CHAPTER 15 – PSYCHOLOGY AND HEALTH

MODULE 15.1 STRESS: WHAT IT IS AND WHAT IT DOES TO THE BODY

After you have mastered the information in this unit, you will be able to:

  • Describe health psychology
  • Define stress, and identify the major sources of stress
  • Explain how the body responds to stress
  • Explain how stress affects the immune system
  • Discuss the psychological factors that buffer the effects of stress

Terms and Concepts:

Health Psychology

Stress

Distress

Stressors

Hassles

Chronic Stress

Frustration

Conflict

Posttraumatic Stress Disorder (PTSD)

Type A Behavior Pattern (TABP)

Acculturative Stress

General Adaptation Syndrome (GAS)

Alarm Stage

Fight-or-Flight Response

Resistance Stage

Exhaustion Stage

Corticotrophin-Releasing Hormone (CRH)

Adrenocorticotrophic Hormone (ACTH)

Adrenal Glands

Adrenal Cortex

Corticosteroids

Adrenal Medulla

Immune System

Lymphocytes

Antigens

Antibodies

Vaccination

Psychological Hardiness

Burnout

  1. The Interrelationships Between Psychology and Physical Health
  2. Study of these relationships is called health psychology
  3. A particular concern of health psychologists is stress
  4. Stress involves pressure, demands placed on an organism to adjust to its environment
  5. Stress is inevitable, and moderate amounts keep us alert and energized
  6. Distress occurs when stress level too high to manage comfortably
  7. Excessive stress leads to physical and psychological problems
  8. Sources of Stress (Stressors)
  9. Hassles
  10. Common, everyday annoyances
  11. Chronic stress—result of collective effect of daily hassles
  12. Chronic stress is a state of persistent tension or pressure
  13. Leads to feelings of exhaustion, irritability, depression
  14. Life events (major changes in life circumstances)
  15. Even good changes (marriage, promotion, birth of a baby) can result in stress
  16. Stress from life events occurs irregularly, sometimes unexpectedly
  17. Greater number of life events associated with higher incidence of physical health problems (note relationship is correlational, not causal)
  18. Stress threshold, coping abilities, optimism related to experience of stress
  19. Evaluation, interpretation of life event related to the level of stress it presents
  20. College Life Stress Inventory—evaluates degree of stress for college students
  21. Frustration
  22. Negative emotion when goals are blocked
  23. May result if goals set unrealistically high
  24. Conflict
  25. State of tension when two or more goals compete and demand resolution
  26. Approach-approach conflict
  27. Simultaneously drawn towards two positive goals
  28. Goals are mutually exclusive—choosing one eliminates possibility of choosing the other
  29. Initially may vacillate between the two alternatives
  30. Eventually choose one course of action or the other
  31. Considered the least stressful type of conflict
  32. Avoidance-avoidance conflict
  33. Must choose between two opposing goals, both of which are unpleasant
  34. Avoiding one unpleasant goal necessitates approaching the other
  35. If no obvious resolution, decision may be put on hold
  36. When conflict is very stressful, one may become immobilized
  37. Approach-avoidance conflict
  38. Goal has both positive and negative qualities
  39. Resolution seems possible by adding up pluses and minuses
  40. However, decision may flip-flop as various aspects considered
  41. Multiple approach-avoidance conflict
  42. Involves the most complex type of conflict
  43. Two or more goals are involved
  44. Each goal has compelling positive and negative attributes
  45. Resolution sometimes possible by combining both goals
  46. In other cases selection of one still results in concern over lost possibilities of the other
  47. Traumatic stressors
  48. Potentially life-threatening events
  49. Natural or technological disasters, combat, accidents
  50. Make maximum demands on coping abilities
  51. Posttraumatic stress disorder (PTSD) may result
  52. Characteristics of PTSD
  53. Avoidance of cues associated with the trauma
  54. Flashbacks, dreams, intrusive memories and images occur
  55. Depression, anxiety impairs ability to function
  56. May be chronically on guard, tense, on edge
  57. Emotional experience may be numbed
  58. Can develop months or years after traumatic experience
  59. Vulnerability relating to coping skills, childhood history, severity of trauma, and available social support
  60. PTSD found in many cultures; culture may influence ability to withstand stress
  61. Type A behavior pattern (TABP)
  62. Hard-driving, competitive, impatient, ambitious
  63. In a rush, aggressive, intense
  64. Unlike Type B behavior pattern, which is more relaxed and mellow
  65. Type A individual at greater risk for heart disease (most likely it is the anger and negativity aspect of personality that contributes the risk)
  66. The Body’s Response to Stress
  67. The general adaptation syndrome (stress response)—GAS
  68. Much of what we know is due to research from Hans Selye (“Dr. Stress”)
  69. Body responds in similar ways to various kinds of stress
  70. Alarm stage
  71. Body’s first response to a stressor (prewired for survival)
  72. Body’s defenses prepare for action
  73. Fight-or-flight response (physical and emotional characteristics)
  74. May be physical or psychological source of stress
  75. Death will occur within hours if stressor extremely damaging
  76. Resistance stage
  77. Occurs if organism lives beyond alarm stage
  78. Stressor continues; body attempts to adapt
  79. Attempt is made to return to normal biological state
  80. Arousal remains high; may be negative emotional reactions
  81. Exhaustion stage
  82. Final stage if stressor continues
  83. Heart rate and respiration decrease to conserve bodily resources
  84. Continued exposure to stress still depletes body
  85. “Diseases of adaptation” may occur (kidney or heart disease, digestive disorders, allergies, depression)
  86. Original stress response meant to turn off rather promptly
  87. Stresses of today are more persistent, may be chronic
  88. Gender differences in response to stress
  89. Women engage in more nurturing behaviors during stress
  90. Males more likely to exhibit aggressive responses
  91. Stress and the endocrine system
  92. Endocrine system is a series of ductless glands throughout body
  93. Glands release secretions known as hormones
  94. Hypothalamus in brain controls responses of endocrine system
  95. Biological steps in stress response
  96. Hypothalamus secretes corticotrophin-releasing hormone (CRH)
  97. CRH stimulates pituitary gland to secrete adrenocorticotrophic hormone (ACTH)
  98. ACTH travels through bloodstream to adrenal glands (located just above kidneys)
  99. ACTH stimulates adrenal glands to secrete corticosteroids (stress hormones)
  100. Corticosteroids help body resist stress; make stored nutrients more available
  101. Adrenal medulla (inner layer in adrenal glands) secretes stress hormones epinephrine and norepinephrine
  102. Epinephrine and norepinephrine increase heart rate; blood sends more oxygen and nutrients more quickly to muscles
  103. Muscles then more capable of fight-or-flight response
  104. Stress and the Immune System
  105. Immune system is body’s primary defense against disease
  106. Diseases fought by means of lymphocytes (specialized white blood cells)
  107. Lymphocytes constantly circulate, alert for antigens
  108. Antigens activate immune system to produce antibodies
  109. Antigen is a recognizable foreign substance in the body
  110. Antibodies are specialized protein molecules that fit precisely into invading antigen (like key fitting into a lock)
  111. Antigen marked for destruction by “killer” lymphocytes
  112. “Memory” of an antigen possible due to prior exposure
  113. Immunity or resistance occurs due to this prior exposure (body is fully ready to respond, and quickly, to known antigen)
  114. Vaccination (immunization) also provides immunity
  115. Stress weakens immune system; individual more susceptible to disease
  116. Stress lowers production of immunoglobulin A and increases levels of interleukin-6
  117. Corticosteroids inhibit immune system’s ability to respond to microbes
  118. Psychological Buffers to Stress
  119. Social support—friends, wide social network help buffer stress
  120. Self-efficacy
  121. Belief that we are capable of doing what we set out to do
  122. High self-efficacy individuals view stressful situation as a challenge
  123. Confidence in abilities strengthens will to persevere
  124. Perceptions of control and predictability
  125. Greater sense of control and predictability—less experience of stress
  126. Locus of control
  127. Internal locus of control—belief that one has considerable influence over events and outcomes (sense of ability to control may result in less experience of stress)
  128. External locus of control—belief that fate is out of one’s hands (likely to be more susceptible to experiencing stress)
  129. Psychological hardiness (research by Kobasa, 1979)
  130. Cluster of personality traits related to resilience to stress
  131. Characteristics of individuals with psychological hardiness
  132. Commitment—and belief that work is important
  133. Openness to challenge
  134. Internal locus of control
  135. Stress is accepted as normal challenge of life, may be interesting
  136. Optimism—key concept in positive psychology
  137. Key concept in positive psychology
  138. Associated with higher resiliency to stress
  139. Burnout
  140. Physical and emotional exhaustion resulting from excessive stress
  141. Associated with feelings of apathy, higher risk of health problems
  142. Burnout due to imbalance between work and other facets of life
  143. Vulnerability to burnout
  144. Role conflict—competing demands for one’s time
  145. Role overload—inability to refuse additional responsibilities
  146. Role ambiguity
  147. Uncertain about others’ expectations
  148. Try to meet all demands on all fronts
  149. Exploring Psychology: Making it in America: The Challenge of Acculturative Stress
  150. Acculturation is pressure to adopt characteristics of new culture
  151. Economics, social support, and language proficiency related to adjustment
  152. Adopting dominant language and customs may lead to financial success, but may also undermine family relationships
  153. Bicultural theory—leading theory
  154. Immigrants do best when they adopt to new culture but also maintain strong ethnic identity
  155. Racism may also increase stress

MODULE 15.2 PSYCHOLOGICAL FACTORS IN PHYSICAL ILLNESS

After you have mastered the information in this unit, you will be able to:

  • Explain how psychological factors are linked to the health of our heart and circulatory system
  • Describe the roles played by psychological factors in the development of cancer
  • Explain the roles of psychological factors in other health conditions such as asthma, headaches, and ulcers

Terms and Concepts:

Arteries

Coronary Heart Disease (CHD)
Atherosclerosis

Plaque

Arteriosclerosis

Heart Attack

Malignant Tumors

Basal Cell Carcinoma

Melanoma

Asthma

Migraine Headache

Peptic Ulcers

  1. Background Factors in Physical Health
  2. Physical health is a function of many influences
  3. Influences include heredity and exposure to infectious organisms
  4. Physical health also related to behavior, lifestyle choices
  5. Coronary Heart Disease
  6. Background factors related to coronary heart disease
  7. The heart is muscle tissue, which needs oxygen and nutrients
  8. Oxygen and nutrients are carried to heart by means of arteries (a type of blood vessel)
  9. Coronary heart disease (CHD) results when flow of blood to heart is insufficient
  10. Usual underlying cause for CHD is atherosclerosis
  11. Atherosclerosis is the major form of arteriosclerosis (hardening of the arteries); it results from buildup of plaque along artery walls
  12. Narrowed arteries (due to atherosclerosis) more likely to be location of blood clots
  13. A blood clot in a coronary artery causes a heart attack (myocardial infarction, or MI), because flow of blood to heart is blocked
  14. Severity of heart attack related to tissue damage from loss of oxygen
  15. CHD is one of the leading causes of death in U.S.
  16. Risk factors for CHD
  17. Overall personal risk is related to individual risk factors
  18. Prominent risk factors
  19. Age—risk increases after age forty
  20. Gender—men more likely to be affected
  21. Family history
  22. Hypertension (high blood pressure)
  23. Factors related to lifestyle
  24. CHD factors that can be controlled through behavior or medical treatment
  25. Hypertension—can be controlled through medication
  26. Smoking—doubles risk of heart attack
  27. Obesity
  28. Diabetes
  29. Cholesterol levels
  30. Lack of physical exercise
  31. Adopting healthier lifestyle associated with reduced risks for individuals who have had heart disease in addition to those who have not
  32. Currently non-Hispanic black Americans at greater risk
  33. Higher rates of obesity, hypertension, and diabetes
  34. Lower access to quality health care; may receive less aggressive treatment from physicians
  35. Emotions and your heart
  36. Emotions implicated in greater risk for heart disease
  37. Hostility (one component in Type A personality)
  38. Persistent anxiety
  39. How emotions affect cardiovascular system
  40. Persistent emotional arousal related to cardiovascular damage
  41. Anger, anxiety result in release of epinephrine and norepinephrine (stress hormones)
  42. Stress hormones increase heart rate, blood pressure, and strength of heart contractions—all add to burden on heart
  43. Stress hormones (especially epinephrine) increase stickiness of blood clotting factors to protect against possible injury—may increase risk of dangerous blood clots within arteries
  44. Individuals who anger easily may also develop higher levels of cholesterol, blood pressure
  45. Other emotional distress also related to cardiovascular risk (such as depression, marital stress)
  46. Cancer
  47. Cancer kills more Americans than heart disease
  48. Disease occurs because body cells reproduce uncontrollably
  49. Ability to regulate cell multiplication is lost
  50. Malignant tumors are these masses of excess tissue
  51. Tumors can originate in any body tissue or organ; can spread to other parts of body
  52. Tumors damage vital body organs and systems, may result in death
  53. Possible causes of cancer
  54. Heredity
  55. Exposure to cancer-causing chemicals
  56. Exposure to some viruses
  57. Two out of three cancer deaths in U.S. attributable to smoking and diet
  58. Alcohol and excess sun exposure are also related
  59. Risk factors in the development of cancer
  60. Family history, age (older ages at greater risk)
  61. Smoking
  62. 90 percent of lung cancer deaths directly attributable to smoking
  63. Smoking related to other cancers, causes perhaps one-third of cancer deaths
  64. Use of tobacco in other forms also harmful, can cause cancer
  65. Diet and alcohol consumption
  66. High levels of consumption of saturated fats—linked to prostate and colon cancers
  67. Obesity is a significant risk factor
  68. Heavy alcohol consumption raises risk of several cancers (including cancers of mouth, pharynx, and esophagus)
  69. Alcohol also related to other health problems, especially diseases of the liver
  70. Sun exposure
  71. Prolonged sun exposure may lead to basal cell carcinoma (most common, least dangerous type of skin cancer)
  72. Basal cell carcinoma accounts for 75 percent of skin cancers
  73. Curable as long as detected early, surgically removed
  74. Severe sunburn early in life related to occurrence of melanoma
  75. Melanoma least common, most deadly skin cancer
  76. Melanoma accounts for about 5 percent of skin cancers
  77. Stress
  78. The role of stress with regard to cancer not yet fully established
  79. Persistent stress may affect immune system’s ability to rid body of cancerous cells
  80. Health professionals provide counseling, other services to assist those with cancer; also promote cancer preventative behaviors
  81. Stress and Other Physical Disorders
  82. Asthma
  83. A chronic lung disease
  84. Bronchial tubes (airways) in lungs become obstructed
  85. Acute attacks—breathing is difficult; may become life-threatening situation
  86. Possible causes of asthma
  87. Allergies
  88. Respiratory infections
  89. Exposure to environmental pollutants such as cigarette smoke
  90. Genetic predisposition for asthma a possibility
  91. Stress may increase asthmatic’s susceptibility for an attack
  92. Headaches
  93. Stress related to several kinds of headaches
  94. Muscle-tension headaches
  95. Stress may cause muscles in scalp, face, neck and shoulders to tense
  96. Experience is dull, throbbing pain and pressure on both sides of head
  97. Migraine headaches
  98. About one in ten Americans are affected
  99. A severe headache that can last for hours or days
  100. Piercing pain, usually on one side of the head
  101. Results from changes in blood flow to the brain
  102. Possibly caused by imbalances in serotonin (neurotransmitter)
  103. Serotonin involved in regulation of blood vessel size (in brain)
  104. Stress and other factors can trigger migraine attack
  105. Peptic ulcers
  106. About one in ten Americans suffer from peptic ulcers
  107. Sore that form on stomach or small intestine lining
  108. Usually caused by H. pylori bacterium
  109. Can have H. pylori in system but not develop ulcers
  110. Suggests that psychological factors play a role
  111. Stress in particular may increase release of stomach acid
  112. Stomach acid and H. pylori together may lead to ulcer formation

MODULE 15.3 APPLICATION: TAKING THE DISTRESS OUT OF STRESS

After you have mastered the information in this unit, you will be able to:

  • Explain some of the ways of removing distress from stress
  1. Steps to Take the Distress Out of Stress
  2. Maintain stress at a tolerable level
  3. Reduce daily hassles
  4. Know own limits
  5. Adopt a reasonable schedule
  6. Take frequent breaks
  7. Develop more effective time-management skills
  8. Learn to prioritize
  9. Develop relaxation skills
  10. Perhaps listen to music
  11. Biofeedback, meditation, deep-breathing exercises may be helpful
  12. Consider a stress-management course
  13. Take care of your body
  14. Get enough sleep
  15. Follow a nutritious, balanced diet
  16. Participate in regular exercise
  17. Get regular medical check-ups
  18. Avoid harmful substances
  19. Gather information—whatever particular issue or illness you are facing, learn more about it
  20. Expand your social network—social support is an important buffer against stress
  21. Prevent burnout
  22. Set reasonable limits and goals
  23. Learn to say “no”
  24. Delegate responsibilities
  25. Replace stress-inducing thoughts with stress-busting thoughts
  26. What is your reaction to disappointing or stressful events?
  27. Are things blown out of proportion?
  28. Review thought pattern in reaction to stress
  29. Keep things in perspective
  30. Remember advantage of self-efficacy (belief in one’s capabilities)
  31. Choose achievable goals
  32. Don’t keep upsetting feelings bottled up
  33. Expressing feels helps minimize demands on autonomic nervous system
  34. Share with a trusted friend, or consider writing in a journal
  35. Control Type A behavior
  36. Take things slower
  37. Read books for enjoyment
  38. Leave your computer at home
  39. Avoid rushing through your meals
  40. Engage in enjoyable activities
  41. Develop relaxing interests
  42. Set realistic daily goals
  43. Hostility is not helpful