chapter 14 stress and illness - madison-schools.com

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Chapter14StressandIllness

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Stress

Psychologicalstatescausephysicalillness.Stressisanycircumstancethatmayberealorperceivedand

threatensone’swell‐being.

Whenseverestressisfeltitimpairsourabilitytocopewithit.

LeeStone/Corbis

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StressandCausesofDeath

Prolongedstress–togetherwithunhealthybehaviors–canincreaseourriskfortoday'sfourleading

diseases.

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BehavioralMedicine

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

exercise,drugsandpoornutriPon).

Psychologistsandphysicianshavethusdevelopedaninterdisciplinaryfieldofbehavioralmedicinethatintegratesbehavioralandmedicalknowledge.

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HealthPsychology

Healthpsychologyisafieldofpsychologythatcontributestobehavioralmedicine.Thefieldstudies

stress‐relatedaspectsofdiseaseandasks:

1.  HowdoemoPonsandpersonalityfactorsinfluenceriskofdisease?

2.  WhataXtudesandbehaviorspreventillnessandpromotehealthandwell‐being?

3.  HowourpercepPonsdeterminestress?

4.  Howcanwereduceorcontrolstress?

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

problems.

StressandIllness

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StressandStressors

Stressisaslipperyconcept.AtPmesitisthesPmulus(missinganappointment)andatotherPmesitisa

response(sweaPngwhiletakingatest).

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StressandStressors

StressisnotmerelyasPmulusorresponse,itisprocessbywhichweappraiseandcopewith

environmentalthreatsandchallenges.

Whenshort‐livedortakenasachallenge,stressorscanhaveposiPveeffects.However,prolongedorthreateningstresscan

beharmful.

BobDaem

mrich/TheIm

ageWorks

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TheStressResponseSystem

Canonproposedthatstressresponse(fast)wasafight‐or‐flightresponsemarkedbyoutpourof

epinephrineandnorepinephrinefrominneradrenalglandsincreasingheartandrespiraPonrates,

mobilizingsugarandfatanddullingpain.

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TheStressResponseSystem

Thehypothalamusandthepituitaryglandalsorespondtostress(slow)

bytriggeringouteradrenalglandstosecreteglucocor,coids(corPsol).

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GeneralAdaptaPonSyndrome

AccordingtoSelyestressresponsetoanykindofsPmulaPonissimilar.Thestressedindividualgoes

throughthreephases.

EPA/YuriKoche

tkov/Land

ov

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StressfulLifeEvents

CatastrophicEvents:earthquakes,combatstress,floodsleadindividualsbecomingdepressed,

sleepless,andanxious.

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SignificantLifeChanges

Deathofalovedone,divorce,lossofjob,promoPonmayleaveindividualvulnerabletodisease.

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DailyHassles

Rushhourtraffic,longlines,jobstress,burnoutaremostsignificantsourcesofstressandcandamage

health

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StressandtheHeart

StressthatleadstoelevatedbloodpressureresultsinCoronaryHeartDiseasescloggingofthevesselsthat

nourishtheheartmuscle.

Plaqueincoronaryartery

Arteryclogged

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PersonalityTypes

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

people.TypeBeasygoing,relaxedpeople(FriedmanandRosenman,1974).

TypeAaremorelikelytodevelopcoronaryheartdisease.

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PessimismandHeartDisease

PessimisPcadultmenaretwiceaslikelytodevelopheartdiseaseovera10yearperiod(Kubzanskyetal.,

2001).

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Stress&SuscepPbilitytoDisease

Psychophysicalillnessisanystress‐relatedphysicalillness,suchashypertensionorheadaches.

Hypochondriasis–misinterprePngnormalphysicalsensaPonsassymptomsofdisease.

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StressandtheImmuneSystem

BlymphocytesfightbacterialinfecPons,Tlymphocytesakackcancercells,viruses,and

microphagesingestforeignsubstances.Duringstressenergyismobilizedawayfromtheimmunesystem

makingitvulnerable.

LennartNilsson/BoehringerIngelheinInternaPonalG

mbH

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StressandColds

Peoplewithhighestlifestressscoreswerealsomostvulnerablewhenexperimentallyexposedtoacold

virus.

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StressandAIDS

StressandnegaPveemoPonsmayacceleratetheprogressionfromhumanimmunodeficiencyvirus

(HIV)toacquiredimmunedeficiencysyndrome(AIDS).UNAIDS/G

.Pirozzi

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StressandCancer

Stressdoesnotcreatecancercells.Researchersdisagreeonwhetherstressinfluencescancer

progression.TheydoagreethatavoidingstressandahopefulaXtudecannotreverseadvancedcancer.

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StressandImmuneCondiPoning

IftheimmunesystemcanbesuppressedthroughcondiPoning.Researchersbelievethatimmune

enhancingresponsescouldbeinculcatedtocombatviraldiseases.

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Health‐RelatedConsequences

Stresscanhaveavarietyofhealth‐relatedconsequences.

Kathleen

Finlay/M

asterfile

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CopingWithStress

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StrategiesForAlleviaPngStress

Reducingstressbychangingeventsthatcausestressorbychanginghowwereacttostressiscalled

problem‐focusedcoping.

WhenwecannotchangeastressfulsituaPon,andrespondbyakendingtoourownemoPonalneedsit

iscalledemoPon‐focusedcoping.

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PerceivedControl

Researchwithratsandhumanshasindicatedthatabsenceofcontroloverstressorsisapredictorof

healthproblems.

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ExplanatoryStyle

PeoplewithopPmisPc(comparedtopessimisPc)explanatorystyletendtohavemorecontroloverstressors,copebekerwithstressfulevents,havebekermoodsandhaveastrongerimmunesystem.

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SocialSupport

SupporPvefamilymembers,marriagepartners,andclosefriendshelppeoplecopewithstress.Their

immunefuncPoningcalmsthecardiovascularsystemandlowersbloodpressure.

BobDaemmrich/Stock,Boston

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ManagingStress

Havingasenseofcontrol,opPmisPcexplanatorystyle,socialsupportcanreducestressandimprove

health.

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AerobicExercise

Canaerobicexerciseboostthespirit?Manystudiessuggestthataerobicexercisecan

elevatemoodandwell‐being,becauseaerobicexerciseraisesenergy,

increasesself‐confidence,lowerstension,

depressionandanxiety.

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Biofeedback,RelaxaPonandMeditaPon

Biofeedbacksystemuseselectronicdevicestoinform

peopleabouttheirphysiologicalresponses,andgivesthemthechancetobringtheirresponseintoahealthierrange.RelaxaPonandmeditaPonhavesimilareffectsinreducingtension

andanxiety.

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Life‐Style

ModifyingTypeAlife‐stylecanreducerecurrenceofheartakacks.

GhislainandMarieDavidDeLossy/Gek

yIm

ages

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Spirituality&FaithCommuniPes

Regularreligiousakendancehasbeenareliablepredictorofalongerlifespanwithareducedriskof

dying.

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InterveningFactors

InvesPgatorssuggestthreefactorsthatintervenebetweenreligiousinvolvementandbekerhealth.

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ManagingStress:Summary

Howcanstressbemanaged?

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ModifyingIllness‐RelatedBehaviors

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ModifyingIllness‐RelatedBehaviors

EliminatesmokingwouldincreaselifeexpectancymorethananyotherprevenPvemeasure.

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WhyPeopleSmoke?

1.  Peoplesmokebecauseitissociallyrewarding.

2.  SmokingalsoresultsbecauseofgenePcfactors.

RusselEinhorn/TheGam

maLiasonN

etwork

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WhyPeopleSmoke?

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

4.  NicoPneisitselfrewarding(posiPvereinforcement).

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BiopsychosocialFactors:Smoking

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HelpingSmokersQuit

Smokinghasdecreasedinwesterncountries,especiallyinhighersocioeconomicandeducaPonal

levelgroups.

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WaystoQuitSmoking

1.  Setaquitdate.

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

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

Afewpointerstoquitsmokingare:

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SmokingAbsPnencePrograms

SmokingabsPnenceprogramsforteens:

1.  InformaPonabouttheeffectsofsmoking

2.  InformaPonaboutpeer,parent&mediainfluence3.  Traininginrefusalskills

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DoProgramsWork?

PrevenPonprogramsdohaveaneffectonsmoking.

PaulJ.Milek

e/PalmBeachPost

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ObesityandWeightControl

Fatisanidealformofstoredenergyandisreadilyavailable.InPmesoffamine

overweightbodiessignaledaffluence.

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BodyMassIndex(BMI)

Obesityinchildrenincreasestheriskofdiabetes,highblood

pressure,heartdisease,gallstones,arthriPs,

certaintypesofcancer,thusshorteninglife‐

expectancy.

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ObesityandMortality

Thedeathrateishighamongveryoverweightmen.

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SocialEffectsofObesity

Whenwomenapplicantsweremadetolookoverweight,subjectswerelesswillingtohirethem.

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PhysiologyofObesity

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

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SetPointsandMetabolism

Whenreducedfrom3,500to450caloriesweightlosswasaminimal6%andthemetabolicrateamere15%.

Obesedefendtheirweightbyconservingenergy.

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TheGenePcFactor

IdenPcaltwinstudiesrevealthatbodyweighthasgenePcbases.

ObesemouseatlethasdefecPvegeneforhormonelepPn,WheninjectedwithlepPnthemouseontheright

sheds40%ofitsweight.

CourtesyofJohnSolPs,TheRockefellerUniversity,N

ewYork,N

Y

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AcPvity

Lackofexerciseisamajorcontributortoobesity.JustwatchingTVfortwohoursresultedin23%ofweightincrease,whenotherfactorswerecontrolled(Huet

al.,2003).

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FoodConsumpPon

Overthepast40yearsaverageweightgainhasincreased.HealthprofessionalsarecajolingUS

ciPzenstolimittheirfoodintake.

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TradingRisks

ThoughcigarekesmokingovertheyearshasdeclinedintheAmericas,obesityisontherise.

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LosingWeight

InUS,two‐thirdsofwomenandhalfofmensaythattheywanttoloseweight.Themajorityofthemlose

moneyondietprograms.

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PlantoLoseWeight

Toloseweightbeginaweight‐lossprogramwhenmoPvated,minimizeexposuretotempPngfoodcues,exerciseasmallamounteveryday,forgiveyourselffor

lapses.

JoeR.Liuzzo

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AlternaPveMedicineOthermedicinalwaysofachievinghealth.