Stress, Coping, & Health

Biopsychosocial Model n Physical illness caused by interactions between biological, psychological, and sociocultural factors n Biology operates in a psychosocial context

Health Psychology n Focuses on how psychosocial factors relate to promotion and maintenance of health, and the causation, prevention and treatment of illness

Stress n Any circumstances that threaten (real or perceived) one’s well-being, and subsequently tax one’s coping abilities n Subjective in nature (e.g., public speaking, flying, being supervised) n Seriousness of impending surgery unrelated to subjective stress

Types of Stress 1 Frustration 2 Conflict 3 Change 4 Pressure

Frustration Occurs in any situation where pursuit of a goal is thwarted Can’t get what you want traffic jams to unrequited love Unrealistic expectations and frustration

Conflict n Faced with two or more incompatible options, motivations or impulses n Freud n Kurt Lewin (1935) –approach-approach –avoidance-avoidance –approach-avoidance

Conflict n Approach-approach n choice between 2 attractive goals n win-win situation n least stressful

Conflict n Avoidance-avoidance n choice between 2 undesirable goals n lose-lose n quit miserable job vs. unemployment n highly stressful

Conflict n Approach-avoidance n Choice to pursue a single goal that has both attractive and undesirable qualities n Promotion = pay raise + increased responsibility n produces vacillation - back and forth behavior, indecision

Change n Any noticeable alterations in life circumstances that require readjustment n not obviously negative events n changes in relationships, work, finances, etc can be stressful, even when welcomed

Change n ustment_rating_scale.htm n People with higher SRRS more vulnerable to variety of physical ailments than lower scorers

Pressure n Expectations or demands that one behave a certain way n Pressure to succeed at work, to publish, to be cordial, etc n Pressures to conform to expectations of self or others n More strongly related to measures of mental health than SRRS and others

Responses to Stress n Emotional (annoyance, anger) n Physiological (racing pulse) n Behavioral (yelling, aggression, avoidance)

Emotional Responses n More likely unpleasant than pleasant n Associated with negative mood n Dependent on cognitive appraisal n Event --> self-blame --> guilt, sadness n Common reactions include: annoyance, anger, ragte, apprehension, anxiety, fear, dejection, sadness, grief, shame, envy, disgust, jealousy

Emotional Responses n Emotional response is motivating (reinforcing, punishing) n Extreme emotional arousal can interfere with coping and performance n Yerkes-Dodson Law (inverted U hypothesis) n optimal arousal dependent on task complexity

Physiological Response n Fight or flight: physiological reaction to threat n autonomic nervous system mobilized for attack or escape n evolutionary value n current adaptive value?

General Adaptation Syndrome n Hans Selye n noticed that animal physiological responses to stress were similar regardless of stressor n stress reactions are non-specific n coined the term stress

General Adaptation Syndrome n Model of body’s stress response 1 Alarm 2 Resistance 3 Exhaustion If stress can’t be overcome, body’s limited coping resources become depleted diseases of adaption

Behavioral Responses n Coping: Active efforts to master, reduce, or tolerate demands created by stress n may be positive or negative n Individuals exhibit styles of coping that are consistent across situations

Aggression n Frustration-aggression hypothesis n not inevitable n context specific n displacement n catharsis

Self Indulgence n Excessive consummatory behavior n shopping, smoking, drinking, eating, internet

Defensive Coping n Defense mechanisms: unconscious reactions that protect individual from adverse emotions (eg, anxiety, guilt) n shield from stress-eliciting events n self-deception, distortion of reality n Commonly unhealthy - avoidant

Adaptive/Constructive Coping n Relatively healthful efforts that people make to deal with stressors 1 Confronting problems directly task relevant action oriented rational consideration of options

Adaptive/Constructive Coping 2 Based on realistic appraisal of stress & coping resources 3 Recognizing and inhibiting potentially disruptive emotional reactions

Impact of Stress on Psychology n “Choke” effect n Burnout - physical, mental, emotional exhaustion attributable to longer-term exposure to stressful situations –fatigue, weakness, low energy –negative attitudes towards self, others, work –hopeless, helpless

Impact of Stress on Psychology n Burnout - need to believe our lives/work are meaningful, and our activities are useful, important, etc n “erosion of the spirit”

Post-traumatic Stress Disorder n Exposure to traumatic event that represented actual or threatened harm, and response involved intense fear, helplessness, or horror n Hyperarousal n Intrusive imagery n Avoidant behavior

Impact of Stress n Insomnia & sleep disturbance (e.g., nightmares) n poor academic performance n sexual problems n substance abuse n depression & dysthymia

Stress & Physical Health n Psychosomatic disorders: physical ailment with genuine organic basis that are caused in part by psychological factors (emotional distress) n not imagined ailments n hypertension, ulcers, migraines, rashes, asthma

Type A Behavior 1 Highly competitive 2 impatient 3 angry & hostile Type B: easy going, relaxed, amicable Type A associated with coronary artery, hypertension, premature mortality

Type A n Double the risk vs. Type B n May depend on other individual factors n attributable to greater physiological reactivity n ups and downs tax cardiovascular system n create more stress for selves n less social support & positive coping

Proximal effects of stress n Stress as catalyst for heart attacks n Stress management training improves outcome with cardiac patients n Depression and heart disease - cause or effect? n Depression - unhealthy behavior

Psychoneuroimmunology n Arthritis, yeast infections, herpes, dental disease, inflammatory bowel disease n Stress depletes and/or suppresses immune activity - vulnerability to infection n Student research - reduced immune activity surrounding final exams n same for recently divorced men

Stress Moderators n Social Support n students reporting greater social support had higher levels of antibody re: combat respiratory infections n strength of relationship rivals cigarette- cancer relationship

Stress Moderators n Optimism - expectance of positive outcome n related to lower incidence of illness and more effective immune functioning n cope in more adaptive ways n pessimists more likely to cope passively n pessimism and self-blame

Stress & Health Impairing Behavior n Poor nutrition n Sedentary lifestyle n Substance abuse n Smoking