普通心理学之心理压力与健康培训课件

普通心理学之心理普通心理学之心理压压力与健康力与健康疾病/健康病源学的转变Contagious diseases(传染病）：由传染源引起的疾病，如天花、伤寒、疟疾、白喉、黄热病、霍乱、脑灰质炎、肺结合等20世纪之前的致命疾病；与nutrition,public hygiene,sanitation and medical treatment等有密切关系.Chronic diseases(慢性病):heart disease、cancer、stroke(中风）等，生活压力（应激）、生活方式等因素是慢性病形成的主要原因。2普通心理学之心理压力与健康3普通心理学之心理压力与健康心身病（蔡能等，1985)心理因素在疾病的发生和病程演变中起主导作用的躯体疾病。例如情绪，通过植物神经、内分泌、肌肉骨骼系统、皮肤及免疫系统等受累而引起的症状群及疾病。4普通心理学之心理压力与健康病源分析（蔡能等，1985）身心分离观点（传统医学观点）：细胞疾病-组织结构改变-功能障碍；身心统一观点：情绪（心理）因素-功能障碍（？）-细胞疾病-组织结构改变。5普通心理学之心理压力与健康Health psychologyHealth psychologyDiscovery of causation,prevention,and treatment（病因、预防及治疗）Health promotion and maintenance（健康的促进和保持）Bio-psychosocial model（生物心理社会模型）:身体疾病由生物、心理及社会文化等因素相互作用引起。6普通心理学之心理压力与健康7普通心理学之心理压力与健康Nature of stressDefination of stress（应激、紧张）Stressors(应激源):events or circumstance(what?)Threaten or perceived threaten ones well-being:(why?)Cognitive appraisal：what affect appraisal？Need to coping:how?8普通心理学之心理压力与健康9普通心理学之心理压力与健康Frustration Frustration（挫折、打击）-blocked goal（与目标不一致）-Traffic jams -failure -loss;情绪：愤怒、恐惧、悲伤；心境：抑郁、焦虑；生理：血压（Novaco,etal.1990)；10普通心理学之心理压力与健康Conflicttwo or more incompatible motivations冲突的三种类型（Lewin,and Miller(1944)Approach-approach(双趋性冲突）：鱼与熊掌；Avoidance-avoidance（双避冲突）：approach-avoidance（趋避冲突）：进退两难、犹豫不决、举棋不定；Neal Miller(1944)的实验：趋（食物+电击）避（无食物+无电击）冲突；-Laura King and Robert Emmons(1991):以问卷调查内心冲突与焦虑、抑郁、及生理症状的关系；11普通心理学之心理压力与健康conflicts12普通心理学之心理压力与健康conflicts13普通心理学之心理压力与健康Change:have to change Two issues:What changes led to stress?Degree?What consequence?Holmes and Rahe:Social Readjustment Rating Scale(SRRS)耗费更多的能量。肺结核的心理因素调查：结婚、晋升、有小孩等；消极刺激；生活变化大，生理疾病和心理问题也多一些（Creed,1993)；-疾病与生活应激的相关研究；14普通心理学之心理压力与健康SocialreadjustmentratingscaleDeath of spouse 100Divorce 73Jail term 63Marriage 50Fired at work 47 Retirement 45Change in school 20Vacation 1515普通心理学之心理压力与健康学生压力量表(Holmes and Raber)16普通心理学之心理压力与健康Pressure:expectationtobehaveincertainwaysPerformance pressureSalespeopleProfessorActorStudentConform pressure（相符）。来源于关系期望的压力（工作、学校、家庭、朋友等）；与自我期望有关（idea self&real self);压力与心理问题、生理疾病。17普通心理学之心理压力与健康国内研究恋爱婚姻与家庭内部问题；恋爱婚姻；子女与父母关系；家庭关系变迁；学校与职业场所的问题；失学；失业；社会生活变化与个人特殊遭遇灾难性事件；生活事件量表18普通心理学之心理压力与健康Responding to stressEmotional respondingPhysiological respondingBehavioral responding19普通心理学之心理压力与健康Figure 13.4Overview of the stress process.A potentially stressful event,such as a major exam,elicits a subjective appraisal of how threatening the event is.If the event is viewed with alarm,the stress may trigger emotional,psychological,and behavioral reactions,as peoples response to stress is multidimensional.20普通心理学之心理压力与健康Responding to stress:emotional responsesStress-specific cognitive reactionspecific emotion(Smith and Lazarus,1991)Self blame自责-Guilt内疚；Helplessness无助-sadness悲伤；Common emotional response:annoyance(烦恼）,anger,and rage;apprehension（忧虑）；anxiety（焦虑）,and fear;dejection（沮丧）,sadness and grief（悲痛）；21普通心理学之心理压力与健康 Emotional responsesCasper,etal.(1987)的研究被试：96女性，时间28天任务：报告她们每天生活中紧张事件与心情；结果：stress led to negative mood;22普通心理学之心理压力与健康Emotionalresponsetostress研究：253 Care-giving partners of men with AIDs coping pattern（Folkman，1997)存在一定的正情绪；Positive emotions:interest and joy;Promote creativity and flexibility;加速信息加工过程；减弱不良的生理反应；情绪反应的作用情绪反应的作用/功能？功能？23普通心理学之心理压力与健康Effects of emotional arousalEmotional arousal and performance(成绩/绩效）The inverted-U-hypothesis（倒U曲线）-简单任务需要较高唤醒水平；-中等难度任务在中等唤醒状态下成绩最好；-复杂任务在较低唤醒状态下才有较好成绩。情绪与认知关系；24普通心理学之心理压力与健康Figure 13.5Arousal and performance.Graphs of the relationship between emotional arousal and task performance tend to resemble an inverted U,as increased arousal is associated with improved performance up to a point,after which higher arousal leads to poorer performance.The optimal level of arousal for a task depends on the complexity of the task.On complex tasks,a relatively low level of arousal tends to be optimal.On simple tasks,however,performance may peak at a much higher level of arousal.25普通心理学之心理压力与健康Physiological ResponsesFight-or-flight response。W.Cannon(1932):cats与dogs的实验；result:increased in breathing and heart rate and decreased in digestive processes。现代生活与应激的生理反应；Responding to Stress PhysiologicallyResponding to Stress Physiologically26普通心理学之心理压力与健康Hans Selye：General Adaptation SyndromePhysical and psychological stress:cold,heat,pain,mild shock,restraint,et.Al.Stressful response:nonspecific reactions.General adaptation syndrome:Alarm（警觉）:fight or flight response,Resistance（抵抗、坚持）:prolonged stress,Exhaustion（疲乏，衰竭）:disease of adaptation(适应疾病）；27普通心理学之心理压力与健康一般适应症候群和慢性应激长期压力带来的生理反应是什么长期压力带来的生理反应是什么?一般适应症候群 报警阶段 抵抗期 疲惫期心身失调28普通心理学之心理压力与健康一般适应症候群的三个阶段29普通心理学之心理压力与健康Brain-body pathways（Felker&Hubbard,1998)Pathway(I):Stress-hypothalamus(下丘脑）-ANS-adrenal medulla(肾上腺髓质）-catechizations(儿茶酚胺）-增强活动（心血管、呼吸、运动系统激活）。Pathway(II):Stress-hypothalamus-Pituitary gland(脑垂体)-ACTH肾上腺皮质激素-adrenal cortex-corticosteroids(皮质类固醇素/可的松）-增强能量消耗（protein and fat）。Effect of stress on immune system(免疫系统）;30普通心理学之心理压力与健康Figure 13.6Figure 13.6Brain-body pathways in stress.In times of stress,the brain sends signals along two pathways.The pathway through the autonomic nervous system controls the release of catecholamine hormones that help mobilize the body for action.The pathway through the pituitary gland and the endocrine system controls the release of corticosteroid hormones that increase energy and ward off tissue inflammation(Felker&Hubbard,1998).31普通心理学之心理压力与健康应激中的躯体反应32普通心理学之心理压力与健康拖沓的健康成本研究者鉴别了研究者鉴别了拖沓和不拖沓拖沓和不拖沓者后要求被试者后要求被试在学期初和学在学期初和学期末报告体验期末报告体验躯体疾病的症躯体疾病的症状状.33普通心理学之心理压力与健康Coping应对:Active efforts to master,reduce,or tolerate the demands created by stress.Adaptive&maladaptive coping;Problem-focused coping&emotional focused coping;Difference from concept of Emotion regulation(?)Coping styles：consistent across situations；Responding to Stress BehaviorallyResponding to Stress BehaviorallyLaunchVideo34普通心理学之心理压力与健康几种应对反应应激预应付可控制的应激源不可控的应激源35普通心理学之心理压力与健康GivingupandblamingoneselfGiving up适当放弃：简单放弃：Learned helplessness(习得无助);Behavioral disengagement(行动脱离);Stress increased and led to depressionSelf blame 适当的自我批判；过分的自责导致焦虑上升;Catastrophic thinking(自责思维/悲观思维/悲惨思维）Development of depression;36普通心理学之心理压力与健康Striking out at otherAggression（攻击）:Frustration-aggression hypothesis（Dollard,et al.，1939).Displacement（转移）：将攻击目标（挫折引起）转移到其它无关的对象，例如，家庭成员;Catharsis(宣泄）-释放发泄紧张情绪，宣泄与抑制对心理/生理适应的作用。37普通心理学之心理压力与健康Indulging oneself（纵容自己）Indulging oneself:在其它方面获得替代满足。Smoking,Drinking，Drugs using,Overeating,Spend money,Internet addiction（网迷).38普通心理学之心理压力与健康Defense mechanisms（防御机制）Repression（压抑）Projection（投射）Displacement（转移/迁怒）Reaction formation（反向形成）Regression（倒退）Rationalization（合理化）Identification（认同）Intellectualization(isolation)智力化,升华。Overcompensation(过度补偿）;Undoing（取消）；Denial of reality（否认）;Fantasy（幻想）；39普通心理学之心理压力与健康Constructive coping（Epstein,1989,1990)-更有效、更加健康的应付方式直接面对问题，积极解决问题；对引起应激环境和应付资源理性现实的评价；学习对可能引起的破坏性情绪反应进行重新组织，或者抑制；努力确保自身不受可能的伤害；-与IQ关系较弱，与社会关系、爱情及成功的工作有较大相关。40普通心理学之心理压力与健康The Effects of Stress1.On Psychological Functioning2.On Physical Health41普通心理学之心理压力与健康FactorsinEffectsofstressStress:High&mediate&low,which is optimal level?Effect:Positive&Negative short&term;Personality:how traits modulate the interaction?For what?Why?How?42普通心理学之心理压力与健康Stress Impaired task performanceStress Impaired task performance Baumeister(1984)的研究：hypothesis:Pressureself conscious increaseperformance decrease X:Pressure Y:Performance on the task of perceptionHome-team(主场）would be under greater pressure than the visiting team（客场）?Early games:home-team winsLast game:home team winsEffects of stress on Effects of stress on psychological functioningpsychological functioning43普通心理学之心理压力与健康Burnout（崩溃）Burnout involves physical,mental,and emotional exhaustion that is attributable to long-term involvement in emotional demanding situation(长期情绪紧张导致生理、心理及情绪上的衰竭）.Pines(1993)concluded,events undermine important and heroic beliefs gradually by heavy,chronic work-related stress.Eg.Retire from an important position.44普通心理学之心理压力与健康Antecedents components consequencesWork overloadLack of social supportLack of control,Inadequate recognition,rewardsExhaustion疲惫不堪Cynicism牢骚Lowered self-efficacy低自我效能Increased physiological illnessIncreased absenteeism,turnoverDecreased commitment to jobReduced productivity45普通心理学之心理压力与健康Posttraumatic创伤 stress disorders(PTSD）灾难经历：Mele:81.3%;women:74.2%。PTSD：too great fear；9%,or 45%。Psychological problems and disorders：depression,anxiety,schizophrenia,and eating disorder；灾难后精神安抚；Social support.46普通心理学之心理压力与健康Psychosomatic diseases（心身病）:由心理因素，尤其是情绪因素引起的，生理上的健康问题（有器质性兵病变）；hypertension,ulcer（溃疡）,asthma（哮喘）,skin disorder,migraine and tension headaches(偏头痛），stroke（中风）,tuberculosis（肺结合）,multiple sclerosis（硬化病）,arthritis（关节炎）,diabetes（糖尿病）,leukemia（白血病）,cancer,various types of infectious disease（传染病）,and the common cold（感冒）(Elliott,1989)。Effects of Stress:PhysicalEffects of Stress:Physical48普通心理学之心理压力与健康Type A and coronary heart disease（Mayer Friedman&Ray Rosenman,1974)Type A:strong competitiveness争强好胜,impatience没耐心 and time urgency，anger and hostility；Type B:relaxed,patient,easy going（随和）,amicable(友善）Type A:更容易得冠心病。49普通心理学之心理压力与健康50普通心理学之心理压力与健康AngerandhostilityMoreanger,andhigherriskofcoronaryevents51普通心理学之心理压力与健康情绪反应与心脏病情绪反应增加心血管系统负担；负情绪反应（anger,stress)心血管病人-myocardial ischemia（心肌缺血）、chest pain（胸疼）等症状。心脏病人在治疗过程中要尽可能地保持平静心境，避免情绪刺激；52普通心理学之心理压力与健康抑郁与心脏病抑郁病人的心率比较高；Pratt,et al.(1996)发现，在他13年的临床经验看，在初诊心脏病人中，抑郁的病人是其他类型病人的4倍。愤怒、悲伤：心率上升；恐惧、厌恶：心率下降;53普通心理学之心理压力与健康Stress and immune functioning免疫反应：lymphocytes（淋巴细胞）的功能，以抵抗外来细菌、滤过性病毒媒体、外物的入侵。Stress reduced immune activity（动物和人类）54普通心理学之心理压力与健康Featured study:Connecting Stress to the common cold Cohen&Tyrrell(1993)Subjects:154(men),266(women)Method:X:High-or Low-stress Y:Cold%结果：高紧张组患病概率更大。特点：考虑了人格和生活习惯等变量。55普通心理学之心理压力与健康人格变量的作用Stress and health：r=.20s.30s,(不能说紧张是引起疾病的必然因素)。人格因素可能起重要作用。56普通心理学之心理压力与健康Figure 13.12Figure 13.12The stress-illness correlation.One or more aspects of personality,physiology,or memory could play the role of a postulated third variable in the relationship between high stress and high incidence of illness.For example,neuroticism may lead some subjects to view more events as stressful and to remember more illness,thus inflating the apparent correlation between stress and illness.57普通心理学之心理压力与健康Factors moderation the impact of stressSocial support(社会支持);Optimism and conscientiousness(责任心)Autonomic reactivity(自主神经的反应性);58普通心理学之心理压力与健康Social Support(社会支持）Increased immune functioning(Uchino,et al.1999)Higher level of an antibody(Jemmott et al.,1988)Social support&social bond.Factors Moderating the Impact of StressFactors Moderating the Impact of Stress（影响紧张作用的调节因素）（影响紧张作用的调节因素）59普通心理学之心理压力与健康.健康促进策略健康促进策略达到最佳健康状态的十步达到最佳健康状态的十步60普通心理学之心理压力与健康 遵医嘱药物治疗改变饮食规定的卧床锻炼期复查康复训练化学疗法.积极治疗积极治疗为什么定期锻炼是降低压力为什么定期锻炼是降低压力,保持健康和长寿计保持健康和长寿计划的一个重要因素划的一个重要因素61普通心理学之心理压力与健康对于健康的心理影响为什么如果对你的朋友诉说自己的想法和感受可能对为什么如果对你的朋友诉说自己的想法和感受可能对你我健康产生积极的影响呢你我健康产生积极的影响呢?62普通心理学之心理压力与健康