Stress, emotion and the heart

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Stress, emotion and the heart
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Basic Reading This course is not organised around
a textbook. I shall refer primarily to material
in journals. Also consult basic health psychology
texts such as EP Sarafino 2006 Health
Psychology biopsychosocial interactions (5th
Edition) S Taylor (2006) Health Psychology (6th
Edition) The is also an excellent by old book on
the topic A Steptoe (1981) Psychological factors
in cardiovascular disorders. Steptoe has also
written a very good chapter on Psychophysiologica
l bases of disease in Johnston Johnston,
Health Psychology, volume 8 of Bellack Hersen
Comprehensive Clinical Psychology (find under
Bellack Hersen)
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Definition Health Psychology The study of
psychological process in health, illness and
health care
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John Hunter famous 18th century Scottish surgeon
anatomist of the 18th century My life is in
the hands of any rascal who chooses to annoy or
tease me Died after argument at St George
hospital medical school (over student admissions)
1897, William Osler - dominant figure in
internal medicine - described the typical heart
disease patient as "a keen and ambitious man, the
indicator of whose engine is always at 'full
speed ahead.
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Patients beliefs about causes of MI. Percentage
considering factor a possible cause At discharge
2month 6 months 12 months Stress 70 72 61 61
Smoking 59 55 47 53 Worry 58 55 33 28 Will of
God 27 21 9 2
Gudmunsdottir, Johnston, Johnston Foulkes,
(2001) BJHP, 6, 81-96.
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Brod. Mental arithmetic leads to increase in
cardiac output (blood pumped by heart). Decrease
in peripheral resistance, but blood pumped bigger
effect in this case so blood pressure increases.
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Heart Rate increased by stress. Decreases again
with exposure but less so in hard but not
impossible condition. Obrist. Hard condition
involves active coping
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Guest lecturer speaking to this class last year.
HR high before and during lecture . Took at least
an hour to get back to normal
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• Coronary Heart Disease and Acute Coronary
  Syndromes
• A slow process of arterial deterioration
• An acute process that triggers a clinical event

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The Reactivity Hypothesis Stress (and some
emotions) leads to altered physiological
responses in some people and these responses are
harmful to the arteries. A stress diathesis
(vulnerability) model.
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Studies in Health populations Kuper Marmot
Hemingway (2002), Seminars in Vascular
Medicine,2, 267-313 Psychological
process positive/no. of studies Type A /
Hostility 6/18 Depression 15/22 Anxiety
4/8 Work characteristics 10/13 (Social
Support 6/9) Studies in Populations with
Cardiovascular Disease Type A/Hostility
2/15 Depression 18/34 Anxiety 8/18 Work
characteristics 2/4 (Social Support
14/21) Seen as positive support overall By K,M
H
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Depression reduced in patients after MI by simple
Counselling intervention
Johnston,M, Foulkes J, Johnston, D, Pollard, B,
Gudmundsdottir, H (1999) Psychosomatic Medicine,
61, 225-233
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Depression reduced in partners of MI patients who
received counselling
Johnston,M, Foulkes J, Johnston, D, Pollard, B,
Gudmundsdottir, H (1999) Psychosomatic Medicine,
61, 225-233
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