Chapter 2-Social Organization, Stress and Health.docx

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Family Relations and Human Development
FRHD 3090
Michelle Preyde

Chapter 2 – Social Organization, Stress, and Health THE P ERSONAL AND THE S OCIAL  View that what is stress for one person is stimulation for another  Relate biological response of individual to social environment acting upon him or her. Response will be influenced by previous experience and perhaps genetic make-up, but is sufficient regularity of response to suggest that right approach is to understand how social environment impacts on biology to cause disease  Model elaborated by Sapolsky is that fight-or-flight response is adaptive in acute stress by may be maladaptive in chronic stress in today’s urban environment  Psychosocial factors and their influences on health are active areas of research B IOLOGICAL PATHWAYS IN A S OCIAL CONTEXT  Biological processes must be involved in connection between social structure and health. Even more than health, biology is thought of as an individual rather than social attribute  Individual, clinical view of health determinants is vitally important. Underlies medical training and biomedical science, and provides framework for treatment, cure, and amelioration of disease  Influences of social structure operate via 3 main pathways – material circumstances related to health directly, and view social and work environment. In turn, shape psychological factors and health-related behaviours o Early life experiences, cultural, and genetic factors also exert influences on health  Balance of influences on health depends on geographical location and historical circumstances of population in question The Fight-or-Flight Response  Humans evolved to rise rapidly to challenge of external, possibly lethal, but short-term threats. May be physical, psychological, or biological, and often are combo of all 3  Psychological POV – f-or-f response is similar in all mammals. Sensory information trigger for set of nerve and hormone signals, which prep the brain and body to respond to emergency. Resulting physiological changes can be key to survival in face of predator’s attach or physical injury  Physical and biological emergencies are comparatively rare but, instead, life is filled with psychological demands and challenges which may active f-or-f response too hard and too often  Mechanism of f-or-f response involves 2 main pathways which together co-ordinate an array of metabolic and physiological changes – rely on parts of the nervous system and several hormonal or endocrine transmitter o Known as neuroendocrine pathways – both are signal pathways that originate in brain, where threat is perceived and evaluated and resulting signal is initiated  Path 1  comes into action rapidly, utilizing sympathetic branch of autonomic nervous system (ANS). Hormonal products of pathway are noradrenaline, released at nerve endings, and adrenaline, secreted into bloodstream by medulla of adrenal glands (sympatho-adrenal pathway)  Path 2  comes into operation over minutes and hours instead of milliseconds. 3 hormone secreting glands (hypothalamus, pituitary, and adrenal glands)  The Sympatho-Adrenal Pathway o Almost instantaneous release of noradrenaline from sympathetic nerve endings and adrenaline from adrenal medulla evokes responses throughout body o Effects due to presence of sympathetic nerves in target organs, and to increased secretion of adrenaline into circulation o Important target organ = heart, controlled, directly, by nerves of autonomic nervous system and, indirectly, by level of adrenaline in blood o Combined effects of sympatho-adrenal activation on mind and body are psychological around and energy mobilization, and inhibition of functions which are irrelevant to immediate survival (e.g. digestion, growth). Precise nature of activation varies according to stressor and duration, but function is essentially to prepare for, or maintain, physical exertion o Can be switched off rapidly, even circulating adrenaline has short-lived effects because its half-life is just few minutes  The Hypothalamic-Pituitary-Adrenal Axis o Results in cortical release into the blood stream from adrenal glands. Hormonal cascade starts in brain with release of corticotrophin releasing factor (CRF) into small vessel that carry it few mm’s from hypothalamus to pituitary gland. o Specialized cells respond to presence of CRF by secreting adrenocorticotrophic hormone (ACTH) into circulation o Cortisol and other related glucocorticoid hormones have both metabolic and psychological effects. Play key role in maintenance and control of resting and stress-related metabolic functions  As antagonists of hormone, insulin, mobilize energy reserves by raising blood glucose and promoting fatty acid release from fat tissues  During emergency, this is desirable effect, but in physically inactive situation, superfluous availability of energy tends to increase output into blood of cholesterol-carrying particles from liver  Brain also target for glucocorticoids, promote vigilance in short-term. Prolonged high level of cortisol can provoke paranoia or depression Acute and Chronic Stress  Neuroendocrine pathways are valuable properties of human biology because they provide the means to survive in the face of environmental challenge  Financial strain, lack of support, and monotonous work may produce low level of psychosocial stress as feature of daily life. Modern populations are largely free of risks of fatal infectious disease but not of more subtle exposures  Acute stress in such contexts provides challenges which often will be exciting, stimulating, and, after the event, emotionally and intellectually satisfying  Ill health is associated with prolonged exposure to psychological demands when possibilities to control situation are perceived to be limited and chances of reward are small The Limits of Stress Reactivity  Constant temperature, carbon dioxide concentration, and osmotic pressure are essential for well-being of cells, tissues, and organs and for integrity of whole organism  Blood sugar, other circulating nutrients and waste products, blood pressure, and heart rate also controlled, but controls have wider margins. o Variability is fact of life, and maintenance of constant internal environment (homeostasis) is about balancing necessary variation against need for physiological stability  Nature and size of biological response to psychological demands can influence health in several ways. Particular response may be directly responsible for disease or may increase vulnerability to certain illness (e.g. colds and flu)  Good evidence for disruptive effect of stressors, such as life events, on existing medical conditions (e.g. diabetes, and rheumatoid arthritis)  Allostatic (ability to achieve stability through change) load hypothesis links psychosocial environment to physical disease via neuroendocrine pathways. Allostatic load, or stress-induced damage, considered relevant in cardiovascular disease, cancer, infection, and cognitive decline; described as sign of accelerated aging The Blood-Clotting System  Blood flow is vital for transport of gases, nutrients, and waste materials to and from body tissues – important that physical i
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