Health Psychology: Stress, Coping, and Well-being

OUTLINE Stress and Coping: -How is health psychology a union between medicine and psychology? -What is stress, how does it affect us, and how can we best cope with it? Psychological Aspects of Illness and Well-Being How do psychological factors affect health-related problems such as coronary heart disease, cancer and smoking? Promoting Health and Wellness How do our interactions with physicians affect our health and compliance with medical treatment? How does a sense of well-being develop?

THE FOCUS OF HEALTH PSYCHOLOGY Biopsychosocial Model

Stress: Reacting to Threat and Challenge Stress: A person’s response to events that are threatening or challenging. Stressors: produce threats to well-being. e.g. exam deadline, family problems, relationship issues, terror attacks, etc. Even positive events may produce stress: planning a party, job interview

The Nature of Stressors: My Stress Is Your Pleasure Stress varies according to individuals. E.g., Bungee jumping, travelling, driving, watching a scary movie. For people to consider an event stressful, they must: Perceive it as threatening or challenging Lack all the resources to deal with it effectively Same event may be stressful at some times, and provoke no stress at other times. e.g. studying well for an exam vs. not having enough time to study

Categorizing Stressors Occur suddenly and typically affect many people simultaneously Cataclysmic events Major life events Post-traumatic stress disorder (PTSD) Personal stressors Daily hassles Uplifts: Minor positive events Background stressors

Categorizing Stressors Cataclysmic events: strong stressors that occur suddenly and typically affect many people at once (e.g. natural disasters, terror attacks, plane crashes) In many cases: no lingering stress. Natural disasters may produce less stress in the long-term than events that initially are not as devastating. Reasons: -natural disasters have a clear resolution – once they are over, people can move on to their future knowing that the worst is behind them. -Allows people to offer social support to each other So what kinds of events tend to be seen as stressful? Natural disasters such as earthquakes and tornadoes, plane crashes or terror attacks are examples of cataclysmic events that can affect hundreds or thousands of people simultaneously.

Categorizing Stressors Personal stressors: major life events that have immediate negative consequences that generally fade with time (e.g. death of a family member, relationship break-up, loss of a job, or even getting married). Typically, personal stressors produce an immediate major reaction that soon tapers off. e.g. stress arising from the death of a loved one tends to be greatest just after the time of death BUT over time less stress.

Categorizing Stressors Post-traumatic stress disorder (PTSD): a phenomenon in which victims of major catastrophes or strong personal stressors feel long-lasting effects that may include re-experiencing the event in vivid flashbacks or dreams. (e.g. rape victim – innocent man who resembles the rapist) Soldiers, child abuse or rape, rescue workers, victims of natural disasters or accidents that produce feelings of helplessness and shock.

Categorizing Stressors Background stressors (daily hassles): Everyday annoyances that cause minor irritations and may have long-term ill effects if they continue or are compounded by other stressful events. e.g. being stuck in traffic, standing in a long line at bank, etc.

The High Cost of Stress Both biological and psychological consequences Psychophysiological disorders: Medical problems influenced by an interaction of psychological, emotional, and physical difficulties Stress affects us in multiple ways Increases the risk of illness Slow recovery from diseases Reduce ability to cope with stress in future

The General Adaptation Syndrome Model: The Course of Stress (Selye, 1947) Physiological response to stress follows the same set pattern regardless of the cause of stress Three phases: Alarm and mobilization Resistance Exhaustion

Coping with Stress Emotion-focused coping Problem-focused coping Managing emotions in the face of stress, seeking to change the way one feels about or perceives a problem Emotion-focused coping Attempting to modify the stressful problem or source of stress Problem-focused coping Use more direct escape routes, such as drug or alcohol use Least effective Avoidant Coping

Coping with Stress People also use: Defense mechanisms: Unconscious strategies to reduce anxiety by concealing the source from themselves and others Emotional insulation: Stops experiencing emotions and thereby remains unaffected and unmoved by both positive and negative experiences

Coping with Stress Learned helplessness Occurs when people conclude that unpleasant or aversive stimuli cannot be controlled Cease trying to remedy the aversive circumstances even if they actually can exert some influence on the situation Experience more physical symptoms and depression

Coping with Stress Coping styles: The hardy personality Hardiness : Characteristic associated with a lower rate of stress-related illness Three components: Commitment Challenge Control Resilience: Ability to withstand, overcome, and thrive after profound diversity

Coping with Stress Social support: Turning to others Mutual network of caring, interested others Enables us to experience lower levels of stress and be better able to cope with stress we do undergo

MODULE 44: Psychological Aspects of Illness and Well-Being How do psychological factors affect health-related problems such as coronary heart disease, cancer, and smoking?

The As, Bs, and Ds of Coronary Heart Disease Type A behavior pattern: Cluster of behaviors involving hostility, competitiveness, time urgency, and feeling driven Type B behavior pattern: Characterized by a patient, cooperative, noncompetitive, and nonaggressive manner Type D behavior pattern: insecurity, anxiety, and the negative outlook Risk for repeated heart attacks

THE DIRECT & INDIRECT PATHWAYS The dual process model The direct pathway (eg stress causes illness) The indirect pathway (eg. Stress causes smoking which causes illness) DIRECT PATHWAY INDIRECT PATHWAY

Psychological Aspects of Cancer Emotional responses of cancer patients to their disease may affect its course Some psychological therapies have the potential for improving quality of life and even extending the lives of cancer patients

Well-Being and Happiness Subjective well-being: People’s sense of their happiness and satisfaction with their lives Characteristics of happy people Have high self-esteem - Positive illusions Have a firm sense of control Are optimistic Men and women are generally made happy by the same sorts of activities – but not always Like to be around other people

Well-Being and Happiness Money does not buy happiness (Well…) Despite the ups and downs of life, most people adapt to life by returning to a steady-state level of happiness