1. Stress, Health, and Coping

2. Stress – Sandy 2012

3. Stress – Sept. 11, 2001

4. Stress

5. Craig Scott

6. Chronic Daily Difficulties Daily difficulties can be caused by facing too many tasks, too little time, and too little control. Daily difficulties can be caused by the lack of social power and freedom:  being bullied  living in poverty  living under oppressive political conditions

7. Stress A negative emotional state in response to events that we perceive as taxing our resources or our ability to cope Stressors—events that are perceived as harmful, threatening, or challenging

8. Biopsychosocial Model of Health Biopsychosocial model—the belief that physical health and illness are determined by the complex interaction of biological, psychological, and social factors Health psychology—the study of how psychological factors influence health, illness, and health-related behaviors

9. When encountering a sudden trauma or other stressor, our body acts to increase our resistance to threat and harm. The Body’s Stress Response System Phase 1: The “fight or flight” sympathetic nervous system responds, reducing pain and increasing the heart rate. The core of the adrenal glands produces norepinephrine and epinephrine (adrenaline). This system, identified by Walter Cannon (1871- 1945), gives us energy to act. Phase 3: Exhaustion. Phase 2: The brain sends signals to the outer part of the adrenal glands to produce cortisol and other stress hormones. These focus us on planning adaptive coping strategies and resisting defeat by the stressor. Hans Selye (1907-1982) indentified this extended “resistance” phase of the stress response, followed by:

10. Change is stressful—e.g., death, marriage, divorce, loss of job, vacations, retirement Life Changes

11. Annoying events in everyday life— We all have “bad hair” days; these minor things can add up to lots of stress Daily Hassles

12. Unpredictable, large-scale events can be extremely stressful and change our lives; can lead to PTSD Catastrophes

13. Conflict Pull between two opposing desires or goals Approach-approach conflict choice between 2 appealing outcomes easy to resolve, low stress Avoidance-avoidance conflict choice between 2 unappealing outcomes more stressful than approach-approach Approach-avoidance conflict one goal with appealing & unappealing aspects most stressful type of conflict often see vacillation

14. Social and Cultural Sources of Stress Social conditions that promote stress poverty, racism, crime low SES tend to have highest levels of stress Culture clashes lead to stress company owned by different culture refugees, immigrants suffer acculturative stress

15. Health Effects of Stress Indirect effects—promote behaviors that jeopardize physical well being such as use of drugs, lack of sleep, poor concentration Direct effects—promote changes in body functions, leading to illness such as headaches and other physical symptoms

16. Endocrine Responses to Stress Fight or flight preparation of body Stress hormones—produced by adrenal glands Adrenal medulla—catecholamines Epinephrine and norepinephrine Increases respiration, BP, heart rate Adrenal cortex—corticosteroids Release stored energy Reduces inflammation and immune system responses

18. General Adaptation Syndrome Hans Selye Three stage process Alarm—intense arousal, mobilization of physical resources (catecholamines) Resistive—body actively resists stressors (corticosteroids) Exhaustion—more intense arousal but this leads to physical exhaustion and physical disorders

19. General Adaptation Syndrome Phase 1: Alarm Reaction Phase 2: Resistance (cope) Phase 3: Exhaustion Stress Resistance

20. Stress and the Immune System Psychoneuroimmunology—studies interaction between nervous system, endocrine system, and immune system Stress leads to suppressed immune function Chronic stress tends to have more influence Stress-weakened immune system increases likelihood of illness

21. Female and Male Stress Response  In response to a stressor such as the death of a loved one, women may “tend and befriend”: nurture themselves and others, and bond together.  The bonding hormone oxytocin may play a role in this bonding.  Women show behavioral and neurological signs of becoming more empathetic under stress.  Men under stress are more likely to socially withdraw and numb themselves with alcohol.  Men are also more likely to become aggressive under stress.  In either case, men’s behavior and brains show LESS empathy and less tuning in to others under stress.

22. Stress and the common cold

23. Stress Increases The Risk of Illness StressorsAppraisalThoughtsFeelingsBrain signals Hormonal action Immune suppression Risk of illness Here we see psycho- neuroimmunology in action:  psychological factors, such as appraisal, thoughts, and feelings.  neurological factors, such as brain signals engaging the stress response system.  immunology, such as stress hormone exposure which suppresses the immune system.

24. Immune Suppression Can Be Learned Ader & Cohen’s rat study UCS (drug) UCR (immune suppression) UCS (drug) UCR (immune suppression) CS (sweetened water) CS (sweetened water) CR (immune suppression)

25. Response to Stress Psychological Factors Perception of control Explanatory style Chronic negative emotions Hostility Social Factors Outside resources Friends and family Positive relationships

26. Perceived Control Sense of control decreases stress, anxiety, & depression Perceptions of control must be realistic to be adaptive

27. Stress factor: Perceived Level of Control  Only the middle, subordinate rat had increased ulcers.  It is not the level of shock, but the level of control over the shock, which created stress. Experiment: the left and middle rats below received shocks. The rat on the left was able to turn off the shocks for both rats. Which rat had the worst stress and health problems?

28. External vs. Internal Locus of Control External locus of control: we picture that a force outside of ourselves controls our fate. Too much internal locus of control: We blame ourselves for bad events, or have the illusion that we have the power to prevent bad events. Locus of control: Our perception of where the seat of power over our lives is located. Internal locus of control: we feel that we are in charge of ourselves and our circumstances. Too much external locus of control: We lose initiative, lose motivation to achieve, have more anxiety about what might happen to us, don’t bother developing willpower.

29. Perceived Control?

30. Explanatory style Optimism use external, unstable, & specific explanations for negative events predicts better health outcomes Pessimism use internal, stable, & global explanations for negative events predicts worse health outcomes

31. Stress, Personality, and Heart Disease Coronary heart disease is North America’s leading cause of death Habitually grouchy people tend to have poorer health outcomes Chronic negative emotions have negative effect on immune system

32. Depression and Heart Disease  Why does depression appear so often with heart disease? Does one cause the other?  One possible answer is that the two problems are both caused by chronic stress.  There may be an intervening variable: excessive inflammation.

33. Type A vs. type B Personality Type A time urgency intense ambition and competitiveness general hostility associated with heart disease Type B more easygoing not associated with heart disease

34. Research on type A Personality Time urgency & competitiveness not associated with poor health outcomes Negative emotions, anger, aggressive reactivity High levels of hostility increase chance of all disease (e.g., cancer)

35. Social Factors Promoting Health Social support—resources provided by others in times of need Emotional—expressions of concern, empathy, positive regard Tangible—direct assistance such as lending money, providing meals Informational—such as making good suggestions, advice, good referrals

36. Social Support Improves ability to cope with stress & benefits health person modifies appraisal of stressor’s significance to be less threatening helps to decrease intensity of physical reactions to stress make person less likely to experience negative emotions Pets as social support especially for elderly and people who live alone Gender and social support

37. Pets as social support

38. Health benefits of a companion

39. Coping Behavioral and cognitive responses used to deal with stressors Involves efforts to change circumstances or our interpretation of them to make them more favorable and less threatening

40. Coping Problem-focused coping managing or changing the stressor use if problem seems alterable confrontive coping planful problem solving Emotion-focused coping try to feel better about situation use if problem out of our control

41. Coping with Stress  Risk: magnifying emotional distress, especially if trying to change something that’s difficult to change (e.g. another person’s traits).  Risk: ignoring the problem.  We might focus on this style of coping when we perceive the stressor as something we cannot change. Problem-focused coping means reducing the stressors, such as by working out a conflict, or tackling a difficult project. Emotion-focused coping means reducing the emotional impact of stress by getting support, comfort, and perspective from others.

42. Problem-focused coping

43. Emotion-focused Coping Strategies Escape-avoidance—try to escape stressor Distancing—minimize impact of stressor Denial—refuse to acknowledge problem exists

44. Emotion-Focused Coping Strategies Wishful thinking—imagining stressor is magically gone Seeking social support—turn to friends, support people Positive reappraisal—minimize negative, emphasize positive Downward comparison—compare self to those less fortunate

45. Culture and Coping Individualist less likely to seek social support favor problem-focused coping Collectivist more oriented to social support favor emotion-focused coping

46. Active Coping Strategies Aerobic exercise can reduce stress, depression, & anxiety Effect above relaxation treatment

47. Aerobic Exercise and Mental Health  Aerobic exercise reduces depression and anxiety, and improves management of stress. How do we know?  Aerobic exercise is correlated with high confidence, vitality, and energy, and good mood.  Is there causation? Perhaps depression simply reduces exercise.  One study establishing causation: mildly depressed young women randomly assigned to an exercise group showed reduced depression caused by exercise alone.

48. Faith Communities and Health: Intervening Factors The health impact of religious involvement may be indirect. Health may improve because of the lifestyle and emotional factors associated with religious involvement, and not [just] the faith.

49. Happiness is:  a mood.  an attitude.  a social phenomenon.  a cognitive filter.  a way to stay hopeful, motivated, and connected to others. The feel-good, do-good phenomenon: when in a good mood, we do more for others. The reverse is also true: doing good feels good. Closer Look at a Particular Emotion: Happiness

50. A More Positive Psychology  Martin Seligman, who earlier kept dogs from escaping his shocks until they developed learned helplessness.  Developed Positive Psychology, the “scientific study of optimal human functioning,” finding ways to help people thrive.  Focus: building strengths, virtue, emotional well-being, resilience, optimism, sense of meaning. Three pillars of Positive Psychology: 1. Emotions, e.g. engagement 2. Character, e.g. courage 3. Groups, Culture, Institutions

51. Wealth and Well-Being: A Change in Goals  In the late 1960s, students entering college had a primary goal of developing a meaningful life philosophy.  Since 1977, being very well-off financially has become more of a primary goal for first year students.

52. Can Money Buy Happiness? Money seems to buy happiness when it lifts people out of extreme poverty. Otherwise, money doesn’t seem to help our mood much. 1. The average level of income (adjusted for inflation) and purchasing power has increased in the United States. 2. The percentage of people feeling very happy, though, has not followed the same trend of improvement.

53. Correlates of Happiness There also may be a genetic basis for a predisposition to happiness. Whether because of genes, culture, or personal history, we each seem to develop a mood “set point,” a level of happiness to which we keep returning. There are behaviors that seem to go with happiness. Whether they are the cause or the effect of happiness is not clear, but it can’t hurt to try them. Researchers have found that happy people tend to: Happiness seems not much related to other factors:  Have high self-esteem (in individualistic countries)  Be optimistic, outgoing, and agreeable  Have close friendships or a satisfying marriage  Have work and leisure that engage their skills  Have an active religious faith  Sleep well and exercise  Age (example: the woman at the laptop in the picture)  Gender (women are more often depressed, but also more often joyful)  Parenthood (having children or not)  Physical attractiveness

54.  Look beyond wealth for satisfaction.  Bring your habits in line with your goals; take control of your time.  Smile and act happy.  Find work and leisure that engages your skills.  Exercise, or just move!  Focus on the needs and wishes of others.  Work, rest, …and SLEEP.  Notice what goes well, and express gratitude.  Nurture spirituality, meaning, and community.  Make your close relationships a priority. Possible Ways to Increase Your Chances at Happiness

55. Relaxation Meditation can lower blood pressure, heart rate, oxygen consumption Can it help with stress-related disease?