CHAPTER 13 STRESS, COPING AND HEALTH

Table of Contents 2 CH. 13 STRESS Psychological states cause physical illness. Stress is any circumstance (real or perceived) that threatens a person’s well-being. When we feel severe stress, our ability to cope with it is impaired. Lee Stone/ Corbis

Table of Contents 3 BEHAVIORAL MEDICINE Centers for Disease Control (CDC) claim that half of the deaths in the US are due to people’s behaviors (smoking, alcoholism, unprotected sex, insufficient exercise, drugs, and poor nutrition). Psychologists and physicians have thus developed an interdisciplinary field of behavioral medicine that integrates behavioral knowledge with medical knowledge.

Table of Contents 4 Stress can be adaptive. In a fearful or stress- causing situation, we can run away and save our lives. Stress can be maladaptive. If it is prolonged (chronic stress), it increases our risk of illness and health problems. STRESS AND ILLNESS

Table of Contents THE RELATIONSHIP BETWEEN STRESS AND DISEASE Contagious diseases vs. chronic diseases Biopsychosocial model Health psychology Health promotion and maintenance Discovery of causation, prevention, and treatment Primary prevention, secondary prevention, tertiary prevention Changing pattern of what is the primary cause of death in last 100+ years.

Table of Contents Levels of Prevention Primary Prevention Prevent disease Identify causes Promote health behaviors Secondary Prevention Catch disease in early stages Prevent further deterioration Tertiary Prevention Manage illnesses with no cure

Table of Contents Figure 13-1, Changing pattern of illness for 100+ years

Table of Contents STRESS: AN EVERYDAY EVENT Major stressors vs. routine hassles Cumulative nature of stress Psychological Stress - Lazarus Cognitive appraisals: primary and secondary Major types of stress Frustration – blocked goal Conflict – two or more incompatible motivations Approach-approach, approach-avoidance, avoidance-avoidance – Change – having to adapt Holmes and Rahe – Social Readjustment Rating Scale – Life Change Units Pressure – expectations to behave in certain ways Perform/conform pressure and psychological symptoms –

Table of Contents

1)Potentially stressful objective events 2)Subjective cognitive appraisal 3)Response 1)Emotional 2)Physiological 3)Behavioral

Table of Contents RESPONDING TO STRESS EMOTIONALLY Emotional Responses Annoyance, anger, rage Apprehension, anxiety, fear Dejection, sadness, grief Positive emotions Emotional response and performance The inverted-U-hypothesis High emotion can sometimes negatively influence task performance, more so for highly complex tasks and less so for simple ones

Table of Contents

RESPONDING TO STRESS PHYSIOLOGICALLY Physiological Responses Fight-or-flight response Selye’s General Adaptation Syndrome Alarm Resistance Exhaustion

Table of Contents 15 GENERAL ADAPTATION SYNDROME According to Selye, a stress response to any kind of stimulation is similar. The stressed individual goes through three phases. EPA/ Yuri Kochetkov/ Landov

Table of Contents 16 THE STRESS RESPONSE SYSTEM Canon proposed that the stress response (fast) was a fight-or- flight response marked by the outpouring of epinephrine and norepinephrine from the inner adrenal glands, increasing heart and respiration rates, mobilizing sugar and fat, and dulling pain.

Table of Contents RESPONDING TO STRESS BEHAVIORALLY Behavioral Responses: Coping – emotion focused Frustration-aggression hypothesis catharsis Defensive Coping – ego defense mechanisms –Freud – Constructive Coping – problem focused

Table of Contents EFFECTS OF STRESS: BEHAVIORAL AND PSYCHOLOGICAL Impaired Task performance Burnout – antecedent-components- consequences Posttraumatic Stress Disorders (PTSD) – effects on hippocampus (cortisol) – slide prevelance of traumatic events Psychological problems and disorders – more in Chapter 14 Positive effects – eustress – Positive Psychology

Table of Contents 19 PERSONALITY TYPES Type A is a term used for competitive, hard- driving, impatient, verbally aggressive, and anger-prone people. Type B refers to easygoing, relaxed people (Friedman and Rosenman, 1974). Type A personalities are more likely to develop coronary heart disease.

Table of Contents 20 PESSIMISM AND HEART DISEASE Pessimistic adult men are twice as likely to develop heart disease over a 10-year period (Kubzansky et al., 2001).

Table of Contents Self-efficacy is the extent or strength of one's belief in one's own ability to complete tasks and reach goals.

Table of Contents EFFECTS OF STRESS: PHYSICAL Psychosomatic diseases Heart disease Cholesterol and inflammation and risks – Type A behavior - 3 elements strong competitiveness impatience and time urgency anger and hostility Emotional reactions and depression Stress and immune functioning Reduced immune activity Possible health problems linked to stress Stress-illness correlation

Table of Contents

24 STRESS AND COLDS People with the highest life stress scores were also the most vulnerable when exposed to an experimental cold virus.

Table of Contents 25 STRESS AND AIDS Stress and negative emotions may accelerate the progression from human immunodeficiency virus (HIV) to acquired immune deficiency syndrome (AIDS). UNAIDS/ G. Pirozzi

Table of Contents 26 STRESS AND CANCER Stress does not create cancer cells. Researchers disagree on whether stress influences the progression of cancer. However, they do agree that avoiding stress and having a hopeful attitude cannot reverse advanced cancer.

Table of Contents Table 13-4a, p. 531

Table of Contents XXX 13.11

Table of Contents 29 COPING WITH STRESS Reducing stress by changing events that cause stress or by changing how we react to stress is called problem-focused coping. Emotion-focused coping is when we cannot change a stressful situation, and we respond by attending to our own emotional needs.

Table of Contents 30 PERCEIVED CONTROL Research with rats and humans indicates that the absence of control over stressors is a predictor of health problems.

Table of Contents 31 EXPLANATORY STYLE People with an optimistic (instead of pessimistic) explanatory style tend to have more control over stressors, cope better with stressful events, have better moods, and have a stronger immune system.

Table of Contents 32 SOCIAL SUPPORT Supportive family members, marriage partners, and close friends help people cope with stress. Their immune functioning calms the cardiovascular system and lowers blood pressure. Bob Daemmrich/ Stock, Boston

Table of Contents 33 MANAGING STRESS Having a sense of control, an optimistic explanatory style, and social support can reduce stress and improve health.

Table of Contents 34 AEROBIC EXERCISE Can aerobic exercise boost spirits? Many studies suggest that aerobic exercise can elevate mood and well- being because aerobic exercise raises energy, increases self- confidence, and lowers tension, depression, and anxiety.

Table of Contents 35 BIOFEEDBACK, RELAXATION, AND MEDITATION Biofeedback systems use electronic devices to inform people about their physiological responses and gives them the chance to bring their response to a healthier range. Relaxation and meditation have similar effects in reducing tension and anxiety.

Table of Contents 36 LIFE-STYLE Modifying a Type-A lifestyle may reduce the recurrence of heart attacks. Ghislain and Marie David De Lossy/ Getty Images

Table of Contents 37 SPIRITUALITY & FAITH COMMUNITIES Regular religious attendance has been a reliable predictor of a longer life span with a reduced risk of dying.

Table of Contents 38 INTERVENING FACTORS Investigators suggest there are three factors that connect religious involvement and better health.

Table of Contents 39 MANAGING STRESS: SUMMARY How can stress be managed?

Table of Contents TYPES OF CONFLICT— COMPLETE ON WHITE SCRATCH PAPER Description in your own wordsIllustrated example Approach-approach Avoidance-avoidance Approach-avoidance