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Chapter 13

PSYC 328 Chapter Notes - Chapter 13: Low-Density Lipoprotein, Posttraumatic Stress Disorder, New Class


Department
Psychology
Course Code
PSYC 328
Professor
Blaine Ditto
Chapter
13

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PSYC328 Chapter 13 Notes
Heart Disease, Hypertension, Stroke, and Diabetes:
Heart disease , hypertension, stroke and diabetes are termed as noncommunicable diseases.
What is Coronary Heart Disease?
Number two killer in Canada
Not a major cause of illness and death until the twentieth century
Accounts for 20 percent of deaths of men and over 22 percent for women
CHD is considered a systemic disease because of it’s responsiveness to inflammatory processes.
General term referring to illnesses caused by atherosclerosis (the narrowing of the coronary arteries)
Narrowing causes shortage of oxygen and nourishment flow, causing angina pectoris
Inflammatory processes, for example the increase of cytokine (IL6) stimulates the process contributing to the
buildup of plaque
Level of Creactive protein (produced in the liver and released into the bloodstream in the presence of
inflammation) indicates damage is occurring as inflammation promotes damage to the walls of blood vessels.
Increased waist circumference and low levels of physical activity are risk factors for CHD, as they are associated
with higher levels of Creactive protein
Risk factors include:
High blood pressure
Diabetes
Cigarette smoking
Obesity
High serum cholesterol level
Metabolic syndrome: Person has THREE or more of the following problems;
Obesity around the waist
High blood pressure
Low levels HDL
Difficulty in metabolizing blood sugar
High triglyceride levels
Heart disease has family history component, which includes genetic predispositions to cardiovascular reactivity
Reactivity can be exacerbated by low SES, harsh early family environment and stress
Role of Stress:
Chronic stress damages endothelial cells, facilitating deposit of lipids, increasing inflammation, ultimately
increasing atherosclerotic lesions
Acute stress involving emotional stress can precipitate heart attack, angina or sudden death
Those with low SES are more common to develop heart disease, especially males.
People with high levels of demand with low levels of control outside of the workplace are at more risk for
atherosclerosis
Social instability, migrants, cultural change are all link to increase risk of CHD
Women and CHD:
CHD is leading killer of women
Occurs later for women
Women are less likely to recover from a cardiac event compared to men
At young ages, women are protected from higher levels of highdensity lipoprotein (HDL), linked to higher levels of
estrogen
Estrogen also diminishes sympathetic nervous system arousal, increasing protective effect against heart
disease
After menopause, decreased estrogen and increased weight gain enhance CHD risk
Women are less likely to receive counseling about heart disease, to receive and use drugs, and more likely to be
misdiagnosed or not to be diagnosed compared to men with CHD
Women report more symptoms of:
Back pain
Palpitations
Nausea/vomiting
Loss of appetite
Progression of atherosclerosis is predicted by anger and metabolic syndrome in women
Little is known about the differences in men and women’s responses to treatment, however women do not receive
the same quality of care
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Nurses’ Health Study in 1976 showed that women who adhered to recommended guidelines involving diet,
exercise, and abstinence from smoking had low risks of CHD
Cardiovascular Reactivity, Hostility, and CHD:
Anger and hostility are implicated as risk factors for CHD
Proneness to expression of anger implicated as a predictor for CHD, survival, and potential trigger for heart attack
Hostility linked to higher levels of proinflammatory cytokines and to metabolic syndrome
Particularly cynical hostility (suspiciousness, resentment, frequent anger, antagonism, and distrust) implicated
Cynical hostility creates more conflict with others, more negative affects, sleep disturbance, and difficulty
extracting social support
Who is Hostile?
Men show higher hostility
Non-whites are found to be more hostile
Lower SES individuals
Developmental Antecedents:
Hostility develops in childhood
Particular child rearing practices such as parental interference, punitiveness, lack of acceptance, conflict or abuse
Create environments of hostility.
Hostility runs in families and both genetic and environmental factors appear to be implicated
Hyperactivity may also predict adult risk for hostility
Expressing Versus Harboring Hostility:
Expression of hostile emotions (anger, cynicism, etc..) associated with enhanced cardiovascular reactivity than
simply the state of anger or hostility
Those who suppressed hostility interpersonally within a study had higher cardiovascular reactivity than those who
expressed hostility interpersonally
This connection between hostile style and increased cardiovascular reactivity is not as reliable for women as it is
for men
Hostility and Social Relationships:
Hostile individuals have more interpersonal conflicts in their lives and less social support, which can contribute to
risk for disease
In a study 60 couples discussed under conditions of high or low threat of evaluation of others either agreeing or
disagreeing with each other. Husbands who were high in hostility showed greater blood pressure reactivity in
response to stressful marital interaction during threat. The same was not found for wives.
Hostility and Reactivity:
Chronically hostile people show more pronounced physiological reactions in response to interpersonal stressors
Hostile individuals exhibit a week antagonistic response to sympathetic activity in response to stress, that in turn
lasts longer
Hostile individuals have larger and longerlasting blood pressure responses and different patterns of immune
activation in response to sympathetic activation
Hostility can predict high levels of creactive protein when paired with anger and depression
Hostility relationship can be thought of as a biopsychosocial process, developing from the environment, with a
genetic predisposition as well as cognitively negative affect response
Mechanisms Linking Reactivity and Psychological Factors:
Stress cause vasorestriction in areas of the heart and accelerates the heart rate, producing a wear and tear on the
coronary arteries producing atherosclerotic lesions
Catecholamines exert a direct chemical effect on blood vessels: rise and fall of catecholamine levels in the
presence of stress prompts changes in blood pressure that undermine the resilience of vessels
Sympathetic activation, which can occur during stress, causes lipids to be shunted into atherosclerosis
Hostility related to increased lipid profiles and increased platelet activation in coronary heart disease patients
Cynical hostility is not related to inflammatory processes
Depression and CHD:
Depression has a central and independent role in development of CHD
Depression is environmentally rather than genetically based in this role
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