Chapter 14 Stress and Heath

• Tuesday, Feb 28 – Ch 13 Quiz/Cards/Study Guide • Tuesday, Feb 28  - U of W Contest• Tuesday, Feb 28 - 531 – 539• Wednesday, Feb 29 – 539 – 546• Wednesday, Feb 29 – Ch 13 Desk Mat due• Thursday, Mar 1 – 546 - 555• Friday, Mar 2 – 555 - 565• Monday, Mar 5 – 565 - 573• Tuesday, Mar 6 – in class essay• Wednesday, Mar 7 – Ch 14 Quiz/Cards/St Guide• Thursday, Mar 8 – Teacher’s Convention• Friday, Mar 9 – Teacher’s Convention• Monday, Mar 12 – Desk Mat due

Stress (531)

• Stress - the process by which we perceive and respond to certain events, called stressors, that we appraise as threatening or challenging.  Stress is not just a stimulus or a response.

•  Stressors can be perceived as challenges that motive/arouse us or as threats that harm us and lead to things like PTSD and physical health problems.

Behavioral medicine (531)

- interdisciplinary field of psychology and medicine

Stress Response System (533)

• Walter Cannon - 1920 physiologist - identified the stress response as part of a unified mind-body system

• stressors trigger the release of stress hormones epinephrine (adrenaline), norepinephrine (noradrenaline) and cortisol.

• The stress hormones enter the bloodstream from sympathetic nerve endings in the adrenal glands.  The sympathetic nervous system also increases heart rate and respiration, diverts blood from digestion to the skeletal muscles, dulls pain and releases sugar and fat from body stores -------- all of this prepares the body for FIGHT or FLIGHT

Fight or Flight AND (543)

There are alternatives to Fight or Flight:

-        withdraw

  -        seek and give support

Failure Turns Into Success (534)

•  Hans Selye, a Canadian scientist, was researching a new sex hormone - he injected rats with the new hormone and observed enlargement of the adrenal cortex, shrinking of the thymus gland and bleeding ulcers.  When he injected the rats with another substance he found the same 3 responses - so he had to conclude that the new hormone was not causing the responses. 

• So, >>>>>>>>>>>>>>

Failure Becomes Success

• At first Selye was depressed about his failure - but then he thought that if he considered the body's nonspecific reaction to any damage - that he might be on to a discovery!  He experimented with other stressors and indeed found that the body's adaptive response to stress was so general that he called it the General Adaptation Syndrome

Selye’s General Adaptation Syndrome (534)

The General Adaptation Syndrome has 3 stages:

1.      Alarm reaction due to the sudden activation of the sympathetic nervous system

2.      Resistance - your functions remain high as you fight

3.      Exhaustion - stress depletes your body's reserves - you are more prone to illness during this stage

Long-Term Stress (535)

• Human's cope well with temporary stress, but, prolonged stress can cause physical deterioration. -------- MRIs show shrunken hippocampus (new memory formation centre) of patients with prolonged stress.

Stressful Life Events (535)

1.  Catastrophes

2.  significant life changes

3.  daily hassles

Catastrophes (535)

• Unpredictable

• large scale

• almost everyone appraises them as stressors/threats

• significant health consequences follow prolonged stress - after 9/11 sleeping pill use rose 28% in New York

• depression and anxiety are typical after a catastrophe

Significant Life Changes (536)

• see p 332 of Engel text for Homes and Rahe theory

• Death, job, marriage, divorce

• young adults are hardest hit because they experience most change

• disease often follows a significant life change - a widow's risk of death doubles in the week following the loss of the spouse

Daily Hassles (536)

• Our happiness is more affected by our response to daily events than from enduring good fortune

• Everyday hassles are a significant cause of stress because they add up and take a toll on our health ---- ie high blood pressure is higher in congested urban areas

Perceived Control (537)

• Catastrophes, significant life changes and daily hassles are more stressful when we appraise them as both negative and uncontrolled

•  Weiss, 1977 - The executive rat can turn off the shock - the subordinate rat cannot.  The control rat is receiving no shock.  FINDING?  The executive rat is no more likely to develop an ulcer than the control rat.

Perceived Control (537)

• In humans a bacteria infection plus uncontrollable stress cause the most severe ulcers.  Antibiotics will kill the bacteria but stress must be reduced to stop the acid secretions.

•  Executives outlive clerical and labourers because they perceive more control. 

Poverty and Inequality (537)

• Wealth also often means control ---- leading to a longer life.  Poorer people have a greater risk of premature death.

•  People die younger in areas with greater income equality (U.S., Britain)

•  Japan and Sweden have less inequality and a higher life expectancy

•  Lynch people at every income level (not just the poor) are at a greater risk of death if they live in communities with great income inequality.

•  Some studies say that income is the key --- others say that inequality is the key.

Optimism and Pessimism (538)

Optimistic people:•  perceive more control•  cope better with stress - ie

have smaller increases in blood pressure and recover more quickly from bypass surgery

• better health --- live longerLoosing control • provokes an outpouring of

stress hormones• immune responses drop

Stress and Hearth (539)

• Since 1950’s coronary heart disease is the leading cause of death

• Behavioral and physiological factors:– smoking/obesity– high-fat diets– physical inactivity– elevated blood

pressure and cholesterol

Friedman Fat Wives (539)

• Friedman (1956) wives consumed as much fat as their executive husbands yet the wives were less susceptible to heart disease ---WHY --- the husbands had stressful jobs  - the wives didn't.

•  Friedman - study of accountants -- blood cholesterol rises in April and then returns to normal after tax season

Type A Type B (539)• Friedman and Rosenman noted the talking style/behavior

of over 3000 male interviewees• Type A's were more reactive, competitive, hard-driving,

impatient, time-conscious, verbally aggressive and easily angered

• Type B's were easy going, relaxed• Type A's were more prone to heart attack - WHY - they

smoked, coffeed more, were more reactive when challenged, secreted more hormones and had higher blood pressure.  Hormones accelerate the build up of plaque of heart disease

•  Anger, pessimism and depression all contribute to heart problems.

Susceptibility to Disease (541)

• Historically we spoke of psychosomatic symptoms --- psychologically caused physical symptoms.  The symptoms weren't real.

•  Now we use the term psychophysiological illness  -- mind-body illness - ie hypertension

•  Hypochondriasis --- misinterpreting normal physical sensations as symptoms of disease.

Immune System (542)• defends body by isolating and

destroying bacteria and viruses• includes 2 types of white

blood cell lymphocytes•  B Lymphocytes -- form in the

bone marrow -- release antibodies that fight bacteria infections

•  T Lymphocytes -- form in the thymus and other lymphatic tissue - attack cancer cells, viruses and sometimes "good" cells like transplants.

Macrophage (542)

Another agent of the immune system is the macrophage which identifies and eats harmful invaders

2 Immune System Errors (542)

1. Responds too strongly and attacks the body's own tissues -- ex. arthritis or allergies.

2. Under-responds and allows cancer cells to multiply

Women and Immunity (542)

• Women have stronger immune systems than men so they are less susceptible to infections BUT more susceptible to self-attacking diseases like MS and lupus

Stress and Immunity (542)

• The brain secretes stress hormones which in turn suppress the immune system's disease-fighting lymphocytes.

• wounds heal more slowly when we are stressed

Fight/Flight OR Immunity (543)

•  Stress triggers fight/flight OR immunity

• When we are diseased, our bodies reduce muscular energy output by inactivity and increased sleep.

•  If stress triggers fight/flight the immune system does not get the energy and we are more susceptible to disease.

Stress and AIDS (543)

• HIV (human immunodeficiency virus) is followed by AIDS (acquired immune deficiency syndrome)

•  HIV is a slow killer - therefore it kills more people because they have time to spread it

• people with AIDS die of diseases like pneumonia because they have no immune system to fight the disease.

•  Stress caused people with HIV to more quickly develop AIDS

Stress and Cancer (543)

• Stress and negative emotion also speed up the progression of cancer

•  Rats implanted with tumor cells and exposed to uncontrollable stress are more prone to cancer.  The stress weakens the immune system so there is less to fight the cancer.  (the stress does not cause the cancer)

•  Some studies on humans find a link between stress and cancer and some studies don't

•  Problem - people blaming themselves for getting cancer or having "wellness macho"

Conditioning the Immune System (544)

Ader and Cohen (1985) discovered that classical conditioning can affect the body's immune system.  On rats, they paired sweet water with an immune-suppressing drug.  Eventually the sweet water alone triggered the immune suppression and tripled the likelihood of the rat getting cancer.

Stress

• Stress, especially in short term amounts, motivates us  ---- adaptive.

•  Stress, especially in long term amounts, depletes our immune system and we get sick

Promoting Health (546)

Health Psychologists• health maintenance• coping with stress• preventing illness• promoting well-

being

Coping With Stress (546)

• Stressors are unavoidable• We must manage stress by

escaping it, confronting it and taking steps to prevent its reoccurrence. 

•  Stress management includes aerobic exercise, biofeedback, relaxation and social support.

Aerobic Exercise (547)

• McCann and Holmes (1984) - assigned depressed subjects to groups who did:

• 1.      aerobics• 2.      relaxation• 3.      control group• The aerobic group had the

greatest drop in depression.

•  

Aerobic Exercise (547)

Why???? Aerobics:1.  strengthens the heart and

lowers blood pressure2.  increases seratonin,

norepinephrine, endorphins boosting mood

3.  enhances cognitive function

4.  grows new brain cells in mice

Biofeedback and Relaxation (548)

• Biofeedback - a system of recording, amplifying and feeding back information about subtle physiological responses.  The machines reflect the results of a person's own efforts so the person can learn to control physiological responses - like a heart rate. -- like tension in forehead muscles (figure 14.13)

• Can we be trained to bring our heart rates and blood pressure under conscious control? 

Biofeedback (548)• Neal Miller (1960) found that rats could modify their

heartbeat if given pleasurable brain stimulation when their heartbeat increased or decreased.

•  Miller and Brucker (1979) - paralyzed humans could learn to control their blood pressures.

•   In 1995 research proved that biofeedback works best on tension headaches but that other relaxation methods work just as well

•  Friedman - Type A heart attack victims - 1/2 treated normally and 1/2 treated normally plus taught relaxation.  The relaxed group had 1/2 the repeat heart attacks.

Social Support (550)

Happily married people live longer:– partners encourage doctor

visits– eat better/exercise with

prompting/ sleep better– drink and smoke less– overcome stress better– confide past traumas

rather than suppressing them

– bolster self esteem

Social Support (550)

• Cohen (1997) - cold virus volunteers --- those with the most social ties were least likely to catch a cold and they produced the least mucous

• Social supports also leads to disclosure - confiding --- rather than a bottling up of stressful issues. 

Spirituality and Faith (553)

• Historically, medicine and spirituality were administered by the same person.   

•  Later the 2 diverge.•  Now the 2 are re-

converging.•  Kark (1996) - studied

religious and secular Jewish communities.  The religious lived longer.

Spirituality and Faith (553)• Partrige (1972) - attending

weekly church decreases mortality rates.  Potential Intervening Variables? Religious have

• healthier life styles• social support• encourages marriage• stress protection of a religious

world view• relaxed meditation of prayer• HOWEVER<  studies

controlling for the intervening variables still concluded a correlation between religion and better health.

Complementary and Alternative Medicine (556)

•  acupuncture, massage, homeopathy, spiritual healing, herbal, chiropractic, Qi

•  Critics - alternative med is most effective for cyclical diseases which would cure themselves in time

•  Pro - many mainstream medical practices began as alternative med

Modifying Illness-Related Behaviors (555)

• Smoking - stopping smoking would increase life expectancy more than any other preventative measure. 

•  The stats don't impress smokers. 

•  Smoking correlates with higher rates of depression, chronic disabilities and divorce.

When/Why People Start Smoking (558)

• usually in early adolescence

• teens with friends who smoke

• low-achieving teens• rebellious and risk taking

teens• movie models are an

influence• parents/sibling smokers

Social-Cognitive Theory on Smoking

• We learn behaviors through models and social rewards.

•  Adolescents are self-conscious and think everyone is watching.  So, they smoke to imitate cool models and the social reward of other's acceptance.

•  Tobacco companies - model smoking through youth-oriented themes of independence, adventure, social approval and sophistication.

Why Do People Not Stop Smoking (559)

• 3 in 4 try• nicotine is as addictive as heroine and cocaine• 1 in 3 who try smoking become addicted• smokers become dependent and develop a tolerance

(need larger dose to get the same effect)• quitting causes withdrawal symptoms of craving,

insomnia, anxiety and irritability.  A cigarette relieves your withdrawal symptoms.

• the acute withdrawal symptoms will gradually dissipate over 6 months.

Why Do People Not Stop Smoking (559)

Nicotine• triggers release of epinephrine and norepinephrine

which diminish appetite and boost alertness.• triggers central nervous system to release

neurotransmitters that calm anxiety and reduce sensitivity to pain.

• increases release of dopamine  (cocaine blocks reuptake of dopamine)

Genes and Smoking (559)

• Cigarette addiction ---- 60% heritability

•  Smokers and nonsmokers tend to differ in a gene that influences responses to dopamine.

How Effective Are Stop Smoking Programs? (560)

• effective in the short run• all but 20% who quit start

again• odds are worse if you quit

solo•  Smoking rates are down

(in America) but they are still high among dropouts and lower socioeconomic levels.  Smoking has skyrocketed in Asia and in developing countries. 

How To Prevent Smoking? (561)

• McAlister (1980) - inoculate younger kids against peer pressure to smoke - have older peers teach younger kids to recognize and resist peer pressure

•  "Chicken" ----"I'd be a real chicken if I smoked just because you want me too!!!"

•  After inoculation, McAlister found that they were half as likely to start smoking as non-inoculated kids (even though parents of both groups had the same smoking rates).

How To Prevent Smoking

Non-smoking curriculum needs to contain:1.      information about effects of smoking2.      info about peer, parent and media influences3.      training in refusal skills through modeling and

role playing

The other way to curb smoking is to raise the price.  Each 10% cost increase nets a 4% reduction in smoking.

Nutrition (562)

• High-carb foods increase our tryptophan in our bloodstream --- leading to an increase in seratonin 

• High protein improves our concentration and alertness

•  High Blood Pressure ---- diet high in salt and low in calcium

•  Breakfast ---- makes us less fatigued by late morning

•  Depression --- diet low in omega 3 (good fat)

Obesity and Weight Control (563)

• 65% of the U.S. is overweight•  fat = stored energy used by the body when food is

scarce = adaptive in times of feast and famine = maladaptive in today's world of plentiful food

•  Obesity --- increases diabetes, high blood pressure, heart disease, gallstones, arthritis, cancer

•  worse for "apples" than for "pears"• physical and psychological threat - how you feel and

how others treat you  --- (the same actor wearing 30 more pounds is less likely to get the job)

Physiology of Obesity (565)

• BMI = Body Mass Index• should be under 26• obese is a score of 30 or more• BMI = kg weight

squared height in metres• (inches/39.4) = metre•  1 pound of fat = 3500 calories•  Dieters have been told they will loose a pound for

every 3500 calories reduced in their diet.  This is FALSE because of the physiology of fat.

Physiology of Obesity

• Why??????????????????• Fat Cells - adults have about 30 billion fat cells• a fat cell can be empty or inflated.  When inflated it can

swell 2 or 3 times a normal size and then it divides.  Once the number of fat cells increases (through genetics, early child eating, adult eating) it never decreases.  Fat cells can shrink but they never disappear.

•  Our bodies maintain our fat - fat tissue has a low metabolic rate therefore it takes less energy to maintain a fat cell.  Thus, once we become fat we require less food to maintain our weight then we did to attain our weight.

Set Points and Metabolism (565)

• Obese people have higher set points - weight thermostats set to maintain body weight within a range.

•  when their body weight drops below the set point, their hunger increases and their metabolism decreases.

•  Therefore, after the rapid weight loss of the first 2 or 3 weeks of a diet, any further weight comes off more slowly.  The metabolic rate drops as you lower your food intake --- the body adapts to starvation by burning fewer calories. 

•  Therefore, reducing your food by 3500 calories my not reduce your weight by one pound!!!!!  And,  after a diet, the body is still in conservation mode so the old amount of food that used to maintain your weight may now actually increase your weight.

The Genetic Factor (566)

• Adoptee studies - despite the same food the adoptee's weight is like their biological parents

•  Identical twins reared apart have similar weights.•  Genes

– influence when our intestines signal "full"– influence how efficiently we burn calories or convert extra

calories to fat– influence how "still" or "fidgety" we are

•  Genes determine why one person is heavier than another but the environment determines why people are heavier today than they were 50 years ago

•  5 MCDONALD'S FRIES = ONE SERVING!!!!!!!!!!!!!

Losing Weight (568)

• most who loose weight eventually gain it back

• better results with programs that modify life-style and ongoing eating habits

• women and even more so girls try loosing weight

• sustained exercise is the best possibility