46f8b4900/html5/thumbnails/4.jpg)
![Page 5: Stress, emotion and the heart. Basic Reading This course is not organised around a textbook. I shall refer primarily to material in journals. Also consult](https://reader035.vdocuments.net/reader035/viewer/2022062619/5515d754550346d46f8b4900/html5/thumbnails/5.jpg)
John Hunter famous 18th century Scottish surgeon & anatomist of the 18th century “ My life is in the hands of any rascal who chooses to annoy or tease me” Died after argument at St George hospital medical school (over student admissions)
1897, William Osler - dominant figure in internal medicine - described the typical heart disease patient as "a keen and ambitious man, the indicator of whose engine is always at 'full speed ahead.”
![Page 6: Stress, emotion and the heart. Basic Reading This course is not organised around a textbook. I shall refer primarily to material in journals. Also consult](https://reader035.vdocuments.net/reader035/viewer/2022062619/5515d754550346d46f8b4900/html5/thumbnails/6.jpg)
Patients’ beliefs about causes of MI. Percentage considering factor a possible cause
At discharge 2month 6 months 12 months
Stress 70 72 61 61
Smoking 59 55 47 53
Worry 58 55 33 28
Will of God 27 21 9 2
Gudmunsdottir, Johnston, Johnston & Foulkes, (2001) BJHP, 6, 81-96.
![Page 7: Stress, emotion and the heart. Basic Reading This course is not organised around a textbook. I shall refer primarily to material in journals. Also consult](https://reader035.vdocuments.net/reader035/viewer/2022062619/5515d754550346d46f8b4900/html5/thumbnails/7.jpg)
Brod. Mental arithmetic leads to increase in cardiac output (blood pumped by heart). Decrease in peripheral resistance, but blood pumped bigger effect in this case so blood pressure increases.
![Page 8: Stress, emotion and the heart. Basic Reading This course is not organised around a textbook. I shall refer primarily to material in journals. Also consult](https://reader035.vdocuments.net/reader035/viewer/2022062619/5515d754550346d46f8b4900/html5/thumbnails/8.jpg)
Heart Rate increased by stress. Decreases again with exposure but less so in hard but not impossible condition. Obrist. Hard condition involves “active coping”
![Page 9: Stress, emotion and the heart. Basic Reading This course is not organised around a textbook. I shall refer primarily to material in journals. Also consult](https://reader035.vdocuments.net/reader035/viewer/2022062619/5515d754550346d46f8b4900/html5/thumbnails/9.jpg)
0
40
80
120
160
200
Hea
rt R
ate
(bp
m),
Act
ivit
y &
Pos
ture
Physical
Activity
Posture Heart Rate
![Page 10: Stress, emotion and the heart. Basic Reading This course is not organised around a textbook. I shall refer primarily to material in journals. Also consult](https://reader035.vdocuments.net/reader035/viewer/2022062619/5515d754550346d46f8b4900/html5/thumbnails/10.jpg)
60
80
100
120
140
160
09:45
10:00
10:15
10:30
10:45
11:00
11:15
11:30
11:45
12:00
12:15
0
500
1000
1500
2000
2500
3000
3500BPM
Activity
Guest lecturer speaking to this class last year. HR high before and during lecture . Took at least an hour to get back to normal
![Page 11: Stress, emotion and the heart. Basic Reading This course is not organised around a textbook. I shall refer primarily to material in journals. Also consult](https://reader035.vdocuments.net/reader035/viewer/2022062619/5515d754550346d46f8b4900/html5/thumbnails/11.jpg)
Coronary Heart Disease and Acute Coronary Syndromes
1. A slow process of arterial deterioration
2. An acute process that triggers a clinical event
![Page 12: Stress, emotion and the heart. Basic Reading This course is not organised around a textbook. I shall refer primarily to material in journals. Also consult](https://reader035.vdocuments.net/reader035/viewer/2022062619/5515d754550346d46f8b4900/html5/thumbnails/12.jpg)
The Reactivity HypothesisStress (and some emotions) leads to altered physiological responses in some people and these responses are harmful to the arteries.
A stress diathesis (vulnerability) model.
![Page 13: Stress, emotion and the heart. Basic Reading This course is not organised around a textbook. I shall refer primarily to material in journals. Also consult](https://reader035.vdocuments.net/reader035/viewer/2022062619/5515d754550346d46f8b4900/html5/thumbnails/13.jpg)
Studies in Health populationsKuper Marmot & Hemingway (2002), Seminars in Vascular Medicine,2, 267-313
Psychological process positive/no. of studies
Type A / Hostility 6/18
Depression 15/22
Anxiety 4/8
Work characteristics 10/13
(Social Support 6/9)
Studies in Populations with Cardiovascular Disease
Type A/Hostility 2/15
Depression 18/34
Anxiety 8/18
Work characteristics 2/4
(Social Support 14/21)
Seen as positive support overall By K,M & H
![Page 14: Stress, emotion and the heart. Basic Reading This course is not organised around a textbook. I shall refer primarily to material in journals. Also consult](https://reader035.vdocuments.net/reader035/viewer/2022062619/5515d754550346d46f8b4900/html5/thumbnails/14.jpg)
![Page 15: Stress, emotion and the heart. Basic Reading This course is not organised around a textbook. I shall refer primarily to material in journals. Also consult](https://reader035.vdocuments.net/reader035/viewer/2022062619/5515d754550346d46f8b4900/html5/thumbnails/15.jpg)
Recruit Discharge 2Mnth 6Mnth 1 Year
Time
0
2
4
6
8
10M
ean D
epre
ssio
n (
HA
DS)
Patients
Control
Inpatient
Extended
Johnston,M, Foulkes J, Johnston, D, Pollard, B, Gudmundsdottir, H (1999) Psychosomatic Medicine, 61, 225-233
Depression reduced in patients after MI by simple Counselling intervention
![Page 16: Stress, emotion and the heart. Basic Reading This course is not organised around a textbook. I shall refer primarily to material in journals. Also consult](https://reader035.vdocuments.net/reader035/viewer/2022062619/5515d754550346d46f8b4900/html5/thumbnails/16.jpg)
Recruit Discharge 2Mnth 6Mnth 1 Year
Time
0
2
4
6
8
10
Mean D
epre
ssio
n (
HA
DS)
Partners/Carers
Control
Inpatient
Extended
Johnston,M, Foulkes J, Johnston, D, Pollard, B, Gudmundsdottir, H (1999) Psychosomatic Medicine, 61, 225-233
Depression reduced in partners of MI patients who received counselling
![Page 17: Stress, emotion and the heart. Basic Reading This course is not organised around a textbook. I shall refer primarily to material in journals. Also consult](https://reader035.vdocuments.net/reader035/viewer/2022062619/5515d754550346d46f8b4900/html5/thumbnails/17.jpg)
Recruit Discharge 2Mnth 6Mnth 1 Year
Time
0
2
4
6
8
10
Mea
n D
epre
ssio
n (
HA
DS
)
Cardiac Counseling (Marie Johnston et al, 1999)Patients
Control
Inpatient
Extended
Recruit Discharge 2Mnth 6Mnth 1 Year
Time
0
2
4
6
8
10
Mean
Dep
ress
ion
(H
AD
S)
Cardiac Counseling (Marie Johnston et al, 1999)Partners
Control
Inpatient
Extended