1. Chapter Fourteen Health

2. Copyright © Houghton Mifflin Company. All rights reserved.14-2 Health Psychology The application of psychology to the promotion of physical health and the prevention and treatment of illness. But isn’t physical illness a purely biological event?

3. Copyright © Houghton Mifflin Company. All rights reserved.14-3 Figure 14.1: Leading Causes of Death, 1900-2000

4. Copyright © Houghton Mifflin Company. All rights reserved.14-4 Stress and Health

5. Copyright © Houghton Mifflin Company. All rights reserved.14-5 Stress An unpleasant state of arousal that arises when we perceive that the demands of an event threaten our ability to cope effectively. Subjective appraisal of the situation determines: How we will experience the stress. What coping strategies we will use.

6. Copyright © Houghton Mifflin Company. All rights reserved.14-6 Figure 14.2: The Stress-and-Coping Process

7. Copyright © Houghton Mifflin Company. All rights reserved.14-7 What Causes Stress?

8. Copyright © Houghton Mifflin Company. All rights reserved.14-8 Scarring Effects of Natural Disasters (Krug et al., 1998)

9. Copyright © Houghton Mifflin Company. All rights reserved.14-9 Crises and Catastrophes Stressors: Anything that causes stress. Posttraumatic Stress Disorder (PTSD): A person experiences enduring physical and psychological symptoms after an extremely stressful event.

10. Copyright © Houghton Mifflin Company. All rights reserved.14-10 Major Life Events Change itself may cause stress by forcing us to adapt to new circumstances. Is change, positive or negative, necessarily harmful? No support that positive “stressors” are as harmful as negative stressors. Impact of change depends on person and how change is interpreted.

11. Copyright © Houghton Mifflin Company. All rights reserved.14-11 Putting Common Sense to the Test… The accumulation of daily hassles does more to make people sick than catastrophes or major life changes. Answer: True… Let’s see why!

12. Copyright © Houghton Mifflin Company. All rights reserved.14-12 Microstressors: The Hassles of Everyday Life Most common source of stress arises from the daily hassles that irritate us. e.g., environmental factors. “Microstressors” place a constant strain on us. The accumulation of daily hassles contributes more to illness than do major life events.

13. Copyright © Houghton Mifflin Company. All rights reserved.14-13 Figure 14.3: Stress in the Dormitory Baum & Valins, 1977.

14. Copyright © Houghton Mifflin Company. All rights reserved.14-14 How Does Stress Affect the Body?

15. Copyright © Houghton Mifflin Company. All rights reserved.14-15 Putting Common Sense to the Test… Like humans, zebras get ulcers. Answer: False… Let’s see why!

16. Copyright © Houghton Mifflin Company. All rights reserved.14-16 Figure 14.4: The General Adaptation Syndrome

17. Copyright © Houghton Mifflin Company. All rights reserved.14-17 What Stress Does to the Heart Type A Behavior Pattern: Characterized by extremes of competitive striving for achievement, a sense of time urgency, hostility, and aggression. A risk factor for coronary heart disease (CHD)? Hostility appears to be the main toxic ingredient in CHD.

18. Copyright © Houghton Mifflin Company. All rights reserved.14-18 Table 14.1: How “Hostile” Is Your Pattern of Behavior? From Anger Kills: 17 Strategies by Redford B. Williams, M.D., and Virginia Williams, Ph.D. Used by permission of Prentice-Hall, Inc., Upper Saddle River, NJ.

19. Copyright © Houghton Mifflin Company. All rights reserved.14-19 Why Is Hostility and CHD Linked? Cardiovascular system becomes overworked. Hostile people are less health conscious. Hostile people are physiologically reactive. In tense social situations they exhibit more intense cardiovascular reactions.

20. Copyright © Houghton Mifflin Company. All rights reserved.14-20 Putting Common Sense to the Test… Stress can weaken the heart, but it cannot affect the immune system. Answer: False… Let’s see why!

21. Copyright © Houghton Mifflin Company. All rights reserved.14-21 What Stress Does to the Immune System Stress compromises the body’s immune system. Psychoneuroimmunology (PNI): A subfield of psychology that examines the links among psychological factors, the brain and nervous system, and the immune system.

22. Copyright © Houghton Mifflin Company. All rights reserved.14-22 Figure 14.5: Pathways from Stress to Illness

23. Copyright © Houghton Mifflin Company. All rights reserved.14-23 Figure 14.6: Stress Duration and Illness From A. Baum and S. Valins, Architecture and Social Behavior: Psychological Studies of Social Density.

24. Copyright © Houghton Mifflin Company. All rights reserved.14-24 Process of Appraisal

25. Copyright © Houghton Mifflin Company. All rights reserved.14-25 Attributional and Explanatory Styles Seligman (1975): Depression results from learned helplessness. Abramson et al. (1989): Depression is a state of hopelessness brought on by the negative self-attributions people make for failure. Depressive explanatory style

26. Copyright © Houghton Mifflin Company. All rights reserved.14-26 Figure 14.7: Explanatory Styles and Depression PSYCHOLOGY 3/E by Kassin, Saul, (c) 1997. Reprinted by permission of Prentice-Hall, Inc., Upper Saddle River, NJ. From Psychology, 3rd Edition by Saul Kassin. Copyright (c) 1997. Reprinted by permission of Prentice-Hall, Inc., Upper Saddle River, NJ.

27. Copyright © Houghton Mifflin Company. All rights reserved.14-27 Hardiness Personality Style Individuals exhibit three characteristics: Commitment. Challenge. Control. Hardiness serves as a buffer against stress. Perception of control is most important factor.

28. Copyright © Houghton Mifflin Company. All rights reserved.14-28 Perception of Control The expectation that our behaviors can produce satisfying outcomes. Self-efficacy: Feelings of competence A state of mind that varies from one specific task and situation to another.

29. Copyright © Houghton Mifflin Company. All rights reserved.14-29 Putting Common Sense to the Test… When it comes to physical health, research does not support popular beliefs about the power of positive thinking. Answer: False…Let’s see why!

30. Copyright © Houghton Mifflin Company. All rights reserved.14-30 Optimism and Hope Optimism is a generalized tendency to expect positive outcomes. Characterized by a nondepressive explanatory style. Health can spring from optimism, as evident by the placebo effect.

31. Copyright © Houghton Mifflin Company. All rights reserved.14-31 Figure 14.8: Hopelessness and the Risk of Death TEMP CREDIT LINE: Everson, S. A. et al. (1996). Hopelessness and risk of mortality and incidence of myorcardial infarction and cancer. Psychosomatic Medicine, 58, 121-133. Reprinted by permission. From S.A. Everson, et al., "Hopelessness and Risk of Mortality and Incidence of Myocardial Infarction and Cancer," Psychosomatic Medicine, Vol. 58, 121-133. Reprinted with permission of Lippincott, Williams & Wilkins.

32. Copyright © Houghton Mifflin Company. All rights reserved.14-32 Pollyanna’s Health Positive thinking cannot guarantee good health. Victims of illness do not just have a “bad attitude.” Limits to positive thinking. Especially if it leads us to see ourselves and events in ways that are not realistic.

33. Copyright © Houghton Mifflin Company. All rights reserved.14-33 Ways of Coping with Stress

34. Copyright © Houghton Mifflin Company. All rights reserved.14-34 Table 14.2: Ways of Coping with Stress From Carver, C.S., M.F. Scheier, and J.K. Weintraub (1989). "Assessing Coping Strategies: A Theoretically Based Approach." Journal of Personality and Social Psychology, 56, 267-283. Copyright (c) 1989 by the American Psychological Association. Reprinted with permission.

35. Copyright © Houghton Mifflin Company. All rights reserved.14-35 Coping Strategies Problem-focused coping Emotion-focused coping Proactive coping

36. Copyright © Houghton Mifflin Company. All rights reserved.14-36 Problem-Focused Coping In dealing with essential tasks, it is better to confront and control than to avoid. Why is not always a beneficial approach? Can be physiologically taxing. Can lead to development of an over- controlling, stress-inducing Type A pattern of behavior.

37. Copyright © Houghton Mifflin Company. All rights reserved.14-37 Emotion-Focused Coping: Shutting Down One way to react to stress is by shutting down and trying to deny or suppress the unpleasant thoughts and feelings. Distraction can be an adaptive form of avoidance coping. Concealing one’s innermost thoughts and feelings can be physiologically taxing.

38. Copyright © Houghton Mifflin Company. All rights reserved.14-38 Emotion-Focused Coping: Opening Up Two aspects to opening up as an emotional means for coping with stress: One must acknowledge and understand one’s emotional reactions to important events. One must express those inner feelings to themselves and others. Why might opening up be helpful? Cathartic experience? Helps to gain insight into the problem?

39. Copyright © Houghton Mifflin Company. All rights reserved.14-39 Self-Focus: Getting Trapped vs. Getting Out Self-awareness theory revisited. A self-perpetuating feedback loop can occur: Being in a bad mood triggers self-focus. Self-focus in people with low self-esteem further worsens the mood. Gender differences: Women brood, and men act out.

40. Copyright © Houghton Mifflin Company. All rights reserved.14-40 Figure 14.9: Aspinwall and Taylor’s Model of Proactive Coping From Aspinwall and Taylor (1997) "A Stitch in Time: Self-Regulation and Proactive Coping," Psychological Bulletin, 121, 417-436. Copyright (c) 1997 by the American Psychological Association. Reprinted with permission.

41. Copyright © Houghton Mifflin Company. All rights reserved.14-41 Putting Common Sense to the Test… People who have lots of friends are healthier and live longer than those who live more isolated lives. Answer: True… Let’s see why!

42. Copyright © Houghton Mifflin Company. All rights reserved.14-42 Proactive Coping: Social Support The helpful coping resources provided by friends and other people. Has therapeutic effects on both our psychological and physical health. Social support and contact related to longevity.

43. Copyright © Houghton Mifflin Company. All rights reserved.14-43 Figure 14.10: Does Being Popular Always Promote Health? From Hamrick, N.S. Cohen, and M.S.Rodriguez (2002). "Being Popular Can be Healthy or Unhealthy Stress, Social Network Diversity, and Incidence of Upper Respiratory Infection" Health Psychology, 21, 294-298. Copyright (c) 2002 by the American Psychological Association. Reprinted with permission.

44. Copyright © Houghton Mifflin Company. All rights reserved.14-44 How Should Social Support Be Defined? Simple social contact model. How many social contacts does a person have? Intimacy model. Does the person have a close relationship with a significant other? Perceived availability. Does the person believe that ample support is available when needed?

45. Copyright © Houghton Mifflin Company. All rights reserved.14-45 Social Support: The Religious Connection Religion provides an important source of social and emotional support for many. Only 15-20% of world’s population have no religious affiliation. Is there a link between religiosity and health?

46. Copyright © Houghton Mifflin Company. All rights reserved.14-46 Treatment and Prevention

47. Copyright © Houghton Mifflin Company. All rights reserved.14-47 Treatment: The “Social” Ingredients All healers provide social support. All therapies offer a ray of hope. All therapies communicate and instill positive expectations. Patients can make meaningful choices about the treatment.

48. Copyright © Houghton Mifflin Company. All rights reserved.14-48 Figure 14.11: The Spread of AIDS Across the Globe

49. Copyright © Houghton Mifflin Company. All rights reserved.14-49 Putting Common Sense to the Test… As role models, celebrities have great influence over public health-care decisions. Answer: True…Let’s see why!

50. Copyright © Houghton Mifflin Company. All rights reserved.14-50 Figure 14.12: Aiming for Good Health

51. Copyright © Houghton Mifflin Company. All rights reserved.14-51 The Pursuit of Happiness

52. Copyright © Houghton Mifflin Company. All rights reserved.14-52 Subjective Well-Being One’s happiness, or life satisfaction, as measured by self-report. In self-reports, 75% of American adults describe themselves as happy. What predicts happiness? Social relationships Employment status Physical health

53. Copyright © Houghton Mifflin Company. All rights reserved.14-53 Figure 14.13: Wealth and Subjective Well-Being From Psychology, 3/E by Saul Kassin. Copyright © 1997. Reprinted by permission of Prentice Hall.

54. Copyright © Houghton Mifflin Company. All rights reserved.14-54 Why Doesn’t Money Contribute More to Subjective Well-Being? Perceptions of wealth are not absolute but relative to certain standards. Social comparison theory revisited. People use their own recent past as a basis of comparison. Adaptation-level theory revisited.

55. Copyright © Houghton Mifflin Company. All rights reserved.14-55 A Set Baseline Level of Happiness? Ratings of happiness are higher among identical twins than among fraternal twins. Fluctuations in mood that accompany positive and negative life events wear off over time. Happiness levels are relatively stable over time and place.