Psychological and Social Factors Influencing Health

Biopsychosocial Perspective: Psychological and social factors influence brain structure and
function, neurotransmitter activity, endocrine system, and gene expression. These factors play
a role in various disorders, including diabetes, cardiovascular diseases, and immune system
disorders like AIDS.
Biopsychosocial Model: The biopsychosocial model recognizes the interplay of biological,
psychological, and social factors in the cause and maintenance of disorders. It contrasts with
the outdated notion that mental disorders lack a strong biological component.
Contribution of Psychosocial Factors: Lowering stress levels and maintaining a rich social
network are associated with better health outcomes, longevity, and cognitive health in aging
individuals. Social isolation can lead to physical and mental deterioration, highlighting the
importance of social connections for overall well-being.
Influence of Psychological and Social Factors on Health: Psychological and social factors
influence health and physical problems in two main ways: by affecting basic biological
processes and by influencing long-standing behavior patterns. These factors can contribute to
the etiology or maintenance of diseases, sometimes in combination with biological factors.
Impact of Lifestyle Behaviors: Unhealthy lifestyle behaviors such as smoking, poor diet,
lack of exercise, and failure to use safety measures contribute significantly to disease and
mortality. These behaviors are enduring habits ingrained in daily living patterns and are major
contributors to many leading causes of death.
Role of Stress: Stress, particularly the neurobiological components of the stress response, is a significant factor attracting attention in understanding
how psychological factors affect physical disorders.
Stress
General Adaptation Syndrome (GAS): Suggests that the body responds to stress in three stages: alarm, resistance, and exhaustion. Chronic stress can
lead to permanent bodily damage or contribute to disease progression.
Definition of Stress: Stress can mean both strain on a structure (e.g., a bridge) and a stimulus or stressor, such as a challenging life event;, stress refers
to the physiological response to a stressor.
Physiology of Stress: Stress activates the sympathetic nervous system and the hypothalamic–pituitary–adrenocortical (HPA) axis, leading to the
release of stress hormones such as cortisol. Cortisol affects various bodily functions and plays a role in the stress response.
Role of the Limbic System and Feedback Loop: The limbic system, particularly the hippocampus, interacts with the HPA axis to regulate the stress
response. Chronic stress may lead to hippocampal cell death, impacting stress regulation and cognitive function.
Social Factors and Stress: Psychological and social factors profoundly influence stress physiology.
Impact of Control: Sense of control over life events plays a crucial role in regulating stress physiology and mitigating the long-term effects of stress.
Having predictability and controllability in life situations can positively influence stress hormone profiles.
Stress, Anxiety, Depression, and Excitement
Relationship between Psychological and Physical Disorders: Stressful life events
combined with psychological vulnerabilities contribute to both psychological and
physical disorders. Longitudinal studies have shown that individuals who develop
psychological disorders or experience high levels of stress are more likely to develop
chronic illnesses or have higher mortality rates.
Continuum of Feelings: Stress, anxiety, depression, and excitement share common
features and can be understood as points on a continuum of emotional states. Sense of
control and perceived ability to cope with a challenge or threat influence which
emotional state predominates.
Differences Among Emotional States:
 Excitement: Characterized by rapid heartbeat, burst of energy, or jumpy stomach. Can be pleasurable, especially if one feels well-prepared and
confident.
 Stress: Occurs when facing a challenging task but feeling pressured due to perceived lack of time or resources. May lead to tension, irritability, or
physical symptoms like headaches or upset stomach.
 Anxiety: Arises when facing a threatening situation and believing there is little control over it. Involves worrying incessantly and feeling less in
control compared to stress.
 Depression: Results from perceiving life as threatening and losing hope about regaining control. Individuals may no longer try to cope and may
experience a persistent low mood.
Underlying Physiology: Similar patterns of sympathetic arousal and activation of neurotransmitters and neurohormones are observed in anxiety,
depression, and stress-related physical disorders. Differences in physiological responses may exist; for example, blood pressure may increase during
anxiety and depression but remain unchanged during excitement or marked stress. Psychological factors, particularly a sense of control and confidence
in coping abilities (self-efficacy), play a crucial role in differentiating among these emotional states.
Stress and Immune Response
Effect of Stress on Susceptibility to Infections:
 Exposure to cold viruses alone is not sufficient to cause a cold; the level of stress an
individual experiences plays a significant role.
 Research by Sheldon Cohen and colleagues has shown that higher levels of stress
increase the likelihood of catching a cold after virus exposure.
 Sociability, positive cognitive style, and optimism can mitigate the impact of stress on
susceptibility to infections.
Stress and Immune System Functioning:
 Chronic stress has detrimental effects on immune system functioning, leading to
increased rates of infectious diseases.
 Stressful life events such as marital discord, job loss, or bereavement can rapidly
weaken the immune system's response.
 Depression is associated with lower immune system functioning, possibly due to
feelings of uncontrollability and negative life events.
Mechanisms Linking Stress to Infections:
 Stress hormones trigger the production of cytokine interleukin 6, leading to
inflammation and breakdown of resistance to infection.
 Chronic stress may activate certain genes involved in the inflammatory response,
exacerbating diseases like cancer, heart disease, and diabetes.
Psychoneuroimmunology (PNI):
 PNI explores the interactions between psychological factors, the nervous system, and the immune system.
 Behavioral changes in response to stress, such as smoking or poor eating habits, can further suppress immune system function. Recent research has
identified molecular pathways linking stress to disease onset by activating certain genes involved in inflammation.

Chronic Pain
 Psychological and Social Factors: Chronic pain is influenced by psychological factors such as anxiety, depression, coping skills, and perceived
control over the situation. Social support, family dynamics, and societal factors also play a role in how individuals experience and cope with pain.
 Biological Mechanisms: The gate control theory of pain suggests that nerve impulses from painful stimuli reach the spinal cord, where a gating
mechanism can modulate the transmission of pain signals to the brain. Additionally, endogenous opioids, such as endorphins, act as natural pain-
relievers within the body.
 Gender Differences: Men and women may experience and cope with pain differently, possibly due to hormonal variations and neurochemical
differences. Women may have additional pain-regulating mechanisms, particularly related to reproductive activity.
 Interaction of Psychological and Physical Experience: Psychological interventions can affect physical pain, and vice versa. Placebo responses and
distraction techniques have been shown to alter brain activity and reduce the experience of pain. Similarly, drugs used for physical pain relief may
also alleviate social pain, indicating an overlap in neural mechanisms.
Chronic Fatigue Syndrome (CFS)
 characterized by symptoms such as lack of energy, marked fatigue, body aches, and occasionally low-grade fever.
 Its prevalence has increased, and it shares similarities with neurasthenia, which was prevalent in the 19th century.
Causes and Prevalence:
 The causes of CFS are not entirely understood but have been attributed to various factors such as viral infections, immune system dysfunction,
exposure to toxins, and clinical depression. However, evidence supporting these hypotheses is lacking.
Contributing Factors:
 Stressful environments, changing societal roles, and rapid dissemination of new technology and information have been suggested as contributing
factors to CFS.
 Genetic factors may also influence the impact of stress and psychological variables in causing CFS.
Denial as a Coping Mechanism
Positive Aspects of Denial:
 Initial Buffering of Shock: Denial can provide a temporary buffer against the shock of receiving a serious diagnosis or experiencing a traumatic
event. It may help individuals cope with overwhelming emotions in the immediate aftermath.
 Easing into Coping Responses: By initially denying the severity of a situation, individuals may be better able to gradually develop coping
strategies and come to terms with their circumstances over time.
 Protection from Anxiety: Denial may temporarily reduce anxiety and distress, allowing individuals to maintain a sense of normalcy and
functioning while they process the reality of their situation.
Timing and Context:
 The effectiveness of denial as a coping mechanism may depend on timing and context. It may be more beneficial in the early stages of coping with
a stressful event when emotions are intense and overwhelming.
 However, continued denial can be detrimental in the long term, as it may prevent individuals from seeking appropriate treatment, adhering to
medical regimens, or making necessary lifestyle changes.
Balancing Denial with Acceptance:
 While denial may offer temporary relief, it is important for individuals to eventually confront and accept the reality of their situation.
 Mental health professionals often work to help individuals transition from denial to acceptance, allowing them to process their emotions, seek
support, and engage in effective coping strategies.