Health Psychology

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Health Psychology Behavioral Medicine

• Health psychology Studies the relationship
  between psychological factors and physical health
• Behavioral Medicine (not Psych) Interdisciplinary
  field integrating behavioral and medical
  knowledge
• Health Psych Division 38

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Health Psychology True or False

• Half the mortality from the 10 leading causes of
  death is due to peoples behavior
• People tend to die younger in areas where there
  is greater income inequality
• Compared to others, pessimists are more than
  twice as likely to develop heart disease
• Writing about personal traumas in a diary reduces
  stress and the likelihood of health problems
• Religious faith and health show a strong positive
  correlation
• Smoking a cigarette takes 12 minutes off ones
  life expectancy
• Genes influence ones propensity to cigarette
  addiction

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Leading Causes of Death 1900 and 2000
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Health and Stress

• Stress A state of psychological tension or
  strain where we respond to stressors that we
  appraise as threatening or challenging. Distress
  and Eustress
• Stressors Events or circumstances that trigger
  stress
• Adjustment Any attempt to cope with stress

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Sources of Distress

• Everyday Hassles Specific examples?
• Pressure
• Frustration
• Discrimination
• Conflict
• Extreme Events and Stress
• Bereavement and loss
• Unemployment
• Divorce and separation
• Catastrophes
• Combat

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Sources of Stress

• Major life changes Social Readjustment Rating
  Scale (SRRS) Holmes Rahe
• Assesses impact of major life changes
• Problems Adult oriented. Fails to account for
  different contexts. Cross-cultural limitations
• SRSS online
• Undergraduate scale
• HR Non-Adult Life Event Scale

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Daily Hassles Approach-Avoidance

• Opposing Tendencies (Lewin) Four types of
  approach-avoidance conflicts
• Approach/Approach conflict When a person is
  simultaneously attracted to two appealing goals.
  Conflict arises from choice
• Avoidance/Avoidance When a person is facing two
  undesirable or threatening choices. A rock and
  a hard place scenario
• Approach/Avoidance A person is simultaneously
  attracted to and repelled by the same situation.
  Mmmmcheesecake, fattening
• Multiple Approach/Avoidance Several alternative
  courses of action with many promising an
  distressing aspects, e.g. get job or go to grad
  school

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Extreme Stress Psychological Consequences

• Post-Traumatic Stress Disorder (PTSD)
• Episodes of anxiety, recurrence, sleepless- ness,
  and nightmares
• Victims may withdraw from social life, job and/or
  family responsibilities
• Depression and suicide

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Stress and the Role of Appraisal

• Psychological stress resides neither in the
  situation nor the person it depends on the
  transaction between the two. It arises from how
  the person appraises an event and adapts to it.
  (LazarusRemember him?)
• Stress impact depends on frequency, duration and
  intensity as well as personality, coping style
  and events of the day

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Locus and Loss of Control

• Catastrophic events, major life changes, daily
  hassles and conflicts are especially stressful
  when perceived as uncontrolled
• Changes in workplace and nursing home settings
  (Rodin) that increase control result in less
  stress, illness and reported higher life
  satisfaction
• Discovering Psych - Health

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Pessimism and Heart Disease

• Pessimistic adult men are twice as likely to
  develop heart disease over a 10-year period
  (Kubzansky et al., 2001)

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Optimistic Explanatory Style
Those with optimistic (instead of pessimistic)
explanatory styles tend to have more control over
stressors, cope better with stressful events,
have better moods, and have stronger immune
systems
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Stress and Individual Differences

• Hardiness A characteristic of people who can
  tolerate stress well or even thrive on it
• Resilience Ability of a person to bounce back
  after a stressful event (Resiliency theory)
  Resilience Q
• Self-imposed stress People who have irrational,
  self-defeating beliefs that add unnecessarily to
  the normal stresses of living

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Socioeconomic and Gender Differences

• Research findings
• Lower socioeconomic status can predict more
  stressful environments and fewer psychological
  resources for dealing with stress
• Women and men seem to be equally affected by
  stress physiologically, but deal with it
  differently (tend and befriend) role of
  oxytocin). Women deal more effectively
• .

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Types of Stress Response
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Stress and Health Type A and B (and D)
Personalities

• Type A Competitive, hard-driving (Friedman and
  Rosenman). Correlates with heart disease, though
  this is Primarily due to 1) negative emotions
  (anger and hostility) and 2) associated behaviors
  (impatience, verbal aggressiveness, and anger)
• Type B More easygoing, relaxed people
• Type D Emotionally distressed people. Often
  characterized by social withdrawal. Correlates
  with higher rates of stress, disease and death

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Stress Reaction

• General Adaptation Syndrome (Hans Seyle)
• Alarm reaction (sympathetic arousal-need to fight
  off physical or psychological threats Cannons
  fight or flight). Epinephrine
• Adaptation/Resistance (effort to maintain high
  level of resistance-attempts to maintain
  psychological equilibrium. Corticosteroid
  production.
• Exhaustion (depletion of reserves)
• The body is designed to cope with temporary
  stress prolonged stress leads to physical
  deterioration due to destructive levels of
  corticosteroids (cortisol)
• Parasympathetic rebound can lead to death

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Selyes GAS
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The Biology of Stress

• GAS and the Fight or flight response (Cannon)
• Hypothalamus directs pituitary to release
  epinephrine into the bloodstream
• Complex of sympathetic arousal Increased heart
  rate, respiration, blood from digestion to
  muscles, masks pain, releases sugar and fat from
  bodys stores to deal with stress.
  Parasympathetic rebound can lead to death
• Release of cortisol/corticosterones (stress
  hormone) from outer part of adrenal gland (its
  how we measure stress)
• Stress Effects HW

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Stress and Disease

• Psycho-physiological illness Stress-related
  physical illness
• Some hypertension, headaches, and
  gastrointestinal issues
• Distinct from hypochondriasis misinterpreting
  normal physical sensations as symptoms of a
  disease
• Psycho-neuroimmunological disease Interaction
  between stress and the immune, endocrine, and
  nervous systems
• Chronic stress can suppress immune function.
  Role of cortisol (lymphocytes)
• Possible link between stress and cancer

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Stress and the Immune System

• B lymphocytes fight bacterial infections
• T lymphocytes attack cancer cells and viruses
• Microphages ingest foreign substances
• During stress, energy is mobilized away from the
  immune system making us vulnerable

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The Brain on Stress

• The damaging (and helpful) effects of stress on
  the brain and cognition (hippocampus cortisol,
  emotions and memory, brain-blood barrier, brain
  degeneration)
• The Human Brain Stress
• Resource The Brain Teaching Modules
• Stress and Memory

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Direct Coping

• Direct/Proactive coping
• Use of intentional methods to address stress
• Confrontation/Compromise/Withdrawal
• Anticipate stressful events and take steps to
  avoid them
• Positive reappraisal (again, Lazarus)
• Alter the way you think about a stressful
  situation or make the best of a tense or
  stressful event. Importance of humor

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Defensive Coping

• Defensive coping
• Occurs when one cannot identify the source of
  stress or do anything to change the situation
• Use of self-deceptive techniques known as
  defense mechanisms to reduce stress. Types
  include denial, repression, projection,
  regression, reaction formation, displacement, and
  sublimation

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Methods of Reducing Stress

• Calm down
• Exercise and healthy lifestyle
• Relaxation training (biofeedback)
• Meditation
• Reach out
• Social support network
• Religion
• Studies have shown an association between
  religion and lower stress levels
• Altruism
• Giving to others (do good)
• Shown to be a good way to reduce stress

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Biofeedback, Relaxation, and Meditation

• Biofeedback systems use electronic devices to
  inform people about their physio-logical
  responses and gives them the chance to bring
  their response to a healthier range (Neal
  Miller). Relaxation and meditation have similar
  effects in reducing tension and anxiety

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The Religion Factor
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Why Do People Smoke?

• Social rewards
• Genetic factors
• Smoking/Nicotine removes unpleasant cravings (aka
  negative reinforcement) by triggering
  epinephrine, norepinephrine, dopamine, and
  endorphins
• Nicotine itself is rewarding (positive
  reinforcement)

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Genetic Factors in Obesity
Identical (MZ) twin studies reveal that body
weight has a genetic basis
The obese mouse on the left has a defective gene
for the hormone leptin. The mouse on the right
sheds 40 of its weight when injected with leptin