Sarah Garfinkle

AP Psychology
Wright Period 1
13 April 2011
Chapter 14: Stress and Health SQ3R
A. What are some behavior related causes of illness and death, and how has health psychology
contributed to the field of behavioral medicine?
1. Prolonged stress ^ risk 4 4 top cause death, heart disease, cancer, stroke, lung disease
a. ½ deaths in US b/c of ppl behavior: smoking, alcohol abuse, etc
2. If behavior source of illness modify, ^ life expectency
a. Behavioral Medicine= an interdisciplinary field tht integrates behavioral y medical
knowledge y applies tht knowledge 2 health y disease
b. Health psychology= a subfield of psych tht provides psychology's contribution to
behavioral medicine
i. Asks how do our emo y personality infl our risk of disase? What attitudes y
behavirors prevent illness.
B. Stress and Illness
1. What is the role of appraisal in the way we respond to stressful events
a. Stress= the process by which we perceive y resp 2 certain events, called stressors, that
we appraise as threatening or challenging
i. Missed train was a stressor. Reaction to that missed train = stress response
ii. Short lived or seen as challeng, stressor= + effects. Athletes thrive off of stress.
Adversity can beget growth
iii. Stressors can threaten us. Severe or prolonged stress= harmful. Abused kids ^ risk of
chronic disease
b. What is the dual-track system by which our body responds to stress and what are the
three phases of the General Adaptation Syndrome?
i. Cannon show stress resp pt of mind-body sys. Extreme cold y emo arouse incidents
→ outpouring of epinephrine y norepinephrine from adrenal gland
I. Alert by brain pathway, Sympathetic Nervous sys ^ HR, divert blood from
digestion, dulls pain 2 prep 4 “Fight or Flight”
II. Cerebral cortex cause adrenal gland 2 secrete glucocorticoid stress hormones
like cortisol. Also fight or flight, but takes longer than Cannon's observ stress
rxns
ii. @ death loved 1, ppl withdraw, pull back, conserve NRG.
I. Women oft seek y give support “tend y befriend”
c. Selye identify General Adaptation Syndrome= Selye's concept of the body's adaptive
sresponse to stress in 3 stages – alarm, resistance, exhaustion
i. Phase I= Alarm rxn b/c activation of sympathetic nervous sys. HR ^, blood 2 skeletal
muscles, feel shocked.
I. Phase II= resistance where temp, BP, respiration rate high. Outpouring of
hormones.
II. Phase III= Exhaustion happens if stress persists b/c body reserves depleted.
More vunerable 2 illness
ii. Prolonged stress= physical deteroration. Severely stressed women had drastically
shortened telomeres (allow cells 2 ÷). Look older than actually are. Child abuse
victim= shrunken hippocampus.

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 d. What are the health consequences of catastrophes, significant life changes, and daily
hassels?
i. Catastrophes
I. Catastrophes= unpredictable lg scale events, such as war y natural disasters, tht
nearly every1 appraises as threatening.
II. Post 9/11, 2/3 Americans trouble sleeping. Post disaster, rates psych disorders ^
17%. Same w/ refugees fleeing homeland
ii. Significant Life Changes
I. Sig life change, ex: death loved 1, loss of job, divorce. Sig personal change
II. Young ppl more oft undergo than older adults. This is why ½ ppl under 50=
frequent stress, but 30% over 50 exp frequent stress.
iii. Daily hassels
I. Happiness stems less from enduring good fortune than from resp 2 daily event.
Same principle 4 neg emo.
II. Everyday annoyances, rush hour traffic, = most sig source stress. Some ppl shrug
off. Others driven up the wall by those stressors.
III. Hypertension high amongst ghetto residents b/c racism, poverty, etc.
2. What is the role of stress in causing coronary heart disease, and what is the difference b/t
Thype A and Type B personalities?
a. Coronary Heart Disease= the clogging of the vessels tht nourish the heat muscle the
leading cause of death in many developed countries
i. Hypertension, family history, y behavioral y psych factors (smoking, obesity, high
fat diet etc) → heart disease.
ii. Friedman y Rosenman found women eat same diet as husband, but men more likely
2 die heart disease. Formulate idea tht stress ^ vunerability 2 heart disease.
b. Friedmen y Rosenman study healthy men. Interview each man abt life.
i. Type A = Friedman y Rosenman's term for competitive, hard driving, impatient,
verbally aggressive, and anger prone ppl
ii. Type B= Friedman y Rosenman's term for easygoing relaxed ppl
I. Of men @ end of study who get heart attack, majority= type A. No pure type B
got heart attack
iii. Relaxed situation, type a y type b arousal ≠ different. When challenged, type A more
physiologically reactive. Hormone secretion, Pulse rate, BP ^. Type B ppl= calm
I. Hormones cause plaque on artery walls → atherosclerosis (hardening of
arteries), high BP, y ^ risk of strokes.
II. Type A toxic core= neg emo, esp anger associate w/ aggressive reative
temperament
c. Pessimists more likely than optimists 2 dev heart disease. Depression ^ risk of heart
attack
3. What is the difference b/t a psychophysiological illness and hypochondriasis?
a. Psychophysiological Illness= literally “mind-body” illness; any stress-related physical
illness such as hypertension and some headaches. Note, this is distinct from
hypochondriasis – misinterpretation of normal physical sensations as symptoms of a
disease.
b. What is the effect of stress on immune system functioning?
i. Immune system is surveilance sys tht defend body by destroy foreing substances.
Contains Lymphocytes (the two types of white blood cells that are part of the body's

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 immune system: B lymphocytes form in the bone marrow and release antibodies that
fight baacterial infections; T lymphocytes form in the thymus and other lymphatic
tissue y attack cancer cells, viruses, y foreign substances), macrophages (identifies,
pursues, y ingests harmuful invaders)
ii. If immune sys rxn 2 strong → arthritis or allergic rxn. Underrxn → dormant herpes
virus erupt, cancer cells multiply.
iii. When animals subject 2 prolonged stress, immune sys= less active. Surgical wounds
heal more slowly in stressed vs nonstressed patients. Ppl more susceptible 2 getting
cold after virus given 2 them if stressed.
c. What are the findings on the link b/t stress and AIDS?
i. AIDS= acquired immune deficiency syndrome caused by human immunodeficiency
virus (HIV). AIDS starts out as HIV. When AIDS develop, difficulty fighting
infections.
ii. Stress y neg emo correlate w/ ^ progression from HIV 2 AIDS. Efforts 2 reduce
stress help ctrl disease, nowhere near as effective as drug treatment or condom use.
d. What are the findings on the link b/t stress and cancer
i. Rodents exposed 2 both Carcinogens (cancer produce substances) y stress more
prone 2 cancer. Link controversial. Some studies have found this to be true, others
say no.
ii. Danger in hyping reports abt attitude y cancer b/c some patients may blame selves 4
illness. New view seems 2 b tht stress ≠ create cancer cells. May affect growth by
weaken body natural defenses ag malignant cells. Use anti cancer drugs instead of
anti cancer smiles.
e. What is the impact of learning on immune system functioning
i. Ader y Cohen realize tht classical conditioning can affect immune system. Give rats
drinking saccharin sweeten water injection of drug tht surpress immune sys
functioning. Eventually, sweetened water able 2 trigger immune surpression
I. This may be the way some placebos (treatments w/ no biochemical effect) work.
Still unsure if possible 2 condition immune sys 2 enhance functioning.
ii. Stress effect on disease resistence price 2 pay 4 benefit of stress. Stress arouses and
motivates us. Makes life interesting. Remember, mind y body interact; everything
psychological is simultaneously physiological. Think abt biting an oranger triggers
salivation.
C. Promoting Health
1. What is the difference b/t problem focused coping y emotion focused coping?
a. B/c stressors unavoidable, need to develop Coping = alleviating stress using emotional
cogntive or behavioral methods.
i. Problem focused coping= attempting 2 alleviate stress directly – by changing the
strssor or the way we interact w/ tht stressor.
I. Impatience leads 2 family fight, I go directly 2 tht family member 2 settle things
II. Used when feel sense ctrl over situation y think we can change circumstances, or
change selves 2 deal w/ circumstances
ii. Emotion focused strategy= attempting 2 alleviate stress by avoiding or ignoring a
stressor y attending 2 emotional needs related 2 1's stress rxn.
I. If I can't get along w/ my mom, I may reach out to a friend to help address my
emotional needs.
II. Use when believe we cannot change a sitaution.

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 III. Sometimes good (ex: take up sport 2 stop thinking abt an addiction). Oft,
nonadaptive (ex: student worry abt not keeping up w/ class reading smokes a
bowl 2 stop thinking abt problems)
b. How does a perceived lack of control affect health?
i. 2 rats get shoced. 1 can turn wheel 2 stop shocks, helpless rat= lowered immunity.
Humans, uncontrollable threats → strongest stress resp. Bacterial infection + stress
→ severe ulcers. More control workers have, longer they live (teachers live longer
than factory workers)
ii. High economic status redicts lower risk heart y respiratory disease.
iii. Losing control → outpouring of stress hormones. Humans feel unable 2 ctrl enviro,
stress hormones ^, BP ^.
c. What are the links between explanatory style, stress, y health?
i. Optimists perceive more ctrl, cope better w/ stressful sit, y healthier.
ii. Pessimists had 2X the death rate of optimists in a Finnish study. Happy ppl live
longer than pessimists. Ppl find humor in daily life benefit. Mirthful humor (not
sarcasm) defuse stress strengthen immune activity.
d. What are some of the ways that social support acts as a stress buffer?
i. Social support – feeling liked, affirmed, and encouraged by intimate friends y family
– promotes happiness y health. Pets also help w/ this
ii. Most ppl find family greatest stress of joy y happiness. Oft very strong. Cancer
patients survival rate higher if married or supported by family y friends.
I. Good marriage @ 50 yr old predicts healthy aging. Bad marriage ≠ good for
health. Ppl w/ social support eat better, exercise more, etc. cope better w/ stress.
iii. Enviro support need 2 belong also foster stronger immune functioning. Social ties
cause ppl 2 b less susceptible 2 cold virus.
I. Close relationships give opportunity 2 confide painful feelings. Ppl whose friend
killed themselves and then buried grief alone worse health than ppl who had
social support.
II. Actively surpressing thoughts can cause thoughts 2 bubble up y preoccupy
person.
2. Managing Stress
a. What are the advantages of aerobic exercise as a technique for managing stress y
fostering well-being
i. Aerobic exercise= sustained exercise tht ^ heat y lung fitness; may also alleviate
depression y anxiety
ii. Esercise y Mood
I. Aerobic exercise can reduce stress, depression, y anxiety
II. Ppl in aerobic exercise program vs other stuff had greatest decrease in
depression.
III. Exercise brings ^ in norepinephrine, serotonin, y endorphin. Enhance cognitive
abilities like memory. Promotes growth of new brain cells.
iii. Exercise y Health
I. Exercise strengthens heart, ^ blood flow, blood vessels open, lower blood
pressure.
II. Physically healthy makes us stronger y better able 2 mange stress. Causes
muscles 2 consume bad fats.
b. What are the benefits of biofeedback y relaxation training as stress-management

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 techniques, and how does meditation as a relaxation technique work?
i. Miller experiment w/ Biofeedback= a system for electronically recording,
amplifying, y feeding back information regarding subtle physiological state such as
blood pressure or muscle tension
I. Biofeedback instruments mirror person's own effort which allow person 2 learn 2
ctrl physiological resp. Yet claims overblown. Simple relaxation produce same
results as biofeedback
ii. Relaxation can alleviate headaches, hypertension, anxiety, insomnia. Type A ppl
taught stress management techniques = ½ heart attack rate as ctrl group.
iii. Benson found that experienced meditators could decrease BP, HR y respiration
I. Called it Respiration Response. Parietal lobe tht tracks where we are in space
less active. Frontal lobe area for focused attn more active.
II. Hypertension pations assigned 2 meditate lower death rate. Same w/ elderly.
c. What is the correlation between religiosity y longevity y what are some possible
explanations for the link?
i. B4 modern medicine, spiritual leader who combined religion y medicine, was a
healer. Hospitals 1st est in monastaries.
ii. Faith factor has been correlated w/ health y healing. Belonging to religious
collective (vs nonreligious kibbutz) associated w/ strong protective effect (not dead)
I. Skeptics say women more religious than men, women outlive men. Religious
involvement expression of gender effect on longevity. Some studies disprove
this. Seems spirituatlity protective effect against death
iii. Religiously active ppl have healthier lifestyles (drink less) yet longevity difference
remains after ctrl for variables. Social support helps explain faith factor. Faith pt of
communal need 2 behlong. Religion encourages marriage
I. Coherent worldview vs atheistic one of uncertainty may cause sense of hope.
3. Modifying Illness-Related Behaviors
a. Why do people smoke?
I. Tobacco kills ppl. Smoking harms almost every organ in the body. Everyone
knows risk of smoking.
II. Smoking correlates w/ higher rates depression, chronic disability, y divorce
ii. When y why do ppl start smoking
I. Smoking is pediatric disease b/c begins early adolescence. Common among ppl
w/ low grades, dropouts
II. Adolescents b/c self conscious oft think world watching them. Imitate older role
models 2 get social reward of being accepted. Project mature image.
▪ Smoking in movies declined when risk known, but then rose again.
iii. Why do people not stop smoking?
I. Tobacco more addictive than heroin. 1/3 ppl tht try cigs become hooked.
II. Smoker becomes dependent. Then develops tolerance needing larger y larger
doses 4 same effect. Quitting causes nicotine-withdrawl symptoms such as
craving, insomnia, anxiety, irritability.
III. Nicotine is reinforcing b/c w/in 7sec, epinephrine y norepinephrine released 2
diminish appetite y ^ alertness. Nicotine stimulates dopamine which basis 4
reward.
iv. Smoking behavior: Bio Infl- genetic infl on nicotine addiction, physiological
addiction. Psych Infl: Adolescence resp 2 cool smoker models. Social Cultural

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 Infl:Persuasive tobacco company effort 2 convince teens 2 start smoking, friends y
family who smoke
b. What are ways of helping smokers to quit smoking – or preventing young people from
ever starting?
i. Pub health warnings, counseling, drug treatments, hypnosis, aversive conditioning,
operant conditioning, cognitive therapy, y support groups. Oft effective in short run,
but only 1/5 participants kick addiction. Yet ½ Americans who ever smoked quit.
I. Many ppl stopped or not started smoking. Bans in public facilities. Yet dropouts
y poor ppl have high smoking rate.
II. Smoking skyrocketing in asia. China 1/3 men will be killed by cigarettes.
Tobacco Cos invest billions in emerging markets who are not well educated
about the dangers of smoking
ii. How can we prevent smoking?
I. Extremely easy 2 never begin smoking than once addicted 2 stop
II. Antismoking programs should give info abt effect of smoking, info abt peer,
parent, y media infl, training in refusal skills via modeling y role playing
III. Also can make it more costly. Knowing smoking suicidal most continue 2
smoke. Raise immediate cost, more direct incentive 2 stop
c. What are the adaptive advantages and modern day disadvantages of a body that stores
fat?
i. Body store fat b/c fat ideal form stored NRG – high calorie fuel reserve to carry the
body through periods when food is scarce – a common occurance in the feast or
famine existance of ancestors. In dev societies, obesity= affluence
ii. significant obesity esp among kids ^ risk diabetes, high BP, heart disease, gallstones,
arthritis, y cancer. Overweight die earlier than slim ppl
d. What are some of the social effects of obesity
i. Stereotype of obese ppl as slow lazy y sloppy. Ppl think obesity matter choice,
evidence of lack of self discipline or personality problem.
I. Obese women make less money than non obese women. Less likely 2 be married
ii. Weight bias shown in hiring decisions. Less likely 2 b hired. Weight discrimination
greater than race or sex discrimination.
e. What are some research findings on the role of heredity y environment in determining
body weight
i. Fat Cells
I. Avg adult= 30-40 billion fat cells, ½ lie near skin surface. Can be relatively
empty 2 overly full.
II. Obese person, fat cells ^ 2-3X normal size, then divide 2 make up to 75million
fat cells. Once number fat cells ^, can never decrease, only deflate
ii. Set points and Metabolism
I. When become fat req less food 2 maintain weight than we did 2 attain it. Fat has
lower metabolic rate. Weight drops below set point (or setting point – range of
weight vs pounds), hunger ^, metabolism decreases.
II. Obese patients lost only 6% of body weight when semi starved. Indv dif in
resting metabolism rate explain why ppl of same height age y act lvl can
maintain same weight even if 1 person does little exercise.
iii. The Genetic Factor
I. Adoptive sibling weight uncorelated w/ each other despite shared meals. ID

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 twins have very similar weight. Obese parent has kid much more likely 2 b obese
II. Many dif genes affect weight. Some genes infl intestines signal “full”, others
dictate how efficiently burn calories.
iv. The food and activity factor
I. B/c of inactivity Americans getting fatter. Poor ppl fatter than rich. Americans
fatter than Europeans. Old Order Amish, obesity practically nonexistant.
II. Lack of exercise y high calorie food + larger serving size, 3X # meals eaten in
fast food restaurants since 1997. World getting fatter, y wider seats are now
availible.
f. What are the chances of success for an overweight person who wants to lose weight?
i. An obese person eating normally, body thinks it's starving.
ii. Most ppl who succeed on weight loss program eventually regain most of weight. Am
spend lots of $ on diet food y drinks.
I. Brownell says we should put tax on calorie laden food, much like w/ cigs.
Revenue from tax subsidizes healthy foods y finances health supportive nutritive
adverts. Fast food free zone around schools. Ban advert junk food 2 kids.
Encourage activity by making for more urban enviro.
II. Schachter realize tht failure amongst weight ctrl groups concentrated in ppl that
failed 2 loose weight. Many ppl succeeded but took many times
iii. some ppl accept weight. Oprah just as loved when lost weight than when she gianed
it back. Happy ppl see themselves as relatively invulnerable 2 health probs esp those
that might arise from own actions.
iv. A Biopsychosocial approach to health
I. Biological Infl: genetic predisposition 2 physiological reactivity, disease,
addiction depression, y other health problems
II. Psychological Influences: appraising stressors as challenges or threats, coping
ability, personality, optimistic or pessimistic explanatory style, healthful or
harmful behaviors, personal ctrl y other pervious experiences, spirituality
III. Social Cultural Influences: Environmental stressors, cultural influences on
eating, smoking, y other behaviors, social support, available medical support.
g. Close Up, for those who want to loose weight
i. Begin only if you feel motivated y self-disciplined
ii. Minimize exposure 2 tempting food cues
iii. Take steps to boost metabolism
iv. Be realistic y moderate
v. Eat healthy foods
vi. Don't starve all day y eat one big meal @ night
vii. Beware of the binge

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