Stress

and
Health

Stress and Health

Why bother studying this issue?

Stress and Health: Why?

Leading causes of death in the US in 1900 and 1991
Percentage
U.S.deaths

Percentage
U.S.deaths

30

30

20

20

10

10

0
Tuberculosis

Pneu- Diarrhea/ Heart

monia enteritis disease

1900

Unlike many leading

killers a century ago,
todays major
killers are more
lifestyle-related

Heart Cancer
disease

Strokes Chronic
lung disease

1991

Relationship between
Stress & Health
MIND/STRESS

BODY/HEALTH

Stress and Health

Behavioral Medicine
interdisciplinary field
integrates behavioral and medical knowledge
applies that knowledge to health and disease
e.g.: quitting smoking

Health Psychology
subfield of psychology
psychologys contribution to behavioral
medicine

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

What is Stress?
Stressors
Catastrophes
Life changes
Hassles

Intervening
factors
Appraisal
Perceived control
Personality
Stress
Social support
reactions
Coping behaviors Physiological
Emotional
Behavioral

How do we respond to
stress?
Cerebral cortex
(perceives stressor)
Pituitary hormone
in the bloodstream
stimulates the outer
part of the adrenal
gland to release
the stress hormone
cortisol

Adrenal
glands

Thalamus
Hypothalamus
Pituitary
gland

Sympathetic nervous
system releases the
stress hormones
epenephrine and
norepinephrine
from nerve endings
in the inner part of
the adrenal glands

The Fight
or Flight
Respons
e

General Adaptation Syndrome

Selyes concept
bodys adaptive
response to
Stress
resistance
stress

The bodys resistance to stress can only

Last so long before exhaustion sets in

Stressor
occurs

Phase 1
Alarm
reaction
(mobilize
resources)

Phase 2
Resistance
(cope with
stressor)

Phase 3
Exhaustion
(reserves
depleted)

Stress and Control

Animal studies of control and helplessness

Executive rat

To shock control

Subordinate rat

To shock source

Control rat

No connection
to shock source

Stress and Control

Langer & Rodin
Studies of nursing home residents
Those given choice did better:
greater life satisfaction
18 mnths later half the death rate!

Teaching Control
Strategies
Example:
Ongoing collaborative study
PI Bruce Compas (UVM)

Coping Skills Support groups

for women with breast cancer
teach coping strategies for managing
stress

Prior research on stress & cancer

Support groups:
seem to provide psychological
benefits
health benefits are still being studied
some research showed increased survival
Spiegel
Fawzy

but some other studies did not

Research Design
12 week Group
Coping Skills
New
breast
cancer
patients

12 week Group
SupportiveExpressive

8 month
Wait-List Control

Follow-up

Follow-up

1-4 year
Follow-up
1-4 year
Follow-up

12 week Group

1-4 year

Coping Skills

Follow-up

12 week Group

1-4 year

SupportiveExpressive

Follow-up

Coping Skill Samples

Cognitive-reframing
Appraisal is key (Lazarus)
A -> B - > C
Activating Event
Belief (Appraisal)
Consequence

Relaxation techniques
Counteract the normal fight-flight
response to stress
Class Exercise
Guided Imagery

Stress & Coronary Heart Disease

Friedman and Rosenman
Type A
competitive, hard-driving,
impatient, verbally aggressive,
anger-prone

Type B
easygoing, relaxed people

Class Exercise

Stress & Coronary Heart Disease

Williams: Updated Theory
Hostility
this is the key feature of Type A related
to health
the toxic core
not simply being hard-working and
intense

Stress and Disease

Negative emotions and health-related
consequences
Heart
disease

Negative
emotions

Unhealthy behaviors
(smoking, drinking,
poor nutrition and sleep)

Stress
hormones

Immune
suppression

Autonomic nervous
system effects
(headaches,
hypertension)

Promoting Health
Can modifying Type A life-style
reduce recurrence of heart attacks or
even death?
Friedman & Ulmer (1984)
assigned hundreds of MI survivors to either:
Standard doctor advice
Life modification counseling + standard doctor
advice

Yes!!!

Promoting Health
Modifying Type A life-style can
reduce recurrence of heart attacks
6

Percentage
of patients 5
with recurrent
heart attacks 4
(cumulative
average) 3

Control patients
Modifying life-style
reduced recurrent
heart attacks

2
Life-style modification patients

1
0
1978

1979

1980

Year

1981

1982

Other factors that may promote

health:

Smoking Prevention
Smoking
has made
a partial
comeback
among
U.S. teens

How to Quit
Interventions beyond education
eliminate the social reinforcement
increase social support for quitting

Cost
tax it to shorten the time between behavior and
punishment
reduces smoking by 4% for every 10% increase in
costs

Nicotine Replacement- Patch & Gum

reduce pharmacological addiction
then treat psychological addiction

Promoting Health
14

Depression
score 13

No-treatment
group

12
11
10
Relaxation
treatment
group

9
8
7
6

Aerobic
exercise
group

5
4
3
Before treatment After treatment
evaluation
evaluation

Aerobic
Exercise
sustained
exercise
increases heart
and lung fitness
may also
alleviate
depression and
anxiety

Prevention
Prudentials experience
with a fitness program
reduced sick days by 20%
reduced medical costs by
46%
saved $1.93 for every dollar
spent on health care

Stress and Control

Matarazzo: What we can do to control our health:
Sleep 7-8 hrs every night
Eat breakfast every day
Get weight in normal range
Dont smoke
Alcohol sparingly or not at all
Regular physical exercise
Wear seat belts
Drive the speed limit
Follow good diet
Have a physician you can communicate with