Stress, Coping & Health

stress conceptualized in a variety of ways including as a stimulus as a response as a “transaction” between the organism and the environment

Measuring Stressful Life Events scale devised in 1967 (Holmes & Rahe)

Lazarus & Folkman’s Transactional Model No Stress Situation is perceived as harmless Individual’s Perception of the Event Primary Appraisal Individual determines the threat to his/her well-being Stimulus Event Situation is perceived as threatening Secondary Appraisal Individual determines coping resources available and the likelihood that they can be successfully employed Coping mechanisms adequate Coping mechanisms inadequate No Stress Stress

General Adaptation Syndrome Alarm “flight or fight response” activation of sympathetic division of ANS Resistance Exhaustion

High Incidence of Illness Stress and Illness mediated by individual differences Individual Differences aspects of personality, physiology, memory, etc (e.g., neuroticism) High Incidence of Illness High Stress

Type A Behaviour and Heart Disease Type A personality Type B personality

Type A Assessment Do you find it difficult to restrain yourself from hurrying others’ speech (finishing their sentences for them)? Do you often try to do more than one thing at a time (such as eat and read simultaneously)? Do you often feel guilty if you use extra time to relax? Do you tend to get involved in a great number of projects at once? Do you find yourself racing through yellow lights when you drive? Do you need to win in order to derive enjoyment from sports and games? Do you generally move, walk, and eat rapidly? Do you agree to take on too many responsibilities? Do you detest waiting in lines? Do you have an intense desire to better your position in life and impress others?

Moderators of Stress Coping Emotion Focused Coping behavioural cognitive Problem-Focused Coping planful problem solving confrontive coping Social Support

Pain and Pain Management

Biological Aspects of Pain Gate Control Theory thin fibers carry sharp-pain information thick fibers convey dull-pain and touch information

Gate Control Theory Acupuncture

Biological Aspects of Pain Endorphins endogenous morphine stress-reduced analgesia

Psychological Aspects of Pain placebo effects neuroticism

Health Promotion AIDs Prevention

Substance Abuse aversion therapy Antabuse UCS (Drug in Alcohol) UCR (Nausea) CS (Alcohol) CR (Nausea)

Harm Reduction Approaches Marlatt et al., 1998 motivational interviewing