Dr. Reem Al-Sabah

Faculty of Medicine

Psychology 220

How Stress Affects Health Allostatic load: the wear and tear on the body as a result

of chronic overactivity of the physiological response to stress.

leads to physical disorders

Chronic stress

impairs immune system

Emotional stress related to >50% of medical problems.

Psychophysiological disorders: physical disorders in

which emotions are believed to play a central role.

Does stress cause disease?

Diathesis-Stress Model — An individual’s susceptibility to stress and illness is determined by two interacting factors

Predisposing Factors (in the person)

genetic vulnerability

acquired behavioral or personality traits

Precipitating Factors (from the environment)

traumatic experiences

Psychoneuroimmunology

A multidisciplinary field that focuses on the interactions among behavior, the nervous system, the endocrine system and the immune system.

Stress Immune system Disease

Psychological and social factors can affect the CNS, endocrine system, and immune system.

Classical conditioning of the immune system (Ader & Cohen, 1975).

How Can Stress Make You Sick?

Physical mechanisms of influence

Direct influence: through the effects of stress on the nervous, endocrine, and immune systems.

1. Peripheral nervous system

2. Secretion of hormones

Indirect influence: changes in health behaviors that increase risks for diseases.

How Does Stress Make You Sick?

Coronary heart disease (CHD)

Overarousal caused by chronic stressors can contribute to CHD.

About third of risk for heart disease connected to stressfulness of people’s environments.

People in high-stress jobs (high demand with little control).

Animal studies have shown that the disruption of the social environment can lead to health problems that resemble coronary heart disease.

The immune system

Lymphocytes: small white blood cells that plays a large role in defending the body against disease.

Stress makes people more susceptible to infectious diseases, allergies, cancers, and autoimmune disorders.

Stress affects the immune system’s ability to defend the body.

The Immune system (Cont.)

One important factor appears to be the extent to which an individual can control stress

Lower controllability = greater impact on immune system

Perception of stress

Marital separation/divorce

Women with breast cancer

Controllability Studies on rats show that uncontrollable shock has a

greater effect on the immune system than controllable shock.

Perception of control (e.g., initiating divorce was more in control; breast cancer patients and optimism/pessimism)

Controllability (Cont.) A demanding family life + a stressful job can

adversely affect women’s cardiovascular health.

The likelihood of disease increases with the number of children for working women but not for homemakers.

Women with flexibility and control over their work, good income, hired help, don’t suffer as much physically or psychologically from their work overload.

Best evidence of how stress affects health: Supportive psychological interventions can slow the progress of cancer (Baum & Posluzny, 1999).

Randomly assigned women with breast cancer into two groups: weekly support groups, or no group.

The support group was to improve the women’s quality of life.

4 years after the study, all the women who had not been in the support group died of their cancer, while a 1/3 of women in the support groups were still alive.

Health-related behaviors

What are some of the health-related behaviors that can increase our susceptibility to illness?

What is the relationship between stress and healthy-behaviors?

Health-related behaviors (Cont.)

Most of the diseases people die from in industrialized countries heavily influenced by health-related behaviors (e.g. smoking, drinking alcohol etc.).

Stress may indirectly affect health by reducing rates of positive health-related behaviors and increasing rates of negative health-related behaviors.

Stress Unhealthy behaviors

Chronic Stress-Induced Disorders Gastrointestinal: peptic ulcer, ulcerative colitis, IBS,

esophageal reflux.

Cardiovascular: essential hypertension, migraine headache, alters the heart rhythms, Raynaud’s disease.

Respiratory: asthma, hyperventilation.

Dermatologic: eczema, acne, psoriasis, alopecia.

Chronic Stress-Induced Disorders (Cont.)

Musculoskeletal: muscle strain, tendonitis, tension headache, low back pain.

Reproductive:, suppresses sperm count, ovulation

and sexual activity, as well as sexual desire and performance in both men and women.

Cognitive: low self-esteem and self-efficacy,

pessimistic expectancy, learned helplessness. Emotional: mood and adjustment disorders, PTSD,

reactive psychosis.

Signs and Symptoms of Stress

Emotional symptoms

• Moodiness • Irritability or short temper • Agitation, inability to

relax • Feeling overwhelmed • Sense of loneliness and

isolation • Depression or general

unhappiness

Cognitive symptoms

• Memory problems • Inability to concentrate • Poor judgment • Seeing only the negative • Anxious or racing

thoughts • Constant worrying

Signs and Symptoms of Stress (Cont.)

Behavioral symptoms

• Eating more or less • Sleeping too much or too

little • Isolating yourself from

others • Procrastinating or neglecting

responsibilities • Using alcohol, cigarettes, or

drugs to relax • Nervous habits (e.g. nail

biting, pacing)

Physical symptoms

• Aches and pains • Diarrhea or constipation • Nausea, dizziness • Chest pain, rapid

heartbeat • Loss of sex drive • Frequent colds

Optimism/Pessimism

How does pessimism affect health?

A pessimistic outlook may affect health directly, by reducing immune system functioning, or indirectly, by reducing a person’s tendency to engage in health-promoting behaviors.

Finding meaning

When faced with a major trauma people say that they feel their lives have changed in extremely positive ways as a result of their experiences.

Finding meaning or positive growth in a trauma seems to help people adjust, both psychologically and physically.

Why are some people able to find meaning and growth in trauma and other do not?

Personality and illness

Hardiness

Focuses on people who are most resistant to stress, who do not become physically or emotionally impaired even in the face of major stressful events

Personalities of hardy people are characterized by:

Commitment to goals

Sense of control

Challenge, or viewing any change as positive

Type A Behavior

1950s two cardiologists used this label to characterize

patients with coronary heart disease

A person’s level of hostility is a better predictor of heart disease

When anger is repressed (held in) it may be more destructive to the heart than anger that is expressed

Type A Behaviors

How does type A behavior or hostility lead to coronary heart disease?

Their sympathetic nervous system appears to by hyperresponsive to stressful situations.

Report more interpersonal conflict.

Less social support.

Hostility may have both direct effects on cardiovascular health by increasing chronic arousal and indirect effects by lowering social support.