Chapter 17- Stress and Health
What is Stress?
Health Psychology- psychology’s contribution to behavioral medicine
Stress - the process by which we appraise and cope with threats and challenges How a person perceives and evaluates
and event makes a difference - the cognitive model of stress▪ Cognitive- thinking and understanding
What is Stress?
Stress the process by
which we perceive and respond to certain events, called stressors, that we appraise as threatening or challenging
StressorsCatastrophes
Life changes
Hassles
InterveningfactorsAppraisal
Perceived control
Personality
Social support
Coping behaviors
StressreactionsPhysiological
Emotional
Behavioral
Stress Appraisal
Stressful event(tough math test)
Threat(“Yikes! This isbeyond me!”)
Challenge(“I’ve got to apply
all I know”)
Panic, freeze up
Aroused, focused
Appraisal Response
Stressful Life Events
Distress and Eustress Catastrophic Events
earthquakes, combat stress, floods
Life Changes death of a loved one,
divorce, loss of job, promotion
Daily Hassles rush hour traffic, long
lines, job stress, burnout Gradually weaken the
body’s defense system and can lead to hypertension
Stress and Health
▪ Leading causes of death in the US in 1900 and 1991
PercentageU.S.deaths
30
20
10
0 Tuber-culosis
Pneu-monia
Diarrhea/enteritis
Heartdisease
1900
PercentageU.S.deaths
30
20
10
0 Heartdisease
Cancer Strokes Chroniclung disease
1991
Unlike many leading killers a century ago,
today’s majorkillers are more lifestyle-related
Physiological Reaction: Fight or Flight (Cannon)
When faced with a stressor, the body reacts with immediate arousal. ▪ Hormones are produced that increase the
amount of blood sugar for extra energy▪ Adrenaline is produced, causing rapid
heartbeat and breathing and enabling the body to use energy more quickly
Used to prepare a person or animal for self-defense Left over from the past; doesn’t work for most of
today’s stress
What is Stress?
General Adaptation Syndrome Selye’s concept
of the body’s adaptive response to stress as composed of three stages
Stressresistance
Phase 1Alarm
reaction(mobilize
resources)
Phase 2Resistance(cope with stressor)
Phase 3Exhaustion(reservesdepleted)
The body’s resistance to stress can onlyLast so long before exhaustion sets in
Stressoroccurs
1)
Ala
rm
Mobilization of fight or flight defensesExceptional alertness
2)
Resi
stance
Find means to cope with the stressor, at least superficiallyMay suffer psychosomatic symptoms from pretending strain is nonexistent
3)
Exhaust
ionReaching the
breaking pointExhaustion and disorientation may developResponses that were good for immediate resistance to stress are detrimental in the long run
General Adaptation Syndrome (Selye)3 Stages of Stress Reactions:
Measuring Stress
The SRRS- Holmes and Rahe› Measured stress using
LCU (life-change units)› Higher score =
higher likelihood of stress-related diseases
› PERCEPTION MATTERS!
The SRRS
Stress and Control (Selye)
Health consequences of a loss of control
No connection to shock source
To shock control To shock source
“Executive” rat “Subordinate” rat Control rat
Perceived Control
All are most stressful when perceived as negative and uncontrolled
The result is vulnerability to ill health and often earlier death
Losing control provokes an outpouring of stress hormones Examples: poverty, optimism
What is Stress?Burnout
physical, emotional and mental exhaustion brought on by persistent job-related stress
Coronary Heart Disease clogging of the vessels that nourish
the heart muscle leading cause of death in the
United States
Stress & Coronary Heart Disease
Hopelessnessscores
3.5
3
2.5
2
1.5
1
0.5
0 Heart attack DeathLow risk Moderate risk High risk
Men who feel extreme hopelessnessare at greater risk for heart attacksand early death
Type A & Type B Personalities Type A- in a chronic state of stress;
almost constant flow of adrenaline into the blood stream
Type B- generally relaxed and patient
Type A people are more prone to heart disease▪ They are more likely to smoke more, sleep
less, and drink more caffeine▪ Their temperament may contribute directly-
more physiologically reactive when threatened with a lack of control
Stress and Disease
Lymphocytes two types of white blood cells that are part of the body’s immune system▪ B lymphocytes form in the bone
marrow and release antibodies that fight bacterial infections▪ T lymphocytes form in the thymus
and, among other duties, attack cancer cells, viruses and foreign substances
Stress and Disease
Psychophysiological Illness “mind-body” illness any stress-related physical illness▪ some forms of hypertension▪ some headaches
Different from hypochondriasis▪ misinterpreting normal physical sensations
as symptoms of a disease
Stress and Disease
Conditioning of immune suppression; sweetened water alone could trigger immune suppression in rats
UCS(drug)
UCR(immunesuppression)
UCS(drug)
UCR(immunesuppression)
CS(sweetenedwater)
CS(sweetenedwater) CR
(immunesuppression)
1 2 3 4 5 6 71. Doesn't mind leaving things temporarily unfinished Must get things finished once started2. Calm and unhurried about appointments Never late for appointments3. Not competitive Highly competitive4. Listens well; lets others finish speaking Anticipates others In conversation (nods, interrupts)5. Never in a hurry, even when pressured Always in a hurry6. Able to wait calmly Uneasy when waiting7. Easygoing Always going full speed ahead8. Takes one thing at a time Tries to do more than one thing at a time; thinks about what to do next9. Slow and deliberate in speech Vigorous and forceful in speech (uses a lot of gestures)10. Concerned with satisfying him/herself, not others Wants recognition by others for a job well done11. Slow doing things Fast doing things (eating, walking) 12. Serene Hard Driving13. Expresses feelings openly Holds feelings in14. Has a large number of interests Few interests outside work15. Satisfied with job Ambitious; wants quick advancement at job16. Never sets own deadlines Often sets own deadlines17. Feels limited responsibility Always feels responsible18. Never judges things in terms of numbers Often judges performance in terms of numbers19. Casual about work Takes work very seriously (works weekends, bring home work)20. Not very precise Very precise (careful about detail)
If you scored over 110 you are a Type A1 If you are in this category and especially if you are over 40 and smoke, you have a high risk of developing cardiac illness and other stress-related illnesses.
If you scored 80 – 109 you are a Type A2 You are also a cardiac-prone personality but your risk of heart disease is not quite as high as a Type A1
If your score is 60 - 79, you are a Type AB You are a mixture of Type A and Type B patterns. This is a healthier pattern than either A1 or A2, but you have the potential for slipping into Type A behavior and you should recognize this.
If your score is under 59, you are a Type B 30 - 50: Type B2 0 – 29: Type B1 This personality complex is characterized by general relaxation
and coping adequately with stress. You express few of the reactions associated with cardiac disease.
Promoting Health
Aerobic Exercise sustained
exercise that increases heart and lung fitness
may also alleviate depression and anxiety
Depressionscore
14
13
12
11
10
9
8
7
6
5
4
3 Before treatmentevaluation
After treatmentevaluation
No-treatmentgroup
Aerobicexercise
group
Relaxationtreatment
group
Promoting Health
Biofeedback system for
electronically recording, amplifying, and feeding back information regarding a subtle physiological state▪ blood pressure▪ muscle tension
Promoting Health Modifying Type A life-style can reduce
recurrence of heart attacks
Percentageof patients
with recurrentheart attacks
(cumulativeaverage)
6
5
4
3
2
1
0
Year1978 1979 1980 1981 1982
Life-style modification patients
Control patients
Modifying life-stylereduced recurrent
heart attacks
Promoting HealthSocial support across the life span
12-14 18-19 25-34 45-54 65-74 15-17 20-24 35-44 55-64 75+ Age in years
100%
90
80
70
60
50
Percentagewith high
support
Obesity and Weight Control
Obesity 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 ofdeath
Weight Discrimination
When women applicants were made to look overweight, subjects were less willing to hire
Willingnessto hire scale
(from1:definitely
not hire to7: definitely
hire)
0
1
2
3
4
5
6
7
Women Men
Normal Overweight
7) Excessive time spend in the resistance phase of Selye’s general adaptation syndrome can contribute to› Increased time needed to adapt to new
emotional situations› Decreased motivation to perform novel taskes› Stress-related diseases like ulcers or heart
conditions› A reduction in the drive to achieve goals› Resistance to learning skills needed for novel
tasks
8) Perceived control over a stressful event tends to result in Less reported stress More frustration regarding the stressful
event More motivation to solve the stressful
problem Increased arousal Higher hear and respiration rates
http://www.pbs.org/wgbh/nova/body/obesity.html