Chapter 13
Stress, Coping and Health – 8th Edition
Table of Contents
The Relationship Between Stress and Disease
Contagious diseases vs. chronic diseases Biopsychosocial model Why?
– The Biomedical Model is unable to fully account for health– Mind-body question– Biomedical treatments only– Failures to account for many psychological factors and health– Placebo effects – how to explain
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. – F 13.1
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 nocure
Table of ContentsFigure 13.1 Changing patterns of illness
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 – Figure 13.2
– Change – having to adapt• Holmes and Rahe – Social Readjustment Rating Scale – Life Change
Units – Table 13.1– Pressure – expectations to behave in certain ways
• Perform/conform• Figure 13.3 – pressure and psychological symptoms – Weiten (1988)
Overview of Stress Process – Figure 13.4
Table of Contents
Richard Lazarus (1966) (p. 512) defined psychological stress as “…a generic term for the whole area of problems that includes the stimuli producing stress reactions, the reactions themselves, and the various intervening processes.”
Lazarus and Folkman (1984) define psychological stress as “a particular relationship between the person and the environment that is appraised by the person as taxing or exceeding his or her resources and endangering his or her well being.”
Psychological Stress
Table of Contents
Appraisal Process
The primary appraisal process determines whether the environment is perceived as psychologically threatening, harmful, or challenging to the person.
The secondary appraisal process is a complex evaluative process in which a person considers resources available to cope with the primarily appraised stressor.
Table of Contents
Table of ContentsFigure 13-3 – Pressure and psychological symptoms (Weiten, 1988, 1998)
Table of Contents
Table of Contents
Responding to Stress Emotionally
Emotional Responses– Annoyance, anger, rage– Apprehension, anxiety, fear– Dejection, sadness, grief– Positive emotions– Slide 12, after 9/11 – correlations between emotion and
resilience
Emotional response and performance– The inverted-U-hypothesis – Figure 13.5 – performance and
task complexity
Table of Contents
Table 13-2, p. 518
XXXXXXXX
Slide 12
Table of Contents
Table of Contents
Responding to Stress Physiologically
Physiological Responses– Fight-or-flight response– Selye’s General Adaptation Syndrome
• Alarm
• Resistance
• Exhaustion
Brain-body pathways in stress – Figure 13.6– sympathetic adrenal medullary (SAM)– hypothalamic pituitary adrencortical (HPA)
Table of Contents
Physiological Stress
Hans Selye first introduced the term stress to medicine in 1936. He noted that animals were induced by a variety of stimuli to show the “syndrome of just being sick” which resulted in adrenal enlargement, gastrointestinal ulcers, shrinkage of the thymus and lymph nodes. This reaction was termed the “general adaptation syndrome” and “stress is the nonspecific response of the body to any demand made upon it”.
Table of Contents
Figure 13.6 – Brain-body pathways in stress: SAM and HPA systems
Lundberg (2002), “[Two] neuroendocrine systems have been of particular interest in the study of stress; the sympathetic adrenal medullary (SAM) system with secretion of the two catecholamines, epinephrine and norepinephrine, and the the hypothalamic pituitary adrencortical (HPA) system with the secretion of cortisol.”
Table of Contents
Responding to Stress Behaviorally
Behavioral Responses: Coping – emotion focused– Frustration-aggression hypothesis– catharsis
Defensive Coping – ego defense mechanisms –Freud – Table 13.2
Constructive Coping – problem focused
Table of Contents
Table 13-3, p. 523
Table 13.2
XXXXXX
Table of Contents
Emotion-focused coping and Problem-focused coping “Emotion-focused (or palliative) coping refers to
thoughts or actions whose goal is to relieve the emotional impact of stress. These are apt to be mainly palliative in the sense that such strategies of coping do not actually alter the threatening or damaging conditions but make the person feel better.” Monat and Lazarus (1991, p. 6)
“Problem-focused coping refers to efforts to improve the troubled person-environment relationship by changing things, for example, by seeking information about what to do, by holding back from impulsive and premature actions, and by confronting the person or persons responsible for one’s difficulty.” Monat and Lazarus (1991, p. 6)
Table of Contents
Effects of Stress: Behavioral and Psychological Impaired Task performance Burnout – antecedent-components-consequences –
Figure 13.7 Posttraumatic Stress Disorders (PTSD) – effects on
hippocampus (cortisol) – prevelance of traumatic events – Slide 22
Reaction to traumatic stress – Figure 13.8 Psychological problems and disorders – more in
Chapter 14 Positive effects – eustress – Positive Psychology –
Flow (Csikszentmihalyi)
Table of ContentsFigure 13.7 – The antecedents, components,and consequences of burnout
Table of Contents
XXXXXX Slide 22
Table of Contents
Effects of Stress: Physical
Psychosomatic diseases Heart disease
– Cholesterol and inflammation (C-reactive protein) and risks – Figure 13.9
– Type A behavior - 3 elements• strong competitiveness• impatience and time urgency• anger and hostility (note in F 13.10 most related to cornary
events)
– Emotional reactions and depression – Figure 13.11 – study by Pennix et al. (2001) – anger and coronary risk
Stress and immune functioning– Reduced immune activity – Possible health problems linked to stress – Table 13.3– Stress-illness correlation – Figure 13.12
Table of Contents
Table of ContentsTable 13.3a Health Problems that may be Linked to Stress
Table of Contents
Table 13.3b Health Problems that may be Linked to Stress
Table of Contents
XXX 13.12
Table of Contents
Factors Moderating the Impact of Stress
Social support– The perceived comfort, caring, esteem or help received from
others.– Types: emotional, belongingness, instrumental (tangible),
informational, esteem/relational, and network (Facebook and MySpace?)
– The existence or quantity of social relationships– the amount of assistance individuals believe is available to them– the amount of assistance individuals receive– Alameda County Study in 1965 – related to health outcomes, tend
to live longer– Increased immune functioning
Optimism– expectation of good things will happen and bad things will not
happen, contrasted to pessimism– Related to psychological well-being, physical well-being– More adaptive coping– Pessimistic explanatory style
Conscientiousness– Fostering better health habits
Autonomic reactivity– Cardiovascular reactivity to stress
Table of Contents
Health-Impairing Behaviors
Smoking – prevalence in U.S. - Figure 13.13– Smoking cessation – Figure 13.14
Poor nutrition – obesity – “Super Size” generation– Cholesterol and coronary risk – Figure 13.15
– High fructose corn syrup effects Lack of exercise – increased T.V. watching effects study Obesity – BMI – United States 2005 & 2008 data – CDC – Slide
33 & 34 – changes over the years Alcohol and drug use Risky sexual behavior Transmission, misconceptions, and prevention of AIDS – AIDS
Risk Knowledge Test - Figure 13.16
Table of ContentsFigure 13.13 The prevalence of smoking in the United States
Table of ContentsFigure 13.14 Quitting smoking and cancer risk
Table of Contents
Fig. 13-14, p. 535
Figure 13.15 – The link between cholesterol and coronary risk
Table of Contents
BMI Classifications – Slide 30 BMI = 19-25; Normal; Low Risk BMI = 25-30; Moderately overweight; Some Risk BMI = 30-35; Class 1 obesity; High Risk BMI = 35-40; Class 2 obesity; Very High Risk BMI> 40; Class 3 obesity; Extreme Risk
BMI > 30, or ~ 30 lbs. overweight for 5'4" person for 2005 - CDC
Table of Contents
BMI Classifications – Slide 31 BMI = 19-25; Normal; Low Risk BMI = 25-30; Moderately overweight; Some Risk BMI = 30-35; Class 1 obesity; High Risk BMI = 35-40; Class 2 obesity; Very High Risk BMI> 40; Class 3 obesity; Extreme Risk
BMI > 30, or ~ 30 lbs. overweight for 5'4" person for 2008 - CDC
Table of Contents
Reactions to Illness
Seeking treatment– Ignoring physical symptoms
Communication with health care providers– Barriers to effective communication
Following medical advice– Noncompliance
Biopsychosocial factors in health – Figure 13.17
Table of Contents
Figure 13.17 –Biopsychosocial factors in health
Table of Contents
Stress Management
Relationship to coping to self-esteem Cognitive reappraisal – Ellis’s model – Figure 13.18 Humor – Figure 13.19 Relaxation Response – Benson – Figure 13.20 and
Slide 41 Stress Inoculation Training – Slide 42 Physical fitness and mortality – Figure 13.21
Table of ContentsFigure 13.18 – Albert Ellis’s A-B-C model of emotional reactions
Table of Contents
Fig. 13-18, p. 543
Figure 13.19 – Possible examination for the link between humor and wellness
Table of Contents
Stress management techniques -adapted from Monat & Lazarus (1991)
Environment/Lifestyle: time management, proper nutrition, exercise, finding alternatives to frustrated goals, stopping bad habits
Personality/Perception: assertiveness training, thought stopping, refuting irrational ideas, stress inoculation, modifying type A behavior
Biological responses: progressive relaxation, relaxation response, meditation, breathing exercises, biofeedback, autogenics
Table of Contents
Relaxation Response – Benson – Slide 41
“The relaxation response is perhaps best understood as a psycho-physiological state of hypoarousal engendered by a multitude of diverse technologies [techniques]” (Everly, 1989, p.149)
Meditation - a self-generating practice of a variety of techniques designed to induce the relaxation response by use of a repetitive focal device
Progressive relaxation - relax selected muscles by first tensing then relaxing the muscles
Table of Contents
Stress Inoculation Trainingdeveloped by Donald Meichenbaum – Slide 42
Stage 1 - education - the person is given a framework for understanding his/her stress response
Stage 2 - rehearsal - the person learns to make cognitive self-statements as a form of coping and problem solving
Stage 3 - application - the person uses the information and skills learned in the first two stages in actual stress situations, moving from lower to higher stress situations
Top Related