STRESS AND HEALTH CHAPTER 16

Transcription

1 1 STRESS AND HEALTH CHAPTER 16

2 STRESS & HEALTH Where are we going today? Definitions of stress Causes: Bring on the stressors! How does stress affect us physically? Physiological Stress Response Stress & the Immune System PTSD post-traumatic stress disorder Coping Strategies for Stress

3 3 HEALTH PSYCHOLOGY Can the mind affect the body to the point of death? Walter Cannon reviewed reports from around the world Physical trauma can cause death, why not psychological trauma? Profound link between the mind and the body This research is just one part of a larger area looking into the relationship between mind-body-health Health psychology (a part of behavioral medicine) is: interested in how various factors (biological, psychological, and social) are related to the development and maintenance of disease, as well as the promotion of health.

4 4 EXPERIENCING STRESS The term stress means different things to different people Lay person tension and unpleasant feelings Athlete training before a contest Business work load and time pressure Psychologists use different definitions and measure it in different ways Major life events Daily hassles Biological measures Most common definition focuses on: Person-Environment Fit- poor fit results in stress

5 5 DEFINITIONS OF STRESS Stressor: situation or stimulus producing stress Stress as a physical force Most simplistic view Emphasis on external events Need to simply resist external pressure Stress as an internal tension Way mentally deal with stressor Internal war to cope with the overwhelming May eventually lead to disease Stress as body arousal Medical research shows that people react physiologically the same way regardless of type of stress

6 YERKES-DODSON RULE 6

7 TYPES OF STRESSORS Catastrophes: war, natural disaster, trauma Societal: pressures of social, cultural, and economic environment Hassles: minor annoyances or frustrations Usually involves blocking of a goal Any changes in the status quo Social Readjustment Rating Scale > 300 = 70% chance of stress-related illness Acute stress versus chronic stress Chronic = bad!

8 WHY DO WE HAVE STRESS? Is stress a positive or negative emotion? Evolutionary benefit Fight or Flight survival mechanism Our stress response is an adaptive response to that environment Models of stress: General Adaptation Syndrome Selyé was not the first to use the term stress Examined link between stress and disease Started with environmental focus Non-specific response to the environment Homeostasis

9 PHYSICAL STRESS RESPONSE Hans Selye 1930s - General Adaptation Syndrome: changes in physiology in response to a stressor Alarm reaction: fast but short response Release of steroid hormones, increase BP Resistance Stage: chronic response Reduction hormone levels, continue shift energy to stress, body adapted to stress Exhaustion: depletion of resources Increase in hormone levels, dangerously low levels of immune system, increased sensitivity to stressor

10 MODEL OF STRESS SELE S GENERAL ADAPTATION SYNDROME (GAS) 10

11 HORMONES & STRESS Neurons provide short-term acute activation of the sympathetic nervous system -> fight or flight Hormones provide chronic activation of the sympathetic nervous system

12 STRESS ACTIVATED HORMONES HPA axis: Hypothalamus and Pituitary stimulate the Adrenal cortex to release cortisol Cortisol stimulates the body to elevate the blood glucose level & increase basal metabolism Glucocorticoid receptors are found on almost every cell in the body

13 IMPACT OF STRESS ON GENERAL HEALTH Chronic stress increases the risk of developing hypertension Air traffic controllers have a high rate of burnout chronic stress High stress airports Low stress airports

14 IMPACT OF STRESS ON THE IMMUNE SYSTEM Natural killer cells (lymphocytes) search out foreign antigens and destroy them Stress steals the energy needed to maintain normal levels of natural killer cells

15 STRESS & RECOVERY FROM INJURY Stress takes energy away from recovery processes in the body Healing of a wound following a biopsy - Control group vs Caregivers of elderly family members

16 STRESS AND DISEASE 16

17 17 STRESS AND DISEASE Exams can be dangerous to your health Physiological Change After exam cold or flu? Not everyone gets sick Exposure Contraction Stressor Stress Reactivity Stress Recovery Allostatic Load Stress Resistance Illness Contraction Symptoms or illness Behavioral change

18 STRESS & THE IMMUNE SYSTEM Method: Ss given nasal spray containing a cold virus Finding: Reported levels of stress positively correlated with increased probability of contracting cold How does chronic stress impact the immune system?

19 STRESS & THE IMMUNE SYSTEM Method: Ss kept a 12-week record of daily events Results: 3-5 days prior to upper respiratory infection there was increase in undesirable with decrease in desirable events

20 POST-TRAUMATIC STRESS DISORDER (PTSD) Post-Traumatic Stress Disorder (PTSD) delayed stress reaction to a major stressor Flashbacks of trauma (hallucinations) Avoidance of stimuli associated with trauma Chronic arousal Physical symptoms: sleep loss, weight loss, exaggerated startle response Pain-control system may become constantly activated Involves diminished pleasure Alienation from other people (guilt, fear)

21 PTSD - TREATMENT Medically treat the individual symptoms Sleep disturbances, anxiety, depression Cognitive-Behavioral Therapy Exposure / Desensitization procedures PTSD = Type of conditioning so use extinction Stress coping mechanisms Cognitive thought patterns rationalization of the traumatic event and avoidance

22 22 COPING WITH STRESS Coping definition Constantly changing efforts to manage the specific demands that are appraised as exceeding the resources of the individual Approach versus Avoidance Approach: Confronting problem, gathering information, taking direct action Avoidance: Minimize importance of event Problem-focused versus Emotion-focused Problem-focused: proactive attempt to reduce demands, increase resources Emotion-focused: Manage emotions evoked by event

23 23 COPING WITH STRESS Social Support Push (constant support) versus Pull (demand from others) Informational support: Others who have had similar experiences provide information Emotional support: Warmth and nurturance, single confidant, more important for men Appraisal support: Helping others understand and identify coping strategies Tangible support: Provision of material support, services, financial assistance, or goods

24 24 CONTROL AND STRESS Attributions of control over the environment are important in the experience of stress Andy Baum and Three Mile Island Three Mile Island was a nuclear power plant near Harrisburg, PA that had a core meltdown in 1979 Many people started to report illnesses and moved away from Harrisburg Health effects or lack of control? Compared people with radon gas in basement to people who stayed near the power plant More stress with TMI accident compared with people who were exposed to radon gas

25 25 CONTROL AND STRESS Perceived control predicts amount of stress experienced Langer and Rodin (1976) Nursing home residents One group was given more control: move furniture, choose menu items, sit with different people, take care of a plant Control group: no change in routine, were given a plant but were not asked to care for it Overall results showed that having more control and more responsibility was very beneficial for the first group Results were maintained for 18 months after the study

26 ROLE OF PERSONALITY TYPES Personality does influence response to stressor and use of coping mechanisms Type A intense, aggressive, competitive, impatient Type B relaxed, laidback, unmotivated, patient Ineffective use of coping mechanisms may prolong stress response Prolonged stress increases susceptibility to disease and illness So, personality can play an indirect role in your susceptibility to disease

27 27 PERSONALITY AND STRESS Worst Cities for Worst Cities for Angriest Cities Women s Health Men s Health (Men s (Men s Health, 2006) (Women s Health Health, 2010) 2010) Orlando, FL Detroit, MI St. Petersburg, FL St. Petersburg, FL Jacksonville, FL Birmingham, AL Detroit, MI Riverside, CA Modesto, CA Baltimore, MD Bakersfield, CA Cleveland, OH Nashville, TN Memphis, TN Detroit, MI Wilmington, DE Birmingham, AL Charleston, WV Miami, FL St. Petersburg, FL Toledo, OH Memphis, TN Las Vegas, NV Memphis, TN Jacksonville, FL St. Louis, MO St. Louis, MO St. Louis, MO Charleston, WV Bakersfield, CA

28 28 STRESS MANAGEMENT What to do about stress? Gain control over your environment Need to find ways to decrease stress after it happens Time management Relaxation techniques Progressive muscle relaxation Autogenic relaxation Meditation Biofeedback Exercise, Don t smoke, Nutrition, Avoid risky behavior Aerobic exercise is very effective in improving mood and decreasing stress

29 29 STRESS MANAGEMENT Ongoing study in Alameda County CA (Berkley) Identified health related behaviors (More the better, >6) Getting 7-8 hours of sleep a night Breakfast Rarely eat between meals Drinking moderate amounts of wine 1 drink a day better than 0 and more than 2 No smoking Exercise regularly Maintain healthy weight