壓力與健康專業(yè)知識講座

StressandHealthBehavioralMedicineinterdisciplinaryfieldthatintegratesbehavioralandmedicalknowledgeandappliesthatknowledgetohealthanddiseaseHealthPsychologysubfieldofpsychologythatprovidespsychology’scontributiontobehavioralmedicine壓力與健康專業(yè)知識講座第1頁StressandIllnessLeadingcausesofdeathintheUSin1900and壓力與健康專業(yè)知識講座第2頁StressandIllnessStresstheprocessbywhichweperceiveandrespondtocertainevents,calledstressors,thatweappraiseasthreateningorchallenging壓力與健康專業(yè)知識講座第3頁StressAppraisalStressfulevent(toughmathtest)Threat(“Yikes!Thisisbeyondme!”)Challenge(“I’vegottoapplyallIknow”)Panic,freezeupAroused,focusedAppraisalResponse壓力與健康專業(yè)知識講座第4頁PituitaryhormoneinthebloodstreamstimulatestheouterpartoftheadrenalglandtoreleasethestresshormonecortisolSympatheticnervoussystemreleasesthestresshormonesepinephrineandnorepinephrinefromnerveendingsintheinnerpartoftheadrenalglandsThalamusHypothalamusPituitaryglandAdrenalglandsCerebralcortex(perceivesstressor)壓力與健康專業(yè)知識講座第5頁StressandIllnessGeneralAdaptationSyndrome

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

Stressoroccurs壓力與健康專業(yè)知識講座第6頁StressfulLifeEventsCatastrophicEventsearthquakes,combatstress,floodsLifeChangesdeathofalovedone,divorce,lossofjob,promotionDailyHasslesrushhourtraffic,longlines,jobstress,burnout壓力與健康專業(yè)知識講座第7頁StressfulLifeEventsChronicStressbyAge壓力與健康專業(yè)知識講座第8頁PerceivedControlHealthconsequencesofalossofcontrolNoconnectiontoshocksourceToshockcontrolToshocksource“Executive”rat“Subordinate”ratControlrat壓力與健康專業(yè)知識講座第9頁PerceivedControlEqualityandLongevity壓力與健康專業(yè)知識講座第10頁StressandtheHeartCoronaryHeartDiseasecloggingofthevesselsthatnourishtheheartmuscleleadingcauseofdeathinmanydevelopedcountries壓力與健康專業(yè)知識講座第11頁StressandtheHeartHopelessnessscores3.532.521.510.50HeartattackDeathLowriskModerateriskHighriskMenwhofeelextremehopelessnessareatgreaterriskforheartattacksandearlydeath壓力與健康專業(yè)知識講座第12頁StressandtheHeartTypeA

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

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