1. Stress, Coping, Adjustment, and Health
Chapter 18
Stress, Coping, Adjustment, and Health
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2. Stress, Coping, Adjustment, and Health Introduction
Illness has many causes microbial, viral,. The behavior is important. The Swine flu [H1N1], AIDS and other illnesses and epidemics may be related to many of our behavior habits (what we do and practice). Other life style factors such as smoking, bad diet, lack of exercise lead to illness. How is psychology related to this?
Health psychology: studies the relationship between the mind and the body as well as the ways I which these two components respond to challenges from the environment (e.g. stressful events, germs) to produce either illness or health .
Personality can have an impact on health in many ways, and many psychologists are developing new methodological approaches to the study of this link (see the models) . Do some people differ in getting ill? Do some recover faster than others? Doo different people react differently to stress? Etc..
Stress : the subjective feeling produce by events that are uncontrollable or threatening. Stress is a response to the perceived demands in some situation.
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Stress, Coping, Adjustment, and Health Models of the Personality-Illness Connection
Interactional model
Transactional model
Health behavior model
Predisposition model
Illness behavior model
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Stress, Coping, Adjustment, and Health Models of the Personality-Illness Connection
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5. Models of the Personality-Illness Connection Interactional model
Objective events happen to a person, but personality determines the impact of events by influencing a person’s ability to copy
Personality moderates the relation between stress and illness
Coping response influences degree, duration, and the frequency of a stressful event
Problem: Researchers are unable to identify stable coping responses that are consistently adaptive or maladaptive
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6. Stress, Coping, Adjustment, and Health Transactional model
Personality has three potential effects
Can influence coping
Can influence how a person appraises events
Can influence events themselves
Appraisal suggests that it is not the event itself that causes stress, but how the event is interpreted by a person
People don’t just respond to situations, they also create situations through choices and actions
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Stress, Coping, Adjustment, and Health Models of the Personality-Illness Connection
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8. Stress, Coping, Adjustment, and Health Health behavior model
Personality does not directly influence the relation between stress and illness
Instead, personality affects health indirectly, through health promoting or health degrading behaviors, e.g. those low in the trait of conscientiousness engage in a variety of health damaging behaviors.
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9. Stress, Coping, Adjustment, and Health Predisposition model
Associations may exist between personality and illness because of a third variable that is causing them both
Association found between illness and personality because of some predisposition that underlies them both
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10. Stress, Coping, Adjustment, and Health Illness behavior model
Personality influences the degree to which a person perceives and attends to bodily sensations, and the degree to which a person interprets and labels sensations as illness
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11. Stress, Coping, Adjustment, and Health A Common Theme in the Models
Most models of personality and illness include a key variable of stress
Stress is not “out there” in our lives, representing something that happens to us
Instead, stress lies in part in how we interpret and respond to those events
Thus, stress lies “in between” the event and the person
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Stress, Coping, Adjustment, and Health Models of the Personality-Illness Connection
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13. Stress, Coping, Adjustment, and Health The Concept of Stress
Stress is a subjective feeling produced by events perceived as uncontrollable and threatening
Stressors: Events that lead to stress and have several common attributes
Extreme in some manner, in that stressors produce a state of feeling overwhelmed
Produce opposing tendencies in us, such as wanting and not wanting some activity or object
Perceived as uncontrollable
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Stress, Coping, Adjustment, and Health The Concept of Stress: Stress Response
Startle, heart beats fast, blood pressure increases, sweaty palms and soles of feet—fight-or-flight response, increase in sympathetic nervous system activity
General Adaptation Syndrome (GAS)
Alarm stage: Fight-or-flight response
If stressor continues, stage of resistance: Body uses resources at above average rate, even though fight-or-flight response subsided
If stressor is constant, the person enters the stage of exhaustion: More susceptible to illness, because physiological resources are depleted
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Stress, Coping, Adjustment, and Health The Concept of Stress: Major Life Events (Holmes & Rahe, 1967)
Major Life events: Identified both positive and negative events that are stressors. They are those that require people to make major adjustments in their lives.
People who experienced most stress also are more likely to have a serious illness over the next year
Subsequent experimental work suggests that people under chronic stress deplete bodily resources and become vulnerable to infections
Current thinking is that stress lowers the functioning of immune system, leading to lowered immunity to infection and resulting in illness
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Stress, Coping, Adjustment, and Health The Concept of Stress: Daily Hassles
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Stress, Coping, Adjustment, and Health The Concept of Stress: Daily Hassles
Major events stress, but infrequent
Daily hassles provide most stress in most people’s lives
Research indicates that people with a lot of minor stress suffer more from psychological and physical symptoms
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Stress, Coping, Adjustment, and Health The Concept of Stress: Daily Hassles
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Stress, Coping, Adjustment, and Health The Concept of Stress: Varieties of Stress
Acute stress: Results from the sudden onset of demands and experienced as tension headackes, emotional upset, etc…..
Episodic acute stress: repeated episodes ofacute stress, such as meeting deadlines each month. This leads to migraines, hypertension, anxiety, depression etc…
Traumatic stress (e.g., Post-traumatic stress disorder [PTSD] a collection of symptoms): a massive instance of acute stress, the effects of which can reverberate for years or even a lifetime. It is
Chronic stress: a serious stress that does not end.
Stress has additive effects, cumulating in a person over time
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Stress, Coping, Adjustment, and Health The Concept of Stress: Primary and Secondary Appraisal
Stress is the subjective reaction of a person to potential stressors
According to Lazarus (1991), in order for stress to be evoked, two cognitive events must occur
Primary appraisal: Person perceives an event as a threat to goals
Secondary appraisal: Person concludes they do not have resources to cope with demands of threatening event
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Stress, Coping, Adjustment, and Health The Concept of Stress: The Role of Positive Emotions in Coping with Stress: A Closer Look
General hypothesis: Positive emotions and appraisals may lead to a lowered impact of stress on health
Three coping mechanisms are capable of generating positive emotion during stress (Folkman & Moskowitz, 2000)
Positive reappraisal: Person focuses on the good in what is happening
Problem-focused coping: Thoughts and behaviors that manage or solve an underlying cause of stress
Creating positive events: Creating positive time-out from stress
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22. Stress, Coping, Adjustment, and Health Coping Strategies and Styles
Attributional Style
Optimism and Physical Well-Being
Management of Emotions
Disclosure
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Stress, Coping, Adjustment, and Health Coping Strategies and Styles: Attributional Style
Answer to question, “Where does the person typically place the blame when things go wrong?”
Three dimensions of attribution:
Locus: location of the cause {internal versus external ; internal (dispositional), External (situational) to the person}.
Stability (unstable versus stable) whether the cause is likely to stay the same in the near future or can change
specific versus global : Specific are the ones constrained to that circumstance. The global attribution s involve a wide range of one’s experiences. (see Abramson et al. 1978). Abramson, L. Y., Seligman, M. E. P., & Taasdale, J. D. Learned helplessness in humans: Critique and reformulation. Journal of Abnormal Psychology, 1978, 87,
Different measures: Attributional Style Questionnaire (ASQ), Content Analysis of Verbatim Explanations (CAVE) (Read pp ).
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Stress, Coping, Adjustment, and Health Coping Strategies and Styles: Refinements to the Attributional Style Construct
Optimism-pessimism (Peterson, 2000): People who make stable, global, and internal explanations for bad events termed “pessimists,” whereas people who make unstable, specific, external explanations for bad events termed “optimists”
Dispositional optimism (Scheier & Carver, 2000): Expectation that good events will be plentiful and bad events rare in future
Self-efficacy (Bandura, 1986): Belief that one can do behaviors necessary to achieve desired outcome
Optimistic bias: People generally underestimate their risks, with the average person rating risks as below true average
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Stress, Coping, Adjustment, and Health Optimism and Physical Well-Being (pp ) The role of positive Emotions in coping with stress: A Closer Look ( :
Optimism and Physical Well-Being : Optimism predicts 1- good health and 2- health promoting behaviors (read pp ).
The role of positive Emotions in coping with stress: A Closer Look ( :
Positive emotions play an important role in stress process . Lazarus , Kanner, & Folkman (1980) speculated that they may : 1- sustain coping efforts, 2- Provide a break from stress, and 3- Give people time and opportunity to restore depleted resources.
Frederickson (1998, 2000) suggested that positive emotions are important in facilitating adoptive coping and adjustment to stress. She developed a “broaden and build model” of positive emotions:
Positive emotions broaden the scope of attention, cognition and action. The person sees options in the stressful situation, thinks about more alternatives , and may try different ways of coping with stress.
The build up part suggests that positive emotions help a person build up reserves of energy, as well as build social resources.
Folkman & Moskowiwitz (2000) based on above identified 3 coping mechanisms capable to generate positive emotions:
Positive appraisal, a cognitive process whereby a person focuses on the good in what is happening or has happened.
Problem-focused coping: using thoughts and behaviors to manage or solve the underlying cause of the stress.
Creating positive events: this related to creating a positive time-out from stress.
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Stress, Coping, Adjustment, and Health Optimism and Physical Well-Being (pp )
How Does Optimism Promote Health? It can be promoted through
the effects on the immune system (According to new research, a glass-half-full attitude also strengthens the immune system. The study, which tracked changes in optimism and immune response among first-year law students, found that as students became more optimistic, they showed stronger cell-mediated immunity, the flood of immune cells that respond to an invasion by foreign viruses or bacteria. See
an emotional mechanism: e.g. 1- the adaptive value of coping through processing and expressing emotion, 2- Emotional response provides essential feedback for self-regulation , 3- potential mechanism for EAC's effects is its facilitation of habituation to a stressor .
a cognitive process (see for example explanatory style, the person may hold beliefs that s/he can reduce risks.
effects on social contacts Social support has long been known to promote psychological health and to protect against the adverse health effects of stress. 
direct behavioral mechanism. “health-related quality of life is a relatively new area of behavioral research such as to participate in life's major activities . You can read this article on personality influences preventive health behaviour (
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Stress, Coping, Adjustment, and Health Management of Emotions (pp )
Emotional inhibition: controlling your anxiety or hiding that you are disappointed.
Some theorists suggest that emotional inhibition leads to undesirable consequences.
Chronically inhibited emotion seems to come with certain “costs” to the nervous system
Someone who characteristically inhibits emotional expression may suffer effects of chronic sympathetic nervous system arousal
Other theorists see emotional inhibition more positively
Emotions serve the function of communicating to others how we are feeling
Research indicates that emotional expressiveness may be good for our psychological health and general adjustment
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28. Stress, Coping, Adjustment, and Health Disclosure
Disclosure: is telling someone about a private aspect of oneself.
Pennebaker argues that not discussing traumatic, negative, upsetting event can lead to problems:
Those who keep unpleasant information about themselves a secret are more likely to develop anxiety and depression than those who tell someone.
Those who do not talk about their problems visit the hospital more frequently.
Telling a secret can relieve stress, increase health
Confronting the traumatic memory by telling someone or even writing about it. releases the person from the work of keeping the secret
The more the participants talked about the tragedy with others, the better their subsequent health.
Just the act of writing about an upsetting event, even if no one ever reads the writing, may have a beneficial effect on health.
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Stress, Coping, Adjustment, and Health Type A Behavior and Cardiovascular Disease
Type A personality are competitive and aggressive, more active and energetic in their actions and speaking, and more ambitious and driven. Type A is a collection of 3 subtraits
Competitive achievement motivation: they work hard and achieve goals.
Time urgency: they hate wasting time. They are always in ah hurry and feel under pressure to get the most done in the least amount of time.
Hostile and aggressive because of frustration. They get frustrated easily which make them act unfriendly or even malicious manner.
Early studies of Type A found it was an independent risk factor for developing cardiovascular disease
Early studies conducted by physicians using structured interview
Structured interview gets at the lethal component
Later research used self-report surveys
Studies using surveys less likely to find relationships between Type A and heart disease than studies using structured interview
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30. Summary and Evaluation
Some psychologists study the link between personality and health
Personality influences health in many ways
Understanding why some personalities are more resistant to stress, better able to cope, and better able to adjust is an important goal with a practical application
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