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Lecture 8: Stress and illness - Dr. Reem AlSabah


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Lecture 8: Stress and illness - Dr. Reem AlSabah

  1. 1. Dr. Reem Al-SabahFaculty of Medicine Psychology 220
  2. 2. 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.
  3. 3. 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
  4. 4. 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
  5. 5.  Psychological and social factors can affect the CNS, endocrine system, and immune system. Classical conditioning of the immune system (Ader & Cohen, 1975).
  6. 6. How Can Stress Make You Sick?
  7. 7. 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.
  8. 8. How Does Stress Make You Sick?
  9. 9. 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.
  10. 10. 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.
  11. 11. The Immune system (Cont.)  One important factor appears to be the extent to which an individual can control stressLower controllability = greater impact on immune system  Perception of stress  Marital separation/divorce  Women with breast cancer
  12. 12. Controllability Studieson 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)
  13. 13. 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.
  14. 14.  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.
  15. 15. 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?
  16. 16. 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
  17. 17. 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.
  18. 18. 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.
  19. 19. Signs and Symptoms of Stress Cognitive symptoms Emotional symptoms• Memory problems • Moodiness• Inability to concentrate • Irritability or short temper• Poor judgment • Agitation, inability to• Seeing only the negative relax• Anxious or racing • Feeling overwhelmed thoughts • Sense of loneliness and• Constant worrying isolation • Depression or general unhappiness
  20. 20. Signs and Symptoms of Stress (Cont.) Physical symptoms Behavioral symptoms• Aches and pains • Eating more or less• Diarrhea or constipation • Sleeping too much or too• Nausea, dizziness little• Chest pain, rapid • Isolating yourself from heartbeat others• Loss of sex drive • Procrastinating or neglecting• Frequent colds responsibilities • Using alcohol, cigarettes, or drugs to relax • Nervous habits (e.g. nail biting, pacing)
  21. 21. 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.
  22. 22. 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?
  23. 23. Personality and illnessHardiness 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
  24. 24. 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
  25. 25. Type A Behaviors
  26. 26. 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.