Coping with stress “Worried Sick” – last section on coping

Coping with stress Overview: 1.Psychosocial moderators of the stress response 2.Ways of coping

Moderators: Factors that influence impact of a “stressor” yCoping styles and strategies (including appraisal) ySocial support yControl: unpredictable events; ambiguous tasks yPersonality & current state of person

The role of appraisal in stress

Appraisal: Attributional style zExplanatory Style yA person’s propensity to attribute outcomes to positive causes or negative causes yNegative Explanatory Style xPessimistic attributions that are global, stable, and internal

The Negative Stress Cycle

Social Support ySocial Support xCompanionship, emotional connection, material assistance, touch, and/or honest feedback, etc. xHandout: Bowling Alone

Social Support and Health yPeople who perceive strong social support experience: xfaster recoveries xfewer medical complications xlower mortality rates at any age (Alameda County Study) xless distress in the face of terminal illness yWritten exercise: Write about one of your close friends and the support he/she provides

Just thinking about support helps! yFor this study, “undergraduates (41 men, 41 women) wrote about supportive ties or casual acquaintances. Supportive ties were rated as warmer and less controlling than acquaintances, and writing about them evoked reductions in negative affect, especially for low-hostile participants," the researchers said. y"Compared with the acquaintance condition, the supportive tie condition resulted in reduced heart rate and blood pressure response during a subsequent speech stressor” among low-hostile participants. Mental activation of supportive ties, hostility, and cardiovascular reactivity to laboratory stress in young men and women. Health Psychology, 2004;23(5):

How Social Support Makes a Difference xAmeliorate stress hormones xEncourages healthier lifestyles xBetter relationships with doctors, nurses, etc.

Research studies Better immune/endocrine function (3 of 3) Lower mortality from cancer (4 of 6) Lower blood pressure (14 of 23) Less heart disease (7 of 11) Less stroke (1 of 1) Lower cholesterol (3 of 3) Less cigarette smoking (23 of 25) More likely to exercise (3 of 5) Lower mortality (11 of 14) ( ) Clergy mortality (12 of 13) However, multiple problems with the research Numerous new studies now under review Religious involvement as a form of social support

Religious Attendance and Life Expectancy

Possible Reasons for Correlation Between Religious Involvement and Health

Moderators: Personal Control yPersonal Control xself-efficacy (Albert Bandura) xDesign an intervention for nursing home residents to increase their perceptions of personal control xLanger & Rodin (1976): Nursing home residents who were given more responsibility over their daily lives were more active, sociable, happier, and had lower mortality rates than other residents

Perceived Control and Biological Effects zUncontrollable stressors trigger stronger corticosteroid response zStress aroused in a person with a sense of mastery can actually enhance immune functioning

Who Copes Well? zAppraisal of a stressor is impacted by personal resources such as personality zPersonality styles related to health yType A yOptimism/Pessimism yMastery/Locus of Control yHardiness/Resilence

Moderators: Personality -- hardiness zHardiness yCluster of stress-buffering traits consisting of commitment, challenge, control yLinked to lower levels of anxiety, adaptive coping styles, and adjustment to cancer, cardiovascular disease, diabetes, and many other health problems yHardy people are more likely to engage in positive reappraisal of stressful events

Personality: Optimism and Immune Functioning

Coping with stress zCoping yWhat is your most frequent and/or effective coping method? yCoping -- a dynamic process to reduce stress and/or restore balance xInvolves cognitive, behavioral, emotional, social, spiritual aspects

Coping Strategies zProblem-Focused Coping — dealing directly with a stressor by reducing its demands or increasing one’s resources for meeting those demands zProactive Coping — anticipate potential stressors and act to prevent them or to mute their impact zHealth buffers – exercise, sleep, nutrition

Problem-focused: e.g., time management Time stress! Strategies: Common time-consumers? (identify and minimize) Prioritizing Avoiding procrastination Assertiveness (e.g., saying no when necessary Others?

Coping Strategies zEmotion-Focused Coping yperson tries to control his or her emotional response to a stressor xescape-avoidance xreappraisal(e.g., “is this really that important?” “am I engaging in faulty thinking?) xonly connect! xothers? (see following slides)

Relaxation-based approaches yMindfulness yMeditation yYoga yBiofeedback yHypnosis yRelaxation xGuided imagery xSystematic desensitization xPMR

Coping: Psychotherapy zPsychotherapies: yCognitive-behavioral (e.g., cognitive restructuring) yPsychodynamic