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Stress and DiseaseDr. Donald B. Giddon

Harvard University, Fall 2013

QUESTION 3:

Why is a particular organ or system a target of stress?

• Stimulus specificity

• Response specificity

• Individual response hierarchy

• Symptom specificity

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Bases of Organ Specificity/Diathesis

• Genetic

• Psycho Dynamic

• Learning/Conditioning

• Personality Conflict

• Attitudes

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Psychophysiological Disorders and the Attitudes Said to Be Associated with Them-------------------------------------------------------------------------------------------------- Disorder Specific Attitude-------------------------------------------------------------------------------------------------- Acne The person feels he or she is being “picked on” and

wants to be left alone.

Asthma The individual feels left out, unloved, or ignored, and wants toscreen out another individual or the situation, and not haveanything to do with them.

Hypertension The person feels threatened with being harmed by an ever-present danger. As a result, he or she feels the need to be onguard, and prepared to meet all threats.

Hives There are feelings of taking a beating (or being mistreated)and being helpless to do anything about it.

Raynaud disease The person wants to take some hostile physical action(such as hitting) but does not know what the actual actshould be.

Migraine The individual feels that something has to be accomplished orachieved or some goal reached. The person then relaxesafter the effort is exerted.

Duodenal ulcer The individual feels deprived of what is due him or her (i.e.,what is owed or promised) and wants to seek revenge or geteven.

Rheumatoid The person feels tied down, restrained, or restricted andwants to

arthritis restore freedom of movement.

Hyperthyroidism The individual feels he or she might lose a loved person orobject, and takes care to prevent such a loss by holding on orpossessiveness. 5

Affective Psychological Responses To Self Confrontation With Computer Displayed Profile Images

Anderson, Amram, Giddon Psychophysiology 35(1)S16, 1998

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Purpose

• To Investigate The Affective Responses To Self Confrontation With Computer Imaging.

• Hypothesis– The affective and physiological responses to

self confrontation with computer images would differ from responses to computer image distortions of other neutral faces.

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Method

• Confront Subjects With Computer Images of Own Profile, and Images of “Control” Profiles.

• Measure Physiological Responses That Reflect The Affective State of The Subject.– Peripheral Blood Volume Pulse Wave.

– Heart Rate.

– Heart Rate Variability.

– Affective Measures of Pleasantness, Acceptability, Similar to Self, Tenseness, Concern

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Blood Volume Pulse Wave (BVP)

• Photoplethysmograph– Measures the variation in the opacity of a limb caused

by the changing quantity and quality of blood contained in it. (Pulse Oximeter)

– One of the cardiovascular parameters strongly influenced by the mental processes is the blood volume pulse of the peripheral tissues.

– Measured In Millimeters.

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Heart Rate

• Measured in Interbeat Interval (IBI) in Milliseconds.

• Increases During Stress, Physical Exertion, Sympathetic Stimulation.

• Decreases During Relaxation, Slow Wave Sleep, Parasympathetic Stimulation, Psychological Orientation.

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HR Variability (HRV)

• Standard Deviation of The Beat To Beat Interval Per Unit TIme.

• Increases During Stress, Physical Exertion, Sympathetic Stimulation.

• Decreases During Relaxation, Slow Wave Sleep, Parasympathetic Stimulation, Psychological Orientation.

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Prior to Viewing

• Baseline Physiologic Recording.

• Mental Math Task.– Cognitive/Affective Control.– Subtract 17 from 287.

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Results

• Physiological Analysis.– Completed For 10 Subjects.– Values Averaged (S1,S2) (O1,O2)

• IBI

• HRV

• BVP

• Subjective Analysis.– Completed For 16 Subjects.– Values Averaged (S1,S2) (O1,O2)

• Semantic Differential.14

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Group Results

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Summary of Group Results

• Averaging of individual results revealed no change for group.

• No generalizable pattern for physiological data.• Each individual has own pattern of physiologic

responses (individual response hierarchy)• Identified own true profiles• Found unaltered Most Acceptable• When individual responses averaged across

group, no significant difference to self and other images.

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Conclusion

• Individual pattern of responding to computer images of own and other faces.

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TABLEOriginal Autonomic Balance Scores of Men

Who Later Developed Various Disorders

Disorder Numberof Men

Mean AutonomicBalance

Score

High blood pressure 23 64.74

Persistent anxiety 33 66.47

Apprehension or fear 49 65.8

Excessive sweating 52 67.3

Heart trouble 21 67.66

Hay fever 52 68.27

Stomach pains 63 68.53

Allergies 78 68.55

Migraine 15 68.99

Arthritis 28 69.74

Asthma 16 70.06

Peptic ulcer 40 70.38

Low blood pressure 12 73.54

No disorders reported 111 68.22

In: Suter, S. Health Psychophysiology. Erlbaum Assoc., 1986, p. 87

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What Have We Covered?What Have We Covered?

Question1 – What is stressful for a given individual?Question1 – What is stressful for a given individual?

Question 2- What are the mediators or pathways to diseasesQuestion 2- What are the mediators or pathways to diseases

Today, Today, Question 3 – Question 3 – Why is a particular organ or system a target of stress?Why is a particular organ or system a target of stress?

Still to do, Question 4 – Still to do, Question 4 – What are the Cognitive, Affective and Behavioral Responses toWhat are the Cognitive, Affective and Behavioral Responses to Disease ? Disease ?

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Disorders Associated with Increased Stress System Activity

• Severe chronic disease• Anorexia• Melancholic depression, • Personality disorders, Obsessive compulsive disorder• Active EtOH, EtOH/Narcotic Withdrawal, • Excessive exercise• Malnutrition• Hyperthyroidism• PMS

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Behavioral ResponsesVoluntary and Semi-Voluntary

• E.g. Habits

–Bruxism

–Smoking

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Vulnerability Combination

High life stress

and

Low social support

and

Poor coping skills

Increased risk of injury

Resiliency Factors either Low life stress

or

High social support

or

Good coping skills

Lower risk of injury

Interaction of Psychosocial Causal Factors

Accident Prone BehaviorAccident Prone Behavior

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Review of Other Responses to StressReview of Other Responses to StressDisorders Associated with Decreased Stress Response Disorders Associated with Decreased Stress Response

• Atypical depression• Cushing’s Syndrome• Seasonal Affective Disorder• Hypothyroidism.• Obesity--some forms.• PTSD.• Nicotine W/D.• Inflammatory Disease• Allergy/Atopy

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Depression Women 2X more likely to suffer from depression as men. Depression significantly associated with morbidity and mortality.

Depressed, elderly pts show more physical illness than matched controls. Significantly higher 4-year mortality.

Depressed, HIV pts show greater progression of HIV than non-depressed.

Linear relationship between depressed affect and cellular immune parameters.

Evolutionary significance

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