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
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

6. General Adaptation Syndrome (GAS, Selye)
Series of bodily reactions to prolonged stress; occurs in three stages:
Alarm Reaction
Body resources are mobilized to cope with added stress
Stage of Resistance Body adjusts to stress but at a high physical cost; resistance to other stressors is lowered
Stage of Exhaustion Body’s resources are drained and stress hormones are depleted, possibly resulting in psychosomatic disease, loss of health, or complete collapse

7. 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

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

9. 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

10. 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

11. 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

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

13. 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

14. 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

15. 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

16. Appraisal
Ask students to interview each other, making a list of activities found to be “boring,” “relaxing,” “fun,” and “stressful.”
Most likely, many activities will be listed in different categories by different people. Discuss perceptual differences in primary appraisal

17. Table 13-3, p. 433

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

19. 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

20. 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

21. 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

22. 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

23. Frustration and Violence
In recent years, there has been an epidemic of kids killing kids. In what ways might frustration have led to many of these acts of violence?
How might children be taught to manage their frustration in ways other than lashing out violently (and often fatally) at their peers?

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

25. Conflicts

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

27. 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

28. 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

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

30. 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.
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

31. 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

32. What might come up in facing a conflict? Anxiety
Feelings of tension, uneasiness, apprehension, worry, and vulnerability
We are motivated to avoid experiencing anxiety

33. 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

34. 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

35. 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

36. Think of someone you are mad at or frustrated with
Think of someone you are mad at or frustrated with. Then, either draw or write something that represents them on a piece of paper, and when I say GO, tear it up into small pieces.
Do you feel better about the conflict situation?
Displaced Aggression

37. Table 13-4, p. 441

38. 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

39. Apply this to humans. In what ways can we learn to be helpless?
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.
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

40. 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

41. 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

42. 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

43. 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

44. Microstressors (Hassles)
Any distressing day-to-day annoyance
Acculturative Stress Caused by many changes and adaptations required when a person moves to a foreign culture

45. 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

46. 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

47. 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

48. 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
What cultural values would encourage Type A behavior? Type B behavior? More hardy personalities? Why?

49. Put students in groups of six
Put students in groups of six. One person stands in the middle, and the other five put their arms around the waists of the people on either side. The person in the middle has five minutes to break out of the circle. Count backwards for the final 30 seconds.
Did you see students increase the vigor of their attempts during the last few seconds?
Caution students against expressing their frustration aggressively.