1. Chapter 12: Stress, Coping, and Health

2. The Relationship Between Stress and Disease
Contagious diseases vs. chronic diseases
Biopsychosocial model- physical illness is caused by a complex interaction of biological, psychological, and sociocultural factors
Health psychology- the field of study that seeks to determine the importance of psychological factors in illness, as well as in prevention and health maintenance
Discovery of causation, prevention, and treatment

3. Stress as an Everyday Event
Stress- any circumstances that threaten or are perceived to threaten one’s well being and that thereby tax one’s coping ability
Major stressors vs. routine hassles
Cumulative nature of stress
Cognitive appraisals
The experience of feeling stressed depends largely on cognitive processes; going on a new date is exciting for some, terrifying for others. People’s appraisals of events are very subjective and influence the effect of the event

4. Major Types of Stress
Frustration: blocked goal (Ex. traffic jams)
Conflict: occurs when two or more incompatible motivations or behavioral impulses compete for expression
Approach-approach- when a person has a choice between two attractive goals
Avoidance-avoidance- when a person has a choice between two undesirable alternatives
Approach-avoidance- when a choice must be made about whether to pursue a single goal that has both attractive and unattractive aspects

5. Major Types of Stress
Change: having to adapt- any noticeable alterations in one’s living circumstances that require readjustment
Social Readjustment Rating Scale- measures life change as a form of stress, giving higher points (life change units) for more stressful events
Life Change Units
Pressure: involves expectations or demands that one behave in a certain way, pressure to perform or to comply.

6. Figure 12.2 Types of conflict

7. Responding to Stress Emotionally
Emotional responses
Annoyance, anger, rage
Apprehension, anxiety, fear
Dejection, sadness, grief
Positive emotions
There are strong links between cognitive appraisals and which set of emotions one experiences as a function of a stressor; self-blame leads to guilt, helplessness to sadness, etc.
Effects of emotional arousal
The inverted-U-hypothesis-High emotion can sometimes negatively influence task performance, more so for highly complex tasks and less so for simple ones

8. Figure 12.3 Overview of the stress process

9. Figure 12.4 Arousal and performance

10. Responding to Stress Physiologically
Selye’s General Adaptation Syndrome
Alarm (fight-or-flight response)- occurs when an organism recognizes a threat and mobilizes resources
Resistance- stage occurs when the stress is prolonged. This is a period when physiological arousal stabilizes but is still above baseline, as the organism copes with the stressor
Exhaustion- occurs when the body’s resources are depleted. Selye believed that this is where diseases of adaptation come in
Physiological effects of stress include the fight-or-flight response, discovered by Walter Cannon (1932). The FF response is a physiological reaction to threat in which the autonomic nervous system (ANS) mobilizes the organism for attacking (fight) or fleeing (flight) an enemy.
The fight-or-flight response is adaptive if one is faced with a predator; however, modern stressors are more long term (the checkbook).
Hans Selye began studying stress in the 1930s to determine the effects of these chronic stressors. He used an animal model, exposing them to both physical and psychological stressors to determine effects, which were nonspecific. That is, the reactions did not relate to the type of stress.
Selye formulated a theory about how stress reactions occur called the general adaptation syndrome.
The alarm stage occurs when an organism recognizes a threat and mobilizes resources – essentially enters the FF response.
The resistance stage occurs when the stress is prolonged. This is a period when physiological arousal stabilizes but is still above baseline, as the organism copes with the stressor.
The exhaustion stage occurs when the body’s resources are depleted. Selye believed that this is where diseases of adaptation come in.
Psychologists have also identified two major brain-body pathways by which stress affects the body. First, the hypothalamus signals the adrenal glands to produce catecholamines, which ready the body for action. The second pathway is from the hypothalamus to the pituitary gland, which produces corticosteroids.

11. Responding to Stress Physiologically
Brain-body pathways
First, the hypothalamus signals the adrenal glands to produce catecholamines, which ready the body for action
The second pathway is from the hypothalamus to the pituitary gland, which produces corticosteroids

12. Figure 12.5 Brain-body pathways in stress

13. Responding to Stress Behaviorally
Coping- active efforts to master, reduce, or tolerate the demands created by stress
Styles of coping
Learned helplessness- passive behavior produced by exposure to unavoidable aversive events
Frustration-aggression hypothesis- aggression is always caused by frustration
Self-indulgence-eating, drinking, smoking, shopping
Defensive coping-erecting defense mechanisms
Constructive coping-realistically appraising situations and confronting problems directly

14. Stress and Physical Health
Psychosomatic diseases- as physical ailments with a genuine organic basis that are caused in part by psychological factors, especially emotional distress…things like hypertension, ulcers, asthma, eczema, and migraine headaches
Heart disease- accounts for nearly one-third of the deaths in the U.S. each year, and atherosclerosis, or gradual narrowing of the coronary arteries, is the principle cause of CHD
Type A behavior—three elements
strong competitiveness
impatience and time urgency
anger and hostility

15. Stress and Physical Health
Emotional reactions and depression
reactions can trigger cardiac symptoms in patients with stable coronary disease. Depressive disorders may also be a risk factor for heart disease, with some studies showing that the risk of CHD is doubled with depression
Stress and immune functioning
Stress has also been shown to decrease the immune response, the body’s defensive reaction to invasion by bacteria, viral agents, or other foreign substances, and decreasing white blood cells called lymphocytes. The featured study in the text explores the effects of stress on contracting the common cold

16. Figure 12.6 Anger and coronary risk

17. Table 12.3 Health Problems that may be Linked to Stress

18. Figure 12.7 The stress-illness correlation

19. Factors Moderating the Impact of Stress
Social support- provided by members of one’s social network, appear to decrease the negative impact of stress
Increased immune functioning
Optimism
More adaptive coping
Pessimistic explanatory style
Positive effects
the effects of stress are not entirely negative. Recent research suggests that stress can promote personal growth or self-improvement, forcing people to develop new skills, reevaluate priorities, learn new insights, and acquire new strengths. Conquering a stressful challenge may also lead to improved coping abilities and increases in self-esteem

20. Health-Impairing Behaviors
Smoking- health risks decline quickly for those who give up smoking, but quitting is difficult and relapse rates are high
Poor nutrition and lack of exercise- poor nutritional habits and lack of exercise have been linked to heart disease, hypertension, and cancer, among other things
Transmission, misconceptions, and prevention of AIDS- Misconceptions about AIDS are common, either overestimations or underestimations of risk. Many young heterosexuals downplay their risk for HIV, causing them not to adopt the behavioral practices that minimize risk

21. Figure 12.8 The prevalence of smoking in the United States

22. Communication with health care providers
Reactions to Illness
Seeking treatment
Ignoring physical symptoms
Many reactions to illness are not conducive to health. For example, many people ignore physical symptoms, resulting in delay in medical treatment
Communication with health care providers
Barriers to effective communication
Even when they seek medical help, communication between patients and health care providers is not always honest or efficient
Many reactions to illness are not conducive to health. For example, many people ignore physical symptoms, resulting in delay in medical treatment.
Even when they seek medical help, communication between patients and health care providers is not always honest or efficient.
Noncompliance with medical advice is a serious issue. Noncompliance is more likely if instructions are hard to understand, when they are difficult to follow, and when patients are unhappy with their doctor.

23. Reactions to Illness Following medical advice Noncompliance
Noncompliance with medical advice is a serious issue. Noncompliance is more likely if instructions are hard to understand, when they are difficult to follow, and when patients are unhappy with their doctor