压力与健康专业知识讲座

StressandHealthBehavioralMedicineinterdisciplinaryfieldthatintegratesbehavioralandmedicalknowledgeandappliesthatknowledgetohealthanddiseaseHealthPsychologysubfieldofpsychologythatprovidespsychology’scontributiontobehavioralmedicine压力与健康专业知识讲座第1页StressandIllnessLeadingcausesofdeathintheUSin1900and压力与健康专业知识讲座第2页StressandIllnessStresstheprocessbywhichweperceiveandrespondtocertainevents,calledstressors,thatweappraiseasthreateningorchallenging压力与健康专业知识讲座第3页StressAppraisalStressfulevent(toughmathtest)Threat(“Yikes!Thisisbeyondme!”)Challenge(“I’vegottoapplyallIknow”)Panic,freezeupAroused,focusedAppraisalResponse压力与健康专业知识讲座第4页PituitaryhormoneinthebloodstreamstimulatestheouterpartoftheadrenalglandtoreleasethestresshormonecortisolSympatheticnervoussystemreleasesthestresshormonesepinephrineandnorepinephrinefromnerveendingsintheinnerpartoftheadrenalglandsThalamusHypothalamusPituitaryglandAdrenalglandsCerebralcortex(perceivesstressor)压力与健康专业知识讲座第5页StressandIllnessGeneralAdaptationSyndrome

Selye’sconceptofthebody’sadaptiveresponsetostressinthreestagesStressresistancePhase1Alarmreaction(mobilizeresources)Phase2Resistance(copewithstressor)Phase3Exhaustion(reservesdepleted)Thebody’sresistancetostresscanlastonlysolongbeforeexhaustionsetsin

Stressoroccurs压力与健康专业知识讲座第6页StressfulLifeEventsCatastrophicEventsearthquakes,combatstress,floodsLifeChangesdeathofalovedone,divorce,lossofjob,promotionDailyHasslesrushhourtraffic,longlines,jobstress,burnout压力与健康专业知识讲座第7页StressfulLifeEventsChronicStressbyAge压力与健康专业知识讲座第8页PerceivedControlHealthconsequencesofalossofcontrolNoconnectiontoshocksourceToshockcontrolToshocksource“Executive”rat“Subordinate”ratControlrat压力与健康专业知识讲座第9页PerceivedControlEqualityandLongevity压力与健康专业知识讲座第10页StressandtheHeartCoronaryHeartDiseasecloggingofthevesselsthatnourishtheheartmuscleleadingcauseofdeathinmanydevelopedcountries压力与健康专业知识讲座第11页StressandtheHeartHopelessnessscores3.532.521.510.50HeartattackDeathLowriskModerateriskHighriskMenwhofeelextremehopelessnessareatgreaterriskforheartattacksandearlydeath压力与健康专业知识讲座第12页StressandtheHeartTypeA

FriedmanandRosenman’stermforcompetitive,hard-driving,impatient,verballyaggressive,andanger-pronepeople

TypeBFriedmanandRosenman’stermforeasygoing,relaxedpeople压力与健康专业知识讲座第13页StressandtheHeart压力与健康专业知识讲座第14页StressandDiseasePsychophysiologicalIllness“mind-body”illnessanystress-relatedphysicalillnesssomeformsofhypertensionsomeheadachesdistinctfromhypochondriasis--misinterpretingnormalphysicalsensationsassymptomsofadisease压力与健康专业知识讲座第15页StressandDiseaseLymphocytestwotypesofwhitebloodcellsthatarepartofthebody’simmunesystemBlymphocytesforminthebonemarrowandreleaseantibodiesthatfightbacterialinfectionsTlymphocytesforminthethymusand,amongotherduties,attackcancercells,viruses,andforeignsubstances压力与健康专业知识讲座第16页StressandDiseaseConditioningofimmunesuppressionUCS(drug)UCR(immunesuppression)UCS(drug)UCR(immunesuppression)CS(sweetenedwater)CS(sweetenedwater)CR(immunesuppression)压力与健康专业知识讲座第17页StressandDiseaseNegativeemotionsandhealth-relatedconsequencesUnhealthybehaviors(smoking,drinking,poornutritionandsleep)PersistentstressorsandnegativeemotionsReleaseofstresshormonesHeartdiseaseImmunesuppressionAutonomicnervoussystemeffects(headaches,hypertension)压力与健康专业知识讲座第18页PromotingHealthAerobicExercisesustainedexercisethatincreasesheartandlungfitnessDepressionscore14131211109876543BeforetreatmentevaluationAftertreatmentevaluationNo-treatmentgroupAerobicexercisegroupRelaxationtreatmentgroup压力与健康专业知识讲座第19页PromotingHealthBiofeedbacksystemforelectronicallyrecording,amplifying,andfeedingbackinformationregardingasubtlephysiologicalstatebloodpressuremuscletension压力与健康专业知识讲座第20页PromotingHealthModifyingTypeAlife-stylecanreducerecurrenceofheartattacksPercentageofpatientswithrecurrentheartattacks(cumulativeaverage)6543210Year19781979198019811982Life-stylemodificationpatientsControlpatientsModifyinglife-stylereducedrecurrentheartattacks压力与健康专业知识讲座第21页PromotingHealthSocialsupportacrossthelifespan12-1418-1925-3445-5465-7415-1720-2435-4455-6475+Ageinyears100%9080706050Percentagewithhighsupport压力与健康专业知识讲座第22页LifeeventsTendencytowardHealthIllnessPersonalappraisalChallengeThreatPersonalitytypeEasygoingNondepressedOptimisticHostileDepressedPessimisticPersonalityhabitsNonsmokingRegularexerciseGoodnutritionSmokingSedentaryPoornutritionLevelofsocialsupportClose,enduringLacking压力与健康专业知识讲座第23页PromotingHealthPredictorsofmortality10.80.60.40.20MenWomenNotsmokingRegularexerciseWeeklyreligious attendanceRelativeriskofdying压力与健康专业知识讲座第24页PromotingHealthReligiousAttendance压力与健康专业知识讲座第25页PromotingHealthThereligionfactorismulitidimensionalReligiousinvolvementHealthybehaviors(lesssmoking,drinking)Socialsupport(faithcommunities,marriage)Positiveemotions(lessstress,anxiety)Betterhealth(lessimmunesystemsuppression,stresshormones,andsuicide)压力与健康专业知识讲座第26页PromotingHealthComplementaryandAlternativeMedicineunprovenhealthcaretreatmentsnottaughtwidelyinmedicalschools,notusedinhospitals,andnotusuallyreimbursedbyinsurancecompanies压力与健康专业知识讲座第27页AlternativesystemsofmedicalpracticeBioelectromagneticapplicationsDiet,nutrition,life-stylechangesHerbalmedicineManualhealingMind-bodycontrolPharmacologicalandbiologicaltreatmentsSubfieldsofAlternativeMedicineHealthcarerangingfromself-careaccordingtofolkprinciples,tocarerenderedinanorganizedhealthcaresystembasedonalternativetraditionsorpracticesThestudyofhowlivingorganismsinteractwithelectromagnetic(EM)fieldsTheknowledgeofhowtopreventillness,maintainhealth,andreversetheeffectsofchronicdiseasethroughdietaryornutritionalinterventionEmployingplanandplantproductsfromfolkmedicinetraditionsforpharmacologicaluseUsingtouchandmanipulationwiththehandsasadiagnosticandtherapeutictoolExploringthemind’scapacitytoaffectthebody,basedontraditionalmedicalsystemsthatmakeuseoftheinterconnected-nessofmindandbodyDrugsandvaccinesnotyetacceptedbymainstreammedicine压力与健康专业知识讲座第28页PromotingHealthSmoking-relatedearlydeaths40,00030,00020,00010,000033,3481,6861,135556202SmokingSuicideVehicleHIV/Homicide crashAIDSCauseofdeathNumberofdeathsper100,000压力与健康专业知识讲座第29页ThePhysiologicalEffectsofNicotine压力与健康专业知识讲座第30页PromotingHealthFewerCanadiansmokersMalesFemales1970197419781982198619901994-1996- 19951997Year60%50403020100PercentageofCanadianssmoking压力与健康专业知识讲座第31页SmokingPreventionU.S.teensmoking压力与健康专业知识讲座第32页SmokingPreventionResultsofasmokinginoculationprogramPercentageofstudentswhosmoke2015105004912162133SeventhgradeEighthgradeNinthgradeMonthsofstudyControlschoolSchoolwithsmokingPreventionprogramFewerteenstookupsmokingwhen“inoculated”againstit压力与健康专业知识讲座第33页ObesityandWeightControlObesityandbodymassindex压力与健康专业知识讲座第34页ObesityandWeightControlObesityandmortality18.518.5-20.5-22.0-23.5-25.0-26.5-28.0-30.0-32.0-35.0-4020.421.923.424.926.427.929.931.934.939.9 Body-massindex(BMI)MenWomen2.82.62.42.22.01.81.61.41.21.00.80.6Relativeriskofdeath压力与健康专业知识讲座第35页WeightDiscriminationWhe