Chapter 4Psychological Factors and Health

Psychological Factors and Health

Physical, Emotional, and Cognitive Effects of Stress

Health psychology—The field of psychology that studies the relationships between psychological factors and the prevention and treatment of physical health problems.

The Body’s Response to Stress

General adaptation syndrome (GAS): Hans Selye’s term for a hypothesized three-stage response to stress.

Stage 1: Alarm reaction Stage 2: Resistance Stage 3: Exhaustion

Stage 1: Alarm Reaction

Also called the alarm reaction, this is the first stage of the GAS, which is triggered by the impact of a stressor and characterized by activity in the sympathetic division of the nervous system.

• Fight-or-flight reaction

• Regulated by endocrine system The autonomic nervous system (ANS) consists of the sympathetic

nervous system and the parasympathetic nervous system.

Sympathetic Nervous System

The sympathetic nervous system accelerates bodily processes, such as heart rate and breathing, and leads to the release of energy from stored reserves in times when the body needs additional oxygen and fuel to work harder.

This system takes over during the alarm reaction.

Parasympathetic Nervous System

The parasympathetic nervous system restores the body’s reserves of energy and tones down bodily arousal.

Autonomic Nervous System

Components of the Alarm Reaction

Stage 2: Resistance Stage

After the alarm reaction, the body enters the resistance or adaptation stage. Levels of endocrine and sympathetic nervous system activity are lower than in the alarm stage but are still higher than normal.

During this stage, the body attempts to restore lost energy and repair bodily damage.

Stage 3: Exhaustion Stage

The exhaustion stage is characterized by weakened resistance and possible deterioration.

If the stressor is not dealt with properly, one may enter the exhaustion stage. Individual abilities to deal with stressor vary, but the body will become exhausted if the stress continues indefinitely.

The parasympathetic system dominates. Continued stress during the exhaustion stage can lead to “diseases of adaptation” (hives, allergies, and coronary heart disease).

Stress and Emotions

While positive emotions can bring use joy, negative emotions can fill us with dread. Stress can lead to anxiety, anger, and depression.

Emotional Effects of Stress

Anxiety usually occurs in response to threats such as physical danger, loss, and failure.

Anger usually occurs in response to stressors such as anger and social provocation.

Depression usually occurs in response to loss of a loved one, failure, periods of inactivity or lack of stimulations and prolonged stress.

Stress and Cognition

Under stress, people may have difficulty thinking clearly or remaining focused on the task at hand.

High levels of bodily arousal that characterize the alarm reaction stage can impair memory functioning and problem-solving ability (example: test anxiety).

Immune System

The immune system is the system of the body that recognizes and destroys foreign agents that invade the body.

Chronic stress can weaken the immune system and can make one more vulnerable to disease. For example, during stress the body increases the production of corticosteroids. Corticosteroids suppress the functioning of the immune system and make one more vulnerable to illness.

Life Changes and Physical Health

Social supports can moderate the effect of persistent stress on the body.

Life changes may also contribute to increased stress and risk for illness.

Factors in Health and Illness

Multifactorial model

• The belief that health and illness are a function of multiple factors involving biological, psychological, and cultural domains, and their interactions.

• Biological factors play important role in determining the risk of serious illness.

• The likelihood of living a long and healthy life is also determined by factors we can control.

Numbers of US Deaths Due to Behavioral Causes

Healthier Behaviors Save Lives

Human Diversity and Health

Life expectancy is rising for all ethnic groups in the United States, but the life expectancy for African Americans is still approximately seven years behind European Americans.

Socioeconomic status (SES), diet, exercise patterns, access to healthcare, and genetic factors all contribute to this difference.

Ethnicity and Health

Some diseases affect certain

ethnic groups in

disproportionately higher

numbers.

Socioeconomic status: Less well-

educated people are more likely

to smoke and suffer from

obesity, and often lack access to

early detection.

.

Ethnicity and Health

Disproportionately high numbers of African Americans and Latino/Latina Americans in the United States are living with HIV/AIDS.

Nearly half of the men and three-quarters of the women with AIDS are African American or Latino/Latina American, even though these groups make up only about one-quarter of the population.

Ethnicity and Health

African Americans are more likely than European Americans to have heart attacks and strokes and to die from them.

Early diagnosis and treatment might help decrease the racial gap.

Access to and seeking health care rates vary, with European Americans more likely to seek regular preventive care.

Deaths per 100,000 US Women from Heart Disease

Ethnicity and Cancer

African Americans have higher rates of cancer than any other racial or ethnic group in our society, and have higher death rates from cancer than any other American group except Native Americans.

African Americans are disproportionately represented among the lower income groups, and people from poorer communities have higher cancer death rates.

People from poorer areas tend to have more risk factors (physical inactivity, smoking) and often lack access to early detection (screening) programs and treatment services.

Rates of Lung Cancer among Major Racial/Ethnic Groups

Gender and Health

Gender has implications for health.

One prominent risk factor for coronary heart disease is male gender. Men are more likely than women to develop coronary heart disease until about age 65, when the rates begin to even out.

Gender may also play a role in how cardiac incidents are treated. When women and men show up in the emergency room with symptoms of heart attacks and other serious cardiac problems, the conditions are more likely to be misdiagnosed in women.

Psychological Factors in Physical and Health Problems

The workings of the mind and the body are actually more closely intertwined than they may appear.

Psychological factors play a role in a great many physical disorders.

Headaches: Pounding Away

Headaches are among the most common stress-related physical ailments. Two of the most common types are muscle-tension and migraine:

• Muscle-tension headaches—The single most frequent type of headache. • Migraine headaches—Migraines are

intense, throbbing headaches that often affect one side of the head. They are complex neurological disorders and can last for hours or days.

Muscle-tension Headaches

Persistent stress can lead to contraction of shoulder, neck, forehead, and scalp muscles.

These are characterized by dull pain on both sides of the head.

Catastrophizing an event—blowing it out of proportion—can bring on a tension headache.

Migraine Headaches

• Migraines are often accompanied by sensitivity to light, loss of appetite, nausea, vomiting, sensory and motor disturbances, and changes in mood.

Sensory and motor disturbances may precede the onset of the migraine.

The underlying causes of migraine are not well understood but might relate to changes in blood flow to the brain and subsequent imbalances of serotonin.

Menstrual Problems

Premenstrual syndrome refers to a cluster of physical and psychological symptoms that afflict some women prior to menstruation.

50 to 75% of women experience some discomfort prior to or during menstruation.

Causes of PMS

Negative attitudes toward menstruation (e.g., believing that menstruating women are unclean) can worsen menstrual problems but PMS primarily has a biological basis. The body’s sensitivity to female reproductive hormones (estrogen and progesterone) plays an important role.

PMS also appears to be linked with imbalances in the brain of neurotransmitters such as serotonin and gamma-aminobutyric acid (GABA).

Premenstrual syndrome appears to be caused by a complex interaction between female sexual hormones and neurotransmitters.

Symptoms of Menstrual Distress

Coronary Heart Disease

• Coronary heart disease is the leading cause of death in the United States.

• Some of the common risk factors:• Age• Family history• Physiological conditions• Lifestyle factors• Type A behavior• Negative emotions• Job strain

Healthy Heart Habits

• To reduce the risk of coronary heart disease:• Avoid/stop smoking,

control weight, and follow a healthful diet.

• Reduce hypertension.• Lower LDL cholesterol.• Modify Type A

behavior.• Exercise.

Cancer

Cancer is characterized by the development of abnormal, or mutant cells that may take root anywhere in the body.

Some causes of cancer include• Inheriting a predisposition for cancer

• Exposure to cancer-causing chemicals

• Even certain viruses

• Obesity

• Diets high in fat or low in fiber

• Depression

• Stress

Lifetime Risk of Cancer Diagnosis

Cancer Prevention and Coping

Avoid smoking and heavy usage of alcohol.

Modify diet by reducing fat and increasing intake of fruits and vegetables.

Exercise regularly.

Have regular medical checkups.

Minimize exposure to stress and learn to manage unavoidable stress.

If living with cancer, maintain hope and a fighting spirit and participate actively in your care.

4.4 Becoming an Active Health Care Consumer

• Medical care is more complicated in the past.

• Active consumers of health care:• Take an active role in managing health care by learning about

health care options, choose health care providers wisely, and weigh treatment alternatives carefully

• Ask questions—plenty of them—of their health care providers to help ensure the best-quality care and understand the treatment alternatives available

• Believe that they are ultimately responsible for managing their own health care

• Take steps to protect themselves from mismanaged care

Tips for Talking with Your Doctor

Describe your complaints clearly and fully. Don’t hold back, cover up or distort your symptoms.

Don’t accept a treatment recommendation that you don’t want. Get another opinion.

Insist on explanations in plain language.

Don’t be swayed by a doctor who says your problems are “all in your head.”

Preventing Mismanaged Care

Learn about a health plan before joining.

Discuss coverage for hospital stays.

Insist on your right to see a specialist.

Learn what to do in case of emergencies.