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Stress, emotion and the heart

Stress, emotion and the heart. Basic Reading This course is not organised around a textbook. I shall refer primarily to material in journals. Also consult basic health psychology texts such as EP Sarafino 2006 Health Psychology: biopsychosocial interactions (5 th Edition)

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Stress, emotion and the heart

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  1. Stress, emotion and the heart

  2. Basic Reading This course is not organised around a textbook. I shall refer primarily to material in journals. Also consult basic health psychology texts such as EP Sarafino 2006 Health Psychology: biopsychosocial interactions (5th Edition) S Taylor (2006) Health Psychology (6th Edition) The is also an excellent by old book on the topic A Steptoe (1981) Psychological factors in cardiovascular disorders. Steptoe has also written a very good chapter on “Psychophysiological bases of disease” in Johnston & Johnston, Health Psychology, volume 8 of Bellack & Hersen Comprehensive Clinical Psychology (find under Bellack & Hersen)

  3. Definition Health Psychology The study of psychological process in health, illness and health care

  4. John Hunter famous 18th century Scottish surgeon & anatomist of the 18th century “ My life is in the hands of any rascal who chooses to annoy or tease me” Died after argument at St George hospital medical school (over student admissions) 1897, William Osler - dominant figure in internal medicine - described the typical heart disease patient as "a keen and ambitious man, the indicator of whose engine is always at 'full speed ahead.”

  5. Patients’ beliefs about causes of MI. Percentage considering factor a possible cause At discharge 2month 6 months 12 months Stress 70 72 61 61 Smoking 59 55 47 53 Worry 58 55 33 28 Will of God 27 21 9 2 Gudmunsdottir, Johnston, Johnston & Foulkes, (2001) BJHP, 6, 81-96.

  6. Brod. Mental arithmetic leads to increase in cardiac output (blood pumped by heart). Decrease in peripheral resistance, but blood pumped bigger effect in this case so blood pressure increases.

  7. Heart Rate increased by stress. Decreases again with exposure but less so in hard but not impossible condition. Obrist. Hard condition involves “active coping”

  8. Guest lecturer speaking to this class last year. HR high before and during lecture . Took at least an hour to get back to normal

  9. Coronary Heart Disease and Acute Coronary Syndromes • A slow process of arterial deterioration • An acute process that triggers a clinical event

  10. The Reactivity Hypothesis Stress (and some emotions) leads to altered physiological responses in some people and these responses are harmful to the arteries. A stress diathesis (vulnerability) model.

  11. Studies in Health populations Kuper Marmot & Hemingway (2002), Seminars in Vascular Medicine,2, 267-313 Psychological process positive/no. of studies Type A / Hostility 6/18 Depression 15/22 Anxiety 4/8 Work characteristics 10/13 (Social Support 6/9) Studies in Populations with Cardiovascular Disease Type A/Hostility 2/15 Depression 18/34 Anxiety 8/18 Work characteristics 2/4 (Social Support 14/21) Seen as positive support overall By K,M & H

  12. Depression reduced in patients after MI by simple Counselling intervention Johnston,M, Foulkes J, Johnston, D, Pollard, B, Gudmundsdottir, H (1999) Psychosomatic Medicine, 61, 225-233

  13. Depression reduced in partners of MI patients who received counselling Johnston,M, Foulkes J, Johnston, D, Pollard, B, Gudmundsdottir, H (1999) Psychosomatic Medicine, 61, 225-233

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