Stress, Health, and Coping

Stress, Health, and Coping
Chapter Twelve Stress, Health, and Coping

Stress: Negative emotional state occurring in response to events that are perceived as taxing or exceeding a person’s resources or ability to cope Cognitive appraisal model of stress: Stress model that emphasizes the role of an individual’s evaluation (appraisal) of events and situations and of the resources available to deal with the event or situation (Lazarus) Stress: Negative emotional state occurring in response to events that are perceived as taxing or exceeding a person’s resources or ability to cope

Stress and Health Psychology
Events are not stressful in and of themselves, but stress is determined by your subjective response to external events or circumstances. We evaluate and re-evaluate coping strategies our coping responses as we manage stressful circumstances. If coping efforts are successful, stress will decrease. If unsuccessful, stress will increase. If you believe you have the resources necessary to meet a challenge, you’ll experience little or no stress.

Health psychologists study how biological, behavioral, and social factors influence health, illness, medical treatment, and health-related behaviors. Main Foci How to promote health-enhancing behaviors How people respond to being ill How people respond in the patient–health practitioner relationship In their research and clinical practice, health psychologists are guided by the biopsychosocial model. According to this model, health and illness are determined by the complex interaction of biological factors, such as genetic predispositions; psychological factors, like health beliefs and attitudes; and social factors, like family relationships and cultural influences .

Sources of Stress Life Events and Change
Stressors: events that are perceived as harmful, threatening, or challenging Social Readjustment Rating Scale (SRRS) Contains 43 life events that have been assigned a numerical rating of life change units of relative impact Suggests that any change is inherently stress-producing Tends to produce similar results across many cultures Revised Social Readjustment Rating Scale (SRRS) Better weighs the influences of gender, age, marital status, and other individual characteristics See .Table 12.1 for additional information about sample items for SRRS.

Sources of Stress: Life Events and Change
Problems with the SRRS Weak link between SRRS and physical and psychological problems Assumes a given life event will have the same impact on everyone Assumes that change in itself, whether good or bad, produces stress Most researchers agree that undesirable events are significant sources of stress but that change in itself is not necessarily stressful Click to reveal bullets.

Sources of Stress: Traumatic Events
Traumatic events: Events or situations that are negative, severe, and far beyond our normal expectations for everyday life or life events. When traumas are intense or repeated, some psychologically vulnerable people may develop posttraumatic stress disorder (PTSD). Most people recover from traumatic events without ever developing PTSD. 85% of people report exposure to a traumatic event during their lifetime Fewer than 30% of those who experience major disasters—such as floods, earthquakes, and hurricanes—develop PTSD.

Developing Resilience
Seery and others High and low levels of cumulative adversity were associated with poor health outcomes Experiencing some stress was healthier than experiencing no stress at all People who have had to cope with a moderate level of adversity develop resilience. How would you define resilience? Resilience: Ability to cope with stress and adversity, to adapt to negative or unforeseen circumstances, and to rebound after negative experiences Psychologist Mark Seery and his colleagues (2010) found that people who had experienced some adversity in their lives handled new stressors better than people who had experienced either a high level of adversity or none at all. After experiencing a significant negative event, they were less distressed and experienced fewer posttraumatic stress symptoms. Even more important, they were generally happier with their lives than people whose lives had been either very hard or relatively carefree.

Daily Hassles That’s Not What I Ordered!
Everyday minor events that annoy and upset people might be cumulative. Number of daily hassles people experience is a better predictor of physical illness and symptoms than is the number of major life events experienced. Women are more likely to report daily stressors that are associated with friends and family. Men are more likely to feel hassled by stressors that are school-related or work-related.

Examples of Daily Hassles
Daily Hassles Scale Concern about weight Concern about health of family member Not enough money for housing What else can you add here? College Daily Hassles Scale Increased class workload Troubling thoughts about the future Fight with boyfriend/girlfriend Acculturative Daily Hassles for Children It bothers me when people force me to be like everyone else. I don’t feel at home here in the United States. See Table 12.2 lists examples from the original Daily Hassles Scale and from other scales developed for specific populations. Arguing that “daily hassles” could be just as stress-inducing as major life events, Richard Lazarus and his colleagues constructed a 117-item Daily Hassles Scale. Later, other researchers developed daily hassles scales for specific groups. Sources: Research from Blankstein & Flett, 1992; Kanner & others, 1981; Ross & others, 1999; Staats & others, 2007; Suarez-Morales & others, 2007. Daily hassles Concern about weight Concern about health of family member Not enough money for housing Too many things to do Misplacing or losing things Too many interruptions Don’t like current work duties Traffic Car repairs or transportation problems College Daily Hassles Increased class workload Troubling thoughts about your future Fight with boyfriend/girlfriend Concerns about meeting high standards Wasting time Computer problems Concerns about failing a course Concerns about money Acculturative Daily Hassles for Children It bothers me when people force me to be like everyone else. Because of the group I’m in, I don’t get the grades I deserve. I don’t feel at home here in the United States. People think I’m shy, when I really just have trouble speaking English. I think a lot about my group and its culture.

Work Stress and Burnout Is It Quitting Time Yet?
Characteristics of burnout Exhaustion and depletion of emotional and physical resources Feelings of cynicism, demonstrating negative or overly detached attitudes Causes of burnout Overload Lack of control Solution Sense of community Burnout: An unhealthy condition caused by chronic, prolonged work stress that is characterized by exhaustion, cynicism, and a sense of failure or inadequacy

Social and Cultural Sources of Stress
People who live under difficult or unpleasant conditions have few resources and experience chronic stress. Chronic stress is also associated with lower socioeconomic status and poorer physical health. Racism and discrimination are another important source of chronic stress (microaggressions). People who live under difficult or unpleasant conditions experience chronic stress. People in less privileged groups have fewer resources with which to cope with stressors Crowding, crime, poverty, and substandard housing Chronic stress is also associated with lower socioeconomic status. Personal perception of low social status is associated poorer physical health. Racism and discrimination are another important source of chronic stress Subtle instances of racism, called microaggressions, contribute to chronic stress.

Subjective Socioeconomic Status and Health
The volunteers’ subjective social status was assessed by showing them a picture of a ladder and asking them to indicate where they thought they stood relative to their fellow Americans in terms of income, education, and occupation. All the volunteers were then exposed to a cold virus. Even after controlling for factors such as smoking and other risk factors, Sheldon Cohen and his colleagues (2008) found that subjective, rather than objective, social status was associated with susceptibility to infection. Regardless of their objective socioeconomic status, participants who perceived themselves as being lower in social status were more susceptible to infection than those who did not. Source: Data from Cohen & others (2008). The objective socioeconomic status of a group of volunteers was assessed in terms of income level and education. What did they find?

The Stress of Adapting to a New Culture
Reducing stress Acceptance of ethnic and cultural diversity by new society Existence of some familiarity with new language and customs, advanced education, and social support from friends, family members, and cultural associations Similarity of new culture to old culture Acculturative stress The stress that results from the pressure of adapting to a new culture. Acculturative stress results from the pressure of adapting to a new culture.

The Stress of Adapting to a New Culture
Two questions people are faced with when entering a new culture: Should I seek positive relations with the dominant society? Is my original cultural identity of value to me, and should I try to maintain it?

Patterns of Adapting to a New Culture
Four possible patterns of acculturation Integration = low stress Assimilation = moderate stress Separation = high stress Marginalization = greatest stress According to cross-cultural psychologist John Berry, there are four basic patterns of adapting to a new culture (Sam & Berry, 2010). Which pattern is followed depends on how the person responds to the two key questions shown on the previous slide. Source: Research from Sam & Berry (2010).

Physical Effects of Stress The Mind-Body Connection
Stress can indirectly affect a person’s health by prompting behaviors that jeopardize physical well-being, such as not eating or sleeping properly. Stress can directly affect physical health by altering body functions, leading to symptoms of illness or disease.

Stress and the Endocrine System
Fight-or-flight response (Walter Cannon) Rapidly occurring chain of internal physical reactions that prepare people either to fight or take to flight from an immediate threat Endocrine response Threat perceived (amygdala), and hypothalamus and lower brain structures activate sympathetic nervous system Sympathetic nervous system stimulates adrenal medulla to secrete hormones called catecholamines, including adrenaline and noradrenaline Catecholamines trigger rapid and intense bodily changes associated with the fight-or-flight response Cannon believed prolonged arousal is harmful. He made many lasting contributions to psychology, including an influential theory of emotion, which was presented in chapter 8. During World War I, Cannon’s research on the effects of stress and trauma led him to identify the body’s response to threatening circumstances—the fight-or-flight response.

Endocrine System Pathways in Stress
Figure 12.4 Endocrine System Pathways in Stress Two different endocrine system pathways are involved in the response to stress (Joëls & Baram, 2009). Walter Cannon identified the endocrine pathway shown on the left side of this diagram. This is the pathway involved in the fight-or-flight response to immediate threats. Hans Selye identified the endocrine pathway shown on the right. This second endocrine pathway plays an important role in dealing with prolonged, or chronic, stressors.

Stress and the General Adaptation Syndrome
Hans Selye researched the effects in rats of exposure to extreme stress. Adrenal glands became enlarged. Stomach ulcers and loss of weight occurred. Thymus gland and lymph glands, two key components of the immune system, shrunk. Prolonged Stress Stress causes pituitary to release ACTH ACTH causes adrenals to release corticosteroid (cortisol) In short-term reduces inflammation, enhances muscles; long-term immune system weakened General adaptation syndrome Hans Selye’s term for the three-stage progression of physical changes that occur when an organism is exposed to intense and prolonged stress. The three stages are alarm, resistance, and exhaustion.

Prolonged Stress Produces General Adaptation Syndrome (GAS)
Devastating effects of prolonged stress develops in three progressive stages. Alarm Intense arousal occurs. There is mobilization of physical resources (release of catecholamines). Arousal remains above normal. Resistance Body actively tries to resist or adjust to the continuing stressful situation. Resistance to new stressors is impaired. Exhaustion Physical exhaustion and physical disorders appear. Symptoms of the alarm stage reappear, only now irreversibly. Energy reserves are depleted and adaptation begins to break down, leading to death.

Stress, Chromosomes, and Aging
Telomeres protect genetic data in the chromosomes from being broken or scrambled during cell division. Telomeres get shorter with each cell division, as we age, and as a result of elevated levels of stress hormones. People under chronic stress have shortened telomeres. Let’s look at a telomere in the next slide. Telomeres: Repeated duplicate DNA sequences that are found at the very tips of chromosomes.

Telomeres Figure 12.5 Telomeres As shown in the drawing on the right, telomeres are short, repeated DNA sequences that are found at the very tips of chromosomes (Epel, 2009b). In the photo on the left, the telomeres are the fluorescent tips on the blue-stained human chromosomes. Like the plastic tips that protect shoelaces from fraying, telomeres protect the genetic data in the chromosomes from being broken or scrambled during cell division. With each cell division, the telomeres get shorter. However, an enzyme called telomerase can protect and even lengthen telomeres. Psychologists today are actively studying the environmental factors that affect telomere length, including behavioral interventions that increase telomerase activity (Blackburn & Epel, 2012; Jacobs & others, 2011).

Effects of Chronic and Acute Stress on Telomerase Activity
Telomerase is an enzyme that protects and lengthens telomeres. Elissa Epel and colleagues found telomerase activity was significantly lower in women who were under chronic stress (“caregivers”) than it was in a control group of low-stress women. Figure 12.7 Effects of chronic and acute stress on telomerase activity In response to an acute stressor in the laboratory, telomerase activity rose sharply in both groups. Even at its peak, however, telomerase activity in the chronic stress group remained significantly below that of the control group. Data from Epel & others (2010). Epel’s research is the first experimental demonstration that telomerase activity is directly affected by acute psychological stress. Acute, short-term stress produced a positive, adaptive effect on telomerase activity; chronic stress had a negative, maladaptive effect on telomerase activity.

Stress and the Immune System
Produces specialized white blood cells that protect body from viruses, bacteria, and tumor cells Lymphocytes Includes specialized white blood cells that fight bacteria, viruses, and other foreign invaders Figure 12.8 The Immune System Your immune system battles bacteria, viruses, and other foreign invaders that try to set up housekeeping in your body. The specialized white blood cells that fight infection are manufactured in the bone marrow and are stored in the thymus, spleen, and lymph nodes until needed.

Stress and the Immune System
Psychoneuroimmunology is an interdisciplinary field that studies the interconnections among psychological processes and the nervous system and immune system. CNS and immune system are directly linked via sympathetic nervous system. Surfaces of lymphocytes contain receptor sites for neurotransmitters and hormones, including catecholamines and cortisol. Lymphocytes produce neurotransmitters and hormones. Psychoneuroimmunologists have discovered that lymphocytes themselves produce neurotransmitters and hormones,

Stresors That Influence the Immune System
Highly stressful events and common stresses are associated with reduced immune system functioning. End or disruption of important interpersonal relationships Caring for a family member with Alzheimer’s disease Marital arguments Pressure of exams

Mysterious Placebo Effect
Genuine painkilling drugs and placebos activate the same brain area, called the anterior cingulate cortex. Cognitive expectations, learned associations, and emotional responses can have a profound effect on the perception of pain. Placebo: Inactive substance with no known effects Anterior cingulate cortex contains many opioid receptors. Placebo treatment activates opioid receptors in several brain regions associated with pain. Research has also demonstrated that placebos produce measurable effects on other types of brain processes, including those of people experiencing Parkinson’s disease or major depressive disorder

Psychological Factors That Influence the Response to Stress
Personal control Feeling of control of stress-producing event often reduces psychological distress or physical arousal. Nursing-home residents who had opportunities to make choices (high control) were more active, alert, and healthier than does who did not (low control) (Rodin and others). Perception of personal control must be realistic to be adaptive. Personal control is more valued in individualistic cultures. People who can control a stress-producing event often show no more psychological distress or physical arousal than people who are not exposed to the stressor.

Explanatory style (Seligman) Optimistic explanatory style Uses external, unstable, and specific explanations for negative events Predicts better health outcomes; strong immune system Pessimistic explanatory style Uses internal, stable, and global explanations for negative events Predicts worse health outcomes Explanatory style is relatively stable, especially for negative events

Chronic negative emotions Strong link between negative emotions and poor health People who are habitually anxious, depressed, angry, or hostile are more likely to develop a chronic disease, such as arthritis or heart disease. Positive emotions Associated with increased resistance to infection, decreased illnesses, fewer reports of illness symptoms, less pain, and increased longevity Negative: People who are habitually anxious, depressed, angry, or hostile are more likely to develop a chronic disease, such as arthritis or heart disease. Positive: Less likely to develop heart disease Bring calming and health protective effects to the cardiovascular, endocrine, and immune systems Associated with health-promoting behaviors Predict more friends and stronger social networks

Individual Factors That Influence the Response to Stress
Type A behavior and hostility Exaggerated sense of time urgency, trying to do more and more in less time General sense of hostility, displaying anger and irritation; associated with heart disease Greater increases in blood pressure and heart rate Type B behavior More easygoing, relaxed, laid-back Not associated with heart disease Hostile Type As react more intensely to a stressor than other people do the research evidence demonstrating the role of personality factors in the development of stress-related disease is impressive Personality characteristics are just some of the many factors involved in the overall picture of health and disease.

Do Personality Factors Cause Disease?
Psychologists and other scientists are cautious about the connections between personality and health. Many studies are correlational. Personality factors might indirectly lead to disease via poor health habits. Disease may influence a person’s emotions, rather than the other way around. Researchers try to disentangle the relationship by prospective studies

Social Factors Social support Effects of low social support
Includes resources provided by other people in times of need Effects of low social support Socially isolated people were twice as likely to die as people with good social relationships. Chronic loneliness predicts poorer physical and mental health, higher death rates, and decreased cognitive functioning. Here, young Nepali volunteers work together to help clear the rubble from homes in their neighborhood after a 7.9-magnitude earthquake struck Nepal in April, 2015. Negative interactions with other people are often more effective at creating psychological distress than positive interactions are at improving well being. More likely have serious health problems if parents are low in love and caring Isolation is as potent a health risk as smoking, obesity, alcohol abuse, and physical inactivity Social support from your community can buffer the effects of stress, especially during natural disasters.

Social Factors Positive effect of diverse social networks
Greater resistance to upper respiratory infections Lower incidence of stroke and cardiovascular disease among women in a high-risk group Lower incidence of dementia and cognitive loss in old age

Social Factors How can social support positively benefit health?
Can modify our appraisal of a stressor’s significance May decrease intensity of physical reactions to a stressor Makes people less likely to experience negative emotion Provides direct assistance (money, meals, trips to doctor, referrals) What about negative impact? Negative interactions can create psychological distress. Unwanted or inappropriate social support can increase stress.

Gender Differences in the Effects of Social Support
Women List close friends along with their spouse as confidants. Serve as providers of support, which can be stressful. Suffer from the stress contagion effect. Become more upset about negative events that happen to relatives and friends. Men Rely on close relationship with spouse or partner. Are particularly vulnerable to social isolation.

Providing Effective or Ineffective Social Support
Effective Strategies Listening well and showing concern Asking questions that encourage the stressed person to express feelings and emotions Expressing affection and understanding about why the person is upset Investing time and attention in helping Ineffective Strategies Giving advice that the person under stress has not requested Saying “I know exactly how you feel” Talking about yourself or your own problems Minimizing the importance of the person’s problem Joking or acting overly cheerful Offering your philosophical or religious interpretation Emotional Support: expressions of concern, empathy, and positive regard Tangible Support: involves direct assistance

Coping : How People Deal with Stress
Behavioral and cognitive responses used to deal with stressors Efforts to change circumstances, or our interpretation of them, to make them more favorable and less threatening Adaptive coping Dynamic and complex process Realistically evaluating situation and determining what can be done to minimize the impact of the stressor Dealing with the emotional aspects of the situation

Problem-Focused Coping Strategies
Aimed at managing or changing the stressor Is most effective when control can be exercised Confrontive coping Using aggressive or risky tactics Is ideal if direct and assertive but not hostile

Problem-Focused Coping Strategies
Planful problem solving Analyzing situation rationally Identifying solutions Implementing solutions

Gender Differences in Responding to Stress: “Tend-and-Befriend” or “Fight-or-Flight”?
Men tend to withdraw from their families, wanting to be left alone. Women tend to seek out interactions with their marital partners. Women likely to seek out and use social support when under stress. Why does this occur? Why? Tending to offspring in times of stress would be vital to ensuring survival of species. Women developed a tend-and-befriend behavioral response to stress rather than fight-or-flight Maybe because oxytocin is higher in women than in men Oxytocin associated with maternal behaviors

Emotion-Focused Coping Strategies
Occurs when people believe nothing can be done to alter a situation Person directs effort toward relieving or regulating emotional impact of stressful situation Emotion-focused coping strategies Escape-avoidance Seeking social support Distancing Denial Positive reappraisal Negative religious coping Escape-avoidance: Try to escape stressor Examples: sleeping, drugs, fantasy, exercising, immersing self in work, hobbies, studies Associated with poor adjustment, depressive symptoms, anxiety Seeking social support Distancing: Minimize impact of stressor Humor Detached, intellectual, or depersonalized attitude Denial: Refuse to acknowledge problem Can compound the situation Positive Reappraisal Positive religious coping Associated with lower stress, better health Negative religious coping Anger, question beliefs, think they are being punished Can lead to poor health

Culture and Coping Strategies
Individualistic Cultures Emphasize personal autonomy and personal responsibility in dealing with problems Emphasize importance and value of exerting control over circumstances Are less likely to seek social support in stressful situations than are members of collectivistic cultures Favor problem-focused strategies, such as confrontive coping and planful problem solving Collectivistic Cultures Are oriented toward social group, family, or community, and toward seeking help with problems Place greater emphasis on controlling personal reactions Are more likely to rely on emotional coping strategies than people in individualistic cultures

Minimizing the Effects of Stress
Suggestion 1 Avoid or minimize the use of stimulants. Suggestion 2 Exercise regularly. Suggestion 3 Get enough sleep. Suggestion 4 Practice a relaxation or meditation technique.

Stress, Health, and Coping

Similar presentations

Presentation on theme: "Stress, Health, and Coping"— Presentation transcript:

Similar presentations

About project

Feedback

Log in

Auth with social network:

Stress, Health, and Coping

Similar presentations

Presentation on theme: "Stress, Health, and Coping"— Presentation transcript:

Similar presentations

About project

Feedback