1. Chapter 12: Health, Stress, and Coping

2. Health Psychology
Health Psychology: Uses behavioral principles to prevent illness 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

3. Behavioral Risk Factors
Behaviors 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, and hostile

4. Ways to Promote Health and Early Prevention
Refusal Skills Training: Program that teaches young people how to resist pressures to begin smoking
Can be applied to other drugs and health risks
Life Skills Training: Teaches stress reduction, self-protection, decision making, self-control, and social skills

5. Ways to Promote Health and Early Prevention (cont.)
Role Model: Person who serves as a positive example of good and desirable behavior
Wellness: Positive state of good health and well-being

6. Figure 12.1 The nine leading causes of death in the United States are shown in this graph. As you can see, eight of the top nine causes are directly related to behavioral risk factors (infection is the exception). At least half of all deaths can be traced to unhealthful behavior. The percentage of day-to-day health problems related to unhealthful behavior is even higher (Mokdad et al., 2004). (Data from McGinnis & Foege, 2002.)
Figure 12.1

7. 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
Stressor: Condition or event that challenges or threatens the person
Pressure: When a person must meet urgent external demands or expectations

8. Figure 12.2 Stress is the product of an interchange between a person and the environment.

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

10. How to Manage a Threat
Primary Appraisal: Deciding if a situation is relevant or irrelevant, positive or threatening
Secondary Appraisal: Assess resources and decide how to meet the threat or challenge
Perceived lack of control is just as threatening as an actual lack of control

11. Coping With Threats
Emotion-Focused Coping: Trying to control one’s emotional reactions to the threatening or stressful situation
Problem-Focused Coping: Managing or correcting the distressing situation
Traumatic Stresses: Extreme events that cause psychological injury or intense emotional pain

12. Frustration
Negative emotional state that occurs when people are prevented from reaching desired goals
External Frustration: Based on external conditions that impede progress toward a goal
Can be social or non-social
Personal Frustration: Caused by personal characteristics that impede progress toward a goal

13. Figure 12.3 Frustration and common reactions to it.

14. 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
Scapegoating: Blaming a person or group for conditions they did not create; the scapegoat is a habitual target of displaced aggression

15. 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

16. Types of Conflicts

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

18. 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

19. 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

20. Ambivalence
Mixed positive and negative feelings; central characteristic of approach-avoidance conflicts

21. Figure 12. 5 Conflict diagrams
Figure 12.5 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.)
Figure 12.5

22. 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

23. Anxiety
Feelings of tension, uneasiness, apprehension, worry, and vulnerability
We are motivated to avoid experiencing anxiety
Similar to fear but based on unclear threat

24. Freudian Ego Defense Mechanisms
Habitual and unconscious (in most cases) mental processes designed to reduce anxiety
Work by avoiding, denying, or distorting sources of threat or anxiety
If used short term, can help us get through everyday situations
If used long term, we may end up not living in reality
Protect idealized self-image so we can live with ourselves

25. 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 held out of our awareness
Reaction Formation: Impulses are repressed and the opposite behavior is exaggerated

26. 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

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

28. Figure 12.6 In the normal course of escape and avoidance learning, a light dims shortly before the floor is electrified (a). Since the light does not yet have meaning for the dog, the dog receives a shock (non-injurious, 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.
Figure 12.6

29. Depression
State of feeling despondent 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

30. 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

31. 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

32. 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
Microstressors (Hassles): Minor but frequent stresses

33. Psychosomatic Disorders
Illness where 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 (e.g., stomach pain and asthma)

34. Biofeedback
Applying informational feedback to bodily control
Aids voluntary regulation of bodily states 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

35. Figure 12.7 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.
Figure 12.7

36. Cardiac Personalities
Type A Personality: Personality type with elevated risk of heart disease; characterized by time urgency, 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

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

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

39. Stage One: Alarm Reaction
Body resources are mobilized to cope with added stress

40. Stage Two: Stage of Resistance
Bodily adjustments to stress stabilize but at a high physical cost; resistance to other stressors is lowered

41. Stage Three: Stage of Exhaustion
Body’s resources are drained and stress hormones are depleted, possibly resulting in:
Psychosomatic disease
Loss of health
Complete collapse

42. 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

43. Stress Management
Use of 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

44. More on Stress Management
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

45. Figure 12.9 The stress game. (Adapted from Rosenthal and Rosenthal, 1980.)