1. Ch. 15 Stress and Health McElhaney

2. Ch 15 Key Topics ► 1. Big Picture definition and significance of stress- ► 2. Health – ► Behavior Health Risks ► Risk Factors ► Significance Chart Causes of Death page 550 ► Significance Pg 550 Chart High School Risky behavior ► Disease prone ► Health Promoting Behaviors ► Early Prevention ► 3. Stress ► Reinforce definition of stress and types of stress Eustress ► Biology and Stress- Autonomic nervous system ► Significance table Pg 554- Signs + symptoms of stress ► Role of Stressor and pressure ► Occupation and Burnout- how to prevent burnout ► Lazarus research and appraising stress ► 4. Coping ► Types of coping- problem focused and Emotion focused ► Frustration- external and Personal ► Reactions to Frustration- Hostility, Aggression, Displaced Aggression ► Conflicts- 4 basic forms- Approach-Approach, Avoidance-Avoidance, Approach-Avoidance, Multiple Conflicts ► Anxiety- Definition Defense mechanisms ► Denial, Repression, Reaction Formation, ► Regression, projection, Rationalization ► Compensation, Sublimation ► Learned Helplessness, Depression, role of hope ► Psychosomatic illness ► Type A and B personalities ► General Adaptation syndrome, alarm reaction, resistance, reaction ► Stress and the Immune System (what should we know) ► 5. Psychology in Action- ► What are the recommended ways to manage stress? ► Which are the best in your opinion? ► Pg 580- Summarize the wisdom of: “Coping with Frustration and Conflict”

3. 3 Parts of Chapter 1. Behavior health Risks and stress 2. What is stress and how does it affect us? 3. How can one cope/respond to stress and maintain health?

4. Big Picture definition and significance of stress- ► Health is affected by stress. ► “Stress occurs whenever a challenge or threat forces a person to adjust or adapt.” ► “Stress is a behavioral factor that directly affects personal wellbeing.”

5. Big Idea ► Stress is a major risk factor for illness and disease ► Stress is caused by interaction between people and the environment ► The body’s reaction to stress damages internal organs and immune system

6. What causes Stress? ► Appraisal of Stress ► Stress- is dependent on how we perceive events and react to them.

7. Behavior Risk Factors ► Stress- Is a major risk factor if Prolonged and Severe ► Behaviors that increase risk of disease and death ► Examples: ► High level of stress ► High blood pressure ► Cigarette smoking ► Abuse of alcohol ► Obesity/Overeating ► Unsafe sex ► Exposure to toxic substances ► Violence ► 45% of all deaths are due to unhealthy behavior = tobacco, drinking, drug use and lack of exercise

8. See Page 550 High School Risky Behavior ► Physical Fight 42% ► Carried Weapon 22% ► Had one or more drinks 30% ► Mary-Jane 33% ► Sex 53% ► Unsafe Sex 47% ► Cigarette Smokers 31% ► Eating Fatty Foods 34% ► Sedentary Lifestyle 34%

10. Stress- ► Eustress is good stress- example of challenges and rewards ► Stressor- an event that challenges or threatens a person

11. Stress Reaction ► Autonomic nervous system Autonomic nervous system Autonomic nervous system  Sympathetic and Parasympathetic  Arousal- with emotion ► ► Pressure- when a person must meet urgent external demand or expectations ► ► Variables to stress: ► ► Control (less stress) and lack of control causes stress (less controls = more stress) ► ► Unpredictable events add to stress ►► ►► ► ► Emotional shocks- intense, repeated, pressure, unpredictable, uncontrollable=stress is magnified

12. Burnout ► ► Nursing, teaching, police, social work and Burnout ► ► Burnout- being physically, mentally + emotionally drained ► ► Emotional Exhaustion- fatigued tense +apathetic; feeling all used up ► ► Cynicism- detached from job, “I don’t give a damn.” ► ► Feeling of reduced personal accomplishment ► ► Helpless, hopeless or angry, poor work performance ► ► Burnout is the opposite of –Job engagement (work seen as important and meaningful, challenging) ► ► To Prevent Burnout ► ► Adjust workload ► ► Keep social support (support gives encouragement)

13. Richard Lazarus- ► ► researcher said ► ► Cognitive appraisal/evaluation ► ► Making the appraisal of a situation= 1. 1. Primary Appraisal – Q: Am I ok or in trouble? a. a.Decide if the situation is relevant or irrelevant positive or negative 2. 2. Secondary Appraisal- Q: What can I do about this situation? a. a.Assess resources b. b.Choose a way to meet threat or challenge c. c.Coping with threats=coping

14. General Adaptation Syndrome ► Hans Selye (1950s) link link ► ► The G.A.S., alternately known as the stress syndrome, is what Selye came to call the process under which the body confronts Stress. ► ► Alarm, Resistance, Exhaustion ► ► First there is an "alarm reaction," in which the body prepares itself for "fight or flight." No organism can sustain this condition of excitement, however, and a second stage of adaptation ensues (provided the organism survives the first stage). In the second stage, a resistance to the stress is built. Finally, if the duration of the stress is sufficiently long, the body eventually enters a stage of exhaustion, a sort of aging "due to wear and tear."

15. General Adaptation Syndrome  Hans Selye (1950s)  Alarm Reaction-Threat produces Emergency Reaction, Body mobilizes for action, Body responds to cope with stress  Resistance – Body consolidates response- physiological defense to minimize tissue damage,  Nerurotransmitters carry messages to organs, adrenal glands release cortico-steroids= increase blood sugar for energy while reducing inflammation and pain. Reducing blood flow to other body functions (reproduction, digestion, growth) are gradually shut down…  over time body becomes depleted… Exhaustion:   At this phase, the stress has continued for some time. Your body’s ability to resist is lost because its adaptation energy supply is gone. Often referred to as overload, burnout, adrenal fatigue, maladaptation or dysfunction – Here is where stress levels go up and stay up!

18. Personality Types ► Disease Prone ► Chronic depression  Low exercise  Poor diet  Problematic sleep ► Anxious ► Hostile ► Frequently ill ► Health Promoting Behaviors ► Exercise ► Not excessive drinking ► No Tobacco ► Not over-eating

19. Personality Types Continued ► Type A ► High risk of heart attack ► Hard driving ► Ambitious ► Highly competitive ► Achievement oriented ► Persistent ► Time urgency ► Anger ► Hostility ► Hardy Personality ► People who can resist stress ► Sense of personal commitment  To self, to work, to family ► Sense of control over lives and work ► Tendency to see life as a series of challenges

20. Type B Personality ► ► These people tend to be productive under stress. ► ► They are very much relaxed, patient and have a lot of self control. ► ► One of the type B personality traits is that these people do not get irritated or angry easily. ► ► They are less competitive and their competitiveness is often productive with good intentions. ► ► They rarely tend to be aggressive or frustrated. ► ► People belonging to type B personality are also very much tolerant and flexible who can change in order to adapt to situations and changes. ► ► These people do not get hyper if their time is wasted and do not mind waiting in queues or wait to get their work done. ► ► Relaxation, enjoyment, fun comes very naturally to them. They spend their free time socializing, shopping or having a good time. ► ► They are very calm as compared to their highly stung counterparts (type A). People of type A personality often wish they were working rather than spending their time in leisure and the type B personality traits are just the opposite. ► ► People of B type personality tend to plan things in advance before executing them.

21. Coping with Threats: ► ► Problem-focused coping (control is the issue)   Need to manage or alter the distressing situation ►► ►► ► ► Emotion-Focused Coping: (when there is no control of the situation)   People try to control their emotional reactions to the situation

22. Frustration ► ► Extreme Situations + Responses ► ► Frustration-negative emotional state occurs when people are prevented from reaching desired goals (2 types) ►► ►► ► ► 1 External Frustration- outside force or individual impedes progress toward a goal (flat tire)   Delays success   Can be social obstacles = people   Or   Non-social = objects ►► ►► ► ► Frustration increases-  as strength of blocked motive increases- frustration increases ►► ►► ► ► 2. Personal Frustration- based on personal characteristics or limitations

23. Reactions to Frustration: ► ► Aggression- any response with intent of harming a person or object   Most frequent response to frustration ► ► *Persistence as a response to frustration- varied vigorous efforts to overcome frustration help ►► ►► ► ► Displaced Aggression   Focusing aggression toward some-other person or object- whoever or whatever is available ► ► Redirection – usually to a safe, less likely to retaliate direction ►► ►► ► ► *Chains of displacement ► ► *Hostility and violence are largely due to displaced aggression ► ► *Scapegoating- available sources blaming ► ► Withdrawal or Escape, Avoidance

24. Conflicts ► ► Conflict- a person must choose between contradictory desires, needs and motive demands ► ► 1. Approach-Approach Conflicts (weak conflict) ► ► Two positive choices ► ► Two desirable alternatives ► ► 2. Avoidance-Avoidance Conflicts (difficult to resolve) ► ► Choice between 2 negative undesirable alternatives ► ► Based on personal needs or bias ► ► 3. Approach-Avoidance Conflicts (difficult to resolve)   People are attracted to   +same goal or activity   Repelled     fear + attraction—could result in ambivalence= mixed positive and negative feelings ► ► Multiple Conflicts- neither complete positive or negative options   AKA- double approach-avoidance- each alternative has positive + negative qualities

25. Psychological Defense ► ► Psychological Defense ► ► Psycho-dynamic-Freud identified ► ► Anxiety- comes with threatening situations ► ► Tense, uneasy, apprehension, worried, vulnerable ► ► Emotion-focused coping = defense mechanism helps us reduce anxiety ► ► Defense Mechanism (definition) (Psychodynamic) ► ► Any mental process used to avoid, deny, or distort sources of threat or anxiety ► ► Help us keep from being overwhelmed by immediate threats

26. Defense Mechanisms 1. 1. Displaced Aggression 2. 2. Conflicts- 3. 3. Approach-Approach, 4. 4. Avoidance-Avoidance, 5. 5. Approach-Avoidance 6. 6. Multiple Conflicts 7. 7. Defense mechanisms 8. 8. Repression 9. 9. Reaction Formation 10. 10. Regression 11. 11. Projection 12. 12. Rationalization 13. 13. Compensation 14. 14. Sublimation 15. 15. Learned Helplessness 16. 16. Acting out 17. 17. Affiliation 18. 18. Passive 19. 19. aggression 20. 20. Avoidance 21. 21. Altruism 22. 22. Humor

27. Psychosomatic illness: ► ► Psychological factors contribute to actual body damage ► ► Not hypochondrias Examples: can be caused by stress ► ► Dyspepsia- stomach pain- not an ulcer ► ► Eczema ► ► Hives ► ► Migrane headache ► ► Rheumatoid arthritis ► ► Hypertension ► ► Colitis ► ► Heart disease ► ► Head, neck ache ► ► Back ache ► ► Indigestion ► ► Chronic diarrhea ► ► Fatigue ► ► Insomnia ► Sexual dysfunction

28. Personality Types Related to Stress ► Type A personality ► High risk of heart attack ► Hard driving ► Ambitious ► Highly competitive ► Achievement oriented ► Persistent ► Time urgency ► Anger ► Hostility ► Very rigid in attitudes ► These people are also prone to heart diseases because of the tensions, stress and worrying attitude. Type B Personality ► These people tend to be productive under stress. ► They are very much relaxed, patient and have a lot of self control. ► One of the type B personality traits is that these people do not get irritated or angry easily. ► They are less competitive and their competitiveness is often productive with good intentions. ► They rarely tend to be aggressive or frustrated. ► People belonging to type B personality are also very much tolerant and flexible who can change in order to adapt to situations and changes. ► These people do not get hyper if their time is wasted and do not mind waiting in queues or wait to get their work done. ► Relaxation, enjoyment, fun comes very naturally to them. They spend their free time socializing, shopping or having a good time. ► They are very calm as compared to their highly stung counterparts (type A). People of type A personality often wish they were working rather than spending their time in leisure and the type B personality traits are just the opposite. ► People of B type personality tend to plan things in advance before executing them.