Stress and Health Stress and Health Behavioral Medicine

Stress and Health

Stress and Health • Behavioral Medicine: • interdisciplinary field that integrates behavioral and medical knowledge and applies that knowledge to health and disease. • Health Psychology: • subfield of psychology that provides psychology’s contribution to behavioral medicine.

Stress and Illness Leading causes of death in the US in 1900 (Tuberculosis) and 2015 (Heart disease). Percentage U. S. deaths 30 20 20 10 10 0 Tuber- Pneu- Diarrhea/ Heart culosis monia enteritis disease 1900 0 Unlike many leading killers a century ago, today’s major killers are more lifestyle-related Heart Cancer Strokes Chronic disease lung disease 2015

What is Stress? Stress: the process by which we perceive and respond to certain events, called stressors, that WE APPRAISE as threatening or challenging. Stressors Catastrophes Life changes Hassles Intervening factors Appraisal Perceived control Personality Stress Social support reactions Coping behaviors Physiological Emotional Behavioral

Stress Appraisal Response Threat (“Yikes! This is beyond me!”) Panic, freeze up Challenge (“I’ve got to apply all I know”) Aroused, focused Stressful event (tough math test)

Cerebral cortex (perceives stressor) Thalamus Hypothalamus Pituitary hormone in the bloodstream stimulates the outer part of the adrenal gland to release the stress hormone cortisol Pituitary gland Sympathetic nervous system releases the stress hormones epinephrine and norepinephrine from nerve endings in the inner part of the adrenal glands Adrenal glands

What is Stress? General Adaptation Syndrome The body’s resistance to stress can only Last so long before exhaustion sets in Stress resistance Stressor occurs Phase 1 Alarm reaction (mobilize resources) Phase 2 Resistance (cope with stressor) Phase 3 Exhaustion (reserves depleted) *Hans Selye’s concept of the body’s adaptive response to stress as composed of three stages: --alarm reaction --resistance --exhaustion

Three Stages of the General Adaptation Syndrome 1) Alarm Reaction--general 3) Exhaustion-- general arousal caused by: *increase of adrenal glands 2) Resistance--arousal subsidies because of: *reaction of sympathetic *decrease in adrenal nervous system output If stressor is not removed, organism moves to: arousal of Stage 1 reappears: Powerful parasympathetic response opposes arousal. If stressor is not removed *counter reaction of in time, death occurs. parasympathetic nervous system If stressor is not removed, organism moves to:

Fight or Flight Syndrome • internal processes that prepares the aroused organism for struggle or escape. • occurs when the situation is interpreted as threatening. (i. e. ) You arrive at your class to find the students taking a test for which you have not prepared: • you have an internal urge to flee but you have learned from experience that you’ll have to face the music sooner or later.

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.

STRESSORS: A stressful stimulus, a condition demanding adaptation. • Primitive Stressors: danger of starvation, exposure to elements, mortal attack. • Traumatic Stressors: earthquake, battle fatigue, floods, hurricanes. • Life Stressors: death of a loved one, divorce, loss of job, promotion. • Daily Stressors: rush hour traffic, long lines, job stress, burnout.

Stressful Life Events Chronic Stress by Age

Life is 10% what happens to you and 90% how you handle it.

WHAT CAN WE DO TO CONTROL OUR HEALTH: 1) Get 7 to 8 hours of sleep every night. 2) Eat breakfast every day. 3) Get your weight to a normal level. 4) Don’t smoke. 5) Use alcohol moderately or not at all. 6) Get regular physical exercise. 7) Wear seat belts. 8) Don’t drive at excessive speeds. 9) Learn good diets and follow them. 10) Find a physician with whom you can communicate.

Stress & Coronary Heart Disease Hopelessness scores 3. 5 3 2. 5 Men who feel extreme hopelessness are at greater risk for heart attacks and early death 2 1. 5 1 0. 5 0 Heart attack Low risk Death Moderate risk High risk

Stress and the Heart

Personality Types and Stress Type B Type A • • • Feel time pressure. Easily angered. Competitive and ambitious. Work hard and play hard. More prone to heart disease than rest of population. • Relaxed and easygoing. • But some people fit in neither type.

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 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 UCS (drug) UCR (immune suppression) CS (sweetened water) • Conditioning of immune suppression UCS (drug) UCR (immune suppression)

Stress and Disease Negative emotions and health-related consequences Heart disease Persistent stressors and negative emotions Unhealthy behaviors (smoking, drinking, poor nutrition and sleep) Release of stress hormones Immune suppression Autonomic nervous system effects (headaches, hypertension)

Promoting Health • Coping with Stress • Problem-focused coping: when we attempt to alleviate the stress directly. • Emotion-focused coping: when we attempt to alleviate the stress by avoiding or ignoring the stressor and attend to the emotional needs related to the stress reaction.

Stress and Control Health consequences of a loss of control “Executive” rat To shock control “Subordinate” rat To shock source Control rat No connection to shock source

Importance of Control and Optimism • Elderly persons in nursing homes, that were given more control, significantly improved their health and psychological well-being. • Studies have also shown that those who are more optimistic and have a more positive “explanatory style” also live longer.

Promoting Health Depression 14 score 13 No-treatment group 12 11 10 Relaxation treatment group 9 8 7 6 Aerobic exercise group 5 4 3 Before treatment evaluation After treatment evaluation Aerobic Exercise: *sustained exercise that increases heart and lung fitness *may also alleviate depression and anxiety

Promoting Health Biofeedback: – electronically recording, amplifying, and feeding back information regarding a subtle physiological state • blood pressure • muscle tension

Promoting Health Predictors of mortality Relative risk of dying 1 0. 8 0. 6 0. 4 0. 2 0 Not smoking Regular exercise Weekly religious attendance Women Men

Promoting Health § Religious Attendance

Promoting Health § The religion factor is mulitidimensional Healthy behaviors (less smoking, drinking) Religious involvement Social support (faith communities, marriage) Positive emotions (less stress, anxiety) Better health (less immune system suppression, stress hormones, and suicide)

Promoting Health Complementary and Alternative Medicine: – Unproven health care treatments. They are not taught widely in medical schools, are not used in hospitals, and are not usually reimbursed by insurance companies.

Subfields of Alternative Medicine Alternative systems of medical practice Health care ranging from self-care according to folk principles, to care rendered in an organized health care system based on alternative traditions or practices Bioelectromagnetic applications The study of how living organisms interact with electromagnetic (EM) fields Diet, nutrition, life-style changes The knowledge of how to prevent illness, maintain health, and reverse the effects of chronic disease through dietary or nutritional intervention Herbal medicine Employing plan and plant products from folk medicine traditions for pharmacological use Manual healing Using touch and manipulation with the hands as a diagnostic and therapeutic tool Mind-body control Exploring the mind’s capacity to affect the body, based on traditional medical systems that make use of the interconnectedness of mind and body Pharmacological and biological treatments Drugs and vaccines not yet accepted by mainstream medicine

Promoting Health Smoking-related early deaths

Smoking Prevention • The ups and downs of U. S. teen smoking.

The Impact of a Healthy Diet

Preliminary findings of 1800 college students: 1) 59 percent say they know their diet has gone downhill. 2) During freshman year, students gain an average of 5. 5 (men) and 4. 5 (women) lbs. 3) 66 percent of freshman don’t consume the recommended five servings of fruits and vegetables. 4) 60 percent eat too much artery-clogging saturated fat. 5) 50 percent of all students don’t get enough fiber. 6) 30 percent of women don’t get enough calcium. 7) 32 percent report decline in body image. 8) 40 percent of women see themselves overweight. 9) 41 percent report decline in overall happiness during freshman year. 10) Students who exercise report greater levels of happiness.

Obesity is caused by three main things: 1) how much exercise we do, 2) how many times we use technology, 3) and how much we eat.

Obesity and Weight Control Obesity and mortality Relative risk of death 2. 8 2. 6 2. 4 2. 2 2. 0 1. 8 1. 6 1. 4 1. 2 1. 0 0. 8 0. 6 18. 5 - 20. 5 - 22. 0 - 23. 5 - 25. 0 - 26. 5 - 28. 0 - 30. 0 - 32. 0 - 35. 020. 4 21. 9 23. 4 24. 9 26. 4 27. 9 29. 9 31. 9 34. 9 39. 9 Men Body-mass index (BM I) Women 40

Obesity and Weight Control Obesity and body mass index

Weight Control § Trading risks

Weight Control § Thinning of Miss America

Weight Control Obesity was more common among those who watched the most television Skinfold fat measure (mm) 32 30 28 26 24 22 20 <2 2 -3 >4 Hours of television watched per day in 1990 s study Boys Girls

Nine Nutritional Rules to live by: 1) Make vegetables and fruits the heart of most meals and snacks. (fiber, vitamins, & other antioxidants) 2) Go for whole grains. 3) Don’t overlook beans. (plant protein, folic acid, fiber) 4) Cook with liquid oils. (olive & canola oils) 5) Favor fat-free dairy products. (calcium, minerals bring down blood pressure) 6) Check your chicken……. take off fat and skin 7) Lighten up on cheese. 8) Move meats to the side. (supporting role) 9) Order fish & shrimp. Choose grilling or broiled seafood for reduced intake of fat and calories.

WHAT DO THE LABELS MEAN? 1) “All Natural” has no legal meaning. (can still have preservatives, artificial flavoring, and other additives) 2) “Light” or “Lite” is virtually meaningless. The term can refer to pale color, low sodium taste, reduced alcohol, fluffy texture. 3) “Sugarless” or “sugar-free” means no sucrose (table sugar) but it does not cover glucose, fructose, or sorbitol. 4) “Enriched” can mean that enriched foods have lost nutrients during processing and then replaced. 5) “Low Calorie” simply means that a food has less than 40 calories per serving and less than 0. 4 calories per gram 6) “Fortified” mean that some nutrient has been added that was not there in the first place 7) “Fruit-blend” refers to as little as 10 percent juice and may be mostly sugar and water 8) “ 75% Lean” mean one-quarter fat by weight, which is a lot of fat.