Myers’PSYCHOLOGY

Chapter14StressandHealth

第1頁StressandHealthBehavioralMedicineinterdisciplinaryfieldthatintegratesbehavioralandmedicalknowledgeandappliesthatknowledgetohealthanddiseaseHealthPsychologysubfieldofpsychologythatprovidespsychology’scontributiontobehavioralmedicine第2頁StressandIllnessLeadingcausesofdeathintheUSin1900and2023第3頁StressandIllnessStresstheprocessbywhichweperceiveandrespondtocertainevents,calledstressors,thatweappraiseasthreateningorchallenging第4頁StressAppraisalStressfulevent(toughmathtest)Threat(“Yikes!Thisisbeyondme!”)Challenge(“I’vegottoapplyallIknow”)Panic,freezeupAroused,focusedAppraisalResponse第5頁PituitaryhormoneinthebloodstreamstimulatestheouterpartoftheadrenalglandtoreleasethestresshormonecortisolSympatheticnervoussystemreleasesthestresshormonesepinephrineandnorepinephrinefromnerveendingsintheinnerpartoftheadrenalglandsThalamusHypothalamusPituitaryglandAdrenalglandsCerebralcortex(perceivesstressor)第6頁StressandIllnessGeneralAdaptationSyndrome

Selye’sconceptofthebody’sadaptiveresponsetostressinthreestagesStressresistancePhase1Alarmreaction(mobilizeresources)Phase2Resistance(copewithstressor)Phase3Exhaustion(reservesdepleted)Thebody’sresistancetostresscanlastonlysolongbeforeexhaustionsetsin

Stressoroccurs第7頁StressfulLifeEventsCatastrophicEventsearthquakes,combatstress,floodsLifeChangesdeathofalovedone,divorce,lossofjob,promotionDailyHasslesrushhourtraffic,longlines,jobstress,burnout第8頁StressfulLifeEventsChronicStressbyAge第9頁PerceivedControlHealthconsequencesofalossofcontrolNoconnectiontoshocksourceToshockcontrolToshocksource“Executive”rat“Subordinate”ratControlrat第10頁PerceivedControlEqualityandLongevity第11頁StressandtheHeartCoronaryHeartDiseasecloggingofthevesselsthatnourishtheheartmuscleleadingcauseofdeathinmanydevelopedcountries第12頁StressandtheHeartHopelessnessscores3.532.521.510.50HeartattackDeathLowriskModerateriskHighriskMenwhofeelextremehopelessnessareatgreaterriskforheartattacksandearlydeath第13頁StressandtheHeartTypeA

FriedmanandRosenman’stermforcompetitive,hard-driving,impatient,verballyaggressive,andanger-pronepeople

TypeBFriedmanandRosenman’stermforeasygoing,relaxedpeople第14頁StressandtheHeart第15頁StressandDiseasePsychophysiologicalIllness“mind-body”illnessanystress-relatedphysicalillnesssomeformsofhypertensionsomeheadachesdistinctfromhypochondriasis--misinterpretingnormalphysicalsensationsassymptomsofadisease第16頁StressandDiseaseLymphocytestwotypesofwhitebloodcellsthatarepartofthebody’simmunesystemBlymphocytesforminthebonemarrowandreleaseantibodiesthatfightbacterialinfectionsTlymphocytesforminthethymusand,amongotherduties,attackcancercells,viruses,andforeignsubstances第17頁StressandDiseaseConditioningofimmunesuppressionUCS(drug)UCR(immunesuppression)UCS(drug)UCR(immunesuppression)CS(sweetenedwater)CS(sweetenedwater)CR(immunesuppression)第18頁StressandDiseaseNegativeemotionsandhealth-relatedconsequencesUnhealthybehaviors(smoking,drinking,poornutritionandsleep)PersistentstressorsandnegativeemotionsReleaseofstresshormonesHeartdiseaseImmunesuppressionAutonomicnervoussystemeffects(headaches,hypertension)第19頁PromotingHealthAerobicExercisesustainedexercisethatincreasesheartandlungfitnessDepressionscore14131211109876543BeforetreatmentevaluationAftertreatmentevaluationNo-treatmentgroupAerobicexercisegroupRelaxationtreatmentgroup第20頁PromotingHealthBiofeedbacksystemforelectronicallyrecording,amplifying,andfeedingbackinformationregardingasubtlephysiologicalstatebloodpressuremuscletension第21頁PromotingHealthModifyingTypeAlife-stylecanreducerecurrenceofheartattacksPercentageofpatientswithrecurrentheartattacks(cumulativeaverage)6543210Year19781979198019811982Life-stylemodificationpatientsControlpatientsModifyinglife-stylereducedrecurrentheartattacks第22頁PromotingHealthSocialsupportacrossthelifespan12-1418-1925-3445-5465-7415-1720-2435-4455-6475+Ageinyears100%9080706050Percentagewithhighsupport第23頁LifeeventsTendencytowardHealthIllnessPersonalappraisalChallengeThreatPersonalitytypeEasygoingNondepressedOptimisticHostileDepressedPessimisticPersonalityhabitsNonsmokingRegularexerciseGoodnutritionSmokingSedentaryPoornutritionLevelofsocialsupportClose,enduringLacking第24頁PromotingHealthPredictorsofmortality10.80.60.40.20MenWomenNotsmokingRegularexerciseWeeklyreligious attendanceRelativeriskofdying第25頁PromotingHealthReligiousAttendance第26頁PromotingHealthThereligionfactorismulitidimensionalReligiousinvolvementHealthybehaviors(lesssmoking,drinking)Socialsupport(faithcommunities,marriage)Positiveemotions(lessstress,anxiety)Betterhealth(lessimmunesystemsuppression,stresshormones,andsuicide)第27頁PromotingHealthComplementaryandAlternativeMedicineunprovenhealthcaretreatmentsnottaughtwidelyinmedicalschools,notusedinhospitals,andnotusuallyreimbursedbyinsurancecompanies第28頁AlternativesystemsofmedicalpracticeBioelectromagneticapplicationsDiet,nutrition,life-stylechangesHerbalmedicineManualhealingMind-bodycontrolPharmacologicalandbiologicaltreatmentsSubfieldsofAlternativeMedicineHealthcarerangingfromself-careaccordingtofolkprinciples,tocarerenderedinanorganizedhealthcaresystembasedonalternativetraditionsorpracticesThestudyofhowlivingorganismsinteractwithelectromagnetic(EM)fieldsTheknowledgeofhowtopreventillness,maintainhealth,andreversetheeffectsofchronicdiseasethroughdietaryornutritionalinterventionEmployingplanandplantproductsfromfolkmedicinetraditionsforpharmacologicaluseUsingtouchandmanipulationwiththehandsasadiagnosticandtherapeutictoolExploringthemind’scapacitytoaffectthebody,basedontraditionalmedicalsystemsthatmakeuseoftheinterconnected-nessofmindandbodyDrugsandvaccinesnotyetacceptedbymainstreammedicine第29頁PromotingHealthSmoking-relatedearlydeaths40,00030,00020,00010,000033,3481,6861,135556202SmokingSuicideVehicleHIV/Homicide crashAIDSCauseofdeathNumberofdeathsper100,000第30頁ThePhysiologicalEffectsofNicotine第31頁PromotingHealthFewerCanadiansmokersMalesFemales1970197419781982198619901994-1996- 19951997Year60%50403020100PercentageofCanadianssmoking第32頁SmokingPreventionU.S.teensmoking第33頁SmokingPreventionResultsofasmokinginoculationprogramPercentageofstudentswhosmoke2015105004912162133SeventhgradeEighthgradeNinthgradeMonthsofstudyControlschoolSchoolwithsmokingPreventionprogramFewerteenstookupsmokingwhen“inoculated”againstit第34頁ObesityandWeightControlObesityandbodymassindex第35頁ObesityandWeightControlObesityandmortality18.518.5-20.5-22.0-23.5-25.0-26.5-28.0-30.0-32.0-35.0-4020.421.923.424.926.427.929.931.934.939.9 Body-massindex(BMI)MenWomen2.82.62.42.22.01.81.61.41.21.00.80.6Relativeriskofdeath第36頁WeightDiscriminationWhenwomenapplicantsweremadetolookoverweight,subjectswerelesswillingtohireWillingnesstohirescale(from1:definitelynothireto7:definitelyhire)01234567WomenMenNormalOv