PSY 707 Week 4 Students PDF

Week 4 PSY 707 Dr. A.J. Fiocco 1 Housekeeping Pleasant Events Calendar due tomorrow Complete Unpleasant Events Calendar this week Paper Topic? 2 Take home from last week: To understand stress, you need to understand wh...

Week 4 PSY 707 Dr. A.J. Fiocco 1 Housekeeping Pleasant Events Calendar due tomorrow Complete Unpleasant Events Calendar this week Paper Topic? 2 Take home from last week: To understand stress, you need to understand what is going on inside the body This knowledge gives you perspective and a better understanding of how stress may impact your health If you can identify where stress shows up in the body, then you have a target to work with Chronic stress plays a significant role in a majority of poor health outcomes Chronic stress accelerates cellular aging BUT! Remember, stress is in the eye of the beholder and the relationship between chronic stress and health outcomes of malleable 3 Class 3 Objectives The relationship between chronic stress and physical health outcomes: Cardiovascular Disease (Most Robust) Skeletal Muscle Tension Atopic Disorder Cancer Gastrointestinal Disorder Type II Diabetes 4  Cardiovascular Disease (CVD) Cardiovascular Disease (CVD): condition affecting the structures or function of the heart or blood vessels Leading cause of death globally Coronary Arterial Disease (aka., coronary heart disease): progressive degenerative inflammatory disease involving atherosclerosis (i.e., clogging) of the arteries Myocardial infarction (aka., heart attack): When the heart has insufficient blood supply usually due to occlusion of a coronary artery which results in cardiac tissue death (angina is a warning – inadequate supply to heart) Most common (~30-50% CVD cases) Stroke (aka., cerebrovascular disease): When brain has insufficient blood supply and oxygen (Ischemic) or ruptured vessel of the brain (hemorrhagic). What’s the connection to stress? 5 CVD: Stress-system activation Activation of the SAM system leads to increased heart rate, blood pressure and release of stress hormones that facilitate cardiovascular output (fight-or-flight!) Heart displays increased force of contraction of blood through the arteries – wear and tear of arteries over time (remember AL!) Thickening and stiffening of arterial walls: arteriosclerosis Increase in cholesterol (LDL) and triglycerides in the blood Cholesterol (LDL) builds up along the arterial walls: atherosclerosis 6 CVD: Hypertension Hypertension: Blood pressure in the arteries is persistently elevated Systolic blood pressure: maximum pressure your heart exerts while beating (pressure of blood as it leaves the heart) Diastolic blood pressure: amount of pressure of the blood against the arterial walls when the heart is relaxed (in between beats) Persons with hypertension are more likely to have high catecholamine levels 7 The Reactivity Hypothesis The Reactivity Hypothesis: Exaggerated or high cardiovascular responses during acute psychological stressors may reflect an increased susceptibility to later cardiovascular pathology (Light, 1981; Obrist, 1981) Image: Turner et al., 2020 8 CVD: Hypertension Study: Relationship between stress and hypertension Design: 3-year follow-up of an occupational cohort Participants: 479 initially healthy men and women (63yrs) Measurement: Salivary cortisol reactivity to mental challenge Reactive participants (40%) had 1.59 increased odds of developing hypertension Hamer & Septoe 2012 J Clin Endocrinol Metab 9 …Bidirectional Multi-System Reactivity Bidirectional Multi-system Reactivity Hypothesis: The magnitude of the response to acute psychological stress (exaggerated or blunted) in both the SAM system and HPA Axis in healthy adults is related to future health and disease outcomes, both physical and mental (Turner et al., 2020). Image: Turner et al., 2020 Image: https://malcolmsmusings.org/2023/09/04/the-goldilocks-principle/ 10 CVD: Hypercholesterolemia Lipoproteins: transport lipids, including cholesterol Low-density lipoprotein (LDL): Bad cholesterol; transfers cholesterol to arterial walls. Increased levels lead to clogged arteries High-density lipoprotein (HDL): Good cholesterol; transfers cholesterol to the liver for breakdown Hypercholesterolemia: excess LDL cholesterol in the blood Increased cholesterol accumulates along the walls of the blood vessels and arteries (plaques); blocking flow of blood to heart and/or brain Figure 5: Harrington , 2013 11 CVD: Prevention 90% of risk can be modified by lifestyle Prevention strategies (INTERHEART): Do not smoke ** Eat fruits and vegetables/ low saturated fats Exercise more Lower cholesterol ** Control obesity (abdominal obesity and w:h more predictive than BMI) Prevent diabetes/metabolic syndrome Manage stress Prevent high blood pressure Use good judgment with alcohol use Yusuf, 2004, Lancet 12  CVD: Tx Prognosis Prevention following an attack: Multicomponent secondary coronary heart disease (CHD) prevention program Objective: Evaluate additive and interactive effects of 3-month change in health behaviors Participants: 869 CHD patients. Intervention: Multi-site Cardiac Lifestyle Intervention Program (Exercise, Diet, and/or Stress management) Outcome: Coronary risk reduction Results: 3 Lifestyle interventions individually, additively and interactively related to improved coronary risk Exercise (low total cholesterol), low-fat diet (weight, low total cholesterol, LDL), stress management (weight, LDL, lower TRI, lower hostility) Daubenmier et al Ann Beh Med 2007 13 CVD: Tx Prognosis Research Question: Does comprehensive lifestyle change stop or reverse coronary atherosclerosis? (with no lipid lowering drugs) Ornish lifestyle program: 10%-fat whole foods vegetarian diet (avoid simple sugars and each complex carbs and whole foods), moderate aerobic exercise, stress management, smoking cessation, group psychosocial support Control: Tx as usual (physician prescribed lifestyle changes) Results: 91% angina reduction in yr1 (vs. 186% increase) and 72% angina reduction in yr5 ( vs. 36% decrease) Decreased arterial stenosis over 1 year (4.5% relative improvement vs. 5.4% relative worsening) and 5 years (7.9% relative improvement vs. 27.7% worsening) Ornish et al. 1990, 1998 14 Is CVD an AGE-RELATED DISEASE? 15 Myocardial Infarct in Younger and Older Adults Background: Findings: Rise in MI among young Increase in “younger young” MI from 2006 -2016 individuals – more productive years lost. Common risk factors: HTN, “younger young” more likely to use marijuana and dyslipidemia, diabetes, cocaine; more likely to present with chest pain smoking, elicit substance use (angina) Lack of research focusing on “older young” more likely to present with HTN,