Stress & Physical Health

Stress and Physical Health

Introduction

  • Chapter Overview: Examines the relationship between stress and physical health.

Behavioral Medicine

  • Definition: A multidisciplinary field focusing on psychological factors within physical illness.

    • Professionals in this field are called health psychologists.

Understanding Stress

  • Definition of Stress: Any challenging event that demands physiological, cognitive, and behavioral adaptations.

  • Types of Stress:

    • Major Life Stressors

    • Daily Stressors (Daily Hassles)

Major Life Stressors

  • Examples of Major Life Stressors: Death of a loved one, incarceration, major illness, divorce, job loss.

  • Key Considerations:

    • Subjectivity of Experience: Stress may not be uniform; experiences can vary greatly between individuals even for the same stressor.

    • Assessment Challenges:

    • Retrospective reports may not accurately reflect stress levels.

    • Failure to distinguish between positive and negative events.

    • Importance of the specific impact of stressors ignored in assessments.

    • Cognitive Evaluation Factors:

    • How individuals evaluate challenges, threats, and harms.

    • Available resources and support systems for coping with stress.

Daily Stress and Hassles

  • Shift in Research Focus: Late 1970s saw an increase in studies focusing on daily stressors (e.g., traffic, workplace conflicts, family disagreements).

  • Daily Diaries Development: Tool to assess daily stress and its effects on wellbeing.

    • Example: MIDUS (Midlife In the United States) study analyzing sex differences in stress.

  • Stress Types: Adaptive vs. Chronic:

    • Chronic stress leads to prolonged physiological responses and potential psychopathology.

Physiological Response

  • Fight or Flight Response: Comprises various physiological systems that activate in response to stress.

    • Stress Response Characteristics:

    • Not always adaptive (e.g., anxiety during tests).

    • Other responses include: Freeze/Fright and Tending/Befriending.

  • Stress Systems Involved: Autonomic Nervous System and the HPA (Hypothalamic-Pituitary-Adrenal) Axis.

Autonomic Nervous System

  • Components:

    1. Sympathetic Nervous System: Often termed the “fight or flight” system.

    2. Parasympathetic Nervous System: Known as the “rest and digest” system.

  • Stress Activation: Stress triggers the HPA axis, resulting in the release of hormones essential for the stress response.

    • Key hormones include:

    • Corticotropin-Releasing Hormones (CRH)

    • Epinephrine (Adrenaline)

    • Cortisol

  • Prolonged Activation Effects: Long-term activation of these systems can lead to various health issues.

Psychoneuroimmunology

  • Definition: Study of how psychological factors influence the immune system.

  • Implications of Long-term Stress:

    • Impairs immune response and increases inflammation.

    • Correlated with higher mortality risks and associated with cardiovascular disease, cancer, and diabetes.

Early Life Stress (ELS)

  • Long-term Impact of ELS: Adverse Childhood Experiences (ACEs) with significant prevalence in mental health disorders.

    • Statistics: 74.4% of individuals with Major Depressive Disorder (MDD) report experiencing ELS.

    • Key Developments Affected: Cognitive and social development, anterior cingulate cortex, amygdala.

    • Theoretical Frameworks: Diathesis-Stress Model, Orchid-Dandelion Theory.

Thesis on Fetal Alcohol Spectrum Disorders (FASD)

  • Definition of FASD: A collective term for brain, behavioral, and physical changes due to prenatal alcohol exposure.

  • Relation to Stress: Children with FASD exhibit changes in their HPA axis and autonomic nervous system; research is ongoing on the persistence of these changes into young adulthood.

  • Heart Rate Variability (HRV): Measured biologically to assess stress levels and autonomic function.

Coping with Stressors

  • Coping Strategies:

    • Problem-Focused Coping: Direct action to address the stressor.

    • Emotion-Focused Coping: Managing emotional responses to stress.

    • Cultural Differences: Variability in coping strategies between cultures (e.g., American vs. Asian).

    • Enhanced Coping Methods: Physical activity, expressing unpleasant emotions, optimism, religious beliefs.

Emotion Regulation (ER)

  • Definition: Techniques for managing and responding to emotions effectively.

  • Examples of ER Strategies:

    • Adaptative: Reappraisal, problem-solving, acceptance.

    • Maladaptive: Avoidance, rumination, and suppression; particularly harmful is rumination.

Resilience

  • Definition: The ability to cope effectively with life’s stressors; varies by individual.

Health Behaviors

  • Importance of Health Behaviors:

    • Engaging in balanced eating, regular sleep, physical activity, and avoiding harmful behaviors like drug use.

  • Role of Social Support: Vital for fostering health behaviors, improving immune function, and strengthening relationships.

Sleep Disorders

  • Obstructive Sleep Apnea (OSA): A common sleep disorder characterized by airway obstruction leading to brief awakenings during sleep, often treated with CPAP machines.

  • Demographics: Higher prevalence of sleep disorders and cognitive impairment within Black, African American, and Hispanic populations.

Stress and Health Models

  • Social Safety Theory: Highlights the significant impacts of social connections and threats on physical and mental health.

  • Biopsychosocial Model: Details that health is shaped by a combination of biological, psychological, and social factors.

  • Minority Stress Model: Explores the effects of discrimination on health outcomes for minoritized groups; addresses issues like systemic racism and its health impacts.

Neurocognitive Disorders

  • Definition: The gradual decline in cognitive functions like memory and reasoning, often associated with aging.

  • Key Terms:

    • Dementia: Characterized by memory loss and cognitive decline.

    • Delirium: A short-term confused state affecting attention and cognition.

  • Diagnosis and Treatment: Conducted by neurologists and neuropsychologists; emphasis on understanding and addressing cognitive impairments.

Types of Neurocognitive Disorders

  • Major Neurocognitive Disorders: Include Alzheimer’s, Frontotemporal disorders, and vascular disorders.

    • Symptoms vary but often include memory deficits, cognitive impairment, and personality changes.

Assessment of Cognitive Declines

  • Differences between Delirium and Dementia:

    • Delirium has a rapid onset and fluctuates, while dementia has a gradual progression.

  • Importance of Accurate Diagnoses: Distinguishing between the two is crucial for effective treatment.

Diagnosis of Neurocognitive Disorders

  • Differentiating Dementia and Depression: Notable overlaps exist, but key differences in progression, memory loss awareness, and comorbidities help distinguish them.

  • Alzheimer’s Disease: Most common form of NCD; significant risk factors include aging and family history.

  • Common Diagnostic Tools: MRI, PET scans, neuropsychological assessments – provide essential insights into brain function and structure.

Treatment of Neurocognitive Disorders

  • Multifaceted Approach: Involves psychological interventions and medications depending on individual disorder presentations.

  • Challenges in Treatment: Varies in effectiveness with specific disorders; frequent need for tailored approaches considering individual histories and symptomatology.

Feeding and Eating Disorders

  • DSM-5 Categories:

    • Includes a spectrum from anorexia nervosa to binge eating disorder.

  • Anorexia Nervosa (AN):

    • Characterized by significant weight loss, fear of gaining weight, and distorted body image. Various medical complications can arise, posing serious health risks.

  • Bulimia Nervosa (BN): Involves binge eating followed by compensatory behaviors such as purging; higher rates among individuals with comorbid disorders.

Attention to Treatment and Prevention

  • Psychotherapy and Medication: Diverse interventions are utilized, including CBT, ACT, and specific medications depending on diagnosis.

  • Cultural Considerations: Awareness of cultural norms regarding body image and health behaviors critical for effective interventions.

  • Prevention Strategies: Shift from traditional stigmatized treatment approaches to nurturing healthy eating and body positivity.

Current Issues and Trends

  • Statistics on Eating Disorders: Notable increases in prevalence post-COVID-19, particularly among younger demographics.

  • Cultural Factors in Gender Differences: Significant disparities in eating disorder incidence between genders and within racial/ethnic groups; consideration of societal factors impacting body image norms.

Final Thoughts

  • Emerging Trends in Health Psychology: Continuous evolution of knowledge about stress, health behaviors, and psychological factors that contribute or detract from well-being.