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Psychology applied to modern life adjustment in the 21st century, 11e chapter 5

Chapter 5
Psychology and Physical Health

Stress, Personality, and Illness, continued

Health psychology is “concerned with how
psychological factors relate to the promotion
and maintenance of health, and with the
causation, prevention, and treatment of
The biopsychosocial model “holds that
illness is caused by a complex interaction of
biological, psychological, and sociocultural

Stress, Personality, and Illness, continued
• Personality, emotions, and heart disease
– Coronary heart disease – “results from a
reduction in blood flow through the coronary
arteries, which supply the heart with blood”.
– Atherosclerosis – “is a gradual narrowing of
the coronary arteries” (see Figure 5.3).

Figure 5.3 Atherosclerosis. Atherosclerosis, a narrowing of the coronary arteries, is the principal cause of
coronary disease. (a) A normal artery. (b) Fatty deposits, cholesterol, and cellular debris on the walls of the
artery have narrowed the path for blood flow. (c) Advanced atherosclerosis. In this situation, a blood clot
might suddenly block the flow of blood through the artery.

Stress, Personality, and Illness, continued
• Hostility and coronary risk
– Research suggests a link between coronary
risk and a behavior pattern termed the Type
A personality.
– Type A personality has three components:
1. A competitive orientation.
2. Impatience and a sense of time urgency.
3. Anger and hostility.

Stress, Personality, and Illness, continued
Hostility and coronary risk, continued
– The “anger – hostility” component of Type A
behavior has the strongest link to coronary
• Research shows that individuals with
above-average hostility scores were twice
as likely to have atherosclerosis than
were those with below-average hostility
scores (see Figure 5.5).

Figure 5.5. Anger and coronary risk. Working with a large sample of healthy men and women who were followed for a
median of 4.5 years, Williams et al. (2000) found an association between trait anger and the likelihood of a coronary event.

Among subjects who manifested normal blood pressure at the beginning of the study, a moderate anger level was associated
with a 36% increase in coronary attacks, and a high level of anger nearly tripled participants’ risk for coronary disease. (Based
on data in William et al., 2000)

Stress, Personality, and Illness, continued
• Emotional reactions and heart disease
– Stress, and its resulting strong emotions,
seems to tax the heart.
– Even brief periods of stress can trigger acute
cardiac symptoms such as angina (chest
– When interviewed after surviving a heart
attack, many patients say that an episode of
anger triggered the symptoms.

Stress, Personality, and Illness, continued
• Depression and heart disease
– Recent studies suggest that the emotional
dysfunction of depression may cause heart
disease (Goldston & Baillie, 2008).
– Overall, it seems that depression doubles
one’s chances of developing heart disease.
– Depression also seems to affect how heart
disease progresses and is associated with
worse outcomes in cardiology patients.

Stress, Personality, and Illness, continued
• Stress and cancer
– Cancer – refers “to malignant cell growth,
which may occur in many organ systems in
the body”.
– There is no direct evidence that stress
causes the onset of cancer.
• However, stress and personality can affect
the course of the disease.

Stress, Personality, and Illness, continued
Stress and cancer, continued
– There may be a cancer-prone personality
(Type C).
• These individuals
– Are passive.
– Do not complain.
– Do not cope well with stress.
– Hold in negative emotions, such as

Stress, Personality, and Illness, continued
• Stress and other diseases
– Life stress has been associated with the
• Rheumatoid arthritis.
• Emergence of lower back pain.
• Asthma.
• Periodontal disease.
• Gastrointestinal disorders.

Stress, Personality, and Illness, continued
• Stress and immune function
– The immune response is “the body’s
defensive reaction to invasion by bacteria,
viral agents, or other foreign substances”.
– A large body of experimental research
indicates that stress can impair immune
functioning in animals.
– Similar immune suppression may also occur
in humans.

Habits, Lifestyle and Health, continued

As shown in Figure 5.9, unhealthy habits
account for the most premature deaths.
Other leading behavioral causes of death
– Alcohol consumption.
– Unsafe driving.
– Risky sexual behavior.
– Illicit drug use.

Figure 5.9. Mortality due to health-impairing behaviors. Synthesizing data from many sources, Mokdad
and colleagues (2004) estimated the number of annual deaths in the United States attributable to various
health-impairing behaviors in an interesting article published in The Journal of the American Medical
Association. As you can see, smoking and obesity are the leading causes of preventable mortality. However,
their mortality estimate for obesity has proven controversial and is the subject of some debate (some
experts argue that their estimate is too high). (Data from Mokdad et al., 2004)

Habits, Lifestyle, and Health, continued
• Smoking
– Health effects associated with smoking
• Greater risk of premature death (13-14
years shorter life expectancy).
• Lung cancer, as well as higher risk for
many other cancers in the body.
• Hypertension, stroke, and other cardiac
diseases (see Figure 5.11).

Figure 5.11. Health risks associated with smoking. This figure provides an overview of the various
diseases that are more common among smokers than nonsmokers. As you can see, tobacco elevates one’s
vulnerability to a remarkably diverse array of diseases, including the three leading causes of death in the
modern world – heart attack, cancer, and stroke.

Habits, Lifestyle, and Health, continued
Smoking, continued
– Giving up smoking
• If people give up smoking, studies show
that their health risks decline reasonably
quickly, reaching normal levels after about
15 years (see Figure 5.12).
• Quitting smoking is difficult, however, and
many people fail several times before

Figure 5.12. Quitting smoking and mortality. Research suggests that various types of health risks
associated with smoking decline gradually after people give up tobacco. The data shown here, from the
1990 U.S. Surgeon General’s report on smoking, illustrate the overall effects on mortality rates. The
mortality rates on the vertical axis show how much death rates are elevated among smokers and exsmokers in comparison to nonsmokers. For example, a mortality rate of 3.0 would mean that smokers’ death
rate was triple that of nonsmokers. (Data from U.S. Department of Health and Human Services, 1990)

Habits, Lifestyle, and Health, continued
• Drinking
– Why do people drink?
• Drinking is widely endorsed in our culture
and is viewed as a desirable social ritual.
• Drinking dulls negative emotions such as
tension, worry, anxiety and depression.
• Alcohol makes people feel more relaxed in
social settings.
• To keep friends and company.

Habits, Lifestyle, and Health, continued
Drinking, continued
– Short-term risks and problems
• The “hangover”, which includes headache,
dizziness, nausea and vomiting.
• Life-threatening overdoses. This is
especially problematic when alcohol is
mixed with a sedative or narcotic drugs.
• Poor judgment, reduced intellectual
• Poor motor coordination.
• Increased anger.

Habits, Lifestyle, and Health, continued
Drinking, continued
– Long-term risks and social costs
• Alcohol dependence, or alcoholism, is
“a chronic, progressive disorder marked by
a growing compulsion to drink and
impaired control over drinking that will
eventually interfere with health and social
• See Figure 5.16 for a list of serious health
problems associated with alcoholism.

Figure 5.16. Health risks associated with drinking. This graphic provides an overview of the various
diseases that are more common among drinkers than abstainers. As you can see, alcohol elevates one’s
vulnerability to a remarkably diverse array of diseases.

Habits, Lifestyle, and Health, continued

– Obesity is a serious risk factor for a number
of health problems and diseases (see Figure

Figure 5.17. Weight and the prevalence of various diseases. This graph shows how obesity, as indexed
by BMI, is related to the prevalence of four common types of illness. The prevalence of diabetes, heart
disease, muscle pain, and hypertension all increase as BMI goes up. Clearly, obesity is a significant health
risk. (Data from Brownell & Wadden, 2000)

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