Health Psychology Exam #1 PDF

Chapter 1 Health Psychology Defined -​ Health psychology is a relatively new field devoted to understanding psychological influences on how people stay healthy, why people become ill, and how they respond when they do get ill What is Health -​ The World Health Organization (WHO)...

Chapter 1 Health Psychology Defined -​ Health psychology is a relatively new field devoted to understanding psychological influences on how people stay healthy, why people become ill, and how they respond when they do get ill What is Health -​ The World Health Organization (WHO) has formally defined health as: -​ “A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” -​ Health is recognized to be an achievement involving balance among physical, mental, and social well-being -​ Objective signs that the body is not functioning properly (e.g., high blood pressure) -​ Subjective symptoms of disease or injury (e.g., pain, nausea) Wellness/Illness Continuum Estimated Contributions of Different Factors to Health Status -​ Health behaviours can confer resilience or risk for the development of illness, as well as help people maintain health and manage disease Health Psychology Focus -​ Health psychologists focus on: -​ Health promotion and maintenance -​ Prevention and treatment of illness -​ Etiology (origins or causes of disease) and correlates of health, disease and dysfunction -​ Studying the impact of health institutions and health professionals on people’s behaviour Health Psychology Roles -​ The educational, scientific and professional contributions of psychology to the promotion and maintenance of health -​ The prevention and treatment of illness -​ The identification of the causes and correlates of health and illness -​ The improvement of the health care system and the formulation of health policy Early Views of Mind-Body Relationship -​ The mind and body were considered a unit  -​ Early cultures believed: -​ Disease = God’s Punishment → Evil spirits entering the body → These spirits could be exorcised through the treatment process -​ Hippocrates developed a humoral theory of illness: -​ Disease = Imbalance of four circulating fluids of the body: -​ blood, black bile, yellow bile, and phlegm -​ The function of treatment is to restore balance among the humours Supernatural or Magical Belief -​ Disease resulted from: -​ Sorcery -​ Breach of social taboo -​ Object intrusion -​ Supernatural possession -​ Losing one’s soul Treatments -​ Confession and appeasing of the Gods -​ Magical sucking to remove the intrusive object -​ Drive out evil spirits by using vile concoctions such as animal excrement or even torture -​ Trephination Greeks – Hippocrates (460-377 B.C) -​ Origin of the view that disease is a natural process -​ “Men think epilepsy divine, merely because they do not understand it… We will one day understand what causes it, and then cease to call it divine. And so it is with everything in the universe.” - Hippocrates -​ Humoral Theory -​ View that disease occurs when the four fluids of the body are out of balance -​ Four fluids are: -​ Blood -​ Black bile -​ Yellow bile -​ Phlegm -​ Personality types -​ Believed to be associated with bodily temperaments in which one of the four humours predominated Hippocrates – Treatments -​ Temperament -​ Phlegmatic -​ Humor: Phlegm -​ Disease: cold, headaches -​ Treatment: Hot baths, warm food -​ Sanguine -​ Humor: blood -​ Disease: angina, epilepsy  -​ Treatment: blood letting -​ Melancholic -​ Humor: black bile -​ Disease: hepatitis, ulcers -​ Treatment: hot baths -​ Choleric -​ Humor: yellow bile -​ Disease: stomach, jaundice -​ Treatment: Blood letting, liquid diet Evolving View of Diseases -​ Anatomical Pathology -​ The belief that disease was localized in anatomy (16th to 18th centuries) -​ Tissue Pathology -​ Specific tissues could become diseased while others remain healthy (late 18th Century) -​ Cellular Pathology -​ Belief that life resided in cells and so cells must be the place to look for disease (19th Century) -​ Germ Theory -​ Discovery that particles in the air that could not be seen (e.g., bacteria) could cause disease -​ Magic Bullet -​ A specific cure could be found for every ailment that restore the person to perfect health -​ Biopsychosocial Model -​ Mind, body, and environment interact in causing disease The Mind-Body Relationship: Psychoanalytic -​ Freud’s early work on conversion hysteria -​ Specific unconscious conflicts produce physical disturbances that symbolize the repressed psychological conflicts -​ The patient converts conflict into a symptom via the voluntary nervous system; and becomes relatively free of anxiety The Mind-Body Relationship: Psychosomatic Medicine -​ Dunbar and Alexander -​ Conflicts produce anxiety, which becomes unconscious and takes a physiological toll on the body via the autonomic nervous system, which produces an actual organic disturbance -​ Offered profiles of disorders thought to be psychosomatic in origin (e.g., anxiety and stress causing ulcers) -​ Helped shape the belief that bodily disorders are caused by emotional conflicts -​ Criticized that a particular conflict or personality style is not sufficient to produce illness, the onset of disease requires the interaction of a variety of factors, including: -​ Possible genetic weakness in the organism  -​ the presence of environmental stressors -​ early and current ongoing learning experiences and conflicts -​ individual cognitions and coping efforts The Mind-Body Relationship: Behavioural Medicine -​ Focus on objective and clinically relevant interventions that demonstrate the connections between body and mind -​ Behavioural medicine is considered the Interdisciplinary field concerned with integrating behavioural science and biomedical science to understand physical health and illness and to prevent, diagnose, treat, and rehabilitate What is the Biopsychosocial Model of Health -​ Biomedical Model -​ All illness can be explained on the basis of aberrant somatic bodily processes; psychological and social processes are irrelevant to disease process -​ Biopsychosocial Model -​ Health and illness are consequences of the interplay of biological, psychological and social factors Relation of Health Psychology to Other Health-Related Fields Current Views of the Mind-Body Relationship -​ We now know that physical health is inextricably interwoven with the psychological and social environment -​ All conditions of health and illness, not just the diseases identified by the early psychosomatic theorists, are influenced by psychological and social factors -​ The treatment of illness and prognosis for recovery are substantially affected by factors such as the relationship between patient and practitioner, and expectations about pain and discomfort -​ With an expanded perspective there is growing interest in more holistic approaches to health and healing -​ Increase in use of alternative and complementary therapies Biopsychosocial Model of Disease -​ The Biopsychosocial Model: Advantages -​ Advantages of the Biopsychosocial Model: -​ Macrolevel processes and microlevel processes interact to produce a state of health or illness -​ The mind and body cannot be distinguished in matters of health and illness because they are intertwined -​ Researchers have adopted a systems theory approach to health and illness -​ All levels in an entity are linked hierarchically and a change on one level will effect change in all the other levels The Biopsychosocial Model: Clinical Implications -​ Diagnosis should always consider biological, psychological and social factors in assessing an individual’s health or illness -​ Recommendations for treatment must examine all three sets of factors -​ Becomes possible to target treatment uniquely to a particular individual -​ The relationship between the patient and the practitioner matters What is the Field of Health Psychology Needed? -​ Only way to develop an adequate understanding of health and illness -​ Changing patterns of illness and causes of death have created a need for understanding and affecting lifestyle factors -​ Advances in technology and research -​ Role of Epidemiology in Health Psychology -​ Morbidity and mortality -​ Health-related quality of life and symptomatic complaints -​ Increased medical acceptance -​ Demonstrated contributions to health Determinants of Health -​ Income and social status -​ Social support networks -​ Education -​ employment/working conditions -​ Social environments  -​ Physical environments -​ Personal health practices and coping skills -​ Healthy child development -​ Biology and genetic endowment -​ Health services -​ Gender -​ Culture What is the Purpose of Health Psychology Training -​ Careers in practice: -​ Physicians, nurses and allied health professionals better able to understand and manage the psychological and social aspects of health than if had traditional background -​ Careers in research: -​ conduct research in public health, psychology and medicine in a variety of settings such as academia, public health departments and Health Canada Important Contributions of Psychology to Health -​ Has provided techniques useful in changing behaviours that affect health and illness. -​ Is committed to keeping people healthy rather than waiting to only treat them when they become ill. -​ Long history of developing reliable and valid measures for assessing health-related factors. -​ Has contributed a solid foundation of scientific methods for studying such behaviours. Chapter 2 The Nervous System -​ Cell body -​ source of life of the cell -​ Dendrites  -​ Branches on the cell bodies that act as receivers of messages from adjacent neurons -​ Axon -​ Projection through which messages travel -​ Synaptic knobs -​ Tips of branches at the end of the axon -​ Sends messages to adjacent neurons -​ Synapse -​ Fluid-filled gap between neurons -​ Message = electrical activity -​ The nervous system (NS) is made up of the central nervous system and the peripheral nervous system -​ The central nervous system (CNS) is made up of the brain and the spinal cord -​ Carries voluntary nerve impulses to skeletal muscles and skin -​ Carries involuntary impulses to muscles and glands -​ The peripheral nervous system (PNS) is made up of the somatic and autonomic nervous systems; Autonomic nervous system is made up of sympathetic nervous system and parasympathetic nervous system -​ Somatic nervous system -​ Controls voluntary movement -​ Autonomic nervous system -​ Controls organs that operate involuntarily -​ Sympathetic nervous system -​ Mobilizes the body for action -​ Parasympathetic nervous system -​ Maintains and restores equilibrium The Brain -​ Frontal Lobe -​ Motor activity -​ Higher level intelligence -​ Planning -​ Problem solving -​ Emotions -​ Self-awareness -​ Parietal Lobe -​ Bodily sensations; e.g., pain, heat -​ Body movement -​ Occipital Lobe -​ Primary visual area of the brain -​ Temporal Lobe -​ Hearing -​ Vision -​ Smell -​ Memory -​ Left & Right Hemispheres -​ Each of the cerebral hemispheres receives sensory  information from the opposite side of the brain, and also controls motor responses on the opposite side of the body (contralateral control) -​ Left Hemisphere -​ Spoken language -​ Number skills -​ Right hand -​ Written language -​ Reasoning -​ Scientific functions -​ Right Hemisphere -​ Music -​ Spatial orientation -​ Left hand -​ Art awareness -​ Creativity -​ Insight The Nervous System Overview -​ The Brain -​ Hindbrain - the lower part of the brainstem -​ Contains: -​ Medulla: receives sensory information from the heart -​ Pons: links the hindbrain and the midbrain -​ Cerebellum: coordinates voluntary muscle movement -​ Midbrain - a part of the central nervous system, located below the cerebral cortex and at the topmost part of the brainstem -​ Major pathway for sensory and motor impulses moving between forebrain and hindbrain -​ The forebrain -​ Has 2 main sections: -​ Diencephalon -​ Thalamus - recognition and relay of sensory stimuli -​ Hypothalamus - helps regulate heart and blood pressure -​ Telecephalon -​ The two hemispheres (left and right) of our cerebral cortex -​ The Limbic System -​ Consists of the: -​ Amygdala – detection of threat -​ Hippocampus – emotional memories -​ Cingulate gyrus, septum, areas of the hypothalamus – emotional functioning -​ Neurotransmitters -​ Chemicals that regulate nervous system functioning -​ Catecholamines -​ Epinephrine and norepinephrine -​ Promote the sympathetic nervous system activity  -​ Released during stressful times -​ The Spinal Cord -​ Transmits messages from the brain to the other areas of the body -​ Efferent – away from the brain out to the body -​ Produces muscle action -​ Afferent – from the periphery to the brain -​ Relays information from the sensory organs -​ The Somatic Nervous System -​ Involved in both sensory and motor functions of skin and muscles -​ The Autonomic Nervous System -​ Controls what is generally involuntary, automatic activity -​ Carries messages between the spinal cord and the smooth muscles of the internal organs -​ The Sympathetic Nervous System -​ Involved in mobilizing and expending energy in response to emergencies -​ Fight or flight response -​ Also prepares the body for strenuous activity -​ The Parasympathetic Nervous System -​ Restores equilibrium, regulates calming processes in the body -​ Decreases arousal, slows breathing and heart rate, lowers heart rate and blood pressure, etc -​ Insert slide #20 The Nervous System Disorders -​ Epilepsy -​ Parkinson’s disease -​ Cerebral palsy -​ Alzheimer’s disease -​ Multiple sclerosis -​ Huntington’s disease -​ Paraplegia, quadriplegia The Endocrine System Overview -​ Complements the nervous system in controlling bodily activities -​ Regulated by the hypothalamus and pituitary gland -​ Communicates via chemical substances called hormones (e.g., adrenaline, cortisol) Adrenal Gland -​ Located on top of each kidney -​ Releases hormones in response to emergencies and stress -​ Cortisol: helps control swelling but continued high levels can lead to high blood pressure, ulcers, etc -​ Epinephrine & norepinephrine (adrenalin and noradrenalin): produce bodily reactions for quick energy Physiological Systems in Stress Response -​ Sympathetic Activation -​ Events perceived to be stressful create sympathetic nervous system arousal -​ Triggers adrenal glands to release catecholamines epinephrine and norepinephrine -​ Blood pressure, and heart rate increase (and many other changes) -​ HPA Activation -​ Hypothalamic-pituitary-adrenocortical (HPA) axis -​ the pituitary gland releases the hormone ACTH, triggering the adrenal release of glucocorticoids, especially cortisol -​ Recurring activation compromises functioning, creating allostatic load -​ Hampers immune functioning Thyroid Gland -​ Located in the neck -​ Produces hormone thyroxin that regulates activity level and growth -​ Hypothyroidism: insufficient thyroid hormones (leads to low activity levels and weight gain) -​ Hyperthyroidism: over-secretion of thyroid hormones (leads to hyperactivity and weight loss, insomnia, tremors, etc) Pancreas -​ Located below the stomach -​ Regulates level of blood sugar by producing insulin which absorbs blood sugar -​ Important gland in diabetes mellitus The Endocrine System Disorders -​ Diabetes -​ Body cannot manufacture or properly use insulin -​ Type I: insulin-dependent diabetes -​ Type II: insufficient insulin or insensitivity to it The Digestive System -​ Consists of: -​ Mouth -​ Breaks down food particles -​ salivary gland action -​ Stomach -​ Initial protein digestion -​ Food is liquified and mixed  -​ Small intestine -​ Chemical breakdown -​ Absorption -​ Large intestine -​ Water absorption -​ Waste storage -​ Enzymes: break down food substances -​ Commands from the brain stem activate the production of saliva -​ Saliva contains enzymes that break down starches -​ Esophagus pushes food to the stomach using peristalsis -​ Additional enzymes and bile continue the food break down -​ Absorption occurs -​ Large intestine (mainly colon) continues absorption of water and passes the remaining waste to the rectum for execution Disorders of the Digestive System -​ Peptic ulcers -​ Open sores in the stomach or duodenum -​ Caused by excessive gastric juices and bacterial infection -​ Hepatitis -​ Liver becomes inflamed -​ Cirrhosis -​ Liver cells die and are replaced by scar tissue -​ Caused by hepatitis and heavy alcohol consumption The Respiratory System -​ Main concepts: -​ Body tissues need a constant supply of oxygen -​ Mechanical action (moving air in and out of the lungs) -​ Gas exchange (respiration) -​ In the alveoli, CO2 (toxic gas) is eliminated and O2 enters the bloodstream -​ Protective mechanisms (sneezing, cough, mucous production) -​ Impaired function (asthma, pneumonia, bronchitis, emphysema, cancer -​ Air enters the body through the nose and the mouth -​ The air travels past the larynx and down the trachea and bronchial tubes into the lungs -​ The bronchial tubes divide into small branches called bronchioles, and then tiny sacs called alveoli Disorders of the Respiratory System -​ Asphyxia -​ Too little oxygen and too much carbon dioxide (can occur in small breathing space) -​ Anoxia -​ Shortage of oxygen (occurs at very high altitudes)  -​ Person looses judgement, passes into a coma -​ Hyperventilation -​ Deep rapid breaths that reduce the amount of carbon dioxide Cardiovascular System -​ Transport system of the body -​ Consists of the heart, blood, and blood vessels -​ Blood vessels consist of -​ Arteries that carry oxygenated (red) blood from the heart to the periphery and brain -​ Veins carries de-oxygenated (blue) blood back to the heart and lungs Heart -​ Fist-sized muscle that circulates blood to and from the lungs to the body -​ Four chambers: -​ Atrium (right & left) -​ Ventricles (right & left) -​ The left side pumps oxygenated blood from the lungs out to the periphery and brain -​ The right side takes deoxygenated blood into the lungs Blood Pressure (BP) -​ Pressure of blood in the arteries -​ As the heart contracts and pushes blood into the arteries (systolic cardiac cycle) the BP rises -​ As the heart rests between beats and no blood is pumped (diastolic cardiac cycle) BP is at its lowest Dynamics of Blood Pressure (BP) -​ Cardiac output -​ Volume of fluid pumped per minute -​ Blood pressure rises as cardiac output rises -​ Blood volume -​ Amount of blood in the systen -​ Blood pressure rises as blood volume rises -​ Peripheral resistance -​ Ease with which blood can pass through the arteries (as resistance increases, BP increases) -​ Elasticity -​ Is the give and take in the arterial walls -​ As elasticity decreases BP increases -​ Viscosity -​ Thickness of the blood -​ BP increases when the thickness of the blood increases Blood Pressure is Dynamic…  -​ When arteries dilate (e.g., in heat) diastolic BP decreases -​ BP increases when heart rate or cardiac output increases in response to activity, change in posture, while talking, when under stress, temperature, etc -​ BP follows a circadian (daily) rhythm such that it is lowest when in deep sleep Cardiovascular System Disorders -​ Atherosclerosis -​ Caused by deposits of cholesterol and other substances on the arterial walls that form plaques and narrow the arteries -​ It is in part of a lifestyle disease because of its association with poor health habits -​ Arteriosclerosis (hardening of the arteries) -​ Over time, plaques harden and blood vessels lose their elasticity which causes increases in blood pressure -​ Consequences of Atherosclerosis -​ Angina Pectoris -​ Insufficient oxygen supply to the heart for its need and removal of waste products resulting in chest pain -​ Myocardial Infarction (heart attack) -​ When there is a blockage of blood supply to an area of the heart cutting off oxygen supply to the tissue in the area and resulting in tissue death -​ Hypertension -​ Permanently high blood pressure -​ Systolic blood pressure >= 140mmHg -​ Diastolic blood pressure >= 90mmHg -​ Essential (primary) -​ No known physical cause (90-95% of cases are of this type) -​ Secondary hypertension -​ Due to specific cause, e.g., adrenal tumour The Cardiovascular System: Blood -​ Adult body contains approximately 5 litres of blood -​ Plasma is the fluid portion and it makes up about 55% of the volume -​ The remaining 45% of the blood compromises substances such as red and white blood cells, proteins, electrolytes, platelets, oxygen, nutrients, and waste -​ Red blood cells primarily carry oxygen and nutrients -​ White blood cells are primarily involved in immune functions -​ Platelets are used in clotting blood and forming scabs -​ Blood cells are manufactured in bone marrow Blood -​ Two components: -​ Formed elements -​ Consist of 3 elements: -​ Red blood cells  -​ Leukocytes (white blood cells) -​ Platelets -​ Plasma -​ Formed Elements: Red Blood Cells -​ Most abundant cells -​ Formed in bone marrow -​ Contains hemoglobin: -​ A protein that attaches to oxygen and transports it to the cells and tissue -​ Anemia is when level of red blood cells is below normal Disorders Related to Red Cell Production -​ Anemia -​ When insufficient red blood cells or hemoglobin impair transport of oxygen to cells -​ Menstruating women may experience anemia due to loss of iron and may be helped by iron supplements -​ Anemia also occurs when bone marrow doesn’t produce enough red blood cells, potentially causing nervous system damage and chronic weakness -​ Sickle-Cell Anemia -​ Genetically transmitted inability to produce sufficient red blood cells and is found primarily in African, Middle eastern, Carribean, and South and Central Americans -​ Cells are sickle-shaped rather than flattened spheres, believed to have developed to improve resistance to malaria but having potentially fatal consequences over the long term Leukocytes (white blood cells) -​ Serve a protective function (e.g, destroys bacteria) -​ Produced in bone marrow and various organs of the body -​ Leukemia is when there is an excessive production of white blood cells that crowd out plasma and red blood cells Disorders Related to White Cell Production -​ Leukemia -​ Disease of bone marrow – common form of cancer -​ Leukopenia -​ Deficiency of white blood cells – may accompany other diseases like TB, measles, and pneumonia -​ Leukocytosis -​ Excessive white blood cells – often response to infections like appendicitis and mononucleosis Platelets -​ Granular fragments that can clump together to prevent blood loss at site of cuts  -​ Produced by bone marrow -​ Hemophilia is when platelets don’t function properly to produce clotting and so if the person receives a cut could bleed excessively Disorders Related to Clotting -​ Platelets -​ Coronary and cerebral thromboses and embolus (detached clot that lodges in the lung) can be fatal Plasma -​ 55% of the blood is plasma -​ Composed of 90% water and 10% plasma protein and other organic and inorganic substances -​ Other substances include hormones, enzymes, waste products, vitamins, sugars, fatty material etc The Immune System -​ Antigens -​ Any substance (e.g., bacterial, viral, fungi) that can trigger an immune response -​ Bacterial -​ Microorganisms in the environment -​ Grow rapidly and compete with our cells for nutrients -​ Can cause illness -​ Fungi -​ Organisms like mould and yeast -​ Also, absorbs nutrients -​ Protozoa -​ One-celled animals that live in water and insects -​ Drinking them can cause diseases -​ Viruses -​ Proteins and nucleic acid -​ They take over the cell and generate their own genetic instructions -​ The immune system is the surveillance system of the body -​ Impacts infection, allergies, cancer, and autoimmune diseases -​ Primary function to distinguish between “self” and “foreign” and to attack what is considered foreign -​ Transplant success can be increased by -​ Using close genetic tissue match -​ Using medications that inhibit the immune system’s attack on the foreign material -​ Allergies are immune response to (normally) harmless substances -​ Allergens are substances that trigger an allergic response (e.g., pollen, cat dander) -​ Infection: -​ One path to illness is the invasion of microbes and their growth in the body -​ Four means of infection -​ Direct transmission  -​ Indirect transmission -​ Biological transmission -​ Mechanical transmission -​ The course of Infection: -​ Incubation period -​ Period of nonspecific symptoms -​ Acute phase (disease is at its height) -​ Fatality or a period of decline during which invading organisms are expelled -​ Infections may be localized, focal, or systemic -​ Immunity: -​ The body’s resistance to injury from invading organisms -​ Develops naturally or artificially through vaccines -​ Occurs through either nonspecific immune mechanisms (fights any infection) or specific immune mechanisms (fights particular microorganisms) -​ Phagocytosis is when certain white blood cells ingest microbes -​ Humoral immunity: -​ Mediated by B lymphocytes -​ Best against bacterial and viral infection -​ Cell-mediated immunity -​ Involving T lymphocytes -​ Best against fungi, parasites, foreign tissue, cancer Organs of the Immune System -​ Lymphatic and Lymphoid organs -​ Deploys lymphocytes -​ Lymphocytes -​ White blood cells that provide main defense against foreign material -​ Produced by bone marrow -​ Lymph Nodes -​ Bean-shaped spongy tissue -​ Largest are in the neck, the arm-pit, abdomen, and groin -​ Filters to capture antigens (foreign material) and has compartments for lymphocytes -​ Lymph Vessels -​ Connects to lymph nodes and carries fluid called lymph into the blood stream -​ Lymphatic Organs -​ Spleen -​ Production of B and T cells; removes old red blood cells -​ Upper left side of the abdomen -​ Filters antigens that the lymph vessels put into the bloodstream -​ Home base for white blood cells -​ Removes worn out red blood cells -​ Tonsils -​ Filter microorganisms that get into respiratory tract -​ Thymus -​ Helps T cells mature; produces hormone important for antibodies Soldiers of the Immune System -​ Phagocytes -​ Engulf and ingest antigens -​ Two types: -​ Macrophages -​ Attach to tissue and stay there -​ Monocytes -​ Circulate in the blood -​ Nonspecific immune processes Specific Immune Processes -​ Cell-mediated Immunity -​ Killer t-cells (CD8) -​ Destroy foreign tissue, cancerous cells, cells invaded by antigens -​ Memory t-cells -​ Remember previous antigen in order to defend against subsequent invasions – last a long time -​ Delayed hypersensitivity t-cells -​ Involved in delayed immune reactions -​ Produce lymphokines that stimulate other t-cells to grow, reproduce and attack -​ Helper t-cells (CD4 cells) -​ Get information of invasions and report to spleen and lymph nodes to stimulate lymphocytes to attack -​ Suppressor t-cells -​ Slow down or stop immune processes Immune System -​ Antibody-mediated immunity -​ Attacks antigens while they are still in the body fluids, before they have invaded cells -​ Antibodies: -​ Proteins produced in the body in response to antigens -​ They combine chemically with antigens to overcome their toxic effects -​ B Lymphocytes -​ Secrete antibodies that protect body against bacterial infection and viral infections Why Can’t We Fight Cancer? -​ Some cancer cells release substances that suppress the immune response -​ Some antigens may be difficult for the immune system to recognize Less Than Optimal Defenses  -​ Immune function changes during the lifespan, increasing in childhood and decreasing in old age -​ Unhealthy lifestyles impair immune functioning -​ Insufficient vitamin A or E decreases the production of lymphocytes and antibodies -​ Vitamin C is important in the effectiveness of phagocytes -​ High fat and cholesterol intake impair immune functioning -​ Poor sleep impairs immune functioning Stress and the Immune System -​ Stress appears to suppress the immune response -​ Killer T-cells are lower during periods of high stress -​ Adrenaline and cortisol that are released during stress appear to increase suppressor T-cells, decrease helper T-cells, and decrease functioning of phagocytes and lymphocytes -​ Chemicals released by our nerves suppress immune functioning in nearby cells Disorders Related to The Immune System -​ AIDS -​ Cancer -​ Infectious disorders: -​ Splenomegaly -​ Infection of spleen -​ Tonsillitis -​ Inflammation impedes filter function -​ Mononucleosis -​ Enlargement in lymph system -​ Lymphoma -​ Tumour in lymphatic system Diseases of the Immune System -​ AIDS -​ Kills by destroying helper T-cells CD4 Autoimmunity -​ Learning that inflammatory response that protects us in some circumstances is a cause or contributor to a great many of our chronic diseases -​ Many diseases we believed had other causes are actually autoimmune in nature, in which the body attacks its own tissue Chapter 6 & 7 What is Stress? -​ Stress is: -​ A negative emotional experience is accompanied by predictable biochemical, physiological, cognitive, and behavioural changes, that are directed either toward altering the stressful event or accommodating to its effects -​ Stressor: a stressful event such as noise or the commute to work -​ Person-environment fit: personal resources sufficient to meet the demands of the environment -​ Stress is the circumstance in which transactions lead a person to perceive a discrepancy between the physical or psychological demands of a situation and the resources of his or her biological, psychological, or social systems Routes Which Stress May Produce Disease -​ Direct physiological effects -​ Elevated lipids -​ Elevated blood pressure -​ Decreased immunity -​ Increased hormonal activity -​ Health habit effects -​ Increased smoking, alcohol use -​ Decreased nutrition -​ Decreased sleep -​ Increased drug use -​ Health behaviour effects -​ Decreased compliance -​ Increased delay in seeking care  -​ Obscured symptom profile -​ Decreased likelihood of seeking care What Theories and Models are Used to Study Stress? -​ Fight or Flight -​ Walter Cannon (1932) -​ Physiological response mobilizes the organism to attack the threat or to flee -​ Biological Aspects of Stress -​ General Adaptation Syndrome -​ Tend-and-Befriend -​ Taylor and colleagues -​ In addition to fight or flight, humans respond to stress with social affiliation and nurturing behaviour -​ May depend on underlying biological mechanisms -​ Theory supported by women who respond to stress by turning to others -​ Psychological Appraisal and the Experience of Stress -​ Primary appraisal processes -​ Events may be perceived as positive, neutral, or negative in their consequences -​ Negative events further appraised for possible harm, threat or challenge -​ Secondary appraisal processes -​ Assessment of one’s coping abilities and whether -​ They are sufficient to meet the harm, threat and challenge of an event -​ Factors leading to stressful appraisal -​ Personal factors -​ Personality, intellectual, motivational -​ Situational factors -​ Strong demands, imminent threat What Stress Does to your Body -​ Head -​ Issues with mood, anger, depression, irritability, sadness and a lack of energy, swings in appetite, concentration problems, sleeping issues, headaches and pain, mental health issues, like anxiety disorders and panic attacks -​ Skin -​ Skin problems like acne -​ Joints and Muscles -​ Aches and pains, tension, lowered bone density -​ Heart -​ Increased blood pressure, increased heartbeat, higher cholesterol and instances of heart attack -​ Stomach -​ Stomach cramps, reflux, and nausea and weight fluctuations -​ Pancreas  -​ Diabetes -​ Intestines -​ Digestive issues like irritable bowel syndrome, diarrhoea and constipation -​ Reproductive System -​ Reduced sex drive, lower sperm production (for men) and increased pain during periods (for women) -​ Immune system -​ Reduced ability to battle and recover from illness Physiology of Stress -​ Physiological recovery process -​ Cortisol levels take longer to return to normal under stress -​ Allostatic load -​ Physiological systems within the body fluctuate to meet demands of stress -​ Can be assessed by different indicators What Makes Events Stressful -​ Dimensions of stressful events -​ Negative events -​ More stressful than positive events -​ Uncontrollable events -​ More stressful than predictable events -​ Ambiguous events -​ More stressful because the person has no opportunity to take action -​ Overload -​ Overloaded people are more stressed than people with fewer tasks to perform -​ Must stress be perceived as such to be stressful? -​ Subjective and objective measures of stress predict psychological distress and health complaints -​ Perceiving stress as harmful to one’s health can increase health problems -​ Can people adapt to stress? -​ Psychological adaptation -​ Most people can adapt to moderate stress, but children, elderly and the poor are more adversely affected by chronic stressors -​ Physiological adaptation -​ Low-level stress produces habituation in most people, whereas chronic stress can accumulate across multiple organ systems -​ Must a stressor be ongoing to be stressful? -​ Anticipating stress can be as stressful as its actual occurrence, and sometimes more -​ Adverse after-effects of stress, such as decreases in performance and attention span, and issues with cognition, learning, and memory are well-documented How Stress Has Been Assessed -​ In the laboratory -​ Acute Stress Paradigm  -​ Short-term stressful events impact physiological, neuroendocrine and psychological responses -​ Has shown how individual differences contribute to stress and what factors ameliorate the experience of stress -​ Inducing disease -​ Intentionally exposing people to viruses -​ Stressful Life Events (SLE) -​ Substantial adjustment to the environment leads to high stress -​ SLE predicts illness -​ Daily Stress -​ Minor stressful events (daily hassles), produce psychological distress and aggravate -​ Physical and psychological health -​ Difficult to measure daily hassles What are the Sources of Chronic Stress -​ Stressful life events is one form of stress but also have chronic stressors that are part of our day-to-day lives -​ Effects of early stressful life experiences -​ Chronic physical or sexual abuse in childhood or adult increases health risks -​ Stress early in life causes developing stress -​ Systems to become dysregulated -​ Chronic stressful conditions -​ Chronic stress, such as living poverty, or remaining in a high-stress job, contribute to psychological stress and physical illness -​ Stress in the workplace -​ Studies of occupational stress -​ Help identify common, everyday stressors -​ Some have physical, chemical, or biological hazards -​ Provide evidence for stress-illness relationship -​ Work stress may be preventable with intervention -​ Overload -​ Chief cause of occupational stress -​ Perception of work overload produces physical health complaints and psychological distress -​ Causes of stress: -​ Ambiguity and role conflict -​ Social relationships -​ control/lack of control -​ Job insecurity -​ Unemployment -​ Other occupational outcomes -​ Combining work and family roles -​ Work-life balance -​ Women and multiple roles: -​ Home and work responsibilities may conflict with one another, enhancing stress  -​ Men and multiple roles -​ Men more distressed by financial strain and work stress -​ Satisfaction in the parent role is also important to men -​ Stress in the workplace can cause fathers to withdraw from their children -​ Children: -​ Social and academic failure at school increases aversive behaviour at home -​ Affected by parents’ work and family stressors -​ Protective effects of multiple roles: -​ Some positive effects of combining home and work responsibilities January 21: Moderators of the Stress Experience What is Coping -​ Thoughts and behaviours used to manage the internal and external demands of situations that are appraised as stressful -​ Several characteristics of coping -​ Relationship between coping and a stressful event is a dynamic process -​ Breadth: the many actions and reactions to stressful circumstances -​ Negativity, stress and illness -​ Negative affectivity -​ A pervasive negative mood marked by anxiety, depression and hostility -​ Neuroticism is related to poor health -​ Negativity can cause a false impression of poor health -​ High negative affectivity produces more vulnerability to illness -​ Personality and coping -​ Perfectionism: the setting of and preoccupation with excessively high standards accompanied by self-criticism -​ Perfectionists at a higher risk of poor health outcomes -​ Coping resources: -​ Positive emotional states are associated with better mental and physical health -​ Optimism -​ Leads to better coping mechanisms and reduces risk of illness -​ Optimistic people differ from pessimists in physiological functioning -​ Self-compassion -​ May buffer the negative effect of stress and translate into better self-regulation of health behaviours -​ Gratitude -​ Associated with positive coping styles such as seeking social support -​ Psychological control -​ The belief that one can determine one’s own behaviour, influence one’s environment and bring about desired outcomes -​ Used in interventions to promote good health habits  -​ Coping style -​ A general propensity to deal with stressful events in a particular way -​ Originates in genes and personal experience -​ Problem-focused coping: -​ doing something constructive about stressful conditions that are harming, threatening or challenging an individual -​ Emotion-focused coping: -​ regulating emotions experienced because of the stressful event -​ Rumination: negative thoughts focused on a stressor -​ Emotional-approach coping -​ Specific coping strategies -​ Personal coping strategies are important when dealing with stressful events -​ People who are able to shift coping strategies to meet the demands of a situation to cope better with stress than those who do not -​ Approach vs. avoidance -​ Each has advantages and liabilities -​ The level of success depends on the length of the stressor Beliefs about Oneself and Control -​ Locus of Control: internal and external -​ Self-Efficacy: efficacy – the belief that we can succeed at a specific activity we want to do -​ Outcome expectancy -​ The behaviour, if properly carried out, would lead to favourable outcome -​ Self-efficacy expectancy -​ They can perform the behaviour properly Traits of the Five-Factor Model of Personality -​ Neuroticism vs Emotional Stability -​ Tendency to experience negative emotions, such as anxiety, tension, sadness, and irritability; feeling vulnerable and unable to cope well with stress vs. calm, even-tempered, relaxed, and able to deal with stressful situations without undue distress -​ Extraversion vs introversion -​ Outgoing, cheerful, and talkative interpersonal style; excitement seeking; assertiveness; a tendency to experience positive emotions vs reserved; enjoyment of, and even preference for solitude and quiet; subdued -​ Openness vs Closed Mindedness -​ Drawn to new experience; intellectual curiosity; flexibility; readiness to examine and reconsider values and beliefs, and to try new things; “in touch” with feelings and aesthetic experiences vs. dislike of change; rigid; dogmatic; narrow -​ Agreeableness vs Antagonism -​ Altruistic, high empathy and concern for others; warm; forgiving; helpful; trusting; co-operative; straightforward; modest vs cold-hearted; cynical;  guarded; disingenuous; mistrusting; argumentative; competitive; arrogant; critical -​ Conscientiousness vs Unreliability -​ High self-control; organized; purposeful; self-image of being capable, prepared, competent; preference for order; dependable; deliberate; self-disciplined; achievement striving vs unorganized; low ambition; lackadaisical; procrastinating What are External Coping Resources -​ External resources include: -​ Time, money, education, a decent job, children, friends, family, standard of living, presence of positive life events, absence of other life stressors -​ Socio-economic status Coping Efforts Centre on Five Main Tasks -​ To reduce harmful environmental conditions and enhance the prospects of recovery -​ To tolerate or adjust the negative events or realities -​ To maintain a positive self-image -​ To maintain emotional equilibrium -​ To continue satisfying relationships with others What are Coping Outcomes -​ Measures of physiological and biochemical functioning -​ Whether and how quickly people can return to their pre-stress activities -​ Effectiveness in reducing psychological distress How Does Social Support Affect Stress -​ What is social support -​ Knowing that one is loved and cared for esteemed/valued and part of a network of communication and mutual obligations -​ Can take several forms: -​ Tangible assistance -​ Informational support -​ Emotional support -​ Invisible support -​ Lack of social support is very stressful, whereas social support effectively reduces psychological distress (such as depression and anxiety) -​ Lowers the likelihood of illness, speeds recovery from illness or treatment, and reduces the risk of mortality due to serious illness -​ Biopsychosocial Pathways: -​ Social support reduces biological responses to stress -​ Social support affect endocrine functioning in response to stress -​ Social support reduces risk of mortality -​ Genetic bases of social support -​ The ability to construe social support or the ability to pick supportive networks may be genetic -​ Moderation of stress by social support -​ Direct effects hypothesis  -​ Social support is generally beneficial during non-stressful times as well as during highly stressful times -​ Buffering hypothesis -​ The health benefits and mental health benefits of social support are chiefly evident during periods of high stress; when there is little stress, social support may have few health benefits -​ Most effective means of support -​ A spouse, partner or close friend may be the most effective social support -​ Overly intrusive social contacts exacerbate stress -​ Matching support to the stressor -​ Matching hypothesis -​ A match between one’s needs and what one receives from others in one’s social network What are Coping Interventions -​ Mindfulness Training -​ Mindfulness-Based Stress Reduction (MBSR): -​ Systemic training in meditation to enable people to self-regulate their reactions to stress and the negative emotions that may result -​ Disclosure and Coping -​ Expressive writing: -​ Confiding in others may reduce the physiological activity associated with the event -​ Written exercises are designed to encourage emotional expression -​ Disclosure is useful for coping -​ Relaxation training and stress management: -​ Relaxation training therapies are valuable for physical and mental health