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Health Psych. Lecture 4 (Early Life Stress)

by: Michelle Venegas

Health Psych. Lecture 4 (Early Life Stress) Psc 126

Marketplace > University of California - Davis > Psychology > Psc 126 > Health Psych Lecture 4 Early Life Stress
Michelle Venegas
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About this Document

These are the fully completed slides from the 4th lecture
Health Psychology
Dr. Camelia Hostinar
Class Notes
health, Psychology, life, stress




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This 33 page Class Notes was uploaded by Michelle Venegas on Wednesday October 5, 2016. The Class Notes belongs to Psc 126 at University of California - Davis taught by Dr. Camelia Hostinar in Fall 2016. Since its upload, it has received 64 views. For similar materials see Health Psychology in Psychology at University of California - Davis.


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Date Created: 10/05/16
EARLY-LIFE STRESS O C T . 3 U C DAVI S1 6 The Foundations of Health Video notes Biology of healthy development is link between experiences we have (pos and Neg) and the kind of developmental exp. That we sustain over lifetime. Early experience is literally built in to bodies. Toxic stress Foundations of healthy development 1. Environment – Security, close attachment -> 2. Stable responsible relationships 3. Good nutrition – Micro AND Macro nutrition. Also availability of food in community. Caregiver & community capacities – Brings residents together and benefits children and adults. (ex. Churches, community groups) Very few social policies that do NOT have an impact Fundamental impacts: Child care, early education, primary health care, public health, private sector agents, zoning regulations. OVERVIEW • 1) What Are Adverse Childhood Experiences (ACEs)? • 2) Pathways from ACEs to Health • 3) Interventions 1) ADVERSE CHILDHOOD EXPERIENCES • ACE Study: ACE study 17,337 adult members of an HMO (Kaiser Permanente in SD partnered w/Centers for Diseases Control) • Looked through records for participants and mailed surveys as well as phone interviews, about childhood experiences. • Extensive data on psychosocial and medical outcomes from medical records and surveys • Asked members to complete a 10-question survey regarding their childhood experiences ACE STUDY: RESULTS Depressed Mood (>2 weeks) in Past Year 60% 50% 40% 30% 20% Prevalence (%) 10% 0% 0 1 2 3 4 or more ACEs ACE STUDY: RESULTS Ever attempted suicide 20% 15% 10% 5% Prevalence (%) 0% 0 1 2 3 4 or more ACEs ACE STUDY: RESULTS Severe obesity (BMI>35) 14% 12% 10% 8% 6% Prevalence (%) 4% 2% 0% 0 1 2 3 4 or more ACEs ACE STUDY: RESULTS Heart disease 6% 5% 4% 3% 2% Prevalence (%) 1% 0% 0 1 2 3 4 or more ACEs ACE STUDY: RESULTS Bronchitis or emphysema 10% 8% 6% 4% Prevalence (%) 2% 0% 0 1 2 3 4 or more ACEs ACE STUDY: RESULTS Anda et al., 2006 IN-CLASS DISCUSSION • Do you think questions about ACEs should be included in routine medical visits? Discuss with your neighbor for the next 5 minutes. BUT HOW DO WE KNOW THESE EFFECTS ARE DUE TO CHILDHOOD ADVERSITY AND NOT ADULT CONDITIONS? A) HEALTH DISPARITIES EVIDENT IN CHILDHOOD FPL = federal poverty level Data from the National Health Interview Survey Braveman et al. (2010, American Journal of Public Health) B) CHILDHOOD SOCIOECONOMIC STATUS IS ASSOCIATED WITH POOR HEALTH INDEPENDENTLY OF ADULT SES Johns Hopkins Medical School Graduates Study Kittleson et al., 2006 2. WHAT ARE THE PATHWAYS FROM ACES TO POOR HEALTH? • 1) Cumulative exposure to stressful experiences –Through “wear and tear”/allostatic load mechanisms • 2) Latent effects –Through “biological embedding” during sensitive periods in development –Developmental programming (sometimes prenatally) –Epigenetic changes Shonkoff, Boyce & McEwen PRENATAL INFLUENCES • Low birth weight  metabolic changes leading to obesity and cardiovascular risk • Idea of “predictive adaptation” • Prenatal influences are said to lead to “programming” because they occur during sensitive periods for the development of many organs and systems • Example of Dutch Famine Study DUTCH FAMINE STUDY DUTCH FAMINE STUDY -RESULTS • Diabetes: People exposed to undernutrition in utero had more diabetes. But found no evidence that diabetes progresses more rapidly among these people • Cardiovascular disease: Among People conceived during the famine, there was a 3-fold increase in coronary heart disease prevalence. • Obesity: Women conceived n famine were more likely to be obese • Stress: People conceived in famine had higher blood pressure rise under stress (as adults). • ALL COMPARED TO PEOPLE BORN AFTER FAMINE DOHAD: AN EMERGING NEW FIELD • DOHaD (Developmental Origins of Health and Disease) = The study of fetal and early postnatal conditions and how they might shape lifelong patterns of health and disease. DOHAD Things that define us How we dress, job, choices we make, genetic difference BUT ALSO Environment and genetic interactinos. DOHAD investigates diseases you were First DOHAD study – investigated fetal life and adult life (During Dutch Famine) Significant because it provided a rare starvation event. Depending on exposure to malnutrition, infants grew up differently. New and developing field. Mechanisms involve epigenetics – Genes change in response to environmental changes SUMMARY Environment has clear impacts on future health DNA actively interacts w/environment to be modified. WHY IS PSYCHOSOCIAL ADVERSITY BAD FOR HEALTH? THE DOUBLE JEOPARDY OF EARLY ADVERSITY Children represent next generation. Will we be successful? Neglect of the child = Child not getting the interactions they need to shape the architecture of brain. Biological sign of danger (When child is not attended to) Connections between nerves fail to form in brain. 4 Types of Unresponsive Care 1. Occasional inattention – No harm. When parent pays attention but sometimes doesn’t. Helps build independence. 2. Chronic under stimulation – Regular basis child has less interaction w/ adults around them 3. Sever Neglect – Prolonged periods of inattention/lack of responsiveness. Not being fed, bathed, etc; enough. Lots of needs NOT met. 4. Severe Neglect in Institutional Setting – Often termed “assessment care”, “temporary care” HOW DOES STRESS CAUSE ILLNESS? Stress Direct physiological Health behavior effects changes • Increased smoking and • Elevated lipids alcohol use • Elevated blood pressure • Decreased immunity • Poor nutrition • Decreased sleep • Increased hormonal • Increased drug use activity • Little exercise HOW DOES STRESS CAUSE ILLNESS? Stress Psychosocial resources Health care • Decreased adherence to • Threatened social support treatment • Reduced optimism • Delay in seeking care • Threats to self-esteem • Obscured symptom profile • Lower sense of mastery • Decreased likelihood of seeking care 3) INTERVENTIONS • 1) Individual prevention and treatment –Treat one person at a time through various types of treatment and therapy • 2) Policy solutions POLICY SOLUTIONS • A) Reduce early-life “toxic stress”. – Acknowledge child maltreatment as a public health issue. • B) Invest in early childhood education programs. – Could have health complications if you don’t. (not just educational) • C) Use child welfare services for health promotion. – Could use child-protective services to provider referrals for children with developmental delays or disabilities. Shonkoff, Boyce & McEwen EXAMPLE: NURSE HOME VISITING PROGRAMS Goals: • Improve prenatal care. • Prevent child injuries, child abuse, neglect, or maltreatment, and reduce emergency department visits. • Improve school readiness and achievement. • Reduce crime, including domestic violence. • Improve family economic self-sufficiency. • Improve the coordination and referrals for other community resources and supports. WHAT OTHER SOLUTIONS CAN YOU THINK OF? • Extend hospital stays so mom can get more attention and training. • Paternal leave. • More access to information for everyone. HOW DO WE BUILD A HEALTHIER SOCIETY? 1) What is Sapolsky’s 1. Lack of control or lack of hierarchy argument about the root 2. Don’t be aggressive, be socially connected w/people. Absence of cause of stress in societstress will impact society positively. Social affiliations are a remarkably 2) What is his suggestionpowerful thing. GIVE more TAKE less. for improving the health 3. Yeah human society? 4. Because people who are aggressive and believe they’re an alpha tend 3) Do you think it would to be more likely to make unsafe decisions. Being less stressed will keep work? you healthier. 4) Why or why not? If you were aggressive and not socially connected, you died. All alpha males were gone. Left w/twice as many females than males. THRIVED in the absence of stress. Be Well!


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