Chapter Fifteen

Psychology and Health

• Health Psychology

– subfield of psychology that provides psychology’s contribution to behavioral medicine,health promotion, disease prevention

• Behavioral Medicine

– interdisciplinary field that integrates behavioral and medical knowledge and applies that knowledge to health and disease

Stress and Health

• Leading causes of death in the US in 1900 and 1991

Module 15.1

Stress: What It Is and What It Does to the Body

Introduction

What is Stress?

• Stress

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

Sources of Stress: Hassles

• Hassles

– Annoyances in daily lives: rush hour traffic, long lines, job stress, burnout

• Chronic stress

– Accumulation of daily hassles

– State of persistent tension or pressure

Sources of Stress: Life Events

• Life events

– Major changes in life circumstances

– Negative or positive (e.g., death of a loved one, divorce, loss of job, promotion).

• May contribute to physical health problems

• Impact on health varies with

– Coping skills

– Attitude, appraisals

Sources of Stress: Frustration

• Frustration

– Efforts toward a goal are blocked

– Negative emotional state

• Conflict

– State of tension resulting from two or more competing goals

Types of Conflict

• Approach-approach

– Two positive but mutually exclusive goals

• Avoidance-avoidance

– Two opposing, unpleasant goals

• Approach-avoidance

– Single goal has both positive and negative qualities

• Multiple approach-avoidance

– Two or more goals, each has positive and negative qualities

Sources of Stress:
Traumatic Stressors

• Potentially life-threatening events

• Posttraumatic stress disorder (PTSD)

– Various symptoms

• Avoidance of cues

• Reexperiencing the event

• Impaired functioning

• Heightened arousal

• Emotional numbing

Sources of Stress: Type A
Behavior Pattern (TABP)

• Characteristics

– Impatient

– Competitive

– Aggressive

– Time urgent

– Prone to anger

• Higher risk of heart disease

• Contrast with Type B pattern

Sources of Stress:
Acculturative Stress

• Immigrants must adjust to a new culture

• Becoming acculturated, adapting to

– Values, language, customs

• May result in acculturative stress

The Body’s Response to Stress

• General adaptation syndrome (GAS)

– Alarm stage

• Fight-or-flight response

• Strong psychological, physiological arousal

– Resistance stage (adaptation stage)

• Attempt to return to normal state

– Exhaustion stage

• Resources seriously depleted

Stress and Disease

• Negative emotions and health-related consequences

Resistance During GAS
(Figure 15.2)

Stress and the Endocrine System

• Hormone system

• Chain reaction to stress

– Hypothalamus: corticotrophin-releasing hormone (CRH)

– Pituitary gland: adrenocorticotrophic hormone (ACTH)

– Adrenal cortex: corticosteroids

– Adrenal medulla: epinephrine, norepinephrine

Stress and the Immune System

• Immune system

– Defense against disease and infection

• 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 the Immune System

– Lymphocytes produce antibodies in response to antigens

– Immunity develops through

• Antigen “memory”

• Vaccinations

– Stress weakens immune system

• Lower production of immunoglobulin A

Body’s Response to Stress (Figure 15.3)

Burnout

• State of physical and emotional exhaustion

• Results from

– Excessive job demands

– Caregiving responsibilities

– Other stressful commitments

• Influenced by

– Role conflict: competing demands for time

– Role overload: can’t say “no”

– Role ambiguity: unsure of expectations

Psychological Moderators of Stress

• Social support

• Self-efficacy

– Belief in ability to accomplish a goal

• Perceived nature of events

– Control

– Predictability

• Internal versus external locus of control

• Psychological hardiness

– Commitment

– Openness to challenge

– Internal locus of control

• Optimism

Positive Psychology

• Developing movement

• Focus on strengths and assets

– Capacity for love

– Optimism

– Spirituality

– Positive emotions

Module 15.2

Psychological Factors in

Physical Illness

Stress and Disease

• Psychophysiological Illness

– “mind-body” illness

– any stress-related physical illness

• some forms of hypertension

• some headaches

– distinct from hypochondriasis – misinterpreting normal physical sensations as symptoms of a disease

Stress & Coronary Heart Disease

Coronary Heart Disease (CHD)

• Background information

– Insufficient flow of blood to heart

– Arteriosclerosis, atherosclerosis, plaque

– Heart attack, myocardial infarction (MI)

• Risk factors

– Age

– Gender

– Family history

– Hypertension

– Smoking

– Obesity

– Diabetes

– Lack of physical activity

– High cholesterol level

• Type A

– Friedman and Rosenman’s term for people who are competitive, hard-driving, impatient, verbally aggressive, anger-prone

• Type B

– Friedman and Rosenman’s term for easygoing, relaxed people

Emotions and Your Heart

• Emotional patterns associated with heart disease

– Type A: hostile, chronic anger

– Persistent anxiety

• Persistent emotional arousal

– Damage to cardiovascular system by stress hormones

Cancer

• Background information

– Body cells exhibit uncontrolled growth

• Cells lose ability to control growth

• Malignant tumors damage body organs, systems

– Many causes

Warning Signs of Cancer
(Table 15.5)

Cancer

• Risk factors

– Smoking

– Diet and alcohol consumption

– Sun exposure

– Stress

Other Disorders and Stress

• Asthma

– Bronchi are obstructed

– Stress may make attacks more likely

• Headaches

– Common: stress-related, muscle-tension headaches

– Migraine headaches

• Peptic ulcers

– Sores in lining of stomach

Module 15.3

Application: Taking the Distress

Out of Stress

Managing Stress Levels

• Reduce daily hassles

• Know your limits

• Follow a reasonable schedule

• Take frequent breaks

• Develop time-management skills

• Learn to prioritize

Take Care of Your Body

• Sleep

• Balanced diet

• Exercise

• Regular medical check-ups

• Avoid harmful substances

Various Techniques

• Develop relaxation skills

• Gather Information

• Expand social network

• Prevent burnout

• Replace stress-inducing thoughts with stress-busting thoughts

• Don’t keep upsetting feelings bottled up

Control Type A Behavior

• Take things slower

• Read books for enjoyment

• Leave your computer at home

• Avoid rushing meals

• Enjoy activities

• Develop relaxing interests

• Set realistic daily goals

Promoting Health

• Aerobic Exercise

– sustained exercise that increases heart and lung fitness

– may also alleviate depression and anxiety

• Biofeedback

– system for electronically recording, amplifying, and feeding back information regarding a subtle physiological state

• blood pressure

• muscle tension

• Modifying Type A life-style can reduce recurrence of heart attacks

• Social support across the life span

• Predictors of mortality