1

Chapter14StressandIllness

2

Stress

Psychologicalstatescausephysicalillness.Stressisanycircumstancethatmayberealorperceivedand

threatensone’swell‐being.

Whenseverestressisfeltitimpairsourabilitytocopewithit.

LeeStone/Corbis

3

StressandCausesofDeath

Prolongedstress–togetherwithunhealthybehaviors–canincreaseourriskfortoday'sfourleading

diseases.

4

BehavioralMedicine

CentersforDiseaseControl(CDC)proclaimthathalfofthedeathsintheUSareduetopeople’sbehaviors(smoking,alcoholism,unprotectedsex,insufficient

exercise,drugsandpoornutriPon).

Psychologistsandphysicianshavethusdevelopedaninterdisciplinaryfieldofbehavioralmedicinethatintegratesbehavioralandmedicalknowledge.

5

HealthPsychology

Healthpsychologyisafieldofpsychologythatcontributestobehavioralmedicine.Thefieldstudies

stress‐relatedaspectsofdiseaseandasks:

1.  HowdoemoPonsandpersonalityfactorsinfluenceriskofdisease?

2.  WhataXtudesandbehaviorspreventillnessandpromotehealthandwell‐being?

3.  HowourpercepPonsdeterminestress?

4.  Howcanwereduceorcontrolstress?

6

Stresscanbeadap:ve–inafearful(stresscausing)situaPonwecanrunawayandsaveourlives.Stresscanbemaladap:ve–ifitisprolonged(chronicstress)itincreasestheriskofillnessandhealth

problems.

StressandIllness

7

StressandStressors

Stressisaslipperyconcept.AtPmesitisthesPmulus(missinganappointment)andatotherPmesitisa

response(sweaPngwhiletakingatest).

8

StressandStressors

StressisnotmerelyasPmulusorresponse,itisprocessbywhichweappraiseandcopewith

environmentalthreatsandchallenges.

Whenshort‐livedortakenasachallenge,stressorscanhaveposiPveeffects.However,prolongedorthreateningstresscan

beharmful.

BobDaem

mrich/TheIm

ageWorks

9

TheStressResponseSystem

Canonproposedthatstressresponse(fast)wasafight‐or‐flightresponsemarkedbyoutpourof

epinephrineandnorepinephrinefrominneradrenalglandsincreasingheartandrespiraPonrates,

mobilizingsugarandfatanddullingpain.

10

TheStressResponseSystem

Thehypothalamusandthepituitaryglandalsorespondtostress(slow)

bytriggeringouteradrenalglandstosecreteglucocor,coids(corPsol).

11

GeneralAdaptaPonSyndrome

AccordingtoSelyestressresponsetoanykindofsPmulaPonissimilar.Thestressedindividualgoes

throughthreephases.

EPA/YuriKoche

tkov/Land

ov

12

StressfulLifeEvents

CatastrophicEvents:earthquakes,combatstress,floodsleadindividualsbecomingdepressed,

sleepless,andanxious.

13

SignificantLifeChanges

Deathofalovedone,divorce,lossofjob,promoPonmayleaveindividualvulnerabletodisease.

14

DailyHassles

Rushhourtraffic,longlines,jobstress,burnoutaremostsignificantsourcesofstressandcandamage

health

15

StressandtheHeart

StressthatleadstoelevatedbloodpressureresultsinCoronaryHeartDiseasescloggingofthevesselsthat

nourishtheheartmuscle.

Plaqueincoronaryartery

Arteryclogged

16

PersonalityTypes

TypeAatermusedforcompePPve,hard‐driving,impaPent,verballyaggressive,andanger‐prone

people.TypeBeasygoing,relaxedpeople(FriedmanandRosenman,1974).

TypeAaremorelikelytodevelopcoronaryheartdisease.

17

PessimismandHeartDisease

PessimisPcadultmenaretwiceaslikelytodevelopheartdiseaseovera10yearperiod(Kubzanskyetal.,

2001).

18

Stress&SuscepPbilitytoDisease

Psychophysicalillnessisanystress‐relatedphysicalillness,suchashypertensionorheadaches.

Hypochondriasis–misinterprePngnormalphysicalsensaPonsassymptomsofdisease.

19

StressandtheImmuneSystem

BlymphocytesfightbacterialinfecPons,Tlymphocytesakackcancercells,viruses,and

microphagesingestforeignsubstances.Duringstressenergyismobilizedawayfromtheimmunesystem

makingitvulnerable.

LennartNilsson/BoehringerIngelheinInternaPonalG

mbH

20

StressandColds

Peoplewithhighestlifestressscoreswerealsomostvulnerablewhenexperimentallyexposedtoacold

virus.

21

StressandAIDS

StressandnegaPveemoPonsmayacceleratetheprogressionfromhumanimmunodeficiencyvirus

(HIV)toacquiredimmunedeficiencysyndrome(AIDS).UNAIDS/G

.Pirozzi

22

StressandCancer

Stressdoesnotcreatecancercells.Researchersdisagreeonwhetherstressinfluencescancer

progression.TheydoagreethatavoidingstressandahopefulaXtudecannotreverseadvancedcancer.

23

StressandImmuneCondiPoning

IftheimmunesystemcanbesuppressedthroughcondiPoning.Researchersbelievethatimmune

enhancingresponsescouldbeinculcatedtocombatviraldiseases.

24

Health‐RelatedConsequences

Stresscanhaveavarietyofhealth‐relatedconsequences.

Kathleen

Finlay/M

asterfile

25

CopingWithStress

26

StrategiesForAlleviaPngStress

Reducingstressbychangingeventsthatcausestressorbychanginghowwereacttostressiscalled

problem‐focusedcoping.

WhenwecannotchangeastressfulsituaPon,andrespondbyakendingtoourownemoPonalneedsit

iscalledemoPon‐focusedcoping.

27

PerceivedControl

Researchwithratsandhumanshasindicatedthatabsenceofcontroloverstressorsisapredictorof

healthproblems.

28

ExplanatoryStyle

PeoplewithopPmisPc(comparedtopessimisPc)explanatorystyletendtohavemorecontroloverstressors,copebekerwithstressfulevents,havebekermoodsandhaveastrongerimmunesystem.

29

SocialSupport

SupporPvefamilymembers,marriagepartners,andclosefriendshelppeoplecopewithstress.Their

immunefuncPoningcalmsthecardiovascularsystemandlowersbloodpressure.

BobDaemmrich/Stock,Boston

30

ManagingStress

Havingasenseofcontrol,opPmisPcexplanatorystyle,socialsupportcanreducestressandimprove

health.

31

AerobicExercise

Canaerobicexerciseboostthespirit?Manystudiessuggestthataerobicexercisecan

elevatemoodandwell‐being,becauseaerobicexerciseraisesenergy,

increasesself‐confidence,lowerstension,

depressionandanxiety.

32

Biofeedback,RelaxaPonandMeditaPon

Biofeedbacksystemuseselectronicdevicestoinform

peopleabouttheirphysiologicalresponses,andgivesthemthechancetobringtheirresponseintoahealthierrange.RelaxaPonandmeditaPonhavesimilareffectsinreducingtension

andanxiety.

33

Life‐Style

ModifyingTypeAlife‐stylecanreducerecurrenceofheartakacks.

GhislainandMarieDavidDeLossy/Gek

yIm

ages

34

Spirituality&FaithCommuniPes

Regularreligiousakendancehasbeenareliablepredictorofalongerlifespanwithareducedriskof

dying.

35

InterveningFactors

InvesPgatorssuggestthreefactorsthatintervenebetweenreligiousinvolvementandbekerhealth.

36

ManagingStress:Summary

Howcanstressbemanaged?

37

ModifyingIllness‐RelatedBehaviors

38

ModifyingIllness‐RelatedBehaviors

EliminatesmokingwouldincreaselifeexpectancymorethananyotherprevenPvemeasure.

39

WhyPeopleSmoke?

1.  Peoplesmokebecauseitissociallyrewarding.

2.  SmokingalsoresultsbecauseofgenePcfactors.

RusselEinhorn/TheGam

maLiasonN

etwork

40

WhyPeopleSmoke?

3.  NicoPnetakesawayunpleasantcravings(negaPvereinforcement)bytriggeringepinephrine,norepinephrine,dopamineandendorphins.

4.  NicoPneisitselfrewarding(posiPvereinforcement).

41

BiopsychosocialFactors:Smoking

42

HelpingSmokersQuit

Smokinghasdecreasedinwesterncountries,especiallyinhighersocioeconomicandeducaPonal

levelgroups.

43

WaystoQuitSmoking

1.  Setaquitdate.

2.  Informfamilyandfriends.3.  Removeallcigarekes.4.  Reviewsuccessfulstrategies.

5.  UsenicoPnepatchorgum.6.  Abstainfromalcohol.7.  Exercise.

Afewpointerstoquitsmokingare:

44

SmokingAbsPnencePrograms

SmokingabsPnenceprogramsforteens:

1.  InformaPonabouttheeffectsofsmoking

2.  InformaPonaboutpeer,parent&mediainfluence3.  Traininginrefusalskills

45

DoProgramsWork?

PrevenPonprogramsdohaveaneffectonsmoking.

PaulJ.Milek

e/PalmBeachPost

46

ObesityandWeightControl

Fatisanidealformofstoredenergyandisreadilyavailable.InPmesoffamine

overweightbodiessignaledaffluence.

47

BodyMassIndex(BMI)

Obesityinchildrenincreasestheriskofdiabetes,highblood

pressure,heartdisease,gallstones,arthriPs,

certaintypesofcancer,thusshorteninglife‐

expectancy.

48

ObesityandMortality

Thedeathrateishighamongveryoverweightmen.

49

SocialEffectsofObesity

Whenwomenapplicantsweremadetolookoverweight,subjectswerelesswillingtohirethem.

50

PhysiologyofObesity

FatCells:Thereare30‐40millionfatcellsinthebody.Thesecellscanincreaseinsizeorincreaseinnumber(75million)inanobeseindividual(Sjöstrum,1980).

51

SetPointsandMetabolism

Whenreducedfrom3,500to450caloriesweightlosswasaminimal6%andthemetabolicrateamere15%.

Obesedefendtheirweightbyconservingenergy.

52

TheGenePcFactor

IdenPcaltwinstudiesrevealthatbodyweighthasgenePcbases.

ObesemouseatlethasdefecPvegeneforhormonelepPn,WheninjectedwithlepPnthemouseontheright

sheds40%ofitsweight.

CourtesyofJohnSolPs,TheRockefellerUniversity,N

ewYork,N

Y

53

AcPvity

Lackofexerciseisamajorcontributortoobesity.JustwatchingTVfortwohoursresultedin23%ofweightincrease,whenotherfactorswerecontrolled(Huet

al.,2003).

54

FoodConsumpPon

Overthepast40yearsaverageweightgainhasincreased.HealthprofessionalsarecajolingUS

ciPzenstolimittheirfoodintake.

55

TradingRisks

ThoughcigarekesmokingovertheyearshasdeclinedintheAmericas,obesityisontherise.

56

LosingWeight

InUS,two‐thirdsofwomenandhalfofmensaythattheywanttoloseweight.Themajorityofthemlose

moneyondietprograms.

57

PlantoLoseWeight

Toloseweightbeginaweight‐lossprogramwhenmoPvated,minimizeexposuretotempPngfoodcues,exerciseasmallamounteveryday,forgiveyourselffor

lapses.

JoeR.Liuzzo

58

AlternaPveMedicineOthermedicinalwaysofachievinghealth.