1 Stress and Disease Dr. Donald B. Giddon Harvard University, Fall 2013 QUESTION 3: Why is a...
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Transcript of 1 Stress and Disease Dr. Donald B. Giddon Harvard University, Fall 2013 QUESTION 3: Why is a...
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Stress and DiseaseDr. Donald B. Giddon
Harvard University, Fall 2013
QUESTION 3:Why is a particular organ or
system a target of stress?
• Stimulus specificity
• Response specificity
• Individual response hierarchy
• Symptom specificity
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Bases of Organ Specificity/Diathesis
• Genetic• Psycho Dynamic• Learning/Conditioning• Personality Conflict• Attitudes
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Psychophysiological Disorders and the Attitudes Said to Be Associated with Them-------------------------------------------------------------------------------------------------- Disorder Specific Attitude-------------------------------------------------------------------------------------------------- Acne The person feels he or she is being “picked on” and
wants to be left alone.
Asthma The individual feels left out, unloved, or ignored, and wants toscreen out another individual or the situation, and not haveanything to do with them.
Hypertension The person feels threatened with being harmed by an ever-present danger. As a result, he or she feels the need to be onguard, and prepared to meet all threats.
Hives There are feelings of taking a beating (or being mistreated)and being helpless to do anything about it.
Raynaud disease The person wants to take some hostile physical action(such as hitting) but does not know what the actual actshould be.
Migraine The individual feels that something has to be accomplished orachieved or some goal reached. The person then relaxesafter the effort is exerted.
Duodenal ulcer The individual feels deprived of what is due him or her (i.e.,what is owed or promised) and wants to seek revenge or geteven.
Rheumatoid The person feels tied down, restrained, or restricted andwants to
arthritis restore freedom of movement.
Hyperthyroidism The individual feels he or she might lose a loved person orobject, and takes care to prevent such a loss by holding on orpossessiveness. 5
Affective Psychological Responses To Self Confrontation With Computer Displayed Profile Images
Anderson, Amram, Giddon Psychophysiology 35(1)S16, 1998
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Purpose
• To Investigate The Affective Responses To Self Confrontation With Computer Imaging.
• Hypothesis– The affective and physiological responses to
self confrontation with computer images would differ from responses to computer image distortions of other neutral faces.
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Method
• Confront Subjects With Computer Images of Own Profile, and Images of “Control” Profiles.
• Measure Physiological Responses That Reflect The Affective State of The Subject.– Peripheral Blood Volume Pulse Wave.– Heart Rate.– Heart Rate Variability.– Affective Measures of Pleasantness, Acceptability,
Similar to Self, Tenseness, Concern
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Blood Volume Pulse Wave (BVP)
• Photoplethysmograph– Measures the variation in the opacity of a limb caused
by the changing quantity and quality of blood contained in it. (Pulse Oximeter)
– One of the cardiovascular parameters strongly influenced by the mental processes is the blood volume pulse of the peripheral tissues.
– Measured In Millimeters.
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Heart Rate
• Measured in Interbeat Interval (IBI) in Milliseconds.
• Increases During Stress, Physical Exertion, Sympathetic Stimulation.
• Decreases During Relaxation, Slow Wave Sleep, Parasympathetic Stimulation, Psychological Orientation.
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HR Variability (HRV)
• Standard Deviation of The Beat To Beat Interval Per Unit TIme.
• Increases During Stress, Physical Exertion, Sympathetic Stimulation.
• Decreases During Relaxation, Slow Wave Sleep, Parasympathetic Stimulation, Psychological Orientation.
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Prior to Viewing
• Baseline Physiologic Recording.
• Mental Math Task.– Cognitive/Affective Control.– Subtract 17 from 287.
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Results• Physiological Analysis.
– Completed For 10 Subjects.– Values Averaged (S1,S2) (O1,O2)
• IBI• HRV• BVP
• Subjective Analysis.– Completed For 16 Subjects.– Values Averaged (S1,S2) (O1,O2)
• Semantic Differential.14
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Group Results
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Summary of Group Results• Averaging of individual results revealed no
change for group.• No generalizable pattern for physiological data.• Each individual has own pattern of physiologic
responses (individual response hierarchy)• Identified own true profiles• Found unaltered Most Acceptable• When individual responses averaged across
group, no significant difference to self and other images.
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Conclusion
• Individual pattern of responding to computer images of own and other faces.
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TABLEOriginal Autonomic Balance Scores of Men
Who Later Developed Various Disorders
Disorder Numberof Men
Mean AutonomicBalance
ScoreHigh blood pressure 23 64.74Persistent anxiety 33 66.47Apprehension or fear 49 65.8Excessive sweating 52 67.3Heart trouble 21 67.66Hay fever 52 68.27Stomach pains 63 68.53Allergies 78 68.55Migraine 15 68.99Arthritis 28 69.74Asthma 16 70.06Peptic ulcer 40 70.38Low blood pressure 12 73.54 No disorders reported 111 68.22
In: Suter, S. Health Psychophysiology. Erlbaum Assoc., 1986, p. 87
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What Have We Covered?What Have We Covered?
Question1 – What is stressful for a given individual?Question1 – What is stressful for a given individual?
Question 2- What are the mediators or pathways to diseasesQuestion 2- What are the mediators or pathways to diseases
Today, Today, Question 3 – Question 3 – Why is a particular organ or system a target of stress?Why is a particular organ or system a target of stress?
Still to do, Question 4 – Still to do, Question 4 – What are the Cognitive, Affective and Behavioral Responses toWhat are the Cognitive, Affective and Behavioral Responses to Disease ? Disease ?
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Disorders Associated with Increased Stress System Activity
• Severe chronic disease• Anorexia• Melancholic depression, • Personality disorders, Obsessive compulsive disorder• Active EtOH, EtOH/Narcotic Withdrawal, • Excessive exercise• Malnutrition• Hyperthyroidism• PMS
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Behavioral ResponsesVoluntary and Semi-Voluntary
• E.g. Habits–Bruxism–Smoking
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Vulnerability Combination
High life stress
and
Low social support
and
Poor coping skills
Increased risk of injury
Resiliency Factors either Low life stress
or
High social support
or
Good coping skills
Lower risk of injury
Interaction of Psychosocial Causal Factors
Accident Prone BehaviorAccident Prone Behavior
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Review of Other Responses to StressReview of Other Responses to StressDisorders Associated with Decreased Stress Response Disorders Associated with Decreased Stress Response
• Atypical depression• Cushing’s Syndrome• Seasonal Affective Disorder• Hypothyroidism.• Obesity--some forms.• PTSD.• Nicotine W/D.• Inflammatory Disease• Allergy/Atopy
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Depression Women 2X more likely to suffer from depression as men. Depression significantly associated with morbidity and mortality.
Depressed, elderly pts show more physical illness than matched controls. Significantly higher 4-year mortality.
Depressed, HIV pts show greater progression of HIV than non-depressed.
Linear relationship between depressed affect and cellular immune parameters.
Evolutionary significance
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