1. Chapter 13 Health, Stress, and Coping

2. Health Psychology
Uses behavioral principles to prevent illness and death, and promote health
Behavioral medicine: Applies psychology to manage medical problems (e.g., asthma and diabetes)
Lifestyle diseases: Diseases related to health-damaging personal habits (e.g., strokes and lung cancer)

3. Behavioral Risk Factors
Actions that increase the chances of disease, injury, or premature death
Disease-prone personality: Personality type associated with poor health; person tends to be chronically depressed, anxious, hostile, and frequently ill

4. Ways to Promote Health and Early Prevention
Refusal skills training: Program that teaches young people how to resist pressures to begin smoking (can also be applied to other drugs)
Life skills training: Teaches stress reduction, self-protection, decision making, self-control, and social skills

5. Community Health Campaign
Community-wide education program that provides information about how to decrease risk factors and promote health

6. More Ways to Promote Health
Role model: Person who serves as a positive example of good and desirable behavior
Wellness: Positive state of good health and well-being; more than the absence of disease

7. Table 13-1, p. 427

8. Table 13-2, p. 428

9. General Adaptation Syndrome (GAS, Selye)
Series of bodily reactions to prolonged stress; occurs in three stages:

10. Alarm Reaction
Body resources are mobilized to cope with added stress

11. Stage of Resistance
Body adjusts to stress but at a high physical cost; resistance to other stressors is lowered

12. Stage of Exhaustion
Body’s resources are drained and stress hormones are depleted, possibly resulting in psychosomatic disease, loss of health, or complete collapse

13. Figure 13.2
The General Adaptation Syndrome. During the initial alarm reaction to stress, resistance falls below normal. It rises again as bodily resources are mobilized, and it remains high during the stage of resistance. Eventually, resistance falls again as the stage of exhaustion is reached. (From The Stress of Life by Hans Selye. Copyright © 1978 by Hans Selye. Used by permission of McGraw-Hill Book Company.)
Fig. 13-2, p. 431

14. Video: Hans Selye and His Research Apparatus

15. Stress
Stress: Mental and physical condition that occurs when a person must adjust or adapt to the environment
Includes marital and financial problems
Eustress: Good stress
Stress reaction: Physical reaction to stress
Autonomic nervous system is aroused

16. Stressor
Condition or event in environment that challenges or threatens the person
Pressure: When a person must meet urgent external demands or expectations

17. Figure 13.2
The General Adaptation Syndrome. During the initial alarm reaction to stress, resistance falls below normal. It rises again as bodily resources are mobilized, and it remains high during the stage of resistance. Eventually, resistance falls again as the stage of exhaustion is reached. (From The Stress of Life by Hans Selye. Copyright © 1978 by Hans Selye. Used by permission of McGraw-Hill Book Company.)
Fig. 13-2, p. 431

18. Immunity
Immune system: Mobilizes bodily defenses, like white blood cells, against invading microbes and other diseases
Psychoneuroimmunology: Study of connections among behavior, stress, disease, and immune system

19. Stress Management
Use of cognitive behavioral strategies to reduce stress and improve coping skills
Progressive relaxation: Produces deep relaxation throughout the body by tightening all muscles in an area and then relaxing them
Guided imagery: Visualizing images that are calming, relaxing, or beneficial in other ways

20. Avoiding Upsetting Thoughts
Stress inoculation: Using positive coping statements internally to control fear and anxiety
Designed to combat negative self-statements (self-critical thoughts that increase anxiety and lower performance)
Coping statements: Reassuring, self-enhancing statements used to stop self-critical thinking

21. Figure 13.9
The stress game. (Adapted from Rosenthal and Rosenthal, 1980.)
Fig. 13-9, p. 455

22. Signs and Symptoms of Ongoing Stress
Emotional signs: Anxiety, apathy, irritability, mental fatigue
Behavioral signs: Avoidance of responsibilities and relationships, extreme or self-destructive behavior, self-neglect, poor judgment
Physical signs: Excessive worry about illness, frequent illness, overuse of medicines

23. Burnout
Job-related condition (usually in helping professions) of physical, mental, and emotional exhaustion; has three aspects:
Emotional exhaustion: Feel “used up” and apathetic toward work
Cynicism: Detachment from the job
Feeling of reduced personal accomplishment

24. Appraising Stressors
Primary appraisal: Deciding if a situation is relevant or irrelevant, positive or threatening
Secondary appraisal: Assess resources and decide how to cope with a threat or challenge
Perceived lack of control is just as threatening as an actual lack of control

25. Table 13-3, p. 433

26. Figure 13.3
Stress is the product of an interchange between a person and the environment.
Fig. 13-3, p. 434

27. Video: Health and Stress

28. Threats
Emotion-focused coping: Trying to control one’s emotional reactions to the situation
Problem-focused coping: Managing or remedying the distressing situation
Traumatic stresses: Extreme events that cause psychological injury or intense emotional pain

29. Frustration
Negative emotional state that occurs when one is prevented from reaching desired goals
External frustration: Based on external conditions that impede progress toward a goal
Personal frustration: Caused by personal characteristics that impede progress toward a goal

30. Reactions to Frustration
Aggression: Any response made with the intention of harming a person, animal, or object
Displaced aggression: Redirecting aggression to a target other than the source of one’s frustration
Targets tend to be safer, less likely to retaliate
Scapegoating: Blaming a person or group for conditions they did not create; the scapegoat is a habitual target of displaced aggression

31. Reactions to Frustration (cont)
Escape: May mean actually leaving a source of frustration (dropping out of school) or psychologically escaping (apathy)
Conflict: Stressful condition that occurs when a person must choose between contradictory needs, desires, motives, or demands

32. Figure 13.4
Frustration and common reactions to it.
Fig. 13-4, p. 436

33. Conflicts

34. Approach-Approach Conflicts
Having to choose between two desirable or positive alternatives (e.g., choosing between a new BMW or Mercedes)

35. Avoidance-Avoidance Conflicts
Being forced to choose between two negative or undesirable alternatives (e.g., choosing between going to the doctor or contracting cancer)
NOT choosing may be impossible or undesirable

36. Approach-Avoidance Conflicts
Being attracted (drawn to) and repelled by the same goal or activity; attraction keeps person in the situation, but negative aspects can cause distress

37. Ambivalence
Mixed positive and negative feelings; central characteristic of approach-avoidance conflicts
Can also be simultaneous attraction and repulsion

38. Figure 13.5
Three basic forms of conflict. For this woman, choosing between pie and ice cream is a minor approach-approach conflict; deciding whether to take a job that will require weekend work is an approach-avoidance conflict; and choosing between paying higher rent and moving is an avoidance-avoidance conflict.
Fig. 13-5, p. 438

39. Figure 13.6
Conflict diagrams. As shown by the colored areas in the graphs, desires to approach and to avoid increase near a goal. The effects of these tendencies are depicted below each graph. The “behavior” of the ball in each example illustrates the nature of the conflict above it. An approach conflict (left) is easily decided. Moving toward one goal will increase its attraction (graph) and will lead to a rapid resolution. (If the ball moves in either direction, it will go all the way to one of the goals.) In an avoidance conflict (center), tendencies to avoid are deadlocked, resulting in inaction. In an approach-avoidance conflict (right), approach proceeds to the point where desires to approach and avoid cancel each other. Again, these tendencies are depicted (below) by the action of the ball. (Graphs after Miller, 1944.)
Fig. 13-6, p. 438

40. Multiple Conflicts
Double approach-avoidance conflicts: Each alternative has both positive and negative qualities
Vacillation: When one is attracted to both choices; seeing the positives and negatives of both choices and going back and forth before deciding, if deciding at all
Multiple approach-avoidance conflicts: When several alternatives have positive and negative features

41. Anxiety
Feelings of tension, uneasiness, apprehension, worry, and vulnerability
We are motivated to avoid experiencing anxiety

42. Freudian Ego Defense Mechanisms
Habitual and unconscious mental processes designed to reduce anxiety
Work by avoiding, denying, or distorting sources of threat or anxiety
If used in the short term, can help us get through everyday situations
If used in the long term, we may end up not living in reality

43. Freudian Ego Defense Mechanisms: Some Examples
Denial: Most primitive; refusing to accept or believe reality; usually occurs with death and illness
Repression: When painful memories, anxieties, and so on are unconsciously held out of our awareness
Reaction formation: Impulses are repressed and the opposite behavior is exaggerated

44. More Freudian Ego Defense Mechanisms
Projection: When one’s own feelings, shortcomings, or unacceptable traits and impulses are seen in others; exaggerating negative traits in others lowers anxiety
Rationalization: Justifying personal actions by giving “rational” but false reasons for them

45. Table 13-4, p. 441

46. Learned Helplessness (Seligman)
Acquired (learned) inability to overcome obstacles and avoid aversive stimuli; learned passivity
Occurs when events appear to be uncontrollable
May feel helpless if failure is attributed to lasting, general factors

47. Figure 13.7
In the normal course of escape and avoidance learning, a light dims shortly before the floor is electrified (a). Because the light does not yet have meaning for the dog, the dog receives a shock (noninjurious, by the way) and leaps the barrier (b). Dogs soon learn to watch for the dimming of the light (c) and to jump before receiving a shock (d). Dogs made to feel “helpless” rarely even learn to escape shock, much less to avoid it.
Fig. 13-7, p. 443

48. Depression
State of despondency defined by feelings of powerlessness and hopelessness
One of the most common mental problems in the world
Childhood depression is dramatically increasing
Some symptoms: Loss of appetite or sex drive, decreased activity, sleeping too much

49. Mastery Training
Responses are reinforced that lead to mastery of a threat or control over one’s environment
One method to combat learned helplessness and depression

50. How to Recognize Depression (Beck)
You have a consistently negative opinion of yourself
You engage in frequent self-criticism and self-blame
You place negative interpretations on events that usually would not bother you
The future looks grim
You can’t handle your responsibilities and feel overwhelmed

51. Stress and Health
Social Readjustment Rating Scale (SRRS): Rates the impact of various life events on the likelihood of contracting illness
Not a foolproof method of rating stress
Are positive life events (getting married, having a child) always stressful?
People also differ in their reactions to stress

52. Microstressors (Hassles)
Any distressing day-to-day annoyance

53. Acculturative Stress
Caused by many changes and adaptations required when a person moves to a foreign culture

54. Psychosomatic Disorders
Psychological factors contribute to actual illnesses (bodily damage) or to damaging changes in bodily functioning
Hypochondriacs: Complain about diseases that appear to be imaginary
Certain kinds of ulcers are not psychosomatic
Most common complaints: respiratory and gastrointestinal

55. Biofeedback Applying informational feedback to bodily control
Aids voluntary regulation of activities such as blood pressure, heart rate, and so on
Helpful but not an instant cure
May help relieve muscle-tension headaches, migraine headaches, and chronic pain

56. Figure 13.8
In biofeedback training bodily processes are monitored and processed electronically. A signal is then routed back to the patient through headphones, signal lights, or other means. This information helps the patient alter bodily activities not normally under voluntary control.
Fig. 13-8, p. 449

57. Cardiac Personalities
Type A personality: Personality type with elevated risk of heart disease; characterized by time urgency and chronic anger or hostility
Anger may be the key factor of this behavior
Type B personality: All types other than Type As; unlikely to have a heart attack

58. Hardy Personality
Personality type associated with superior stress resistance
Sense of personal commitment to self and family
Feel they have control over their lives
See life as a series of challenges, not threats