Chapter 14: Stress, Coping and Health

  • Biopsychosocial Model - Physical illness is caused by a complex interaction of biological, psychological, and sociocultural factors
  • Health Psychology - How psychological factors relate to this promotion and maintenance of health and with the causation, prevention, and treatment of illness

The Nature of Stress

  • Stress - Any circumstances that threaten or are perceived to threaten one's well-being and that thereby tax one's coping abilities
  • Threat \rightarrow  Immediate physical safety, long range security, self-esteem, reputation, peace of mind, or many other things that one values


Stress as an everyday event

  • Routine hassles may have significant harmful effect on mental and physical health


Appraisal = Stress lies in the eye of the beholder

  • Primary Appraisal - Initial evaluation of whether an event is irrelevant to you, relevant but not threatening or stressful
  • When event is viewed as stressful \rightarrow  Secondary Appraisal
  • Evaluation of your coping resources and options for dealing with it
  • Example \rightarrow  Primary Appraisal - Determine whether you saw an upcoming exam stressful
  • Secondary Appraisal - Determine how stressful the exam appeared, in light of your assessment of your ability to deal with the even
  • Anxious, neurotics, unhappy feel more stress


Major Types of Stress

  • Acute Stressors - Threatening events with relatively short duration and a clear point
  • Example \rightarrow  Dealing with the challenge of a major exam
  • Chronic Stressors - Threatening events with relatively long duration and no readily apparent time limit
  • Example \rightarrow  Persistent finanical strains produced by huge credit card debts
  • Frustration - Experienced whenever the pursuit of some goal is thwarted
  • Brief, insignificant
  • Conflict - Two or more incompatible motivations or behavioural impulses compete for expression
  • (Freud) internal conflicts cause psychological distress
  • Approach - Approach Conflict - A choice must be made between two attractive goals
  • Only can choose just one of the two goals
  • Least stressful
  • Avoidance - Avoidance Conflict - A choice must be made between two unattractive goals
  • Most unpleasant and highly stressful
  • Approach - Avoidance Conflict - A choice must be made about whether to pursue a single goal that has been attractive and unattractive aspects
  • Produces vacillation (going back and forth, beset by indecision)
  • Life Changes - Any substantial alterations in one's living circumstances that require readjustment
  • Pressure - Expectations or demands that one behave in a certain way


Responding to Stress

Emotional responses

  • Link between specific cognitive reactions to stress (appraisals) and specific emotions
  • Example \rightarrow  Self blame leading to guilt, helplessness to sadness
  • Common emotional responses to stress
  • Annoyance, anger, rage
  • Apprehension, anxiety, fear
  • Dejection, sadness, grief
  • Positive emotional style is associated with an enhanced immune response


Effects of emotional arousal

  • Strong emotional arousal can interfere with efforts to cope with stress
  • Example \rightarrow  High emotional arousal can interfere with attention and memory retrieval and can impair judgment and decision making
  • Task performance should improve with increased emotional arousal

  • More complex task = decrease of optimal level of arousal (for peak performance)


Physiological responses

  • Fight or Flight Response - Physiological reaction to threat in which the autonomic nervous system mobilizes the organism for attacking (fight) or fleeing (flight) an enemy
  • Mediated by sympathetic division of the ANS
  • General Adaptation Syndrome - Model of the body's stress response, consisting of three stages
  1. Alarm Reaction \rightarrow  Organism first recognizes the existence of a threat
  2. Physiological arousal occurs
  3. Resistance Stage \rightarrow  After prolonged stress, coping efforts get under way
  4. Accustomed to the threat
  5. Exhaustion Stage \rightarrow  Stress continues over a substantial period of time
  6. (Selye) fighting stress are limited
  7. If stress cannot be overcome = body's resource depleted
  8. Disease of adaptation - organ systems damaged by stress


brain - body pathways

  1. Stress
  2. Hypothalamus activates autonomic nervous system
  3. Central part of the adrenal gland is stimulated
  4. Large amount of catecholammes is released into the bloodstream
  5. Mobilized for action
  6. Hypothalamus sends signals to the pituitary
  7. Pituitary secretes a hormona ACTH that stimulates the outer part of the adrenal glands (adrenal cortex)
  8. Corticosteroids are released
  9. Release chemicals that help increase energy and inhibit tissue inflammations in case of injury
  • Stress can interfere with neurogenesis
  • The formation of new neurons


Behavioural responses

  • Crucial dimension of the reaction to stress
  • Coping - Active efforts to master, reduce, or tolerate the demands created by stress
  • Coping effects may be helpful or maladaptive
  • Learned Helplessness - Passive behaviour produced by exposure to unavoidable events
  • Occurs when individuals come to believe that events are beyond their control
  • Can contribute to depression
  • People who can disengage from unattainable goals report better health and exhibit lower levels of a key stress hormone
  • "Giving up" = "Goal adjustment"
  • Catastrophic Thinking
  • Become highly self-critical in response to stress
  • Aggression - Any behaviour that is intended to hurt someone (physical/verbal)
  • Catharsis - Release of emotional tension


Indulging oneself

  • Self-Indulgence - Unwise patterns of eating, drinking, spending, money, gambling
  • New manifestation of this coping strategy = Inherent addiction
  • Excessive time online
  • Anger and depression when thwarted from being online
  • An establishing need for better equipment
  • Adverse consequences (arguments and lying about internet use)
  • Defense Mechanism - Largely unconscious reactions that protect a person from unpleasant emotions (anxiety and guilt)
  • Along with eight from previous chapter (Freud)
  • Denial of reality, fantasy, intellectualization, undoing
  • Self-Deception - Distorting reality so it does not appear so threatening
  • Constructive Coping - Helpful efforts that people make to deal with stressful events
  • Confronting problems directly
  • Based on reasonably realistic appraisals of stress and coping resources
  • Learning to recognize


The Effects of Stress on Psychological Functioning

  • Burnout - Physical and emotional exhaustion, cynicism and a lowered sense of self-efficacy that can be brought on gradually by chronic work-related stress
  • Cynicism - High negative attitudes toward oneself, work and life in general
  • Associated with increased absenteeism and reduced productivity
  • Causations
  • Work overload
  • Struggling with interpersonal conflicts at work
  • Lack of control over responsibilities and outcomes
  • Inadequate recognition
  • Fear of job loss
  • Risk of injury
  • Post-Traumatic Stress Disorder - Enduring psycholoigcal disturbance attributed to the experience of a major traumatic event
  • Vietnam War Veterans
  • Higher incidence of physical disorder
  • Chronic musculoskeletal disorders and obesity


The Effects of Stress on Physical Health

  • Continuous stress weakens the resistance to diseases and disrupts the functioning of hormonal and metabolic systems


Personality, Hostility, and heart disease

  • Coronary Heart Disease - Reduction in blood flow in the arteries
  • Initiation = Inflammation
  • Type A Personality
  • Strong competitive orientation
  • Impatience and time urgency
  • Anger and hostility
  • Ambitious
  • Hard driving perfectionists
  • Exceedingly time-conscious
  • Type B Personality
  • Relatively Relaxed
  • Patient
  • Easy-going
  • Amicable behaviour
  • Less Hurried
  • Less competitive
  • Less easily angered


EMotional Reactions, depression and heart disease

  • Strong emotional reaction might trigger heart attacks in individual
  • 30-70%
  • In the 2 hours immediately following an outburst of anger, there is nearly a fivefold jump in an individual's risk for a heart attack
  • More than a threefold increase in the risk of a stroke
  • Depressive Disorder - Persistent feelings of sadness and despair
  • Elevated rates of depression have been found among patients suffering from heart disease
  • The emotional dysfunction of depression may cause heart disease


Stress, Other diseases and immune functioning

  • Association between life stress and the cause of rheumatoid arthritis
  • Connection of stress and diabetes, herpes, fibromyalgia, inflammatory bowel syndrome
  • Immune Response - Body's defensive reaction to invasion by bacteria, viral agents or other foreign substances
  • Stress and suppressed immune activity
  • High stress = More likely to be infected by virus
  • Long term exposure to stress promotes chronic inflammation
  • Contributes to arthritis, osteoporosis, respiratory diseases, diabetes, cancers


Factors Moderating the Impact of Stress

  • Moderator variables can lessen the impact of stress on mental and physical health
  • Social Support - Various types of aid and environmental sustenance provided by members of one's social networks
  • High social support = greater immune functioning
  • Link between social support \rightarrow  overt emotional solace and instrumental aid from others
  • Americans prefer it
  • Implicit Social Support \rightarrow  The comfort that comes from knowing that one has access to close others who will be supportive
  • Asians benefit from it
  • Connections with the community provides health benefits
  • Optimism - General tendency to expect good outcomes
  • Leads good physical health
  • Longevity, good cardiovascular and immune health
  • Engage in action-oriented, problem-focused coping
  • Emphasize the positive in their appraisals of stressful events
  • Conscientiousness associated with good physical health
  • Less likely to harm oneself with alcohol or drugs
  • Rely on constructive coping strategies
  • Promote better adherence to medical advice and management
  • Associated with higher educational attainment and job performance
  • Hardiness - Constellation of attitudes, beliefs and behavioural tendencies that consist of three components
  • Commitment, control and challenge
  • Tend to approach difficult tasks as challenges
  • Viewed their work as important and were committed to it
  • Saw themselves as in control of their time and efforts


Stress mindset

  • Attitudes and beliefs about stress influences the capacity to handle stress
  • Stress-is-debilitating mindset
  • People assuming stress is mindful
  • Stress-is-enhancing mindset
  • People view stress as an invigorating challenge and opportunity for growth
  • Should be associated with intermediate arousal in response to stress


Positive effects of stress

  • Increased research on well-being, courage, perseverance, tolerance, resilience
  • Intermediate levels of adversity
  • Greatest resilience


Health-Impairing Behaviour

  • Smoking
  • Lack of exercise
  • Alcohol and drug use








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