1. Chapter 18 Psychology and Physical Health

2. Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 18 Models for the Effects of Psychological Factors on Disease Direct Effects Model Interactive Model Indirect Effects Model

3. Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 18 Psychological changes Psychological factors Psychological factors (stress, personality styles) Physiological changes Health-related behaviors (smoking, sleep) Vulnerability to disease Psychological factors Disease x a. Direct effects model b. Interactive model c. Indirect effects model

4. Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 18 Stress and Illness Hans Selye developed the concept of stress as the nonspecific response of the body to demands to adjust to a wide range of changes.

5. Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 18 Stress and Illness Stressors are demands that give rise to the general adaptation syndrome (GAS), which consists of three stages: alarm, resistance, and exhaustion.

6. Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 18 Stress and Illness Among the circumstances that could lead to stress are catastrophes, major life changes such as divorce, acculturative stress, traumatic events such as criminal victimization, and hassles. They have been associated with physiological responses such as increased levels of stress hormones,

7. Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 18 Stress and Illness Researchers found that high levels of life change were associated with Illness. Subsequent Investigation showed that the relation between major life events and illness is not as strong as originally reported. One explanation is that a person's interpretation of events is an important determinant of the event's impact.

8. Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 18 Stress and Illness Everyday minor annoyances (hassles) can accumulate and become associated with subsequent health problems.

9. Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 18 Stress and Illness Interpretation or appraisal of an event often determines whether that event is stressful.

10. Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 18 Stress and Illness Primary appraisal occurs when we determine whether an event is a threat Secondary appraisal occurs when we decide how to deal with the threat.

11. Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 18

12. Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 18 Characteristics of Stressful Events Uncontrollable Natural disasters, and many illnesses Unpredictable Earthquakes, some job layoffs, accidents Challenge capabilities or self concepts Exams, new relationships, a tough new job

13. Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 18

14. Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 18 Stress and Physical Health Problems Ulcers Asthma Headaches Coronary Heart Disease Hypertension Immunocompetence

15. Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 18 Factors the Influence Reactions to Stress I. The Stressor Itself Importance Duration Cumulative effect Imminence Anticipated vs. Unanticipated

16. Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 18 Factors the Influence Reactions to Stress 2. The Individual Perception of threat Presence of a plan Voluntary vs. involuntary Control and predictability Stress tolerance (EA on Rorschach)

17. Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 18 Factors the Influence Reactions to Stress 3. External Resources & Social Support Positive social and family relationships Cultural rituals (funerals, confession, atonement)

18. Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 18 Coping with Stress Ineffective Coping Strategies Withdrawal (avoidance) Aggression Overreliance on primitive defense mechanisms (distort reality)

19. Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 18 Coping with Stress Effective Coping Strategies Removing stressors Cognitive coping – changing the way we think about an event Managing stress reactions – sometimes, if we can’t change the reality, we have to deal with the response schedule relaxing activities relaxation training

20. Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 18 Repressive coping: being unable to admit to negative emotions; lacking an awareness of one’s negative emotions Coping Strategies John Henryism: Constantly battling against obstacles that may be insurmountable Seeking social support: Seeking others who will provide positive emotional and practical support in times of stress Finding meaning or benefit: Searching for some positive meaning or benefit derived from stressful situations

21. Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 18

22. Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 18 Behavioral and Cognitive Interventions InterventionDescription Guided mastery techniques Provide explicit information on how to engage in positive behaviors and opportunities to practice these behaviors in challenging situations. Reduction of catastrophizing cognitions Provide basic education about illness to reduce concern; help the person engage in positive coping. Biofeedback Helps the person identify signs that bodily processes are going awry, and ways of controlling them, often through relaxation. Time management Teach the person to reduce obligations, prioritize and schedule important activities, break tasks up, reward self.