Health

1. Health Social Psychology Chapter 14 December 10, 2004 Class #14

3. Health Psychology • The application of psychology to the promotion of physical health and the prevention and treatment of illness • Social psychological principles now involved in health issues…that wasn’t always the case • Modification of one’s lifestyle, outlook, and behavior can lessen risk of such things as heart disease, cancer, strokes, accidents, AIDS, etc. • From following slide you can view the change in US insofar as leading causes of death 

4. Leading Causes of Death, 1900-2000

5. Stress • The whole process by which we appraise and respond to events that threaten or challenge us • An unpleasant state of arousal that arises when we perceive that the demands of an event threaten our ability to cope effectively • Subjective appraisal of the situation determines: • How we will experience the stress • What coping strategies we will use

6. Major Types of Stressors • Catastrophes • Unpredictable, large scale events • Natural disasters • Cataclysmic events • Sudden, without warning • Ex: WTC tragedy • Significant Life Changes • Daily Hassles

7. Scarring Effects of Natural Disasters • Krug et al. (1998) • These researchers analyzed counties that had experienced disasters • Before/after research revealed some alarming numbers • See next slide 

8. Krug et al. (1998)

9. Posttraumatic Stress Disorder (PTSD) • Up to 70% of adults in U.S. have experienced at least one major trauma (extreme stressor) in their lives… • Examples: • serious accident/natural disaster • rape or criminal assault • combat exposure • child sexual or physical abuse and/or severe neglect • hostage/imprisonment/ torture • sudden unexpected death of a loved one

10. PTSD • Five factors are necessary for diagnosis: • The person must have experienced or witnessed an extreme stressor • Re-experiencing of the traumatic event • Avoidance and emotional numbing • Increased arousal • Set of symptoms that have lasted at least one month

11. Significant Life Changes • Change itself may cause stress by forcing us to adapt to new circumstances • Is change, positive or negative, necessarily harmful? • No support that positive “stressors” are as harmful as negative stressors • Impact of change depends on person and how change is interpreted

12. The Hassles of Everyday Life • Most common source of stress arises from the daily hassles that irritate us • Ex: Environmental factors • “Microstressors” place a constant strain on us • The accumulation of daily hassles contributes more to illness than do major life events

13. Dormitory Life • Baum & Valins (1977) • These researchers compared two layouts of dormitory in university residences… • One was based on a long corridor design, with 17 rooms opening off a single corridor, whereas the other was a suite of three rooms opening off a communal area • The total space per student was about the same in the two designs and the facilities were similar, but student s in the long corridor style residence complained more about being crowded and about having to avoid unwanted social contact • They withdrew from social contact even when they were away from the residence

14. Dormitory Life • Baum & Valins (1977) • Traditional dorms appear to be more stressful than newer suite style

15. They demolished this dorm… • In one case, a 26 floor, 1,300 student residence, Sander Hall, was demolished at the University of Cincinnati in 1991 because of persistent problems of violence and vandalism

16. Karlin et al. (1979) • Students who are accommodated 3 to a room intended for 2 suffer less contentment and lower grades

17. Watch your Blood Pressure… • Evans (1979) • Compared ten person groups of people • Some were in rooms 20 x 30 feet, while others were in rooms 8 by 12 feet • Results: • The people packed into small rooms had higher pulse rates and blood pressure

18. Is noise stressful??? • Research indicates that living in a busy city, near a highway, airport, etc. can have detrimental effects

19. How Does Stress Affect the Body? • Selye (1976) • His General Adaptation Syndrome model illustrates the effects of stress • Selye felt that the body’s adaptive response to stress was very general – like a burglar alarm that would sound off no matter what intruded • His model has three overlapping stages - alarm, resistance, and exhaustion

20. The General Adaptation Syndrome

21. Phase 1: Alarm Reaction • Alarm reaction caused by a sudden activation of your sympathetic nervous system (this is the part of the autonomous nervous system that arouses the body (increases HR, BP, etc.) • Mobilizes energy in stressful situations • So, your body recognizes danger and mobilizes for a "fight-or-flight" situation… • System is activated but since you are in temporary shock – your resistance drops below normal – usually minor and short-term • Therefore, the person may show various symptoms of stress -- headaches, fever, fatigue, sore muscles, shortness of breath, diarrhea, upset stomach, etc.

22. Phase 2: ResistanceTime to fight the challenge • Your body responds to the challenge with an outpouring of stress hormones causing your temperature, blood pressure, heart rate, and respiration all remain high • Everything is in full force to help you cope with the stressors • As body defenses stabilize, the symptoms of alarm seem to disappear • The adjustment to stress and the outward appearance of normality are maintained at high cost… • During this resistance stage, the body is more able to cope with the original stress • However, its resistance to any other stress is lowered

23. Phase 3: Exhaustion • During this phase, the individual reservoir of resources is becoming depleted • The person is especially vulnerable to diseases and in extreme cases collapse and death (immune system is being challenged by the long-term stress) • Example: Heart attack

24. What Stress Does to the Heart • Type A Behavior Pattern: • Characterized by extremes of competitive striving for achievement, a sense of time urgency, hostility, and aggression • A risk factor for coronary heart disease (CHD)? • Hostility appears to be the main toxic ingredient in CHD

25. How “Hostile” Is Your Pattern of Behavior? From Anger Kills: 17 Strategies by Redford B. Williams, M.D., and Virginia Williams, Ph.D. Used by permission of Prentice-Hall, Inc., Upper Saddle River, NJ.

26. Specific Types of Personalities… • Friedman & Rosenman (1959) • Summarized years of research to come up with the much publicized Type A and Type B personalities

27. Type A • Has a chronic sense of time urgency • Rushed and hurried, this person is always "on edge" • Has quick and abrupt speech • Often interrupting others • Is very competitive • Even in noncompetitive situations • Is a hard-driving, achievement-oriented, and status-conscious person • Frequently becomes hostile and aggressive

28. Type B • This person has an easier-going lifestyle • Is much more able to sit back and relax • Less competitive • More understanding and forgiving • Enjoy leisure and weekends more

29. Some Differences… • The most important difference is that Type A men are 2-3 times more likely to suffer angina, heart attacks, or sudden death than type B men • Type A smoke more, sleep less, drink more coffee, walk faster, work later, drink less milk, etc.

30. Situational difference here as well… • Interestingly, in relaxed situations, HR, BP, hormonal secretions, etc. are very similar… • But when harassed…watch out… • Given a difficult challenge, threatened with loss of freedom or control we see big differences… • Type A’s are much more physiologically reactive as HR, BP, hormonal secretions, etc. -- SOAR! • Type B’s remain at moderate levels • Example: Williams (1989) • Subjects asked to do simple math problems • Type A’s stress-hormone levels rose to more than double the Type B’s

31. Why Is Hostility and CHD Linked? • Cardiovascular system becomes overworked • Hostile people are less health conscious • Hostile people are physiologically reactive • In tense social situations they exhibit more intense cardiovascular reactions

32. What Stress Does to the Immune System • Stress compromises the body’s immune system • Psychoneuroimmunology (PNI): A subfield of psychology that examines the links among psychological factors, the brain and nervous system, and the immune system

33. Stress and the Immune System • The immune system is the body’s first line of defense against invading substances and microorganisms • Stress can impair or suppress the immune system • Social support and other stress-mediating factors can help sustain one’s immune system • Social support may prevent illness by providing an outlet for the person under stress

34. Social Support • Quality of social support can influence one’s ability to cope with stress… • Those who have close relationships with friends, relatives, religious organizations, self-help groups, etc. usually benefit and can be helped through a tough time • This type of support is crucial for trauma victims • Posttraumatic Stress Disorder • Having too much support or the wrong kind of support can be as bad as not having enough support • How can this be?

35. Effects of Severe Stress… • Occurs when demands are too intense for our coping techniques (or if we perceive them to be too intense)… • Lowering of Adaptive Efficiency • “Wear and Tear”

36. Lowering of Adaptive Efficiency • Physiological Level • Severe stress can impair the body’s ability to fight off invading bacteria and viruses • We get the flu • Psychological Level • Makes it difficult or impossible for an individual to see a situation objectively or to perceive the alternatives that are actually available • Suicide attempts • When we use all our resources to combat one severe stressor, we have less of a tolerance for others

37. “Wear and Tear” • After we are exposed to a stressful experience, can rest completely restore us to normal levels of functioning? • Selye (1976): says no • Indelible scar is left • Every period of stress adds up

38. Stress and the common cold… • Cohen (1993) • The participants supplied information about three things: • Numbers of negative life events they had experienced in the last 12 months • Perceived stress. A questionnaire measure of how unpredictable, uncontrollable and overloading the individuals found their lives • Negative emotions. Ratings of the extent to which they had felt 15 emotions over the last week; distressed, nervous, sad, angry, dissatisfied with self, calm, guilty, scared, angry at self, upset, irritated, depressed, hostile, shaky and content

39. Cohen (1993) • The volunteers were then exposed to common cold viruses. Two types of outcome were examined: • Infection. Detection of the virus or a significant rise in levels of virus-specific antibodies in nasal samples 2- 6 days after exposure. (It is possible to be infected without becoming ill.) • Clinical colds. A clinician's judgment of cold severity based on symptom checklists, body temperature, and numbers of tissues used per day.

40. Cohen (1993) • Overall, 82% became infected and 46% developed colds (symptoms) • Important findings: • High stress participants: 53% developed colds • Low stress participants: 40% developed colds • Perceived stress and negative affect were associated with infection • Stressful life events were associated with development of clinical colds, given infection.

41. Cohen (1998): Stress Duration and Illness

42. Attributional and Explanatory Styles • Seligman (1975): • Depression results from learned helplessness • Abramson et al. (1989): • Depression is a state of hopelessness brought on by the negative self-attributions people make for failure. • Depressive explanatory style

43. Hardiness Personality Style • Individuals exhibit three characteristics: • Commitment • Challenge • Control • Hardiness serves as a buffer against stress • Perception of control is most important factor

44. Perception of Control • The expectation that our behaviors can produce satisfying outcomes. • Self-efficacy: Feelings of competence • A state of mind that varies from one specific task and situation to another.

45. Optimism and Hope • Optimism is a generalized tendency to expect positive outcomes • Characterized by a nondepressive explanatory style • Health can spring from optimism, as evident by the placebo effect

46. Pollyanna’s Health • Positive thinking cannot guarantee good health • Victims of illness do not just have a “bad attitude” • Limits to positive thinking… • Especially if it leads us to see ourselves and events in ways that are not realistic

47. Coping Strategies • Problem-focused coping • Emotion-focused coping • Proactive coping

48. Problem-Focused Coping • In dealing with essential tasks, it is better to confront and control than to avoid

49. Problem-Focused Coping Stages • Assessment • Identify the sources and effects of stress • Goal Setting • List the stressors and stress responses to be addressed • Designate which stressors are and are not changeable • Planning • List the specific steps to be taken to cope with stress

50. Problem-Focused Coping Stages • Action • Implement coping plans • Evaluation • Determine the changes in stressors and stress responses that have occurred as a result of coping methods • Adjustment • Alter coping methods to improve results, if necessary