Chapter 14 549- 567 Behavioral medicine- an interdisciplinary field that integrates behavioral and medical knowledge and applies

that knowledge to health and disease Health psychology- a subfield of psychology that provides psychology’s contribution to behavioral medicine Stress- the process by which we perceive and respond to certain events, called stressors, which we appraise as threatening or challenging General adaptation syndrome (GAS) - Selye’s concept of the body’s adaptive response to stress in three stages- alarm, resistance, exhaustion Coronary heart disease- the clogging of the vessels that nourish the heart muscle; the leading cause of death in many developed countries Type A- Friedman and Rosenman’s term for competitive, hard-driving, impatient, verbally aggressive, and anger-prone people Type B- Friedman and Rosenman’s term for easygoing, relaxed people Psychophysiological illness- literally, “mind-body” illness; any stress-related physical illness, such as hypertension and some headaches Lymphocytes- the two types of white blood cells that are part of the body’s immune system: B lymphocytes form in the bone marrow and release antibodies that fight antibacterial infections; T lymphocytes form in the thymus and other lymphatic tissue and attack cancer cells, viruses, and foreign substance Coping- alleviating stress using emotional cognitive, or behavioral methods Problem-focused coping- attempting to alleviate stress directly- by changing the stressor or the way we interact with that stressor Emotion-focused coping- attempting to alleviate stress by avoiding or ignoring a stressor and attending emotional needs related to one’s stress reaction Aerobic exercise- sustained exercise that increases heart and lung fitness; may also alleviate depression and anxiety Biofeedback- a system for electronically recording, amplifying, and feeding back information regarding a subtle physiological state, such as blood pressure or muscle tension

• • •

What is stress? a. An event that triggers tension or worry b. A person’s perception of an event i. A perceived difference between a demand placed in a person and his/her ability to handle it; usually based on a past experience c. A person’s physical or psychological response to an event or situation d. Stressor- the stress producing situation, event, or person e. Stress reaction- our body’s response i. Heart rate, immune system clinking, etc. 1. hormones: released from adrenal glands- epinephrine, norepinephrine, glucorticoids, cortisol f. Distress- negative stress; stems from acute anxiety or pressure; takes a toll on the body and mind g. Eustress- positive stress; results from striving to do well h. Death- complete freedom from stress What is conflict? a. Choice between alternates in order to be resolved- consequences involved i. Approach-approach 1. two-attractive choices ii. Approach-avoidance 1. one attractive choice and one unattractive 2. intensity or desire to do the attractive or the perceived threat of avoiding the unattractive determines stress level a. i.e. watch T.V./text-do homework iii. Avoidance-avoidance 1. two unattractive alternatives 2. creates high stress level “lesser of two evils” a. crash or swerve iv. Double-approach avoidance 1. most common 2. both alternative have good/bad aspects. 3. degree of stress depends on intensity of attractiveness or repulsion a. i.e. quit job-friends or no friends (with job) Stress hormones: epinephrine and norepepinephrine from adrenal glands SNS Cerebral cortex-more stress; outer parts of adrenal glands let off glucocorticoid stress hormones Our behaviors, such as smoking regular exercise, nutrition, and exposure to prolonged stress can affect our susceptibility to heart disease, cancer, stroke, and chronic lung disease, as well as making us more vulnerable t high blood pressure, skin rashes, and other illnesses. The field of behavioral medicine is based on the understanding that mind and body interact. Within that field, health physiology studied the ways out

attitudes, emotions, behaviors, and personality influence our health well-being, and risk of disease

Stress is not an action or condition; instead, it is a process by which we respond to stressful events (stressors). An important part of that process is our appraisal of an event as threatening, challenging, or unimportant. Our appraisals help determine whether our response will be healthy feelings of energized and directed arousal, or overwhelming feelings of distress Our response to stress is a prime example of mind-body interaction. The first (and faster) track of the stress-response system is the fight-or-flight response, identified by Walter Cannon, in which the sympathetic nervous system responds to a stressor on several fronts: the inner parts of the adrenal glands pour out epinephrine and nopreinephrine, heart and respiration rates increase, blood flows away from digestive organs and towards skeletal muscles sensation of pain diminish, and the body releases stored sugar and fat, on the slower track of the immune system, the cerebral cortex, perceiving a stressor, stimulates the hypothalamus and pituitary gland to trigger the release of glucocorticoid stress hormones, such as cortical, from the outer part of the adrenals. The three stages of general adaptation syndrome, Hans Selye’s concept of the body’s response to stress are alarm (temporary shock state in which the body mobilizes resources), resistance (period of coping with the stressor), and exhaustion (depilation of reserves following prolonged stress) Large-scale catastrophic events can increase depression and anxiety and cause problem with concentrating and sleeping. Significant personal life events, such as losses and even changes may leave people vulnerable to disease. But daily hassles-the continuing series of small, everyday stressors-are the most significant sources of stress for most people and can damage health and well-being. Stress can increase the risk of coronary heart disease. The vital link in this stressdisease path is negative emotions-depression, pessimism, but especially anger. The Friedman-Rosenman study, the first to show the anger-heart-disease link, contrasted Type A personalities with Type B. Under stress, Type A people are psychologically more reactive, with an outpouring of hormones that accelerate the buildup of plaque to artery walls, leading to high blood pressure and increased risk of strokes and heart attacks. Psychologists use the term psychophysiological illness to describe stress-related physical illness such as hypertension and some headaches. These real illnesses differ from hypochrondriasis, or misinterpreting normal physical sensations as symptoms of a disease. The immunes systems V lymphocytes release antibodies that fight bacterial infections. The T lymphocytes fight cancer cells, viruses, and foreign substances. Other immunesystem agents, the macrophages, ingest harmful invaders, worn-out cells, and other internal debris. Stress does not directly cause disease, but when energy is diverted away from the immune system activities are redirected toward the stress-response system, we become more vulnerable to infections and disease AIDS is caused by HIV virus, not by stress. But stress and negative emotions may accelerate the progression from viral infection to actual AIDS. HIV-positive individuals

benefit more from drug treatments, but programs that reduce stress do seem to help somewhat

Stress does not create cancer cells. Researches disagree on whether stress influences the disease’s progression, but they do agree that avoiding stress and maintain a hopeful and determined attitude cannot reverse the destructive processes under way in advanced cancer Researchers have conditioned immune system suppression in lab experiments. Encouraged by these results, others are working on ways to condition immune-system enhancement When we use problem-focuses coping we attempt to reduce stress by changing the events that trigger stress reactions or by changing the way we react to those events. We tend to use emotion-focused coping when we believe-rightly or wrongly- that we cannot change a stressful situation A perceived lack of control has been associated with higher than normal susceptibility o bacterial infections, cardiovascular disease, and, possibly, a shorter life span due to elevated levels of stress hormones and diminished immune system responses Compared with people with a pessimistic explanatory style, optimists tend to feel they have more control over stressors, cope better with stressful events, enjoy better moods, have stronger immune systems, and live longer than pessimists. Laughter (but not sarcasm) may reduce stress and strengthen the immune system Supportive family member, marriage partners, close friends, and companionable pets help people cope with stressful events. Social support fosters stronger immune functioning, calms the cardiovascular system, and lowers blood pressure Stress-management programs often include aerobic exercise (sustained exercise that increases heart and lung fitness) which raises energy levels, increases self-confidence, lowers tension, and may alleviate depression and anxiety. Studies have linked aerobic exercise to lowered blood pressure, increased arousal, higher levels or neurotransmitters that boost moods (such as norepinephrine, serotonin, and the endorphins), enhanced cognitive abilities, and (in mice) the growth of new brain cells Biofeedback techniques have helped people control tension headaches, but simple relaxation exercises have been equally effective in combating hypertension, anxiety, and insomnia, and in lowering rates of recurring heart attacks. Some have searched for relief from stress and illnesses in complementary and alternative medicine. Studies of people while meditating have shown increases left frontal lobe activity and improved immune functioning, compared with their counterparts in control groups Regular religious attendance has been a reliable predictor of a longer life span. Researchers trying to determine the cause-effect relationship have isolated three intervening variables: (1) religiously active people have healthy lifestyles (smoking and drinking less, for example) (2) faith communities often function as social support networks and often encourage marriage (which, when happy, is associated with better health and longer life spans) (3) religious attendance-with its accompanying coherent worldview, sense of hope for the future, feelings of acceptance, and relaxed meditative

state-may enhance feelings of positive emotions (such as hope and optimism) and decrease feelings of stress and anxiety • Smoking’s allure for teens comes in part from social rewards- identifying with or being accepted by “cool” people. Depending on their genetic inheritance, one in three early smokers will develop a psychological addiction to nicotine, as hard to break an addiction to heroin or cocaine. By triggering a release of epinephrine, norepinephine, dopamine, and the opioids, nicotine takes away unpleasant cravings and delivers rewards

Sign up to vote on this title
UsefulNot useful