Chapter 4: Support, HAI, health risks from stress, (mixed with ch 5)

Types of social support

Emotional/esteem: Feeling loved and cared for by others, valued and respected by others, empathy, concern, positive regard (Extremely useful for cancer patients than any ppl and other types of support)

Tangible/Instrumental: Receiving material aid, assistance from others.

Informational Support: Getting advice & information from others.

Companionship Support: Availability of others to spend time with.

Invisible Support: Someone doing smth for you w/o you realizing that it was a support 

• Tends to be a very positive form of support

• (cohabitating relationship)

Who gets support?

• Less likely to get support if the person is: unsociable, not assertive, don’t help others, feel like they should be independent/unburdensome

• Potential support providers may lack the necessary resources, tired, insensitive to others’ needs

• Women rely more on other women for emotional support than men

• Immigrants in Canada have smaller networks and less use of support

• Social support declines in old age

Maladaptive support (harmful)

• Protective buffering: Keeping info from someone in order to protect them, avoiding potential for negative interaction

• Solicitousness: Expressing concern, helping w/o request

• These forms of interaction are maladaptive for both parties involved

Social Support and Health

• People with fewer than 4 types of social roles were over 4x likely to catch a cold than those with 6 or more roles (less involvement w others, more colds)

  • Subjective loneliness also worsens cold symptoms

• High support, low stress, improved sleep, lower BP. Positive spouse interactions can reduce the effects of job stress.

• less of Cardiovascular Reactivity(lower HR/BP) during stressful task, when a supportive person or a pet is present

• Lower mortality

• Lower chronic loneliness

• Quicker recovery

Direct Effects Hypothesis

Social support benefits health and well-being regardless of the amount of stress. 

• It works by giving people strong feelings of belongingness and self-esteem or by encouraging them to lead healthy lifestyles (e.g., exercising, not smoking)

• Contrast to Buffering hypothesis—support is esp useful when high stress

Stress Prevention Model

A newer theory suggests support provides resources that help people avoid or minimize exposure to stressful events in the first place, thereby reducing overall allostatic load.

Quality of marriage and support

• Marriage only has protective health benefits when marital quality is high. 

  • Unhappy marriages → higher BP than single ppl

  • Frequent marital conflict is linked to more severe atherosclerosis. 

  • Conflict or strain in any relationship → increase the chances of serious illness

When social support fails

• Support is less likely to reduce stress if it is not perceived as supportive (e.g., receiving emotional support when tangible help is needed). Support that is responsive to the recipient's needs is most beneficial.

• Support can sometimes lower self-esteem

• Perceived support is a better predictor of future health than actual received support.

• "Invisible Support" is often most beneficial

Social media use has been associated w

• Loneliness, frustration, anger (after using FB)

• Lower well-being and life satisfaction (after FB)

• Increasing depression

• Negative body image

• Narcissism (w increased visual use of social media)

• Depression, anxiety, psych, distress

Health risks of loneliness

Increased likelihood of early mortality for Loneliness, social isolation, living alone

Human-Animal Interaction (HAI) — physiological & psychosocial

Physiological: reduced blood pressure; improved cardiovascular health; enhanced immune system functioning; improved pain management; lower cortisol output; increased survival time

Psychosocial: improved mood; reduced aggression; increased trustworthiness and trust of others; reduced impact of stress 

• Dog owners live longer than non-dog owners (Companion animals have been identified as a source of support)

• The presence of a pet relieves stress response more than the presence of spouse!

Benefits of HAI

Presence of friendly animals both familiar or unfamiliar, can effectively reduce HR and BP or buffer increases in these parameters in anticipation of a stressor.

These effects may even be stronger with one’s own pet

Mechanisms of HAI

• Animals providing support: Walking, human-human interaction, guiding, emotional support

• And there are similar mechanisms/ factors underlying HAI and HHI (Human-Human Interaction): Touch, eye contact

HAI leads to higher oxytocin output effects of HAI are similar to oxytocin

Oxytocin is released in both humans and animals in response to touch/petting and mutual gaze

• Even looking at pictures of puppies

• Touching smth soft that seems alive

• Female dogs > male dogs

Lower blood-pressure/heart rate from viewing an aquarium

Slow rhythmic movement of fish associated with low SNS

Blue and green are low contrast color combo, and are associated with low amygdala response and low SNS arousal (Stress response)

Spending time in room filled w plants

• Spending time in room (with natural components (plants, fake or real) is associated w low SNS activation

• Plants in offices and hospital rooms — lower stress

• Birdsongs — reduce anxiety

Health benefits of green spaces

• Significant reductions in: Heart rate, Diastolic blood pressure, Salivary cortisol

• Decreases in incidence of: Type 2 diabetes, all-cause mortality, cardiovascular mortality

How can we explain the green space benefits on health?

• Opportunities for physical activity & exercise

• Increased social interaction

• Exposure to sunlight & associated benefits

• Less harmful environmental exposure (noise, pollution)

The “old friends” hypothesis

Increased exposure to micro-organisms, can be imp for the dvlpm of immune system and the regulation of inflam. responses

Suggests that modern increases in inflammatory and autoimmune diseases are due to a lack of exposure to "old friends"—microorganisms (like helminths, microbiota, and commensals) that co-evolved with humans

Mental health benefits of being exposed to greens

• Improved stress recovery following stress induction

•  Lower rumination and reduced depression

• Faster stress recovery after seeing greens (simulated and real. E.g. VR walking on the street w more trees vs no trees)

• Sig impact on positive emotion (happiness)

• But, ppl who live in cities have generally better health (access to health services, food, gyms)

Blue space (view of water, sky)

• From one study, Blue space exposure seems to be better (mental health facts) than green spaces

• Associated w psychological well-being and physical activity in a number of studies

Biophilia hypothesis

• Humans have an innate desire to seek out connections w other life and living systems

  • It’s in our genes and evolution

• Biophilia means a psycho orientation in which indv are attracts to what’s alive and vital in the world

• Supported by evidence of health benefits of HAI and nature

Types of Control and Self-Efficacy

• Behavioral Control: The ability to take concrete action to reduce the impact of a stressor (e.g., using breathing techniques during childbirth).

• Cognitive Control: The ability to use thought processes or strategies to modify the stressor's impact (e.g., positive reappraisal or focusing on a pleasant thought).

• Self-Efficacy—believe that you can successfully do smth (e.g., quitting smoking). Strong self-efficacy → less psychological and physiological strain under stress because they believe they can meet the demands of the situation.

 Beliefs about Control

• Locus of Control: A belief about whether the control for one's successes and failures lies internally (within oneself) or externally (with luck, fate, or others).

• Health Locus of Control: Measured by the Multidimensional Health Locus of Control Scales, this assesses:

  • Internal (control lies with the person)

  • Powerful-others' (control lies with physicians/others)

  • Chance (control lies with luck/fate).

• Health Outcomes: People with a strong sense of control tend to have better health habits and suffer less depression when coping with serious illness (compared to those with strong beliefs in powerful-others' or chance control)

Loss of Control—Learned Helplessness

This condition results from prolonged exposure to high levels of uncontrollable stress. → harder to cope w future stress (even if it’s controllable). It is described as a principal characteristic of depression.

Attribution (Explanatory) Style

The revised learned helplessness theory suggests that people apply a cognitive process called attribution to uncontrollable events across three dimensions.

Describe the patterns of explanation a person uses to make sense of uncontrollable events, particularly negative ones

1. Internal vs. External: Attributing the outcome to one's own inability vs. external factors.

2. Stable vs. Unstable: Judging the cause as long-lasting/permanent vs. temporary.

3. Global vs. Specific: Will this cause affect many areas of life or just the current situation?

Pessimistic Style

People who tend to explain negative events as stable and global causes are at high risk for feeling helpless. If these events are also judged as internal, the resulting depression is likely to involve a loss of self-esteem.

Hardiness

Differentiates people who get sick under stress, and who don’t. It has three characteristics:

1. Control: Belief in one's ability to influence events (a sense of personal control).

2. Commitment: People's sense of purpose or involvement in their activities and relationships.

3. Challenge: The tendency to view changes as incentives or opportunities for growth rather than threats.

Other resilience traits that reduce illness and recovery time from illness

• Sense of Coherence: See the world as comprehensible, manageable, and meaningful.

• Optimism: Use better coping strategies, have better health habits.

Behavioral changes when increase and decrease stress

Increase	Dietary fat consumption, tobacco use (smoking), alcohol abuse, and accidents. High-stress people are more likely to suffer accidental injuries.
Decrease	Consumption of dietary fruits/vegetables, exercise, and quality of sleep. Disrupted sleep is stressful and impairs physiological restoration.

Allostatic Load:

Chronic exposure to intense stressors leads to a "wear and tear" on body systems, which accumulates over time and predicts higher mortality rates.

Cardiovascular System Reactivity

• An exaggerated increase in heart rate and blood pressure during psychological stress is unhealthy.

• High cardiovascular reactivity and poor recovery predict a greater risk of cardiovascular disease,

  • High blood pressure (hypertension)

  • Atherosclerosis.

• Stress also increases unfavorable lipids, activated platelets, and inflammation → atherosclerosis (plaque formation in arteries).

Endocrine System Reactivity

Stress activates the adrenal glands, releasing catecholamines and corticosteroids (like cortisol). Chronically high levels of these hormones are linked to heart damage, sudden cardiac death, and the progression of atherosclerosis.

Metabolic Syndrome

A cluster of risk factors including high cholesterol, high blood pressure, and insulin problems

Associated with increased risk of cardiovascular disease and diabetes.

Immune System Reactivity (Psychoneuroimmunology)

• Acute Stress: Typically activates some components of the immune system.

• Chronic Stress: Generally suppresses both nonspecific and specific immune functions

  • increases inflammation, and impairs the function of T cells and B cells.

  • Suppression increases susceptibility to infectious diseases and cancer.

• Wound Healing: Stress, especially relationship conflict, is shown to delay wound healing.

• Disclosure: Verbally expressing or writing about stressful feelings and traumatic events can improve immune control against viruses and improve overall health.

Digestive System disorder

• Stress is related to flare-ups of ulcerative colitis, Crohn's disease (Inflammatory Bowel Disease)

• Irritable Bowel Syndrome (IBS).

• Stress plays a role in ulcer development, which is typically caused by a combination of stomach juices eroding the lining and a bacterial infection.

Asthma

Combination of allergies, respiratory infections, and biopsychosocial arousal/stress. Stress can trigger attacks and is implicated in the development and worsening of the condition.

Recurrent headache

• Tension-type headache (caused by muscle contraction in the head/neck)

• Migraine headache (caused by dilation of blood vessels and brainstem dysfunction) are the two most common types.

• Stress is a common trigger for both conditions.