psychological (having to pay a debt). Stress is more likely if an event has a negative outcome, but even some positive outcomes (such as a higher paying job with more responsibilities) can also cause stress. Stress occurs when an event is perceived as uncontrollable, unpredictable, or ambiguous. People react to stressors in a variety of ways The study of relations among social, psychological, and physical responses. People who are under severe and/or chronic stress are
more likely to catch a cold, develop an upper respiratory infection, or get the flu. Stress suppresses the ability of the immune system to function adequately and increases people's susceptibility to bacteria and viruses. When people are under stress, wounds heal more slowly, chronic diseases progress more rapidly, and vaccinations are less effective. People or animals under stress develop fewer antibodies following immunization for flu, hepatitis, and tetanus. Interpersonal interactions also affect cell activity and immune functioning. Hostility between spouses, for example, is associated with suppressed immune functioning. Loneliness and perceived social isolation are also associated with poor immune functioning. Happily married men have the best immune functioning.
The variables that affect how stress is experienced and how it affects health and other aspects of functioning. Personality traits are related to stress. As stated before, Type A personality (consistent striving for achievement, impatience and time urgency, and aggressiveness towards others) is
influenced more by stress than Type B personality (easy-going, flexible, and non-aggressive). Type A persons are usually keyed up and have difficultly relaxing. Persons who are hostile and angry, even if they do not have the full Type A pattern, have an increased risk for cardiovascular problems. Negative emotions and/or a pessimistic style have been linked to poorer immune functioning. Optimists, on the other hand, are sick less often and have lower blood pressure. One of the most important predictors of health is socioeconomic status, influenced by variables such as education, income, and occupation. Increased social support from family, significant others, friends, and others in the community also reduces the negative effects of stress.
Include relaxation training, biofeedback, and hypnosis. During biofeedback, patients learn to modify physical responses such as heart rate, respiration, and body temperature. During hypnosis, patients are taught to relax; a trance-like state is induced, and hypnotic suggestions are used to reduce pain and change pain-related thoughts. All of these interventions show positive effects. Cognitive behavioral treatments that involve relaxation, imagery, cognitive therapy (changing thoughts about pain), and behavioral changes can also be useful. Typically, more medical and non-medical strategies are integrated into a pain management program and is individually tailored for a patient's needs. Since the time of Hippocrates, physicians have proposed removing patients from society and housing them in environments where treatment can be provided in a humane setting. However, many of such hospitals and residences proved inadequate or even harmful that, during the 20th century, a movement came about to get patients out of institutions and back into community. At the time, it was felt that needed care would be best provided in smaller, more home-like environments, where patients could live with fewer residents. Placing patients in hospitals was common mainly because, until the 1960s, few treatments controlled aggressive behaviors effectively, making institutionalization the simplest way to protect the public.