Health Psychology - PSYC 3170 Lecture Notes PDF

HEALTH PSYCHOLOGY PSYC 3170 (Lecture Notes) Krista K. Trobst LECTURE 1 – Introduction and History of Health Psychology Thursday, January 9, 2024 WHAT IS HEALTH PSYCHOLOGY? -​ A relatively new field devoted to understa...

HEALTH PSYCHOLOGY PSYC 3170 (Lecture Notes) Krista K. Trobst LECTURE 1 – Introduction and History of Health Psychology Thursday, January 9, 2024 WHAT IS HEALTH PSYCHOLOGY? -​ 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 MAIN FOCUSES OF HEALTH PSYCHOLOGISTS – health promotion and maintenance, prevention and treatment of illness, etiology and correlates of health, illness and dysfunction, and studying of the impact of health institutions and health professionals on people’s behaviour health: a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity OBJECTIVE VS SUBJECTIVE SYMPTOMS 1.​ OBJECTIVE SYMPTOMS – signs that the body is not functioning properly (eg. high blood pressure) 2.​ SUBJECTIVE SYMPTOMS – signs of disease or injury (eg. pain, nausea) THE WELLNESS/ILLNESS CONTINUUM CONTRIBUTIONS OF DIFFERENT FACTORS TO HEALTH 10% → MEDICAL CARE 20% → GENETIC CONTRIBUTIONS 40% → BEHAVIOUR 30% → OTHER FACTORS HEALTH PSYCHOLOGY ROLES 1.​ The educational, scientific and professional contributions of psychology to the promotion and maintenance of health 2.​ Prevention and treatment of illnesses 3.​ The identification of the causes and correlates of health and illness 4.​ The improvement of the health care system and the formulation of health policy HISTORICALLY BELIEVED CAUSES OF DISEASE 1.​ God’s punishment 2.​ Supernatural beings/evil spirits (eg. sorcery, social taboo, object intrusion, supernatural possession, losing one’s soul) 3.​ An imbalance of blood, black bile, yellow bile, and phlegm HISTORIC TREATMENTS OF DISEASE 1.​ Confession and appeasing of the gods 2.​ Magical sucking to remove the intrusive object 3.​ Driving out evil spirits by using vile concoctions such as animal excrement, torture or even trephination (a surgical procedure that involves drilling or scraping a hole into the skull) 4.​ HIPPOCRATES (460-377 B.C.) believed that diseases had a natural cause and were not punishments/supernatural EVOLVING VIEW OF DISEASES 1.​ HUMORAL THEORY (GREEKS, 460-377 B.C.) – view that disease occurs when the four fluids of the body are out of balance (blood, black bile, yellow bile, and phlegm), also related to personality types 2.​ ANATOMICAL PATHOLOGY (16th - 18th CENTURY) – disease was localized in anatomy 3.​ TISSUE PATHOLOGY (LATE 18th CENTURY) – specific tissues could become diseased while others remain healthy 4.​ CELLULAR PATHOLOGY (19th CENTURY) – belief that life resided in cells and so cells must be the place to look for disease 5.​ GERM THEORY – discovery that particles in the air that could not be seen (eg. bacteria) could cause diseases (discovered by leaving wine out) 6.​ MAGIC BULLET – a specific cure could be found for every ailment that will restore the person to perfect health 7.​ BIOPSYCHOSOCIAL MODEL – the current model that the mind, body, and environment interact in causing diseases. Believes that health and illness are consequences of the interplay between the three factors: biological, psychological, and social. -​ Considers macro- and micro-level, describes the mind and body as inseparable. -​ Differs the BIOMEDICAL MODEL which states that an illness can be explained on the basis of aberrant somatic bodily process; psychological and social processes are irrelevant to disease process. This model is considered reductionist and assumes mind-body dualism. THE MIND-BODY RELATIONSHIP 1.​ PSYCHOANALYTIC -​ FREUD – early work on conversion hysteria discussed how unconscious conflicts produce physical disturbances that symbolize the repressed psychological conflicts. -​ The patient convert’s conflict into a nervous system disturbance and relieves anxiety 2.​ PSYCHOSOMATIC MEDICINE -​ DUNBAR & ALEXANDER – profiles of disorders thought to be psychosomatic in origin. Helped shape belief that bodily disorders are caused by emotional conflicts. -​ Is criticized because a particular conflict or personality style is not sufficient to produce illness. 3.​ BEHAVIOURAL MEDICINE -​ Focus on objective and clinically relevant interventions that demonstrate the connections between body and mind. -​ Interdisciplinary field concerned with integrating behavioural science and biomedical science into physical health and to prevent, diagnose, treat, and rehabilitate. BIOPSYCHOSOCIAL MODEL OF DISEASE ADVANTAGES hierarchically and a change on one level -​ The macro-level processes and will affect change in all the other levels micro-level processes interact to CLINICAL IMPLICATIONS produce a state of health or illness -​ Diagnosis should always consider -​ The mind and body cannot be biological, psychological and social distinguished in matters of health and factors in assessing an individual’s illness (they are intertwined) health or illness -​ Researchers have adopted a systems -​ Recommendations for treatment must theory approach to health and illness – examine all three sets of factors all levels in an entity are linked -​ Relationship between the patient and the practitioner matters WHY DO WE NEED THE FIELD OF HEALTH PSYCHOLOGY? -​ Only way to adequately understand health and illness -​ Changing patterns of illness and causes of death have created a need for understanding and affecting lifestyle factors -​ Role of epidemiology in health psychology -​ Advances in technology and research -​ Discusses morbidity and mortality, health-related quality of life and symptomatic complaints, increased medical acceptance, demonstrated contributions to health -​ CAREERS – physicians, nurses, and allied health professionals better able to understand and manage the psychological and social aspects of health than if had traditional background -​ Conduct research in public health, psychology and medicine in a variety of settings such as academia, public health departments and Health Canada -​ Committed to keeping people healthy rather than waiting to only treat them when they become ill LECTURE 2 – The Systems of the Body Thursday, January 16, 2024 THE NERVOUS SYSTEM -​ Is composed of many NEURONS which have the following parts: 1.​ CELL BODY – source of life of cell 2.​ DENDRITES – branches on the cell bodies, receivers of messages from adjacent neurons 3.​ AXON – projection through which messages travel 4.​ SYNAPTIC KNOBS – tips of branches at the end of the axon; sends messages to adjacent neurons -​ Neurons send messages in the form of electrical activity synapse: fluid-filled gap between neurons PARTS OF THE NERVOUS SYSTEM 1.​ CENTRAL NERVOUS SYSTEM – composed of the brain and the spinal cord -​ Carries voluntary nerve impulses to skeletal muscles and skin -​ Carries involuntary nerve impulses to muscles and glands 2.​ PERIPHERAL NERVOUS SYSTEM – conveys messages to and from the rest of the body a.​ SOMATIC NERVOUS SYSTEM – controls voluntary movement of skin/muscles b.​ AUTONOMIC NERVOUS SYSTEM – controls that organs that operate involuntarily between the spinal cord and the smooth muscles i.​ SYMPATHETIC – mobilizes the body for action and strenuous activities -​ Activates the fight or flight response (eg. adrenaline, breathing and enhanced lung capacity, increased heart rate, halting digestion) ii.​ PARASYMPATHETIC – maintains and restores equilibrium -​ Activates the calming responses (eg. lowered heart rate, slower breathing, decreased arousal) PARTS OF THE BRAIN 1.​ FRONTAL LOBE – carries out executive functions like thinking, planning, organizing, problem-solving, emotions, behavioural control, personality, intelligence, motor activity -​ People who are left-handed may have inverted brain sections -​ Memories and language involved in the left-side, art and music involved in the right-side 2.​ PARIETAL LOBE – involved in perception, sensations, body movement, arithmetic, spelling 3.​ OCCIPITAL LOBE – the primary visual area of the brain 4.​ TEMPORAL LOBE – involved in memory, language, hearing, vision, smell, memory 5.​ CEREBELLUM – involved in neurological function -​ Damage in this area may be detrimental to daily functioning and bodily orientation -​ Damage in this area impairs motor functioning and intellectual ability THE HEMISPHERES OF THE BRAIN  1.​ RIGHT HEMISPHERE – controls and receives sensory information from the LEFT SIDE OF THE BODY -​ Involved in music, art, dance, and more inspirationally driven activities 2.​ LEFT HEMISPHERE – controls and received sensory information from the RIGHT SIDE OF THE BODY -​ Involved in language, number skills, reasoning, science, and more cognitively driven activities THE SEGMENTATION OF THE BRAIN 1.​ FOREBRAIN a.​ DIENCEPHALON THALAMUS – recognition and relay of sensory stimuli HYPOTHALAMUS – helps regulate heart and blood pressure b.​ TELENCEPHALON – the two hemispheres (right and left) of our cerebral cortex 2.​ HINDBRAIN a.​ MEDULLA – receives sensory information from heart b.​ PONS – links hindbrain and midbrain c.​ CEREBELLUM – coordinates voluntary muscle movement 3.​ MIDBRAIN -​ A major pathway for sensory and motor impulses moving between forebrain and hindbrain PARTS OF THE LIMBIC SYSTEM 1.​ AMYGDALA – detection of threat 2.​ HIPPOCAMPUS – emotional memories 3.​ CINGULATE GYRUS, SEPTUM, AREAS OF THE HYPOTHALAMUS – emotional functioning neurotransmitters: chemicals that regulate nervous system functioning catecholamines: is released during high stress which promotes the sympathetic nervous system activity; includes epinephrine and norepinephrine THE SPINAL CORD -​ Primary function is to transmit messages from the brain to the other areas of the body. EFFERENT TRANSMISSION – away from the brain out to the body, produces muscle action AFFERENT TRANSMISSION – toward the brain from the body, relays information from the sensory organs NERVOUS SYSTEM DISORDERS  1.​ EPILEPSY – increased firing of unnecessary areas 2.​ PARKINSON’S DISEASE – now considered an autoimmune disorder, body in crisis attacking itself 3.​ CEREBRAL PALSY – bodily control restricted, cognition not affected 4.​ ALZHEIMER’S DISEASE – degradation of memory functioning, especially with age 5.​ MULTIPLE SCLEROSIS – autoimmune disorder, chronic disease that damages the central nervous system 6.​ HUNTINGTON’S DISEASE – entirely genetic neurological disease causing extreme behaviour and poor judgement (can appear like schizophrenia), 7.​ PARAPLEGIA & QUADRIPLEGIA – paralysis from the waist or neck down due to spinal cord damage THE ENDOCRINE SYSTEM -​ 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) PARTS OF THE ENDOCRINE SYSTEM THE ADRENAL GLANDS -​ Located on top of each kidney -​ Release hormones in response to emergencies and stress 1.​ CORTISOL – helps control swelling but continued high levels can lead to high blood pressure, ulcers, etc. 2.​ EPINEPHRINE & NOREPINEPHRINE – (adrenalin and noradrenalin) produce bodily reactions for quick energy -​ When stress occurs, the sympathetic nervous system activates the adrenal medulla and the pituitary gland activates the adrenal cortex 1.​ ADRENAL MEDULLA – heart rate increase, blood pressure increase, blood diverted to muscle tissue, digestion slows, pupils dilate 2.​ ADRENAL CORTEX – increases proteins and fat mobilization, increases access to bodily energy storage, regulates sodium retention HYPOTHALAMIC-PITUITARY-ADRENOCORTICAL (HPA) ACTIVATION -​ Pituitary gland releases hormone ACTH, triggering adrenal release of glucocorticoids, especially cortisol -​ Recurring activation compromises functioning, creating allostatic load -​ This in result hampers immune functioning, which is why we are prone to sickness when we are stressed THE THYROID GLAND  -​ Located in the neck/throat -​ Produces the hormone (thyroxin) that regulates activity level and growth. HYPOTHYROIDISM – insufficient thyroid hormones (leads to low activity levels and weight gain and can often appear like many depressive psychiatric disorders), requires a hormone supplement HYPERTHYROIDISM – over-secretion of thyroid hormones (leads to hyperactivity and weight loss, insomnia, tremors, etc. and often can appear like many high activity psychiatric disorders), requires a hormone blocker; associated with Hashimoto’s disease THE PANCREAS -​ Located below the stomach -​ Regulates level of blood sugar by producing insulin which absorbs blood sugar. -​ Important gland in diabetes mellitus THE PITUITARY GLAND -​ Located behind the brain -​ Is activated by the hypothalamus and especially during times of stress -​ Pituitary gland releases hormone ACTH allostatic load: the amount of pressure that is on the system, allostatic load determines the maximum amount of stress the system can endure ENDOCRINE SYSTEM DISORDERS -​ Includes many disorders such as: 1.​ DIABETES – body cannot manufacture or properly use insulin TYPE I: insulin-dependent diabetes TYPE II: insufficient insulin or insensitivity to it THE DIGESTIVE SYSTEM -​ Has various enzymes which break down food substances -​ Commands from the brain stem activate the production of saliva. -​ The esophagus pushes food to the stomach using peristalsis -​ ENZYMES function in breaking down food in saliva in the mouth and bile in the stomach -​ ABSORPTION occurs mainly in the colon including the absorption of water -​ Remaining waste is passed to the rectum for EXCRETION PARTS OF THE DIGESTIVE SYSTEM 1.​ MOUTH – breaks down food particles, salivary gland action 2.​ STOMACH – initial protein digestion, food is liquified and mixed 3.​ SMALL INTESTINE – chemical break down, absorption 4.​ LARGE INTESTINE – water absorption and waste storage DIGESTIVE SYSTEM DISORDERS  1.​ PEPTIC ULCERS – open sores in the stomach or duodenum caused by excessive gastric juices and bacterial infection. 2.​ HEPATITIS – liver becomes inflamed. 3.​ CIRRHOSIS – liver cells die and are replaced by scar tissue, caused by hepatitis and heavy alcohol consumption THE RESPIRATORY SYSTEM -​ Body tissues need a constant supply of oxygen -​ Functions in mechanical action which is moving air in and out of the lungs -​ The respiratory system facilitates GAS EXCHANGE (respiration) in the alveoli where toxic CO2 gas is eliminated and oxygen enters the bloodstream -​ Has many protective mechanisms such as coughing, sneezing, mucous production RESPIRATORY SYSTEM PROCESSES -​ Air enters the body through the nose and mouth. -​ It travels past the larynx and down the trachea and bronchial tubes into the lung. -​ Bronchial tubes divide into branches called bronchioles, and then tiny sacs called alveoli. RESPIRATORY SYSTEM DISORDERS 1.​ GENERAL IMPAIRMENTS – includes asthma, pneumonia, bronchitis, emphysema, cancer 2.​ ASPHYXIA – too little oxygen, too much carbon dioxide (occurs in an enclosed spaces, occurs in suicide attempts) 3.​ ANOXIA – shortage of oxygen (occurs in high altitudes), people lose their judgement and eventually pass into a coma (children use this to obtain high, some people even do this for sexual purposes) 4.​ HYPERVENTILATION – deep rapid breaths that reduce the amount of carbon dioxide THE CARDIOVASCULAR SYSTEM -​ The transport system of the body. -​ Consists of the heart, blood, and blood vessels -​ Blood vessels consist of the following: 1.​ ARTERIES – carry oxygenated (red) blood from the heart to the periphery and brain. 2.​ VEINS – carry deoxygenated (blue) blood from the periphery and brain back to the heart and lung THE HEART -​ Fist-sized muscle that circulates blood to and from the lungs to the body. -​ There are four chambers of the heart: 1.​ LEFT ATRIUM 2.​ RIGHT ATRIUM 3.​ LEFT VENTRICLE 4.​ RIGHT VENTRICLE -​ Left side pumps oxygenated blood from lungs out to the periphery and brain. -​ Right side takes deoxygenated blood into the lungs. BLOOD PRESSURE (BP)  -​ A measurement of the pressure of blood in the arteries. -​ As the heart contracts and pushes blood into the arteries (systolic cardiac cycle) the BLOOD PRESSURE RISES ↑ -​ As the heart rests between beats and no blood is pumped (diastolic cardiac cycle) the BLOOD PRESSURE IS AT ITS LOWEST ↓ THE DYNAMICS OF BLOOD PRESSURE 1.​ CARDIAC OUTPUT – the volume of fluid that is pumped per minute -​ The blood pressure rises ↑ as cardiac output rises ↑ -​ Large bodies required the heart to work harder to push more blood which is way fatter individuals have more heart problems 2.​ BLOOD VOLUME – the total amount of blood in the system -​ The blood pressure rises ↑ as blood volume rises ↑ -​ Lowering salt intake can lower a person’s blood volume levels which can assist in resisting health problems related to the heart 3.​ PERIPHERAL RESISTANCE – ease with which blood can pass through the arteries -​ The blood volumes rises ↑, the blood resistance rises 4.​ ELASTICITY – refers to the “give and take” in the arterial walls -​ As blood pressure rises ↑, elasticity decreases↓ 5.​ VISCOSITY – refers to the thickness of the blood -​ As blood pressure rises ↑, the viscosity increases ↑ HOW BLOOD PRESSURE CHANGES -​ When the arteries dilate, the diastolic blood pressure DECREASES ↓ -​ Blood pressure INCREASES ↑ when the heart rate or cardiac output increases in response to physical activity (this can include minor things like change in posture, talking, while under stress, when temperature changes, etc) -​ Blood pressure also follows the daily circadian rhythm such as that it is lowest in deep sleep CARDIOVASCULAR SYSTEM DISORDERS 1.​ ATHEROSCLEROSIS – caused by deposits of cholesterol and other substances on the arterial walls that form plaques and narrow the arteries -​ A function of both lifestyle and disease because of its association with poor health habits 2.​ ARTERIOSCLEROSIS – results in a hardening of the arteries -​ Over time, plaques harden and blood vessels lose their elasticity which causes increases in blood pressure 3.​ ANGINA PECTORIS – insufficient oxygen supply to the heart for its need and removal of waste products resulting in chest pain. 4.​ 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 5.​ HYPERTENSION – having a permanently high blood pressure (systolic blood pressure greater than or equal to 140 mmHg, diastolic blood pressure greater than or equal to 90 mmHg) ESSENTIAL (PRIMARY) – no known physical cause (95% of cases are of this type) SECONDARY HYPERTENSION – due to specific cause, e.g., adrenal tumor BLOOD OF THE CARDIOVASCULAR SYSTEM -​ 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 comprises substances such as red and white blood cells, proteins, electrolytes, platelets, oxygen, nutrients, and waste -​ Blood cells are manufactured in bone marrow RED BLOOD CELLS – red blood cells primarily carry oxygen and nutrients -​ Most abundant cells, formed in bone marrow -​ Contains hemoglobin (a protein that attaches to oxygen and transports it to the cells and tissue) ANEMIA — when insufficient red blood cells / hemoglobin impair transport of oxygen to cells -​ Menstruating women may experience anemia due to loss of iron and may be helped by iron supplementation -​ Anemia also occurs when bone marrow doesn’t producing enough red blood cells, potentially causing nervous system damage and chronic weakness -​ SICKLE-CELL ANEMIA – genetically transmitted inability to produce sufficient red blood cells (primarily in African, Middle Eastern, Caribbean, and South and Central Americans) -​ Cells are sickle-shaped rather than flattened spheres, believed to have developed to improve resistance to malaria but has fatal consequences over the long term WHITE BLOOD CELLS – are primarily involved in immune functions -​ Serve a protective function (e.g., destroys bacteria) formed 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 (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 – are used in clotting blood and forming scabs -​ Granular fragments that can clump together to prevent blood loss at the 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. -​ CORONARY AND CEREBRAL THROMBOSIS AND EMBOLISM – detached clot that lodges in lung, can be fatal PLASMA – made up of the other formed components: red blood cells, leukocytes (white blood cells), platelets -​ 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 -​ The surveillance system of the body -​ This system impacts infection, allergies, cancer, and autoimmune diseases -​ Primary function to distinguish between “self” and “foreign” and to attack what is foreign 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, it absorbs nutrients PROTOZOA – one-celled animals that live in water and insects, can cause diseases. VIRUSES – proteins and nucleic acid, they take over the cell and generate their own genetic instructions. TRANSPLANTS – 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 responses 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 PARTS OF THE IMMUNE SYSTEM 1.​ LYMPHATIC AND LYMPHOID ORGANS – deploys lymphocytes 2.​ LYMPHOCYTES – white blood cell that provides main defense against foreign material 3.​ LYMPH NODES – bean-shaped spongy tissue, largest are in the neck, arm-pit, abdomen, and groin, filters to capture antigens (foreign material) and has compartments for lymphocytes. 4.​ LYMPH VESSELS – connects to lymph nodes and brings fluid called lymph into bloodstream 5.​ LYMPHATIC ORGANS a.​ SPLEEN – production of B and T cells; removes old red blood cells -​ Filters antigens that the lymph vessels put into the bloodstream -​ Home base for white blood cells, removes worn out red blood cells b.​ TONSILS – filter microorganisms that get into respiratory tract c.​ THYMUS – helps T cells mature; produces hormone important for antibodies WHAT IS IMMUNITY? -​ The body’s resistance to injury from invading organisms -​ Occurs through either nonspecific immune mechanisms (fights any infection) or specific immune mechanisms (fights particular microorganisms) HUMOURAL IMMUNITY – mediated by B lymphocytes -​ Best against bacterial and viral infection CELL-MEDIATED IMMUNITY – involving T lymphocytes -​ Best against fungi, parasites, foreign tissue, cancer PHAGOCYTES -​ When certain white blood cells ingest microbes, phagocytosis occurs where they engulf and ingest antigens MACROPHAGES – attach to tissue and stay there MONOCYTES – circulate in the blood SPECIFIC IMMUNE PROCESSES 1.​ 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. 2.​ 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 the 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. WHAT CAN IMPAIR IMMUNE FUNCTIONING? -​ Insufficient vitamin A or E decrease production of lymphocytes and antibodies -​ Vitamin C in important in effectiveness of phagocytes -​ High fat and cholesterol intake impair immune functioning -​ Poor sleep impairs immune functioning -​ High stress 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. IMMUNE SYSTEM DISORDERS 1.​ AIDS – caused by HIV, kills by destroying helper T-cells CD4 2.​ CANCER – caused by a failure in programmed cell death 3.​ INFECTIOUS DISEASES a.​ SPLENOMEGALY – infection of spleen b.​ TONSILLITIS – inflammation impedes filter function c.​ MONONUCLEOSIS – enlargement in lymph system d.​ LYMPHOMA – tumor in lymphatic system 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 LECTURE 3 – Stress & Stress Moderators Thursday, January 23, 2024 STRESS -​ Stress can be defined as a negative emotional experience accompanied by predictable biochemical, physiological, cognitive, and behavioural changes -​ These responses are directed either toward altering the stressful event or accommodating to its effects -​ PERSON-ENVIRONMENT FIT – when personal resources are sufficient to meet the demands of the environment, there is less stress -​ 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 -​ STRESS FACILITATORS – there are direct physiological effects (eg. elevated lipids, elevated blood pressure, decreased immunity), health habit effects (eg. smoking, alcohol, poor nutrition), and health-behaviour effects (eg. decreased compliance, delay in seeking health care) stressor: a stressful event such as noise or the commute to work THEORIES AND MODELS OF STUDYING STRESS 1.​ FIGHT OR FLIGHT (WALTER CANNON) -​ Physiological response mobilizes the organism to attack the threat or to flee 2.​ GENERAL ADAPTATION SYNDROME (HANS SELYE) -​ The perceived stressor leads to an alarm reaction, then a stage of resistance, and finally a stage of exhaustion (crash) 3.​ TEND AND BEFRIEND (TAYLOR) -​ 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 4.​ PSYCHOLOGICAL APPRAISAL AND EXPERIENCE a.​ PRIMARY APPRAISAL PROCESSES – events may be perceived as positive, neutral or negative in their consequences, negative events are further appraised for possible harm, threat or challenge b.​ 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 CONTRIBUTING TO STRESSFUL APPRAISAL – includes personal factors like personality, intellectual and motivational and situational factors like strong demands and imminent threat HOW DOES STRESS AFFECT THE BODY? 1.​ HEAD – can cause issues with mood and behaviour (depression, sleep issues, irritability, sadness, headache, pain, anxiety, panic attacks) 2.​ SKIN – problems like eczema, psoriasis and acne 3.​ JOINTS AND MUSCLES – aches and pains, lowered bone density 4.​ HEART – increased blood pressure and cholesterol, increase heart rate, risk of heart attack 5.​ STOMACH – cramps and reflux, nausea, weight fluctuations 6.​ PANCREAS – stress can contribute to diabetes 7.​ INTESTINES – digestive issues like irritable bowel syndrome, diarrhea and constipation 8.​ REPRODUCTION – reduced sex drive, lower sperm production, increased menstruation pain 9.​ IMMUNE – reduced ability to battle and recover from illnesses PHYSIOLOGICAL RECOVERY PROCESSES -​ The body’s cortisol levels take longer to return to normal under stress -​ ALLOSTATIC LOAD – physiological systems within the body fluctuate to meet the demands of stress -​ Can be assessed by different indicators, allostatic load is an assessment of the body’s load that it is taking on at a given moment DIMENSIONS OF STRESSFUL EVENTS 1.​ NEGATIVE EVENTS – more stressful than positive events 2.​ UNCONTROLLABLE EVENTS – more stressful than predictable events 3.​ AMBIGUOUS EVENTS – are more stressful because the person has no opportunity to take action 4.​ OVERLOAD – overloaded people are more stressed than people with fewer tasks to perform For an event to be stressful, we must perceive the event as stressful. Subjective and objective measures of stress predict psychological distress and health problems. ADAPTING TO STRESS 1.​ PSYCHOLOGICAL ADAPTATION -​ Most people can adapt to moderate stress, but children, elderly and the poor are more adversely affected by chronic stressors 2.​ PHYSIOLOGICAL ADAPTATION -​ Low-level stress produces habituation in most people, whereas chronic stress can accumulate across multiple organ systems FACTORS OF A STRESSFUL EVENT 1.​ ANTICIPATING STRESS – anticipating stress can be as stressful as its actual occurrence -​ Anticipating stress can sometimes be more stressful than the actual stressful event 2.​ AFTER-EFFECTS OF STRESS – adverse after-effects of stress, such as decreases in performance and attention span, and issues with cognition, learning, and memory are documented -​ Environmental factors can influence our stress like living in a rural vs city, having clean and working appliances, not living in a loud area, being around comfortable people HOW CAN STRESS BE ASSESSED? 1.​ LABORATORY TESTING a.​ 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 b.​ INDUCING DISEASE – intentionally exposing people to viruses -​ These viruses were at such minute levels that they typically would not become infected, however, stressed individuals did become ill more frequently 2.​ LIFE EXAMPLES a.​ STRESSFUL LIFE EVENTS (SLE) – substantial adjustment to the environment leads to high stress, SLE predicts illness -​ The most stressful events that have been evaluated are first the death of a child, then the death of a spouse, later down the list is divorce, diet, work/academics etc. -​ This is a measure of health and well-being as well b.​ DAILY STRESS – minor stressful events (daily hassles), produce psychological distress and aggravate physical and psychological health; can be difficult to measure daily hassles SOURCES OF CHRONIC STRESS -​ Stressful life events are one form of stress but also have chronic stressors that are part of our day-to-day lives. -​ Increasingly, research is suggesting that these chronic stressors may have a greater effect on health outcomes than do major life events -​ The most important defense against stress is a strong support network EFFECTS OF EARLY STRESSFUL LIFE EXPERIENCES 1.​ CHILDHOOD STRESS – chronic physical or sexual abuse in childhood or adulthood increases health risks -​ In other words, stress early in life causes developing stress and for bodily systems to become dysregulated -​ This does not improve with time or once the early-life stressor is removed 2.​ CHRONIC CONDITIONS – chronic stress, such as living in poverty, or remaining in a high-stress job, contribute to psychological stress and physical illness 3.​ WORKPLACE STRESS – studies of occupational stress can help identify common, everyday stressors -​ Some have physical, chemical, or biological hazards which provide evidence for stress-illness relationship -​ Work stress may be preventable with intervention -​ The chief cause of occupational stress is overload where an individual feels they are doing to much work for pay or praise -​ This facet has increased over recent years with the onset of working from home and being contacted by your profession outside of work hours  -​ A person’s perception of work overload produces physical health complaints and psychological distress -​ CAUSES OF WORK STRESS – ambiguity and role conflict, social relationships, control/lack of control, job insecurity, unemployment, and other occupational outcomes 4.​ WORK-LIFE BALANCE – a person’s home and work responsibilities may conflict with one another, enhancing stress -​ WOMEN – feel the need to fill multiple roles (eg. worker, mother, spouse, house cleaner, cook, caretaker, etc) -​ MEN – 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, children are affected by parents’ work and family stressors -​ However, there is pride to be found in effectively balancing these stressful experiences MODERATORS OF THE STRESS EXPERIENCE -​ The relationship between coping and a stressful event is a dynamic process -​ There is breadth in coping, meaning there are many actions and reactions to stressful circumstances -​ Perfectionists at a higher risk of poor health outcomes coping: thoughts and behaviours used to manage the internal and external demands of situations that are appraised as stressful negative affectivity: a pervasive negative mood marked by anxiety, depression, and hostility -​ Negative can cause a false impression of poor health -​ High negative affectivity produces more vulnerability to illness perfectionism: the setting of and preoccupation with excessively high standards accompanied by self-criticism COPING RESOURCES -​ Overall, positive emotional states are associated with better mental and physical health -​ Furthermore, 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 is associated with positive coping styles such as seeking social support -​ PSYCHOLOGICAL CONTROL – an “internal locus of control” describes 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 BELIEFS ABOUT ONESELF AND CONTROL 1.​ INTERNAL & EXTERNAL LOCUS OF CONTROL – can have contrastingly effects on a person’s beliefs about their control over their lives and their environments -​ Having an “internal” locus of control is better in psychology because it provides us a stake in our lives -​ Having an “external” locus of control can lead to maladaptive beliefs about their abilities to get better mentally or physically, for quitting bad habits, freeing oneself from harmful relationships, etc. 2.​ SELF-EFFICACY – efficacy—the belief that we can succeed at a specific activity we want to do. a.​ OUTCOME EXPECTANCY – that the behaviour, if properly carried out, would lead to a favourable outcome. b.​ SELF‐EFFICACY EXPECTANCY – that they can perform the behaviour properly. TRAITS OF THE FIVE-FACTOR MODEL OF PERSONALITY 1.​ NEUROTICISM VS EMOTIONAL STABILITY -​ Neuroticism can lead to high anxiety, stress, fear and other erratic behaviours. This causes an overly anxious individual and harm physical and mental well-being. -​ Tendency to experience negative emotions such as anxiety, tension, sadness, irritability compared with the ability to feel calm, even-tempered, relaxed, dealing with siutations without stress 2.​ EXTRAVERSION VS INTROVERSION -​ Extraverted people have larger social groups and thus a stronger support system -​ Outgoingness, gregariousness, being cheerful, talkative, assertive compared to being reserved, preferring solitude and quiet 3.​ OPENNESS VS CLOSE-MINDEDNESS -​ Can allow for new opportunities which can be beneficial in building bonds or improving health -​ Drawn to new experiences, intellectual curiosity, flexibility, being drawn to new values and beliefs compared to disliking things, being rigid, having a narrow mindset 4.​ AGREEABLENESS VS ANTAGONISM -​ People like agreeable people leading to stronger social groups and better mental well-being -​ Being disagreeable can lead to health problems on its own due to high stress and anger -​ Being altruistic and empathetic, having warmth and forgiveness compared to being cold-hearted, disingenuous, argumentative, hostile, and arrogant 5.​ CONSCIENTIOUSNESS VS UNRELIABILITY -​ Aids in self control allowing for better health, taking care of oneself mentally and proactively, and avoiding situations that can cause harm -​ Having high self-control and being organized, being prepared and competent compared to being unorganized, having low ambition, and procrastinating DIFFERENCES IN COPING STYLES A person's coping style can lead to a general propensity to deal with stressful events in a particular way; this originates in genes and through personal experience. 1.​ APPROACH VS AVOIDANCE – each has its advantages, levels of success depends on the stressor; related to whether you approach or avoid your problems 2.​ PROBLEM-FOCUSED – doing something constructive about stressful situation 3.​ EMOTION-FOCUSED – regulating emotions experiences because of a stressful event People who are able to shift coping strategies to meet the demands of a situation cope better with stress than those who do not. rumination: negative thoughts focused on a stressor (detrimental to health) EXTERNAL COPING RESOURCES -​ Includes time, money, education, a decent job, children, friends, family, standard of living, presence of positive life events, absence of other life stressors, and socio-economic status FIVE MAIN TASKS OF COPING EFFORTS 1.​ To reduce harmful environmental conditions and enhance the prospects of recovery 2.​ To tolerate or adjust to negative events 3.​ Being able to maintain a positive self-image 4.​ Being able to maintain emotional equilibrium 5.​ Continuing to satisfy 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? -​ A lack of social support is very stressful, whereas social support effectively reduces psychological distress (such as depression and anxiety) -​ Social support lowers the likelihood of illness, speeds recovery from illness or treatment, and reduces the risk of mortality due to serious illness social support: knowing that one is loved and cared for esteemed/valued and part of a network of communication and mutual obligations -​ Forms of social support: tangible assistance, informational support, emotional support, invisible support (helping a person without them knowing about it) THE INTERPERSONAL CIRCUMPLEX 1.​ DOMINANCE – the working dimension, involves getting ahead -​ Higher dominance traits: directiveness, arrogance, and criticalness -​ Traits like introversion lies between the two, but away from both high dominance and high nurturance (distancing)  2.​ NURTURANCE – the love dimension, involves getting along -​ Higher nurturance traits: nurturant, deferentialness, and avoidance -​ Traits like extroversion lies between the two, but towards from both high dominance and nurturance (engaging) DOES SOCIAL SUPPORT AFFECT STRESS? 1.​ BIOPSYCHOSOCIAL PATHWAYS -​ Social support reduces biological responses to stress and affects endocrine functioning in response to stress -​ Social support reduces risk of mortality 2.​ GENETIC BASES OF SOCIAL SUPPORT -​ The ability to construe social support -​ The ability to pick supportive networks may have a genetic component HOW IS SOCIAL SUPPORT MODERATED? 1.​ DIRECT EFFECTS HYPOTHESIS – social support is generally beneficial during non-stressful times as well as during highly stressful times 2.​ 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 (the less likely model) EFFECTIVE MEANS OF SUPPORT -​ Having a spouse, partner, pet (dogs more so than cats due to increased eye contact and oxytocin levels), or close friend may be the most effective social support -​ It can be important to match support to the stressor -​ MATCHING HYPOTHESIS – a match between one’s needs and what one receives from others in one’s social network MINDFULNESS TRAINING – MINDFULNESS-BASED STRESS REDUCTION (MBSR) -​ Systematic training in meditation to enable people to self-regulate their reactions to stress and the negative emotions that may result DISCLOSURE AND COPING 1.​ EXPRESSIVE WRITING – confiding in others may reduce the physiological activity associated with the event -​ Written exercises are designed to encourage emotional expression (eg. writing a heated letter and then burning it or ripping it up) -​ Disclosure is useful for coping 2.​ RELAXATION TRAINING AND STRESS MANAGEMENT – relaxation training therapies are valuable for physical and mental health